Support Provided to Communities in New Zealand which Experience Suicide Contagion or Suicide Clusters
I arranged to meet Sandra Palmer who is a registered trauma counsellor who has been involved in the development of the Clinical Advisory Services Aotearoa Ltd (CASA) which is based in Auckland, New Zealand.
CASA provide a Community Postvention Response Service (CPRS) to communities in New Zealand, which experience a suicide cluster and/or contagion. This service is the first of its kind worldwide. CPRS is funded by the Ministry of Health, as it addresses one of the objectives in the New Zealand Suicide Prevention Strategy, which emphasises the importance of a community response when a suicide cluster and/or contagion occurs.
Both CASA and the Centre for Health Policy, Programs and Economics (2012) based at the University of Melbourne, stress that both interagency cooperation and coordination is essential when there are concerns that clusters of suicide or contagion is occurring within a community.
The immediate aim of any postvention service is to reduce anxiety, distress and suicide risk. CPRS is particularly focused on helping communities identify and support individuals who were vulnerable prior to any exposure to suicide, as well as those who are affected by the suicide. Once the initial contagion is contained and well managed, CPRS then work with the community to refocus their efforts on suicide prevention activities. Such instances demonstrate the overlap between suicide prevention and postvention.
How is CPRS activated?
CPRS monitor all suicide data received in real time from ‘Victim Support’ offices nationwide. This enables CPRS to identify when clusters or contagion is actually occurring. The general public, governmental and non-governmental agencies can also request CPRS to assess a community for suicide contagion and/or suicide clusters.
Support provided by CPRS
Once a referral is received a clinical advisor from CASA will make contact with key stakeholders in the community to determine if they would like CPRS to provide their services. Once they are invited, the presence of contagion/clusters within their community is assessed. This assessment influences the level of CPRS response.
The service can include an assessment of community risk, one off consultations with agencies and long term support for high risk communities that have experienced contagion and/or clusters.
CPRS use a community development model. This means that the CPRS Clinical Advisors do not lead the postvention response. Rather, they enable/empower the communities/agencies to identify their own expertise and knowledge and advise them on local leadership. The process focuses more on supporting communities to clinically manage those most at risk. Once CPRS deem the contagion/cluster to have been contained and the community is able to manage the future postvention response required, they withdraw their services.
Relevance to the UK
The UK received worldwide attention when cluster suicides occurred in Bridgend. To my knowledge we do not currently have any national systems in place to identify and address suicides clusters and/or contagion. Much could be learnt from CASA and their National Community Postvention Response Service (CPRS) provided in New Zealand. It would be a missed opportunity if either Public Health or the Department of Health did not explore this initiative.
I would like to thank Sandra Palmer from CASA for finding the time to meet me and inform me of the ground breaking work they are conducting in postvention.
Associate Minister of Health (2013) New Zealand Suicide Prevention Action Plan 2013-2016, Wellington.