June 2017 A Strategy to Prevent Suicide in New Zealand

Introduction

1.   Rural Women New Zealand (RWNZ) is a not-for-profit member based organisation that reaches into all rural communities and has an authoritative rural voice on issues that  impact on those communities. We welcome the opportunity to provide a submission to the Ministry of health on its draft strategy, A Strategy to Prevent Suicide in New Zealand: Draft for public consultation.

2.   As one of the leading rural organisations promoting and advocating on rural health issues, RWNZ strives to assure the the wellbeing of rural communities is taken into consideration from the beginning of all policy and legislative development, and that all rural people have equal access to all services.

3.   RWNZ is in support of the general framework of this draft strategy. In particular, we support the framework’s focus on supporting positive wellbeing for all ages, increasing awareness and knowledge of suicidal behaviour and mental health, strengthening systems in place to support communities and those who are in distress, and improving collaboration among those working to prevent suicidal behaviour. However, we would strongly support a framework for suicide prevention that will more than adequately address mental health issues in rural New Zealand with concrete targets and detailed methods for improvement.

Overview of Submission

4.   The prevalence of suicidal behaviour in rural New Zealand must be recognised. Based on the Ministry of health’s annual statistical publication, Suicide Facts: Death and intentional self-harm hospitalisations 2013, the suicide rate is higher in rural areas in comparison to urban areas.¹ Rural Health Alliance Aotearoa New Zealand (RHAANZ) 2017 research summary, Farm-related suicides in New Zealand, 2007-2015: A review of coroners’ records shows that between the years 2007 and 2015, there have been185 farm-related suicides.²

5.   New Zealand’s rural communities are at an increased risk of mental illness which can be attributed to, among other factors, vulnerability to economic fluctuations and social isolation. Compounding these issues is the:

• lack of access to services and support due to the distance rural people live from urban centres where most support is available;
• substandard or no access to reliable and affordable internet and mobile coverage due to government policies that will not deliver 100% coverage for the New Zealand population;
• history of inequalities that rural communities face often being overlooked.

6.   In July 2016, RWNZ submitted to the Ministry of Health on, New Zealand Health Research Strategy: Public discussion document. In our submission, RWNZ strongly supported a greater investment into rural health research. As reported by RHAANZ, little research has been conducted about the health and wellbeing of rural communities in New Zealand, whose needs are different from urban communities.³ In order to improve the mental wellbeing of rural communities, we must first understand their needs and how they can be addressed by prioritising rural health research.

7.   RWNZ is in support of the framework’s proposal that in order to strengthen systems to support those who are in distress, all people must have access to appropriate services no matter where they live. The framework proposes that government agencies and non-governmental organisations should collaborate to remove gaps in services. However, it does not provide details or a method concerning how such an effort tis to be executed. If the framework is to be effective, especially in regards to providing equal access to services for all, it must include comprehensive proposals for a course of action with measurable goals and objectives.

8.   While the provision of technological services to support those in distress is crucial, RWNZ urges that the framework for suicide prevention refrain from relying on such services. A variety of methods to support communities, including those non-technological, will be needed in recognition of the fact that rural communities struggle with access to reliable and affordable internet and mobile coverage.

9.   RWNZ supports all of the framework’s proposals to involve, train, and educate community members on suicide prevention. Rural communities struggle with accessing  information and services concerning mental health, and it is difficult to retain and recruit health service employees in rural areas due to connectivity issues.⁴ People in rural communities may also be embarrassed or frightened of seeking mental health services where they can be seen by people they know or recognise in the community. thus, it is essential that rural communities are provided with the tools that they need to improve mental wellbeing within the community and reduce the social stigma associated with mental illness.

10.  RWNZ would like to emphasise that we are in support of the initiative proposed in this framework. We are, however, concerned about the lack of a strategic plan to lead and fund these activities. the strategy states that government agencies will lead or fund only “some” of the activities, while stating that non-governmental organisations (NGOs) “could” lead or fund others. There appears to be no mention of how the NGOs would be funded. If the government is genuinely committed to suicide prevention, then they should provide funding for the NGOs to take on this additional work. Otherwise, NGOs will either be unable to carry out the work this strategy proposes or will have to divert funds from other activities, effectively disadvantaging another vulnerable group. RWNZ would like to see a strategic plan and budget included in the framework. The strategic plan should include precisely who will lead the activities, who will provide the funding and how much money will be funded and allocated to each activity. Where the framework allocates activities to NGOs, there should should also be assurance that funding will also be provided by the government.

Conclusion

11.  RWNZ believes that continuous efforts must be made to improve wellbeing in rural areas and acknowledges that the strategy goes some way to recognising the needs of vulnerable people and proposing initiatives for improvement in support and services.

12.  RWNZ thanks the Ministry of Health for the opportunity to submit on the draft strategy.

Please contact me to discuss our submission further.

Regards

Penelope England

Chief Executive Officer

Rural Women New Zealand

Email: Penelope.england@ruralwomen.org.nz

^{1  Ministry of Health, “Suicide Facts: Deaths and intentional self-harm hospitalisations,” (2013).
2  Rural Health Alliance Aotearoa New Zealand, “Farm-related suicides in New Zealand, 2007 -2015: A review of coroners’ records,” (2017).
3  Rural health Alliance Aotearoa New Zealand, “Framework to Improve Mental Health and Addiction Outcomes,” (2016).
4  Rural Health Alliance Aotearoa New Zealand, “Connectivity – A Rural Health and Wellbeing Issue,” (2016).}