Ko au te timatanga: It starts with me Suicide Prevention Symposium 2019

Helen Leahy, Pouārahi, Te Pūtahitanga o Te Waipounamu

When Great Trees Fall

When great trees fall,
rocks on distant hills shudder,
lions hunker down
in tall grasses,
and even elephants
lumber after safety.

When great trees fall
in forests,
small things recoil into silence,
their senses
eroded beyond fear.

When great souls die,
the air around us becomes
light, rare, sterile.
We breathe, briefly.
Our eyes, briefly,
see with
a hurtful clarity.
Our memory, suddenly sharpened,
examines,
gnaws on kind words
unsaid,
promised walks
never taken.

Great souls die and
our reality, bound to
them, takes leave of us.
Our souls,
dependent upon their
nurture,
now shrink, wizened.
Our minds, formed
and informed by their
radiance,
fall away.
We are not so much maddened
as reduced to the unutterable ignorance
of dark, cold
caves.

And when great souls die,
after a period peace blooms,
slowly and always
irregularly. Spaces fill
with a kind of
soothing electric vibration.
Our senses, restored, never
to be the same, whisper to us.
They existed. They existed.
We can be. Be and be
better. For they existed.

This week a great tree has fallen in the House of Tahu.

A river of tears has flowed in collective grief, carving out a pathway to eternity, as we listen to the wind call his name, Tahu Pōtiki, mokopuna of Karetai and Taiaroa, son of Ōtākou, a leader of the people.

 

We might refer to that loss “kua hinga te kauri o te wao nui a Tāne” (the kauri has fallen in the sacred forest of Tāne).

 

Tonight, however, we know that solitary Kauri is joined with rākau of many other descriptions –

·       the towering Totara, reaching upwards to the sky;

·       a lush kōwhai exploding in a sea of gold;

·       a mis-shapen gnarly Puriri, knotted and sprawling;

·       the tenacious Ti Kouka; spiky and aloof;

·       the heart-shaped leaves of a flourishing kawakawa

·       the sharp prickly cluster of the Manuka;

·       the baby young shoots of delicate nikau.

 

Which rākau do we mourn the most?  

Which are the ones that cause us to clutch our heart in that gasping, breathless sob – kei te hotuhotu te manawa.

The answer of course is all of them.

The importance of this symposium is to remind us all that to the world we may be one person; but to one person, we may be the world.

Did all the rākau in our forest know they were worthy, know they were loved?

Our forest is burning – and we are watching it die.

This year the number of suicides in New Zealand has reached its highest ever level with 685 people dying in the year to 30 June.

Within that, men continue to be at most risk – with 68% of the deaths last year being male.

Additionally, the rate of suicide statistics amongst Māori and Pasifika has experienced a significant rise.

The Māori rate rose from 142 to 169 deaths; Pasifika rose from 23 to 34.

This suicide profile has been variously described as horrendous ….horrible….shattering…one of our biggest long term challenges as a nation.

But in the blur of media noise, there was one very bright light of hope – that came through in a clear statement of principle from our Prime Minister.

She said:  “we need to equip every single person in New Zealand to be ready and able to have conversations at any time in case someone in their life, or in their environment, in their community reaches out to them”.

We now have a virtual academy of explanations that describe causation: early life experiences at home and at school; employment status; mental health; sense of belonging; sense of purpose.

But the greatest risk to our nation would be if we put all our resourcing into defining and redefining the problem and forget to invest in the solutions that are in our control.

Twenty three years ago I was a young policy analyst, working for Te Puni Kokiri, on an exciting new strategy called Kia piki te ora o te Tai Tamariki.

I had very recently experienced two suicides that had set me reeling: the first when I was a classroom teacher at Hagley and we lost a very high performing, successful young man in the last year of school.

The second death came when I was secretary for the Wellington needle syringe exchange –working alongside of the New Zealand Prostitutes Collectives.  Our beautiful receptionist, took her life supposedly out of the blue – but we believe later had been the victim of enduring sexual abuse.

In both respects, I felt completely ill-equipped to understand, to process, to heal.

And then along came Kia Piki designed from a Māori cultural framework by Keri Lawson Te Aho, with the expert advice and opinion of a Mäori Reference Group including Wiki Walker, Grant Berghan; Dr Erihana Ryan, Maihe Cherie Tipene, Phyllis Tangitu, Maire Kipa, and Adrian Te Patu

The vision was simple enough:. to reduce the rate of suicide and suicidal behaviour of taitamariki Māori by strengthening their participation in healthy Māori whānau and communities, which provide safety, security and a uniquely Māori home.

There were some standout bottom lines in this 1996 document:

  • The Strategy affirms that all taitamariki Mäori have whakapapa,

  • The fundamental foundation of Mäori society is the whänau. To To be effective and sustainable in the long term, strategies to prevent taitamariki Mäori suicide must be placed in the context of strengthening whänau as the core unit of Mäori development.

  • A better information base is required if Mäori whänau and communities are to develop strategies to prevent suicides and suicidal behaviour.

I was reminded of this strategy when speaking  yesterday with one of the kaimahi who had been doing that work in Youth Affairs – and we looked back – with the benefit of great hindsight of course – and agreed that the original thrust of Kia Piki had been an idea before its time.

The central platform in the tree of life that Kia Piki was based on was kōrero. 

And so this is where I come to Jacinda and her call for conversations.

Back in 1996 the Māori Reference Group was told in no uncertain terms that due to the sensitivities and the risks involved with talking about suicide – the threat of suicide clusters; the so-called phenomenon of copy-cat suicides - - that we must be circumspect about what we said, who we said it to, and indeed whether we said anything at all.

The Māori Reference team responded with passion that comes from a position of truth.

He aha te kai o te rangatira?  He kōrero he kōrero he kōrero.

In the last month we have had published in a journal of indigenous wellbeing the summary findings of an exploratory data gathering experiences on Māori suicide in Te Waipounamu (Dr Golda Varona, Raniera Dallas, Maire Kipa, Wendy Dallas-Katoa).

Our motivation for doing the research was the reported provisional suicide deaths in New Zealand over the past ten years, particularly among young Māori, indicating that the number of deaths by suicide among Māori has remained high.  

One particularly disturbing trend shows that Māori children as young as ten years of age have completed suicide in the last ten years.   That was particularly poignant for me.   Whereas my experience with suicide twenty years ago was through a work context, for my children it is far more personal.  By the age of ten my son has lost two cousins to suicide – taonga of Ngāti Rangi gone too soon- and his kaiako at kura.   Suicide has become so normalized in his life that when one of our nannies passed away, Rangipunehu immediately asked me, was it suicide?

Back to the research.

In our study, we undertook a small survey to explore and measure mental wellbeing among whānau.  A total of 44 individuals responded to the pilot survey. All respondents were randomly selected during various hui and events across the South Island.

There were a couple of interesting take out points;

  • Rangatahi (18-24 age grouping) stood out for having the lowest mean score for mental wellbeing and also for having a much lower score for connectedness compared to other age groups.

  • This is significant when viewed in light of the fact that data from the Coroner indicates that rangatahi also have the highest numbers of provisional suicide deaths in the last ten years

  • Collectively, the interview participants had witnessed, experienced, or witnessed and experienced twenty suicide attempts of whānau members that did not result directly in death, and thirteen suicides. 

  • The issues whānau associated with suicide and suicide attempts were widely varied and complex. In general, they tended to include a combination of the following: drug and alcohol dependency; post-natal depression; mental illness; problems with personal relationships, with whānau, or both; cultural and whānau disconnection; as well as other factors such as work and employment problems, unsafe school environments, bullying, and peer pressure

I think one of the most devastating findings in the study that often whānau only became aware of the dangers and gravity of the issues besetting their loved one at a much later stage; that is, when the situation had spiralled out of control and the opportunity and/or potential to intervene and help the whānau member had become quite limited.

One whānau described this in more detail:

“Living away from home, in a boarding situation, she was young and vulnerable. We expected the school to protect her and they let her and us down…Nobody told us anything…Serious things were happening that we should have known about, but nobody told us anything. Then we went to a Kaupapa Māori service provider, but it was too late by then...it didn’t work and it was too far from where we lived.”

In other cases, although whānau may have been aware of some of the underlying problems of their own whānau members; for example, in cases of alcohol dependency, they felt that they had very limited resources and/or power to help change things

We spent a lot of time worrying because we never knew where he was or whether he was safe and okay… …[But] when he killed himself, we did not see it coming. I think that when it happened he was just fooling around to get attention, but he was so drunk he probably tripped and it became a reality

The headline that all of us can take from this study in Te Waipounamu – and it’s not new -  indicate that whānau access suicide intervention health services only after a suicide incident or suicide attempt.

On the whole, these health services generally use a clinical/health-based approach. Whānau, however, pointed out that a culturally grounded whole-of-whānau approach is required to address issues around mental health and suicide, particularly amongst young whānau.

They and their whānau needed more tools and support, particularly around the prevention of suicide.

Let me remind you what Māori told us in 1996:

  • A better information base is required if Mäori whänau and communities are to develop strategies to prevent suicides and suicidal behaviour

The interview participants pointed out that some of them had to struggle through a variety of issues around health services. These issues included delays in the diagnosis for mental illness, a dismissive or casual approach by health services, and prohibitive costs for some services, among others.   One whānau member said:

“When we approached them [health services] for psychiatric assessment for [our whānau member], it took a long time to get a diagnosis [for mental illness]… So while that went on and we waited, she was harming herself – another suicide attempt, and then another, and another…and the delays really took a heavy toll on our whānau.”

We experienced a bit of a casual approach from the staff at [health services]… The fact that he [whānau member] was quite young; it was like they thought he was just acting up.  His suicide attempts were not really taken seriously…he wasn’t given the proper attention. We [whānau] were told by the staff at [health services] to take him home and give him a milkshake and let him sleep it off…Well, he hung himself two weeks later…He succeeded in killing himself.”

A number mentioned that some whānau could barely afford the cost of health services. They also found some services to be culturally “alien” and unsympathetic to their needs.

“It is the cost factor…A lot of money is required to access this grief counselling thing…Also, I found that the process around grief counselling was alien and I could not understand it. They give me all these pamphlets to read, and every time I was in session with those guys, they put a timer on, and I was thinking about how much is this costing me and whether I had enough time to finish what I had to say. I did not really get any acceptable resolution. I got depressed and lost my job…

And, yeah, someone mentioned a Māori provider to me, but I live in a small community and I did not want people I know to know my problems and weaknesses

Various comments made by whanau during the in-depth interviews suggest that being actively involved and connected to whānau, culture, and community can give people suffering from trauma, distress, or mental illness a reliable source of non-judgmental support and a sense of safety.

As one interview participant explained:

“Home is supposed to be your safe place. It is where you can be who you are and not care about being accepted because you already are…I think it is important to have a place…like the marae you know, just as an example…a place that will be always open for everyone and anyone when they need to take their mind off things, be busy, have some company, hear a few old stories, that sort of thing.

Having the freedom to be able to go to such a place when you need to helps, even if it really doesn’t solve your immediate problems, it still helps.”

For me, that was one of the findings that gives us inspiration to keep moving forward, to place one step after another.

It doesn’t take a co-design campaign; a sector-wide review; an evaluation of best practice…..

All it takes is to believe.  

Ko Au Te Timatanga (it starts with me)

To believe that being connected culturally and with whānau is pivotal to suicide prevention and intervention.

Indeed, as we know, whānau being culturally informed and fully involved is important for Māori wellbeing in general.

The participants in our study told us that whānau need to know their rangatahi better, particularly for whānau living outside their iwi boundaries.

We need to have safe and open places for people to go to meet and talk to others.

We need to identify – who are the healers in your whānau?  

We all have those who are the archivists – the historians – who take the photos at the family reunion.   We know too, the ones that watch how the money is spent; who’s being locked out, who’s feeling disconnected.

Ko Au Te Timatanga (it starts with me)

What we can do today is become more proactive, more self-actualising, about who are the ones who keep us safe; who are the ones who will challenge unsafe behaviours; who are the ones to wrap loving arms around us when we need it most.

We have no reason or time to wait to make the change we need to see happen.

A whānau-centred approach to recovering from suicide is necessary to prevent individuals from internalising and solely focusing on the experience of personal grief and loss.

Such an approach can enable us all as individuals to transcend the focus on self and realise the wider context of whānau around suicide and potentially empower whānau to have conversations that challenge and question traditional attitudes in relation to suicide.

This afternoon – while most of us were thinking about what we might eat for dinner, a sixteen year old eco-warrior, Greta Thunberg sailed into Manhatten.   She travelled from Britain on a transatlantic yacht to attend a UN summit on zero emissions after refusing to fly because of carbon emissions caused by planes.

When a reporter asked her “don’t you just want to be a kid” Thunberg replied:

“I would love not to have to do this and just go to school but I want to do this because I want to make a difference.   The older generation are the ones who are causing this problem and they should not be saying to us “just be a normal kid.   Because they are the ones that caused this and we are just trying to clean up after them”.

Thunberg had a mission: to tell Mr Trump: ‘Listen to the science’ .

What have you done lately?   What would you do?

Feel the fear – tuwhitia te hopo!

 

 

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