Lakes DHB suicide postvention plan to avoid Rotorua, Taupō clusters

Michele Elliott, whose son Jordan Leigh Gray died by suicide in Kawerau, is an advocate for bereaved whānau. Photo / Eli Hill (Wairarapa Times-Age)

The Lakes District Health Board oversees about 110,000 people. Twenty-three died by suicide in the year to June 2019 in the Lakes area and, during that time, the board employed one full-time equivalent position to support suicide bereaved. Now the board is rethinking what it does after suspected suicides. Samantha Olley reports.

A plan to prevent suicide clusters and contagion in the Lakes District Health Board area is awaiting final sign-off as figures show more people are taking their own lives in Rotorua and Taupō.

Twenty-three of the 685 New Zealanders who took their own lives in the year to June 30 lived in the Lakes area.

It was the highest number of suicides since 2010/2011 and more than twice the number the year before, when nine people committed suicide.

The Lakes DHB has said it needs to improve support for people bereaved by suicide, called "postvention", and as part of its proposed plan, it is looking at bringing in a designated postvention co-ordinator.

Many other health boards around the country employ postvention co-ordinators or others who oversee responses to suspected suicides.

The DHB told the Rotorua Daily Post it did not specifically involve suicide-bereaved families in the formation of its plan, and there had not been a cluster in the area in the year to June 2018 or after.

Michele Elliott pictured in Kawerau with a photograph of her son, Jordan Leigh Gray. Photo / File

MicheleElliott, whose son Jordan Leigh Gray died by suicide in 2010, told the Rotorua Daily Post establishing a Lakes DHB postvention co-ordinator "would be a great idea" but bereaved families needed to be at the table during the formation of the postvention plan.

"The DHB can't just decide and discuss everything themselves," Elliott said.

"At the end of the day, these services are provided for us, the bereaved and the wider community."

She said her son's death put her in "a dark place".

"I had grief on top of grief. My kids' anger towards their brother was thrown at me. It was a double tragedy. So I had to find my way out to keep my sanity, it took years to adjust."

Jordan Leigh Gray was one of 13 youths who died by suicide in Kawerau between 2010 and 2012.

Afterwards, Elliott set up a support group for people bereaved by suicide.

"It was a hard time, but as families, we all go through it differently. We can be there for each other."

Elliott said any DHB postvention team needed to be willing to regularly meet with the bereaved and listen to them - "not shut us down if we say something they don't like".

"We all want opportunities to contribute to the health and wellbeing of whānau. We don't want the number of bereaved to be bigger than it already is. We need to work together to prevent more lives being lost."

She said a co-ordinator needed to be approachable to all ethnicities and all ages, so people in crisis could turn to them for help and they, in turn, could provide referrals.

In documents released under the Official Information Act, the Lakes DHB's strategy, planning, and finance team said postvention co-ordinators were "not a guarantee to reducing the suicide".

"There has been significant turnover due to burnout in some regions as these roles work in isolation ... However, without a co-ordinator to arrange a combined response, it can prove challenging to start."

Currently, the DHB employs two Taupō-based staff members to cover one full-time equivalent postvention position.

As part of the plan, the DHB is aiming to reduce the Māori self-harm hospitalisation rate by 10 per cent by June 30, 2020.

Nick Saville-Wood, chief executive of the Lakes District Health Board. Photo / File

Chief executive Nick-Saville Wood said in the year to June 2019, the standardised self-harm hospitalisation rate for Māori aged 10 to 24 was 57.8 per 10,000 in the Lakes DHB.

The Mental Health Foundation's advocacy alliance specialist Michael Naera - formerly of the Te Runanga o Ngāti Pikiao Trust in Rotorua - "wholeheartedly" congratulated the DHB for its postvention strategy and called it "a significant step".

He said organisations such as Patua te Taniwha Charitable Trust, Tūwharetoa Health Services and Te Rūnanga o Ngāti Pikiao Trust needed to be included to bring the plan to life.

The Mental Health Foundation's advocacy alliance specialist Michael Naera - formerly of the Te Runanga o Ngāti Pikiao Trust in Rotorua. Photo / File

Naera stressed that any postvention co-ordinator in the DHB needed to be "in sync with Māori communities including knowing the tikanga and kawa of iwi, hapū, whānau and hapori Māori (Māori communities)."

Patua Te Taniwha Charitable Trust trustee Camilia Ransfield (left), chairwoman Mataku-Ariki de Roo and secretary Cassey Thompson. Photo / File

"In my experience, when you rely heavily on clinical frameworks and services to determine wellbeing for Māori, it can turn horribly wrong. To the point where everyone is doing a lot of things but no one knows what that looks like.

"The consequence is at times seeing bereaved whānau becoming more in strife in managing their grief and loss. Not to mention, the community scrabbling to look for answers and solace from the impact of suicide."

He said a whānau ora approach was key to helping Māori manage grief and loss because it focused on aspirations, hope and resolution.

"Māori continue to use ancient frameworks that have been tested for centuries so we know it works".

Bay of Plenty DHB suicide postvention coordinator Renee Wilton. Photo / File

The Bay of Plenty DHB, which covers the Tauranga, Katikati, Te Puke, Whakatāne, Kawerau and Ōpōtiki areas, has had a full-time postvention co-ordinator for the last three-and-a-half years.

Co-ordinator Renee Wilton said she was a central contact point for resources, support, and education, and helped ensure bereaved families, friends and workplaces were "identified and have access to timely and appropriate support".

The Lakes District Health Board's suicide postvention plan

The proposed "process of notification" plan after a suspected suicide starts with first responders - police - who then notify the Coroner, who should then notify the postvention co-ordinator.

Rotorua police station. Photo / File

The co-ordinator's job is then to search for next of kin, identify any necessary groups such as Māori health agencies or schools, then complete a community assessment and task relevant agencies with follow-up work.

The co-ordinator will continue supporting the bereaved people for a year after the death and will also work with relevant agencies to watch out for any related contagion, cluster or pact linked to the suicide.

Rotorua clinical psychologist George Furstenburg. Photo / File

The DHB sought input from Rotorua groups who had postvention experience including Te Rūnanga o Ngāti Pikiao Trust, the Ministry of Education, NZ Police, Victim Support, Oranga Tamariki, and Te Arawa Whānau Ora and psychologist George Furstenburg.

Coronial services declined to comment on the plan.

What is a suicide cluster?

Multiple suicides or suicide attempts, or both, occurring closer together in time, geography, or through social connections than would normally be expected for a given community.
Source: Ministry of Health

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 or 09 5222 999 within Auckland (available 24/7)
• SUICIDE CRISIS HELPLINE: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• YOUTHLINE: 0800 376 633 ,free text 234 or email talk@youthline.co.nz or Online chat.
• 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
• SAMARITANS – 0800 726 666.