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The Southern district (Otago-Southland) suicide prevention plan for the next three years has just been released but draughting of the document predated the advent of Covid-19.
The pandemic, lockdown and the expected economic recession would all put enormous strain on southerners, Ms Scarth said.
"It is not inevitable that suicide rates go up and there have been a lot of good responses to Covid-19, but it will be [a matter of] sustaining those responses and keeping that investment in the community.
"It does really have to be a community response, especially in rural areas, and there is some good evidence out there about how to cater to those needs at a time of recession, and I have been working with a lot of people, including the Ministry of Social Development, to cater for that, and that will be a key focus when setting up those projects."
Suicide statistics can vary wildly from year to year and experts caution against seeking trends from isolated numbers.
However, Southern statistics — 57 of the 685 suicide deaths nationwide in 2018-19 were in Southern, a rate of 17.2 per 100,000 compared with a national rate of 13.9 per 100,000 — suggested a proactive approach was needed, Ms Scarth said.
"We have been on a downward trend, happily, but until you see that downward trend continue for five to 10 years you can’t get very excited about it.
"We have done our best to target the strategy to where we have seen the most need over the past decade, but we have to be very adaptable."
The Southern plan fits into an overarching national suicide prevention plan, and was reviewed and approved by the national body without alteration.
The region needed its own plan as there were circumstances unlike other regions, Ms Scarth said.
"We are very rural, around 40% of the population, which is unique among DHBs. We have a lot of isolation and that, combined with high housing costs in some of those areas, it sets up real challenges for service delivery," Ms Scarth said.
"We have a unique demographic profile as well, so I think that means we have to have our own strategy to reflect the trends we see around suicide."
The success or otherwise of suicide prevention measures could be assessed to a degree by what had happened to people who talked about taking their own life or made plans to do so, but it was much harder to gauge their impact on people who struggled in silence, she said.
"There will be people going through incredible distress now, with losing their jobs, but suicide never crosses their mind and what does that mean? Does it mean that we are doing a good job at suicide prevention, or does it mean that they are resilient and have good support around them?
"You do the best you can based on the evidence and community need and hope for a downward trend."
When Ms Scarth wrote the plan there was little or no direct funding to prevention and postvention community organisations; many of those volunteers had since been granted some funding, a welcome boost for people who worked incredibly hard, she said.
Some funds had come from the Ministry of Health and was only for 18 months, but she was hopeful it would continue.
Need to talk? 1737, free 24/7 phone and text Healthline: 0800 611-116
Lifeline Aotearoa: 0800 543-354
Suicide Crisis Helpline: 0508 828-865 (0508 TAUTOKO)
Samaritans: 0800 726-666
Alcohol Drug Helpline: 0800 787-797
General mental health inquiries: 0800 443-366
The Depression Helpline: 0800 111-757