Warning: This article is about youth suicide and may be distressing for some readers.

For the past five weeks, the New Zealand Herald has run a special series called Break the Silence. The series has analysed why we have the highest teen suicide rate in the developed world and the second highest youth (25 and under) rate.

It has also explored the history of why silence on suicide has been orthodox in New Zealand since the mid-1990s, the different ways the issue has been handled in classrooms and how thousands of distressed children are turned down by specialist mental health services each year.

During our coverage - and while we were researching this series - we have been approached by dozens of advocates, experts, academics, grieving family members and people who have suffered from suicidal ideation who have raised more than 50 potential solutions to reduce our youth suicide rate. We have chosen 10 to highlight: five yesterday and five today.

1. Increase counsellors in schools:

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We canvassed all 507 secondary schools across the country and asked how they could be better supported to deal with suicide and were told time and time again of the need for more counsellors in schools.

Southland's James Hargest College principal Andrew Wood said "the single most useful thing" the Ministry of Education could do for suicide prevention was reintroduce tagged funding for counsellors in schools.

Education reforms in the mid-1990s removed mandatory funding that forced schools to have one counsellor for every 400 students. The reforms allowed schools to become self-governing, so funding previously set aside for counsellors could be shuffled elsewhere and some schools did just that.

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The full Break The Silence series can be read here

Investigation: The untold story teen suicide in the North

We now have some schools with more than 600 students and not one counsellor.

The New Zealand Association of Counsellors' "number one recommendation" for the Government since 2013 has been to revisit staffing formulae in schools, particularly tagged funding for counsellors.

Education minister Nikki Kaye believes listening to youth is a big part of the solution. Photo / Michael Craig
Education minister Nikki Kaye believes listening to youth is a big part of the solution. Photo / Michael Craig

Education Minister Nikki Kaye is investigating the possibility of increasing counsellors in schools, but said it was important to ensure any new services represented the needs of students and were not just a repeat of "what we've done in the past".

2. Specific suicide prevention training for frontline workers:

Last month, Auckland hosted the National Zero Suicide forum where two international experts told 100 mental health advocates that suicide-specific training was one of the most important suicide-prevention strategies worldwide.

"Suicide-specific training is what saves lives," said US-based David Covington, leader of the international "zero suicide" prevention movement.

"These simple actions are proven to make a difference," he said.

This isn't just mental health training, but training to allow frontline workers to responsibly and confidently handle suicidal patients.

Covington told the forum about the recent success of the Applied Suicide Intervention Skills Training (Asist) programme in the US.

For the past decade, Lifeline has run the Asist programme in New Zealand under a Ministry of Health contract.

But, that contract was cut in March and the funding was passed on to a new preferred supplier, LeVa.

In September, LeVa will roll out LifeKeepers - a new national training programme. It aims to increase the number of people able to identify and support individuals at risk of suicide and refer them to services that can help.

"It will build upon best practice and will be quality assured, clinically safe and culturally relevant," LeVa said.

3. Increase funding for youth mental health:

Almost 2000 young people were rejected or quickly referred on from specialist mental health services in New Zealand last year.

Max, 13, attempted suicide when he was only 10. He is one of many who wants to see an increase in funding for Camhs. Photo / Mike Scott.
Max, 13, attempted suicide when he was only 10. He is one of many who wants to see an increase in funding for Camhs. Photo / Mike Scott.

That number, which was released to the Herald under the Official Information Act, grows every year.

So does the wait time: kids in some parts of the country wait up to six months for an appointment.

Child psychiatrist Dr Arran Culver, who works for the Child and Adolescent Mental Health Service (Camhs) in Wellington, says New Zealand faces a "chronic and systemic lack of services for children".

Camhs is "significantly underfunded", Culver said. It gets about 13 per cent of the total district health board specialist mental health funding, but is expected to meet the needs of all those aged 19 and under, which is a quarter of the population.

"If we were getting a fair slice, we should be getting 25 per cent of the overall funding because we are seeing 25 per cent of the population," Culver said.

4. Update the Ministry of Education advice to schools:

For years, the Ministry of Education advised schools to shut down conversations about suicide.

They suggested affected schools avoid the word suicide by instead labelling it a "tragic death", help their students grieve and then try to get the school back to a normal routine as quickly as possible.

However, many schools around the country told the Herald they felt this policy restricted their ability to talk openly and honestly with their students about suicide.

Kamo High School teacher Tracey Lawson broke official policy by talking openly to her class about suicide after the deaths of two students. She wants policies to change. Photo / Mike Scott
Kamo High School teacher Tracey Lawson broke official policy by talking openly to her class about suicide after the deaths of two students. She wants policies to change. Photo / Mike Scott

Many complained to the ministry and, in 2013, the policy was officially updated, allowing schools to use the word suicide - but only sparingly.

However, it doesn't appear to have reached Kiwi classrooms as nearly all the 235 schools who responded to the Herald survey of our 507 secondary schools said they would avoid the word suicide after a student death because of official policies.

Silence on suicide in schools is outdated and has to change, said Heather Henare, chief executive of Skylight, a charitable trust that specialises in grief support for children.

"Talking openly about suicide is one of the most helpful things you can do," she said.

The ministry is reviewing the advice it provides to schools on this issue.

5. Listen to our youth

Over the six months we spent researching the Break the Silence series and the past five weeks of coverage, time and time again we have been told the most significant thing the Government - and society in general - can do to prevent teen suicide is listen to our youth.

"You all know the answer is to listen to us. But, why don't you do it? You're talking about us, so why don't you ask us?" said one young advocate at a recent suicide prevention forum in Auckland.

In 2012, after 19 young people took their lives in Northland in one of New Zealand's biggest youth suicide clusters, a then-15-year-old boy wrote about the reasons his friends were taking their lives.

"Youth = aren't being listened to," Ezekiel Raui wrote.

His brainchild, a million-dollar government trial, will be rolled out in schools next year in a bid to encourage youth to support and talk to one another about their struggles.

Health Minister Dr Jonathan Coleman says new mental health initiatives will be announced soon. Photo / George Novak
Health Minister Dr Jonathan Coleman says new mental health initiatives will be announced soon. Photo / George Novak

Health Minister Jonathan Coleman told the Herald a big focus for the Government's soon-to-be-announced mental health initiatives will be around "listening to young people and what works for them".

Education Minister Nikki Kaye reiterated this sentiment. She said she is working with Coleman to build resilience in youth and that young people would be "part of the solution".

Where to get help

If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call police immediately on 111.

OR IF YOU NEED TO TALK TO SOMEONE ELSE:

LIFELINE: 0800 543 354 (available 24/7)
• SUICIDE CRISIS HELPLINE: 0508 828 865 (0508 TAUTOKO) (available 24/7)
YOUTHLINE: 0800 376 633
• NEED TO TALK? Free call or text 1737 (available 24/7)
KIDSLINE: 0800 543 754 (available 24/7)
WHATSUP: 0800 942 8787 (1pm to 11pm)
• DEPRESSION HELPLINE: 0800 111 757