WARNING: This article references suicide and mental health issues
Two years ago Jonah* didn't think he was going to make it.
Almost all his life the teenager has been a ward of the state, during which he claims to have been the victim of repeated abuse by caregivers.
As a result, Jonah said he attempted to take his life "many" times. His social worker accused him on one occasion of doing it for "attention", referencing how they couldn't see any "signs" of what he'd tried to do.
"They thought I was attention-seeking to move placements.
"I would never use trying to take my own life as a means to attention seek because it is not right. I was very depressed from all this abuse and trauma that I had encountered, and that's the reason I tried to take my own life."
New Zealand's youth suicide rate is notoriously bad, with Unicef reporting in 2020 that it was the second-worst in the developed world at 14.9 deaths per 100,000 adolescents.
And for children interacting with New Zealand's state care system, it could be much worse.
Last year Oranga Tamariki confirmed five young people in state care had taken their lives between 2017 to 2021.
The situation regarding youth mental health has been described as a "crisis" by a leading education group and the Children's Commissioner now intends to raise the issue with the Suicide Mortality Review Committee and Mental Health and Wellbeing Commission.
The Ministry of Justice reported there had been 28 confirmed or suspected suicides of young people aged 12-25 between January 2017 and June 2021 in which Oranga Tamariki was a case party.
However, the ministry said this did not mean the young people were in state care; it could mean that they had presented evidence, provided information to the coroner or were to receive a copy of the findings.
"It would not be correct to assume that in the 28 cases referred to, Oranga Tamariki or another relevant party was involved in the care of the deceased."
Coroners' reports provided to the Herald of some of the children who died from suicide in which our state care system was a party are a confronting read.
Peeling back the pages often reveals a similar pattern of past abuse, mental health issues and calls for help, some of which were never answered.
Of the nine reports seen by the Herald, seven of the young people lived in the North Island, and several reports noted a history of sexual or physical abuse.
Many of the records showed a history of mental health issues, including PTSD, depression, suicidal ideation and self-harm.
One report said they had been left with the distinct impression that "greater efforts" could have been made to connect with and support the young person.
Pattern of trauma
When Jonah was deep in the clutches of mental health issues, he claimed Oranga Tamariki didn't think his condition was "significant" enough for the agency to cover counselling support.
"Every young person in care has trauma and should be able to have free access to the services that they desperately need. And it's obvious with these coroners' reports and statistics that Oranga Tamariki is failing with that."
As a suicide survivor, and as a ward of the state, Jonah claimed pre-existing trauma, abuse in care and not being valued or listened to by the system could lead to young people taking their lives.
"The biggest thing is that mental health counselling and services need to be a statutory entitlement for every young person in care, no matter their age or background."
St John ambulance this year reported officers were responding to a "concerning rise" in the number of mental health and suicide attempt calls – which were up 30 per cent on the previous year.
"We continue to respond to very distressed and vulnerable patients but the most disturbing trend is the number involving patients aged under 14," St John deputy chief executive of ambulance operations Dan Ohs said.
"This age group had a 36 per cent increase in 2021 (up 49 to 186 patients) compared to the previous year (137 patients) and was 77 per cent higher compared to 2019 (105 patients)."
University of Auckland professor of Indigenous Studies Tracey McIntosh said the number of young people who have been through the system and taken their own lives spoke to the level of trauma these young people had.
"...Young people who have had often not just one really adverse life experience but the cumulative element of it and the way that it wears [them] down."
McIntosh told the Herald varying degrees of mental health support was available for tamariki in care, but the inquiry into abuse in care showed that this is both a historic and contemporary issue.
The academic believed this was one of the country's most critical issues.
"Aligned with that is that their experiences are not sufficiently responded to at the time, or they're not believed or that it's not taken seriously enough. All of those elements mean it's sort of the opposite of what a trauma-informed and - the other element - what a culturally informed care system would look like."
This, she said, demanded a much more holistic support system rather than an individual psychiatrist or psychologist.
Similar to Jonah, McIntosh said the need for young people to feel believed was significant. Survivors she'd spoken to about their attempts to be heard and seen, were like traumatised children when sharing their korero 40, 50 and even 60 years later.
Although New Zealand has an elevated suicide rate for young people, she said the high rate of suicide for those in care, particularly of indigenous people, was not unique to this country.
"We see a much higher rate of suicide and youth suicide among young Māori and particularly those that have been in care."
Figures provided to the Herald last year show more than two-thirds of the children who have died of all causes in state care since Oranga Tamariki was established in 2017 were Māori.
Children's Commissioner Judge Frances Eivers said the rate of suicide in Aotearoa was devastating, unrelenting and, on some days, felt intractable.
"The loss of a child or young person is particularly heartbreaking. No matter whether a child has had a safe and loving upbringing, or faced challenges every day of their lives, losing them because they saw no other option, had lost all hope, tells us something must change."
Eivers said it was known that mental distress was rising among children and young people, and she would be raising this with the Suicide Mortality Review Committee and Mental Health and Wellbeing Commission to understand how to urgently address this.
Worryingly, data collected by the Ministry of Health shows the number of self-harm hospitalisations for people aged 10 to 24 rose from 4274 in the year to September 2016 to 5652 in the year to September 2021 – an increase of almost a third.
New Zealand Teachers Federation president Cherie Taylor-Patel said over the past two years the Covid-19 pandemic had put more stress on communities and families.
"Where once upon a time you would see students acting out in different ways, maybe in intermediate and high school, now you're seeing quite extreme behaviours in primary schools as well."
She said the mental health space in schools had been under-resourced for the past 20 years.
"We don't have enough specialists in the system to, if you like, do a wrap-around service and support for our most at-risk and vulnerable students."
This meant there wasn't enough specialist support for students with higher needs.
"It is a crisis, and it requires, which is one of the complexities about the whole thing, a multi-pronged approach. There's not one solution."
In her experience, support for young people in the state care system was variable, depending on their case worker and the quality of care and the relationship they had with foster families.
"They are extremely vulnerable, they're already vulnerable because they're in state care, there's complexities around what support they need anyway, and there'll be things missing already. So when you put a pandemic overlay over that they do become our most vulnerable students."
Oranga Tamariki Services for Children and Families deputy chief executive Glynis Sandland said the physical and mental wellbeing of any child or young person was of critical importance, and often the children who came into care had complex needs.
Sandland told the Herald their staff worked alongside partner agencies to identify and support young people in care to meet their mental health needs.
"All children that come into the care of Oranga Tamariki are referred for a Gateway assessment, this is a comprehensive interagency assessment of the child's health, education and wellbeing needs."
She said children and young people in care were supported to have a regular health assessment, an annual medical check and, if required, specialist care including mental health and psychological assessments.
As well as this, Sandland said workers had access to the Towards Wellbeing Programme which supported their mahi by helping to assess and understand suicide risk based on known factors and helped to develop a responsive suicide risk management plan.
Sandland said when a suicide attempt was made, staff used tools such as Intensive Clinical Support Services to provide clinical treatment services to children and young people in care with serious mental health, emotional and/or behavioural problems and complex needs.
Jonah is feeling better now, but he said others still suffering in care needed to try to find access to support if they could.
"You need to believe in yourself, you need to believe that I can do this and that I belong in New Zealand."
*Jonah's name has been changed to protect his identity.
Where to get help:
• Lifeline: 0800 543 354 (available 24/7)
• Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youth services: (06) 3555 906
• Youthline: 0800 376 633
• Kidsline: 0800 543 754 (available 24/7)
• Whatsup: 0800 942 8787 (1pm to 11pm)
• Depression helpline: 0800 111 757 (available 24/7)
• Rainbow Youth: (09) 376 4155
• Helpline: 1737
If it is an emergency and you feel like you or someone else is at risk, call 111