NEW ZEALAND: YOUTH PEER SUICIDE PROGRAM
Fears for teenagers who counsel
Suicide prevention programmes in schools remain
contentious, as debate rages over whether they reduce the risk or could
enhance it. Oskar Alley reports.
Student Amanda Myocevich had come home from Rosehill
College, Auckland, with a gift for her father. The 16-year-old had
volunteered to work as a Yellow Ribbon ambassador, a schools-based peer
support programme that encourages troubled teenagers to talk to
schoolmates about their problems.
Her father Keith Myocevich recalls: “She just came
home one day and showed me a cap with a yellow ribbon on it and said:
'Do you want it dad?”
“I didn't realise she was an ambassador till . . .
In October 2002 Amanda was found dead. The coroner
ruled her death was self-inflicted. Myocevich remains at a loss to
explain his daughter's actions. He refuses to believe Amanda was bullied
at the Auckland college and her friends confirmed that view.
“We'll never know why Amanda did it,” he says after a
“As far as I knew, and her sister knew, she was a
happy girl. Myself I thought it was exams coming up and it was too much
for her. That's what I think it was anyway.”
“God, she was applying for doing makeup artistry in
films, sending away for brochures . . . I don't know.”
“My (other) daughter said: 'Dad we'll never know.'
What I'm trying to do is remember the good times.”
Debate continues over whether suicide prevention
should be included in schools, and whether teens helping teens is an
Myocevich is aware of the debate. He believes Amanda
was too young and “not the right sort of person to be an ambassador”.
Critics say teenagers should not be expected to become
“ambassadors”, to take responsibility for their troubled peers. They
believe too much talk of suicide risks “normalising” or even promoting
it, and that adult teachers, counsellors and mental health professionals
should do the work. Advocates stress suicidal teens need help and
support and are more likely to turn to someone their own age, or that
their friends have a better chance of spotting signs of depression, a
common factor in suicide attempts.
Yellow Ribbon is the highest-profile suicide
prevention programme in New Zealand, used in more than 170 schools. The
organisation is the educational arm of the Youth Suicide Awareness
Trust, established in 1998 and co-founded by Peter Quinn, whose son
Paul, 18, took his life in 1997 after a car he was driving crashed,
killing a female friend.
Last month his younger son Michael, 15, was found
dead. Teenage mourners at his funeral wore homemade yellow ribbons and
draped his rugby jersey across his casket. The school Paul attended uses
the Yellow Ribbon programme and some students act as ambassadors to help
fellow students. Ambassadors volunteer or are selected by their
schoolmates or the guidance counsellor.
The organisation co-ordinates peer support programmes
in schools, with student ambassadors available to listen to fellow
students' concerns. Its slogan is: “It's OK to ask for help.” The
ambassadors are trained to work under the supervision of a guidance
counsellor and to refer students to the appropriate professional for
help. Their work is also monitored and evaluated monthly by the
organisation's regional co-ordinators. Yellow Ribbon was first used in a
pilot scheme at Auckland's Macleans College in October 1999. Principal
Byron Bentley said last week he had no hesitation introducing the scheme
and it remained valuable.
“We're talking about a programme that encourages young
people to know they have help when they need it,” he says.
“I can't think of what could be more important than
“Given this country's youth suicide rate we should be
supportive of anything that aims to help teenagers with their anxieties
and lets them know they're not alone.”
But Canterbury Suicide Project principal investigator
Dr Annette Beautrais points to a significant volume of research that
warns against peer support programmes.
“There isn't evidence that talking about it prevents
it,” she says.
“There is some evidence that talking about it
normalises it and makes it more readily available to young people as an
option for when they have problems.” Beautrais, one of the country's
leading suicide researchers, is also concerned that the sort of teens
who volunteer to help their peers could themselves be most at risk of
Claims that medical authorities do not know what
causes suicide are incorrect and “freak out” parents, fuelling anxiety
created by the widely held impression that the rate of teen suicides is
higher than it is, says Beautrais.
“I have never seen a case where a suicide has come out
of the blue,” she says.
International studies, and Beautrais' own work, have
identified“"remarkable commonality” in risk factors, including the fact
that 90% of cases have at least one mental disorder, typically
depression. In a study last year based on data from 1265 young people,
Beautrais examined factors that influenced their vulnerability to a
suicide or attempted suicide. While depression was the strongest risk
factor she also identified social, family and individual issues that
encouraged suicidal behaviours when depressed. These included the
possibility of previous sexual or physical abuse, family living
standards, parental anger or alcohol problems, low self-esteem and
truancy or poor exam performance.
Beautrais says it has yet to be proved “beyond doubt”
that there is an association between peer support programmes and
suicides “and that's the argument its supporters will always make”.
Yellow Ribbon began by concentrating on suicide
prevention in schools, based on its American namesake. But criticism of
the original programme has seen the organisation modify its direction to
encouraging students to seek help with their problems. A study by
Auckland University's injury prevention centre last year contained
strong warnings about peer-based support services in schools, with
“concerning data” suggesting they could do more harm than good. It
studied Yellow Ribbon, but also other groups dedicated to positive
mental health initiatives for youths such as Project K and Project Hope.
“Evidence suggests there may be mixed effects of the
suicide prevention programmes on some students,” the study said.
“Caution is required in relation to the safety and
efficacy of peer support programmes.
“Emerging evidence suggests that they may increase the
vulnerability of troubled young people.”
The study was also concerned with the “huge
responsibility” and stress facing teenagers who try to help their
Youth suicide researchers stress the age bracket
covers those aged 15 to 24, and it is among the older members of that
group (those aged 20 to 24) that suicide rates are highest. Figures from
Youth Suicide Prevention New Zealand show overall, 75% of suicides occur
over the age of 25. In 2001 people aged 20 to 24 had the highest suicide
rates of any group (25.3 deaths per 100,000 population) followed by
adults aged 25 to 29 (21.7%) and 30 to 34 (21.2%). Beautrais says
although it is imperative to continue investigating school student
deaths, they have received disproportionate media attention and the
problem is perceived as being much worse than it is.
The Auckland University study's authors — Dr Sara
Bennett, associate professor Carolyn Coggan and Dr Marilyn Brewin —
recommended clear guidelines for school-based programmes. They said such
programmes should not raise awareness of suicide, not encourage young
people to take a high degree of responsibility for their peers, and
should have strong relationships with trained counselling services and
mental health professionals.
Yellow Ribbon chief executive Keith Pittman
acknowledges the study's findings, but stresses his organisation is
working closer than ever with relevant government departments.
“We've reacted to what the research says and there
were concerns from the government that we've addressed” he says.
“We're very keen to all work together, it's not about
patch protection, it's about making a difference.”
Although Fight for Life celebrity boxing contests have
boosted Yellow Ribbon's profile and funds, other fundraising avenues are
“We've followed the government advice and removed the
direct references to suicide and this year we're looking at
consolidating the good work we've done, and moving forward,” Pittman
The organisation's financial set-up has been checked
and approved by auditors and two health professionals have given a best
practice tick to the schools-based programme. Youth Development Ministry
national suicide prevention co-ordinator Sue van Daatselaar van
Daatselaar confirms the ministry is working closely with Yellow Ribbon
to ensure the programme supports schools to refer young people and their
families to the right kind of professional help when problems are
evident. More work is also being done to target school leavers who are
harder to track when they enter tertiary institutions and workplaces.
“There is a line trending downwards when you look at
the rate of youth suicides. It's a good sign we're on the right track
but the work doesn't stop now.”
But opinion is sharply divided over the merits of
using teens to help teens.
Hamilton-based clinical psychologist Narelle Dawson is
a passionate supporter: “One of the reasons I think Yellow Ribbon is
doing a wonderful job is that they have the best message ('It's OK to
ask for help') that I've ever heard go out to anyone”" she says.
“Young people when they have a problem invariably go
to peers rather than the school counsellor or to adults. Anyone who's
got children knows that when they become teenagers they talk to each
Dawson is completing her government-funded PhD thesis
on a project which includes “psychological autopsies” on six youth
suicide cases, contrasting social factors with youths who did not commit
Most research is geared towards why young people
consider suicide, therefore Dawson feels it is important to study why
others did not. She has little time for criticism that organisations
like Yellow Ribbon risk normalising suicide with a reliance on role
models and fundraisers such as Fight for Life.
“When we look at inappropriate sensationalism we need
to look at what's done at some of the funerals. I went to one for a
girl's suicide where the whole school attended and the priest told them
she was now in Oparadise' and watching down from above.
“I was absolutely appalled.”
5 July 2004