What works? Individuals’ Experiences and Knowledge of Suicide Prevention Interventions in Aotearoa/New Zealand

Abstract

In Aotearoa/New Zealand, suicide rates first peaked in 1998 when 577 people died by suicide and the country had the highest number of youth suicides among all OECD¹ countries (WHO, 1999). The number of deaths by suicide has since fluctuated each year; however, latest figures show a concerning increase that exceeds those of 1998; with 668 people dying between June 2017 and May 2018 (Chief Coroner's Office, 2018). This figure is the highest number of deaths by suicide to date in Aotearoa/New Zealand. In response to suicide rates in 1998, the Ministry of Health constructed and published several frameworks, reviews, strategies and action plans. Historically, these documents have been written with input from academics, health professionals and bereaved family/whanau members. Input from current users of these services has not featured in any Ministry of Health documents to date. People who use suicide prevention interventions and who could arguably be seen as experts in this area have not been asked for their knowledge and feedback regarding the efficacy of these interventions. This thesis by research aims to gain further insight into the effectiveness of suicide prevention intervention in Aotearoa/New Zealand by asking service users 'what works?' Throughout the North Island, twenty semi-structured interviews were conducted with individuals with lived experience of suicidal ideation and/or attempt. Using thematic analysis, the resulting data revealed a variety of interventions that participants found effective including art therapy, the diagnoses of auto-immune diseases, practising mindfulness, certain medications and spirituality. These interventions, among other effective services and treatments, are presented as themes of the data that were developed through the lens of the four dimensions of Durie's (1994) Te Whare Tapa Whā model of health, with an addition of tukutuku representing the overlapping psychosocial interventions. Participants' discussions of best practice are also explored in an attempt to inform practice to make it 'best' or at least better, practice. With a constructionist epistemology, this research uses a qualitative descriptive methodology and aims to give service users 'a voice' by contributing to the existing field of suicide prevention research.The findings and subsequent discussion of the data promote the use of a strengths-based approach within social work. It is hoped that this study can influence future legislation and policy formation and ultimately, reduce the rates of suicide in Aotearoa/New Zealand.