This annual report - Taranaki District Health Board

Local Policy Documents and Evidence-Based Reviews Relevant tothe Prevention of Suicide and Intentional Self-HarmIn New Zealand, the New Zealand Suicide Prevention Strategy provides a framework for suicideprevention among young people and the wider population. A number of local and internationalreviews also address the prevention of suicide and self-harm in young people and these aresummarised in Table 116 below. In addition, a range of publications focus on mental health issuesin young people more generally, and these are summarised in Table 91 on Page 354.Table 116. Local Policy Documents and Evidence-Based Reviews Relevant to the Prevention ofSuicide and Intentional Self-HarmMinistry of Health Policy DocumentsAssociate Minister of Health. 2006. The New Zealand Suicide Prevention Strategy 2006–2016. Wellington: Ministry ofHealth. http://www.health.govt.nz/publication/new-zealand-suicide-prevention-strategy-2006-2016The New Zealand Suicide Prevention Strategy provides a framework for suicide prevention in all ages, for the period2006 to 2016. Its aim is to reduce the rate of suicidal behaviour and its effects on New Zealanders, while recognising thatsuicide affects some groups more than others, including young people aged 15 to 24 years. The strategy identifies sevengoals: to promote mental health and wellbeing, and prevent mental health problems; to improve the care of people whoare experiencing mental disorders associated with suicidal behaviour; to improve the care of people who make non-fatalsuicide attempts; to reduce access to the means of suicide; to promote the safe reporting and portrayal of suicidalbehaviour by the media; to support families/whānau, friends and others affected by a suicide or a suicide attempt; and toexpand the evidence about the rates, causes and effective interventionsMinistry of Health. 2008. New Zealand Suicide Prevention Action Plan 2008–2012: The Summary for Action.Wellington: Ministry of Health.Ministry of Health. 2008. New Zealand Suicide Prevention Action Plan 2008–2012: The Evidence for Action.Wellington: Ministry of Health.http://www.health.govt.nz/publication/new-zealand-suicide-prevention-action-plan-2008-2012These companion documents provide the 2008-2012 action plan for the New Zealand Suicide Prevention Strategy 2006–2016. The Evidence for Action document provides the evidence base for the goals of the strategy and the Summary forAction identifies outcomes, actions, milestones, whānau ora considerations, timeframes and the lead agenciesresponsible for implementing the actions.Cochrane Systematic ReviewsHawton KKE, et al. 1999. Psychosocial and pharmacological treatments for deliberate self harm. CochraneDatabase of Systematic Reviews doi:10.1002/14651858.CD001764http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001764/frame.htmlThis review, published in 1999 and reviewed (with no change to the findings) in 2009, assessed the effectiveness ofpsychosocial and/or psychopharmacological treatments versus standard or less intensive types of aftercare for patientswho have deliberately harmed themselves by self-poisoning or self-injury. Twenty-three RCTs (3,014 participants) wereincluded. A non-significant trend toward reduced repetition of deliberate self-harm (DSH) was observed for problemsolvingtherapy, and for provision of a card to allow emergency contact with services. Significant improvements wereidentified in a single trial of depot flupenthixol for recurrent repeaters of self-harm (OR 0.09, 95% CI 0.02 to 0.50) and asingle trial of intensive dialectical behavioural therapy for female patients with borderline personality disorder andrecurrent self-harm (OR 0.24, 95% CI 0.06 to 0.93) but numbers were small and the trials should be interpreted withcaution. Overall, insufficient numbers of patients in nearly all trials limited the conclusions that could be reached aboutwhich forms of treatment are most effective and the authors call for larger trials.Other Systematic ReviewsRobinson J, et al. 2011. Preventing suicide in young people: systematic review. Australian and New Zealand Journalof Psychiatry, 45(1), 3-26.This study aimed to review RCTs of interventions for adolescents and young adults who had presented to a clinicalsetting with a suicide attempt (SA), suicidal ideation or deliberate self-harm (DSH). The analysis included 15 publishedand six ongoing RCTs, the majority of which recruited young people from inpatient or community mental health servicesfollowing a SA or DSH and most interventions were delivered in outpatient settings. Overall study reporting quality waspoor and only a few study results could be combined in meta-analysis, which did not find any significant differences. Onlyone study, assessing individual cognitive behavioural therapy (CBT) found a significant difference between theintervention and treatment as usual. The authors concluded that although individual CBT based interventions may showsome promise, the evidence base for effective interventions was very limited.Suicide and Intentional Self-Harm - 423