A new community-led strategy for suicide prevention says many people are living in an extreme state of stress, the mental health services sector "feels overwhelmed" and health practitioners are not coping with growing need.
The strategic approach released this week by Healthy Families Whanganui, Rangitīkei and Ruapehu says youth suicide and serious self-harm are increasing, men are dying from suicide at nearly three times the rate of women, and suicide rates among Māori continue to be disproportionately high.
The initiative is calling for radical change across the health system. It wants a coalition of health providers and the community to focus on reducing the "unacceptable" rate of suicide and bring lasting change to wellbeing in the region.
"As it stands, suicide rates in the Whanganui District are too high," the report says.
"The wellbeing of citizens and their whānau/families in the District is not where we want it to be. Through the strategy we are seeking to reduce suicide numbers in our region, the rate of suicide, the level of suicidal behaviour and the level of serious intentional self-harm."
Annual provisional suicide statistics for deaths reported to the coroner in the year to 2020 show the suicide rate for men in 2019-2020 was 19.03, nearly three times that of women at 7.18. However, attempted suicide rates for women were significantly higher than attempts by men.
The rate of suicide for Māori, at 20.24 deaths per 100,000 people, is increasing. European and other deaths show a rate of 12.08.
In Whanganui, the rate of reported suicides is 14.62. For Māori in Whanganui, the rate is 16.06. The rate for Māori men aged between 25-29 was highest, while Pasifika have very low rates of suicide in Whanganui.
According to statistics from Whanganui Regional Health Network, Māori are most prevalent in serious self-harm hospitalisation rates for youth aged 10-24, as they are in attempted suicides and suicides, the report says.
Self-harm has been rising since 2018 amongst those aged 15-19, with 42 incidents in 2020. Females are most prevalent, as they are in attempted suicides. Between the ages of 10-14, three children in the Whanganui District were hospitalised for serious self-harm in 2020 - before that, there were no cases reported.
The strategy, Growing Collective Wellbeing, notes there appears to be a correlation between social and economic deprivation and suicide, with rates among lower socio-economic groups significantly higher and growing, and many people are trying to cope on their own with stressors such as intergenerational trauma, financial burden or violence.
Marguerite McGuckin, Lead Systems Innovator for Healthy Families Whanganui Rangitīkei Ruapehu, said the three-year approach has been guided by local communities, partners, advisors and other stakeholders who are willing to work together to achieve change.
"We want sustainability and system change - we need to have the shift from intervention to prevention," McGuckin said
"We want transformation, going from an isolated health response to collective action with deep and durable impact. It's those sorts of shifts that we need so that it will become sustainable for our communities.
"I think we're all hoping for solutions that will happen in five minutes, and that's not doable if we want sustainability. With a whole-of-community and whole-of-systems approach we believe that it will be sustainable as opposed to a bandaid."
The first phase of the strategy identifies 11 initiatives, including reducing compounded toxic stress for whānau, increasing social inclusiveness and connection, running collective wellbeing campaigns and training all front-line staff as "wellbeing responders".
Healthy Families Whanganui Rangitīkei Ruapehu is managed through Māori health provider Te Oranganui.
"It's a different approach, the first approach of its kind amongst any of the DHBs. We're coming at it with a preventative and a whole-of-systems, whole-of-community approach," McGuckin said. "We have to thank the chief executive and Whanganui District Health Board for being courageous and bold enough to actually put this out to the community to design.
"On top of that, to have all of the community and our partners and stakeholders knocking on our doors wanting to be part of this approach is amazing. They've been a part of that journey for the last two years.
"We all have a part to play in keeping ourselves or our mates or our communities on the right end of that wellbeing spectrum instead of at suicide and suicidal behaviour. Our people need to know that it's OK to be well but vulnerable - it's about getting them back to being well again.
"How can we do that as a community, how can we do that as a system, how can we do that as a whānau and iwi and hapū? As a whole ecosystem, how can we do that collectively and with impact?"
Where to get help:
Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.
Lifeline: 0800 543 354 or text HELP to 4357
Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.
Depression Helpline: 0800 111 757 (24/7) or text 4202
Samaritans: 0800 726 666 (24/7)
Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email email@example.com
What's Up: online chat (3pm-10pm) or 0800 WHATSUP / 0800 9428 787 helpline (12pm-10pm weekdays, 3pm-11pm weekends)
Kidsline (ages 5-18): 0800 543 754 (24/7)
Rural Support Trust Helpline: 0800 787 254
Healthline: 0800 611 116
Rainbow Youth: (09) 376 4155
If it is an emergency and you feel like you or someone else is at risk, call 111.
Local Democracy Reporting is a public interest news service supported by RNZ, the News Publishers' Association and NZ On Air.