Frequently asked questions
- Aren't our suicide figures falling and doesn't that mean our prevention strategies are effective?
- Isn't it true that 90% of people who commit suicide have a mental disorder?
- I know people who have felt better while taking antidepressants - aren't they effective for some people?
- The figures show that people care of Mental Health Services are 20x more likely to kill themselves but isn't that because those under psychiatric care are more ill than those in the community?
- Suicide isn't an accident so why should families get ACC?
Aren't our suicide figures falling and doesn't that mean our prevention strategies are effective?
10 people commit suicide every week in New Zealand and the figures have risen steadily over the past five years.
You may have heard SPINZ report there were 483 suicides in 2007 and that this was a big decrease on the previous year's 511 suicide deaths. If you did, you will have heard them say this is evidence of the effectiveness of current strategies.
It became evident that SPINZ had mislead the public when the Chief Coroner released figures showing that in fact there were 540 suicides in 2007. Rather than believing the government is being effective, the Chief Coroner expressed his deep concern that suicide deaths are 50% higher than those from fatal road accidents. back to top
Isn't it true that 90% of people who commit suicide have a mental disorder?
No! Most research shows that only around 30% of people who commit suicide were diagnosed with depression or another mental disorder before they died. Given you only have to feel sad for two weeks or drink too much alcohol to get this diagnosis that's not surprising.
The studies which show 90% of people have a mental disorder when they commited suicide are those that use the 'psychological autopsy.' A psychological autopsy is a mental health assessment on a dead person. In the majority of suicide victims there is no evidence of a mental disorder so psychiatrists interview family and friends and ask if the person was sad, or had trouble sleeping, or changes in weight or appetite. They then diagnose the person with depression!
A review of the suicides investigated by the Health & Disability Commissioner between 2005-2010 showed the vast majority had been assessed by a psychiatrist as having no mental disorder BUT had been prescribed multiple psychotropic drugs. They commited suicide soon after starting the drugs, a dose change or during withdrawal. back to top
I know people who have felt better while taking antidepressants - aren't they effective for some people?
In 2008 a group of researchers reviewed the clinical trial data used by pharmaceutical companies to obtain FDA approval for their drugs. This study, known as the Kirsch meta-analysis, showed antidepressants are little or no more effective than placebo (sugar pills).
In the clinical trials, both those taking sugar pills and those taking the drugs felt better. The major difference was that those on sugar pills did not face the doubled risk of suicide than of those on the drugs faced.
Of course large numbers of people on the drugs dropped out of the trials due to intolerable side effects and their results were not included in the trial data. back to top
The figures show that people care of Mental Health Services are 20x more likely to kill themselves! but isn't that because those under psychiatric care are more ill than those in the community?
Thats not what the data produced by the Director General shows. He says only 18% of those who committed suicide under mental health service care were diagnosed with depression while we're told 20% of the general population meet the diagnostic criteria for depression.
His figures show 13% diagnosed with bi-polar and 11% with schizophrenia while the most common diagnosis was 'other' which includes labels such as factitious disorder (making up symptoms), social anxiety disorder (shyness) and things like not being able to sleep after drinking coffee! It also includes a huge number of people who were put in care and given psychotropic drugs with no diagnosis or a diagnosis of no mental disorder. back to top
Suicide isn't an accident so why should families get ACC?
It is not CASPER's position that support (financial or otherwise) should be provided under ACC but it is our position that it should be provided. Suicide is different from other deaths in many ways and many of the issues faced by the families of suicide victims are specific to this kind of bereavement. Suicides often occur in the home and are frequently very violent. Family members are generally first on the scene. Research has shown that the families of suicide victims do not recieve the same level of support from friends and family as other bereaved families. There are few services tailored specifically for suicide survivors and unlike other families facing court proceedings over the death of a family member, our families rights are not covered by victims rights legislation. If we are unable to work following the suicide of a child or family member who was not the main income earner we are not entitled to the ACC cover we would get for a rugby injury or sprained ankle. When the few rights we had were recently removed by government, we consider a review of those needs and the relative costs of providing and not providing them should have been undertaken. There is opinion in medico-legal circles that the removal of ACC entitlements will shift costs to the justice sector as families seek compensation through court proceedings. Families bereaved by suicide are deeply traumatised and in desparate need of support, whether provided by central government or the community. A caring society would not leave such families isolated and unsupported. back to top
What are the alternatives to a mental health approach to suicide?
Changes in mood and behaviour which impair functioning are often the result of general medical conditions. A thorough physcial health assessment should always be conducted before any mental health diagnosis is made. Many physical conditions and vitamin or mineral deficiencies can cause low mood, changes in sleep and appetite and lack of interest in previously pleasurable activities. Recent research has shown a link between suicidal thinking and planning and a range of general medical conditions. Identifying and treating these conditions may alleviate what may appear to be symptoms of depression. Strong social support networks within families, peer groups and communities help people to survive stressful life events as do the development of coping strategies. The creation of social, economic and cultural environments which support employment, family functioning and inclusion and optimism is an important suicide prevention strategy. back to top