February 15, 2005

Worlds Apart

Ben Thomas writes...

The
winding up of the Yellow Ribbon Trust has caused little fanfare, with most attention focused on the Trust’s relationship with Dean Lonergan’s Fight For Life.

(Time for the indulgence of a bitchy aside? Good. Lonergan, who talked himself up as a tireless supporter of youth suicide prevention, slammed
articles about suicide I published in Craccum magazine in 2000. He called them irresponsible and immature in – curiously – an issue of Brass magazine. Then came the fracas about whether macho aggressive posturing was the best way to prevent youth suicide. Rather than revamp the concept, Lonergan shifted the circus sideways, into raising funds for meningococcal disease. Glad to see he was always sincere. End aside.)

A couple of years ago, I would have been outraged about the decision to call it quits (no tasteless jokes about Yellow Ribbon taking its own life – that can get you into trouble). This is a victory for Associate Minister of Health Jim Anderton. In 2003 Anderton and minister of heterosexuality, John Tamihere, wrote to schools formally discouraging them from cooperating with schemes like Yellow Ribbon (and threatening future regulation of such programs).

This is because of a worldview Anderton shares with the Ministry of Health: discussion of suicide causes it.

Anderton consistently misrepresents research which shows media reporting of a particular method of suicide increases the prevalence of that type of death as a proportion of the whole.

Anderton is quoted in the Herald’s story on the closure of Yellow Ribbon saying:

"The literature is very clear - if you raise the profile of youth suicide you get a higher rate of suicide. That's why the media briefings are on the basis that we don't want the method of death being publicised."

Even the Ministry of Health’s polemical Suicide and the Media: the reporting and portrayal of suicide in the media doesn’t go so far as to support Anderton’s position. It posits that some research “demonstrates” (a cynic might say “suggests”) a link between the reporting (actually, the de-contextualised reporting) of specific cases of suicide and an increased incidence of suicide. The link is clearest in cases of geographical proximity (sometimes leading to suicide “clusters”, which account for around 5% of all suicides) or celebrity suicides. Discussion of the issue shows no demonstrable link, but is thought to increase risk where such discussion “normalises” suicide as a response to emotional difficulty.

The research surrounding depictions or reporting of the method of suicide shows quite clearly that well-publicised methods of suicide will gain in popularity, but at the expense of other methods. For example, a televised drama showing suicide by jumping in front of a train increased the number of suicides by train jumping in Berlin. The Ministry’s guidelines are ambiguous, but studiously avoid claiming any increase in the total number of suicides.

So, a couple of years ago, it would have been tempting to label Anderton a liar and a fraud. But one mellows with age, and more saliently, becomes better acquainted with the nuances involved. There was a remarkable drop in the rate of youth suicide in New Zealand in 1999 (around 25%); a further big drop in 2000 (20%), and lesser falls in subsequent years until a slight rise occurred in 2003.

My reading of these events is that they followed the foundation of the Youth Suicide Awareness Trust in 1998. The next year, Yellow Ribbon (an arm of the YSAT) launched its schools programme and over both years Martyn “Bomber” Bradbury devoted many hours of radio time on (then new and exciting) Channel Z to promoting Lifeline and suicide awareness. In 2000, Craccum created a contagion of media caterwauling, which was followed by the Herald's publication of
a full page feature on a Ministry of Health report into suicide methods, complete with a self-congratulatory editorial lauding the newspaper’s own courage. Fight for Life made the issue truly mainstream after steadily increasing coverage. Greater awareness led to more support for at-risk youngsters. Media mentions of the issue of suicide skyrocketed after 1998 and the number of deaths tumbled: a real-time experiment putting the lie to Anderton’s belief that if you raise the profile of youth suicide you get a higher rate of suicide. (The MoH’s guidelines were published in 1999, before the drop in suicide rates was observed)

Of course, that is how I would tell it.

Another narrative, perhaps just as plausible, is that the youth suicide prevention strategy was signed off in 1998, and has worked superbly. Suicides are down, in spite of – rather than because of – callous assholes who just don’t have enough respect for Jim Anderton. Callous assholes like Bradbury and Yellow Ribbon’s Marco Marincovich and even myself. My limited (and indirect) experience with the government-funded programmes is that they have helped a lot of people. Most are geared towards those identified (rightly) as particularly high risk – attempted suicides and the family of successful suicides, rather than general prevention.

A third explanation is that the Labour government’s impending election turned the tide. There was an explosion in numbers starting in 1984, and only falling appreciably in 1999. Although this theory doesn't explain the rise in 2003, it remains a 900-pound gorilla in the room that has to be faced by all dedicated free marketeers.*

The epidemiology of suicide is so imprecise as to defy answers to any of the questions that people desperately and sincerely want addressed. You can never know another man’s mind, particularly not in the grip of a pathology powerful enough to override the biological imperative towards life itself. The statistics banked up by researches quickly lose coherence and composition if you stare at them hard enough – suicides, attempted suicides, para-suicides (where death was not really intended), failed para-suicides, where a cry for help goes horribly wrong. It’s like discerning green from turquoise from aquamarine from blue on a spectrum. And that’s only where the subject obviously embarked on self-harm, making it apparent they wanted to die. The missing category is so-called “accidental death” – youths fished out of waterways for example, or poisonous levels of alcohol or drugs.

The ultimate answer that comes from the experts in this country is that many suicides stem from mental illness, but the fact is that the same experts diagnose one fifth of the adult population as having said mental illness. Moreover, biologically at least, there is nothing to suggest depression, bipolar disorder and schizophrenia are any less prevalent in countries where the suicide rate is significantly lower than in New Zealand.

Which is the problem. One can point out that Anderton is wrong in his precis of various studies, but it doesn’t necessarily follow that Yellow Ribbon should be publicly funded, particularly at the expense of other programmes. We don’t know what caused the remarkable drop in suicides in the last 6 years. But then, that seems as good a reason as any to make no sweeping changes.

New Zealand, if I may generalise and romanticise for a second, is an introspective, self-harming culture. Barriers on American motorway overpasses were erected as much to stop malicious thrill-seekers throwing bowling balls and stray rubble into traffic, as to stop anyone throwing themselves. Here the former is unthinkable; the latter,
accepted wisdom. It’s a piss-poor suicide prevention strategy, but it’s an interesting insight into our culture.

A digression I shouldn’t have allowed myself, either. Romanticism of an ugly reality is a definite negative, no matter what your worldview. The MoH will point this out with abandon: films romanticise suicide, books romanticise it, apparently Craccum romanticised it. But the MoH is also guilty of romanticism – its media guidelines treat the “S” word like Demogorgon, a medieval demon whose mere name was meant to bring disaster and ruin. The taboo, much dismantled now, but ironically perpetuated by the MoH, lends just as much unreality to the issue in public consciousness as the beautiful, inscrutable Kirsten Dunst character in the Virgin Suicides.

So to end with some broad value judgments: Jim Anderton was wrong to demonise Yellow Ribbon, to demonise the Fight for Life and (in a startling admission of lack of authorial detachment) to demonise me. It is unfortunate that Yellow Ribbon has folded, and even more unfortunate that such a worthy cause could not manage to find sufficient funding without rugby players beating up each other to entice the crowds. And unfortunate that the media still insists on debating whether we can talk about suicide instead of actually talking about the damned thing itself.

* Which is not to say it can’t be faced: there is a difference between ultimate causes and proximate causes, and every policy has consequences downstream. Neo-liberal champions could easily point to lives saved by the economic rescue of New Zealand. But an overall estimate of lives saved versus lives lost would involve a utilitarian calculus that would be, to understate the matter, fraught with difficulties of perception.



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