International Initiative for Mental Health Leadership exchange 2018 – Implementing cross-sectoral policies for suicide prevention

Suicide is a global public health issue which has devasting effects on whanau and communities throughout the world.  While each country has its unique approaches to reducing suicide, in May this year a platform was created in Stockholm for leaders in the suicide prevention field to come together and share their experiences and explore ways in which cross-sectoral suicide prevention strategies can be implemented as part of the International Initiative for Mental Health Leadership (IIMHL). 

IIMHL and the International Initiative for Disability Leadership (IIDL)  is a collaborative between eight countries that focuses on improving disability, mental health and addiction services, and outcomes for people accessing services. Participating countries take turns hosting leadership exchanges (or week-long learning events) every 16 months at which disability, mental health and addiction leaders share evidence-based innovations, practices and problem-solving strategies.

New Zealand representatives – Dr Barbara Disley (CEO Emerge Aotearoa), Denise Kingi-Uluave (Senior Research Manager, Le Va), and Dr Monique Faleafa (CEO Le Va) – joined 13 other participants from around the world at 2-day leadership exchange hosted by the Public Health Agency of Sweden and The Substance and Mental Health Services Administration (SAMHSA) of the United States. The countries represented were: Sweden, Canada, New Zealand, Ireland, Finland, Greenland and The United States of America. 

The overall theme of the leadership exchange was exploring the challenges and opportunities associated with the development and implementation of broad policies to prevent suicide, on different levels in society.

Le Va was honoured to be invited by the exchange organisers to present on Youth Suicide in New Zealand.  Monique and Denise presented a national snapshot of youth suicide, and policy and programmes supported by the New Zealand government. They also shared the work of Le Va’s two national suicide prevention programmes: LifeKeepers national suicide prevention training programme and FLO: Pasifika for Life, including Aunty Dee.

Site visits:

The group visited two organisations in Stockholm: the Sweden’s National Center for Suicide Research and Prevention (NASP) at the Karolinska Institute and the Psychiatric Acute Mobility Team. These visits showcased innovative examples including the following presentations:

Talk Today – Is an initiative by the Canadian Mental Health Association which focuses on youth within the Canadian hockey league and highlights the importance of educating coaches, staff etc in suicide prevention

SAMHSA – Youth suicide prevention in the U.S. 

Youth suicide prevention in New Zealand – Le Va presented their two national suicide prevention programmes with an emphasis on cultural considerations, holistic wellbeing, and a strength-based approach.

• https://www.health.govt.nz/our-work/mental-health-and-addictions/working-prevent-suicide 
• https://www.leva.co.nz/our-work/suicide-prevention  
• www.lifekeepers.nz
•  www.auntydee.co.nz 

Youth Aware of Mental Health (YAM) in Sweden – This programme builds skills through classroom learning to promote problem solving and teach cognitive behavioural skills and it is being implemented in a number of countries worldwide with positive evaluations.  

Psychiatric Acute Mobility Team (PAM) located at a hospital in central Stockholm. This team has a mental health ambulance specifically designed for responding to mental health crises.

A number of key messages for New Zealand (and all countries) emerged from the exchange:

• From a government level – we need consistent government policies that use top-down bottom-up approaches and leverage leadership, authority, accountability as well as include lived experience by those affected to implement effective, culturally appropriate suicide prevention action plans.  Social inequities need to be addressed along with investment into the development of effective programmes and educational resources.

• Going forward there is a need for stronger leadership, more connecting and sharing of information, and holistic culturally appropriate, strength-based approaches that start early in the life cycle to build skills and resilience.

• The sharing of effective school-based programmes that support young people through the use of techniques such as Cognitive Behavioural Therapy skills to acquire strategies early in life to deal with trauma and adversity.

• The importance of effective crisis services that are responsive, caring and provide immediate access to skilled mental health support to enable effective de-escalation, assessment and intervention.

• Some of the key challenges the group identified were: Increasing inequalities, concerns in regard to safe and responsible messaging (social media, Netflix, media reporting) and youth suicide.

 In summary the group recommended:

 “There is a need for wider sharing of evaluated programmes that build on peer support, strengthen protective factors and promote community-based action.  More needs to be done to ensure that programmes respond to those at greatest risk, that all interventions promote better outcomes for indigenous populations and for young people”.

 Dr Barbara Disley and Dr Monique Faleafa also represented New Zealand with 10 other countries as invited members of the IIMHL Council of Public Health Leadership. They continue to be a part of this group, which identified key themes across countries: 

• Increasing demands for mental health services is influencing the need to take a more systematic, upstream, social determinants of health approach.

• Seeing widening gaps in health inequalities across countries; need to look at underlying issues, such as racism, colonialization, poverty.

• Need to work across jurisdictions/sectors; call on other non-mental health professionals to understand and advocate for prevention and for those populations most at risk for poor mental health.

• Importance to influence positive societal change across different levels (e.g. macro vs program level; allocation of resources).  Need to reflect our values in policies and programs

• Broader human rights perspective in mental health and using this to influence change.

We wish to thank IIMHL New Zealand for their ongoing support in ensuring New Zealand continues to share, learn and demonstrate strong leadership in this space.

Nga mihi, ia manuia, malo ‘aupito,

Monique, Barbara and Denise.