New Zealand Healthcare system and professional practice
Introduction
Over the past few decades, evidence has shown that it is not uncommon for people to be overwhelmed and have no hope that things might differ. However, it is essential to note that while thinking about suicide is common, not everyone who thinks about it plans to go through with it. Suicide is a global challenge and occurs throughout a lifespan and is considered the second leading cause of death among 15-29-year olds globally. According to the World Health Organization, close to 850,000 people die each year due to suicide.
In New Zealand, suicide is common across all populations. However, some vulnerable populations such as youth and people with addictions and mental health problems are often more likely to die by suicide. Additionally, in 2016 alone, 533 people died by suicide in New Zealand, with male and female cases being at 412 and 141, respectively. Notably, the highest rates of suicides were among the youths. In this connection, this paper will address the aspect of suicide among the youths in New Zealand and how ‘Every Life Matters-He Tapu te Oranga o ia Tangata: Suicide Prevention Strategy 2019-2029’ is tailored to address suicide issues among the youths and how it is likely to affect their health outcomes. Additionally, social determinants of health relating to suicide among youths will be addressed and their ability to access health services on an equitable basis.
Health needs and suicide among youths in New Zealand: An overview
According to the World Health Organization, the way young people live their lives has significantly changed over time, thus creating a range of poorly understood, yet critical pressures that affect their psyche and behavior. In New Zealand, for instance. Family structure, children’s practices, and level of parental engagement have changed. Additionally, technology has also changed the nature of communication and social networks in the community. These changes have had a significant impact on the lives of young people in the country. Unlike other generations, these changes have seen youth face more choices at an earlier age in life. Evidence shows that traditional community support systems such as the church and youth groups have declined. Notably, the pace of both sociological and technological changes is unprecedented, thus rendering young people vulnerable to suicide, especially those with less psychological resilience.
Statistics show that in 2010 alone, New Zealand recorded the highest suicide mortality rate among OECD countries at 15.6 per 100,000 adolescents between 15 and 19 years. Apart from this, between 1st July 2014 to 30th June 2016, 238 suicide cases were reported among individuals aged 12-24 years. Also, the suicide mortality rates of Maori youth are higher as compared to their non-Maori counterparts. In 2012, for instance, the suicide mortality rate of the Maori youths aged between 12-24 years was 48.0 per 100,000, while that of non-Maori youths was 16.9 per 100,000. What is more, even though suicide rates among non-Maori youths have significantly declined since 1996, the Maori youths have not.
Besides, the rate of hospital admission for self-harm among New Zealand youths is about 50-150-fold higher as compared to suicide cases. Additionally, according to a recent study by (..), a higher percentage of youths in the country have suicidal thoughts.
Emerging evidence suggests that suicide in New Zealand cannot be considered just due to mental health disorders. A recent study by (..), denotes that the likelihood of suicide is associated with several factors. Some of which comprise low-income, family relationships, social-demographic factors, restricted educational achievement, low self-esteem, drug and alcohol abuse, depression, loneliness, family violence, and a history of suicidal behavior among family and friends.
Also, as depicted earlier, even though suicide rates are higher among youths in New Zealand, they vary significantly across different populations. For instance, suicide rates among the Maori community are higher than that of non-Maori community. According to (..), many factors contributed to this, including poverty, health inequality, inequity, and social fragmentation. Other aspects that affect this include higher use of drugs and alcohol, poor living environments, and a more significant gang presence.
Whanau Ora and social determinants of health
The Whanau Ora is an approach that places families at the center or service delivery. It achieves this by requiring the integration of health, education, and essential social services to improve individuals’ health outcomes in New Zealand. According to (..), health outcomes are unevenly distributed between populations in New Zealand. For instance, the Maori community has an average of the poorest health status compared to any ethnic group in New Zealand. Scores of specific social determinants of health among the Maori community is low. For instance, employment, education, income levels, and the creation and distribution of wealth is stagnated. Apart from this, social and cultural factors such as social support, social cohesion, cultural participation, perception of safety, and discrimination are also high.
Additionally, environmental factors such as waste disposal, urban design, public safety, quality of air, working, and housing conditions in New Zealand are relatively low. With comparatively weak social structures and determinants of health, youths in New Zealand have fallen prey to suicide. Also, as depicted earlier, the suicide mortality rates of Maori youth are higher as compared to their non-Maori counterparts. In 2012, for instance, the suicide mortality rate of the Maori youths aged between 12-24 years was 48.0 per 100,000, while that of non-Maori youths was at 16.9 per 100,000. In this connection, it is clear that essential social services and determinants of health have had a significant impact on youths’ health outcomes in New Zealand and contribute towards the ever-rising cases of suicide in the country.
According to the World Health Organization, suicide prevention is somewhat complicated because understanding all causes of suicide at an individual level is almost impossible. To address the issue of increased suicide cases in New Zealand, the New Zealand government under the Ministry of health developed ‘‘Every Life Matters-He Tapu te Oranga o ia Tangata: Suicide Prevention Strategy 2019-2029’.
‘Every Life Matters-He Tapu te Oranga o ia Tangata: Suicide Prevention Strategy 2019-2029’ and how it is tailored to address health needs and outcomes of youths
The term ‘He Tapu te Oranga o ia Tangata’ refers to the Maori belief that people’s health and wellbeing are sacred. This policy was developed based on a wide variety of experiences and contributions from individuals, families, groups, and organizations. It documents experiences from individuals who have had suicidal thoughts and views on what is needed to prevent suicide. This policy recognizes that there are unique challenges faced by every individual. Therefore, it has been tailored to ensure services are fair and just and are helping in addressing the issue of suicide among youths. Additionally, while this strategy focuses on a whole-of-society approach to suicide prevention, it also emphasizes the need to improve individuals living environments.
‘Every life matters’ has two main sections; Suicide prevention strategy 2019-2020 and Suicide prevention Action Plan 2019-2024. The former outlines the framework and strategic direction of how individuals can work together to achieve the vision. The latter identifies specific actions that must be undertaken to achieve the vision and prevent suicide among individuals in New Zealand.
The vision of this particular policy is that every life matter and by working together, a future where there is no suicide in Aotearoa New Zealand can be achieved. Even though achieving a future where there is no suicide is somewhat ambitious, it is not entirely impossible. Attaining this’ policy’s vision will mean that suicide rates have reduced, and every individual has increased confidence in life.
This policy has been tailored to address the issue of suicide among youths in New Zealand in the sense that it recognizes the need to have increased confidence in life. It achieves this by recognizing that having a strong identity, knowing where one comes from and where they belong is crucial. As depicted earlier, most suicide cases are due to hopelessness and the fear that things cannot get any better. However, having a strong identity and knowing where one comes from tends to give individuals a purpose and need to live, especially for the youths. Therefore, it is clear that this policy has been tailored to address the health issues and suicide cases among youths in New Zealand.
Furthermore, every life matter has also been tailored to address health needs and suicide among youths in New Zealand in the sense that it honors Te Tiriti o Waitangi (the treaty of Waitangi). As depicted earlier, suicide cases are comparatively higher among the Maori than non-Maori youths. Therefore, while Every Life Matters is a strategy for all people in the country, it recognizes that honoring the special relationship with the Maori community under Te Tiriti o Waitangi is paramount towards achieving the overall vision of the strategy. According to (..), the special relationship between the Maori and the Crown under Te Tiriti o Waitangi will support the way the government can work with people from diverse backgrounds, including iwi, hapu, Maori, and whanau. Apart from this, achieving better health outcomes for all indigenous communities in New Zealand is everyone’ s responsibility. In this connection, with suicide rates among the Maori being the highest, Maori leadership and active participation in suicide prevention are vital. In line with this, as the most vulnerable community, this policy involves the Maori in decision-making, planning, development, and delivery of suicide prevention services. This policy sets out the need of the Maori and the Crown to work together as a team to ensure that the community experiences the same level of health and wellbeing as a non-Maori community. Additionally, it also recognizes the need to respect the Maori’s cultural concepts, values, and practices in suicide prevention among the youth.
Apart from this, the policy is tailored to build a more robust system that supports wellbeing and responds to people’s needs, thus playing a crucial role in suicide prevention. According to (..), the accompanying action plan set out by Every Life matter outlines the critical enabling actions fundamental to suicide prevention. Among the actions set out is establishing a Suicide Prevention Office to support both evaluation and monitoring of Every Life Matters. Here, the Suicide Prevention Office will work alongside research expertise, people who have experienced suicide before, the Maori community, and other agencies such as District Health Boards. The role of the Suicide prevention office is to collect information and report on progress regarding the implementation of the policy. Additionally, the office will also collaboratively work with Mental Health and Wellbeing Commissions to monitor the government’s role in improving mental health and overall wellbeing of youths in New Zealand. With the establishment of such essential support services, it is clear that Every Life Matters is tailored to effectively and adequately address the issue of suicide among youths in New Zealand.
Also, the policy details actions to reduce suicide risks such as promoting wellbeing and proactively responding to suicidal distress and behavior among youths. Apart from this, it also details the need that supports individuals and families after a suicide.
Conclusion
Even though Every Life Matters has been instrumental in addressing the issue of suicide among youth in New Zealand, more needs to be done to reduce suicide and support an individual with suicidal thoughts. According to (..), one cannot reduce suicide rates alone. However, an individual can make a difference. It is also essential to note that due to increased complexity and interactions between proactive factors and risks associated with suicide, flexible references to suicide prevention must be adopted. Also, even Every Life Matters recognizes that a broader range of policies and initiatives must also be brought to reduce suicide cases in New Zealand. Some of these initiatives include eliminating family cases of family and sexual violence, supporting individuals impacted by alcohol and drug abuse, improve on child and youth wellbeing as well as embedding Whanau Ora approaches in addressing the issue of suicide. Therefore, it is conclusive that even though suicide among youth in New Zealand has been rising at a relatively alarming rate, it can be reduced when appropriate measures are put in place. Every Life Matter is a policy that has been instrumental in addressing the issue of suicide in the country. For that reason, no doubt, adopting even more flexible policies and strategies will significantly impact suicide cases among youths in New Zealand.