There have been some encouraging signs of a reduction in lives lost to suicide in the past few years, after a decade of relatively static rates. Evidence-based interventions are required to build on this momentum and ensure that as a country we continue to see reductions in the suicide rate.

This publication summarises the most up-to-date and relevant local and international literature on suicide prevention and postvention. It highlights what the most impactful interventions are for the New Zealand context, and where the gaps in the research are.

As literature on suicide prevention mostly reflects a Western, individualised, and often psychiatric perspective on suicide within a strong positivist tradition, this review has ensured a specific search for, and inclusion of, suicide prevention activity in Aotearoa New Zealand, irrespective of publication status or study design.

The review highlights the importance of, and relative under-utilisation of universal strategies that address structural determinants such as poverty, loss of land, discrimination and violence, un- and underemployment, such as unemployment benefits, active support of return to labour market programmes, social welfare and robust employment protection legislation.

Key evidence-based universal interventions include increasing adherence to responsible media suicide reporting guidelines, as well as application to social media and all public communication, restricting access to means of suicide, and reducing access to alcohol are critical. 

Key findings

• Assessments with those experiencing suicidal distress needs to focus on the factors contributing to that distress, that are amenable to intervention and resources directed towards providing effective solutions to those difficulties.
• There is a great deal of interest, and indeed clinical innovation, in the area of peer support and social support interventions. However, as yet there is little high-quality evidence evaluating these interventions in relation to suicidal behaviour outcomes.
• Workplace interventions focusing on first responder (defined as military, police, firefighters and likely applies other first responders such as ambulance staff) suggests that multilevel interventions are associated with reduced suicide rates in these groups.
• There is a need for a greater focus on the prevention of all types of violence and particularly sexual violence as part of suicide prevention interventions. The experiences and needs of men who have been subject to sexual violence is particularly under-investigated.
• People experiencing suicidal distress should be offered access to range of psychological interventions so they can find one that best meets their needs.
• Most psychological interventions focus on individuals as the unit of intervention, which is at odds with models of wellbeing such as Te Whare Tapa Wha and the emerging evidence of good practice from Pacifika and Māori suicide prevention efforts in Aotearoa New Zealand. The key unit of intervention is whānau.