3. Research Question
“A comparative analysis of social marketing
and community development approaches
for Māori suicide prevention.”
4. Aims and Objectives
• Define the terms: social marketing and community development
with respect to Māori suicide prevention.
• Identify forms of social marketing and community development
currently in practice.
• Identify and analyse suicide trends within indigenous populations,
with particular emphasis on Māori.
• Perform a comparative analysis of social marketing and communitybased intervention through discussion with experts in the field of
mental health with particular emphasis on Māori suicide.
5. Aims and Objectives
• Investigate the cost-effectiveness of social marketing and community
development in Māori suicide prevention and the economic, social,
cultural, and political costs of Māori suicide.
• Discuss the logistics of community development and social
marketing as forms of intervention.
• Produce a set of recommendations for the Mental Health
Foundation based on the findings of the study.
8. • “Application of commercial marketing technologies to the
analysis, planning, execution and evaluation of
programmes designed to influence the voluntary or
involuntary behaviour of target audiences in order to
improve the welfare of individuals and society” – Donovan
and Henley (2003)
• Benefit lies with society rather than the marketer or
contractor.
10. Community Development
• “The concept of community development involves a
group of people with a shared identity interacting in
order to come up with ideas, ways to improve and
also solutions to problems” (Cavaye, 2006).
11. The Kia Piki te Ora o te Taitamariki
Strategy
• Keri Lawson-Te Aho authored and
developed ‘Version One’.
• MoH implemented programme (2000).
• Māori-tailored approach aimed at reducing
taitamariki (youth) suicide.
• Achieved strengthening of whānau, hapū
and iwi by focussing on community
development.
• In 2010 the programme evolved into an all
ages strategy (Kia Piki) - mainstreaming.
13. Māori Suicide Statistics
• 82 Māori suicide deaths in 2008.
• 2008 Māori suicide rate was 13.3/100,000 population, while
non- Māori rate was 10.6/100,000 population.
• 2008 Māori youth (15-24y) suicide rate was 27.6/100,000
compared to non-Māori youth – 16.4/100,000.
• Greatest disparity between Māori and Non-Māori exists in the
younger population (15-24 y).
• Māori suicide rates show no downward trend over time unlike
non-Māori.
14. Māori Suicide Statistics II
• Māori male suicide rates were 2.25 times higher than female
Māori suicide rates in 2008.
• When comparing Māori with non-Māori male suicide rates,
Māori were higher. Similar in Females.
• Globally, suicide rates among indigenous populations is a
noted problem.
• In all these countries indigenous suicide rates are higher than
non-indigenous groups.
15. Age-standardised Suicide Rate,
by Ethnicity and Gender 1996-2008
35.0
Maori Male
30.0
Maori Female
Rate per 100,000 population
25.0
Non-Maori Male
Non-Maori Female
20.0
15.0
10.0
5.0
0.0
1996
1997
1998
1999
2000
2001
2002
Year
2003
2004
2005
2006
2007
2008
16. Youth Suicide Rate, by Ethnicity 1996-2008
45.0
40.0
Maori
Rater per 100,000 population
35.0
Non-Maori
30.0
25.0
20.0
15.0
10.0
5.0
0.0
1996
1997
1998
1999
2000
2001
2002
Year
2003
2004
2005
2006
2007
2008
17. Māori Suicide Risk Factors
• Inequalities
• Historical Trauma
Colonisation
Cultural Identity
Individualistic Society
• Population Age Structure
• Welfare Services
• Unemployment
• Incarceration
• Reduced Contact with Healthcare Services
18. Social Marketing
• Social marketing initiatives in New Zealand:
SunSmart
Land Transport Authority campaign
“It’s About Whānau” anti-smoking
Like Minds Like Mine
• Social marketing targeting suicide:
“Start the Conversation Today” – Māori TV Campaign.
“Reachout” – Internet-based campaign targeting
Australian Youth.
19. Community Development
• In NZ, should work within Māori communities, at the
whānau, hapū and iwi levels.
• Cultural development as a protective factor against
suicide.
• International studies
Increase in awareness (Allen et al 2010
Utilize local knowledge, skills, resources (Smith et al 2003)
Can be self sustaining (Lucke et al 2003)
Difficult to assess results
quantitatively
Funding difficulties
21. Key Informants List
RANGATIRA
• Professor Sir Mason Durie, Pro Vice Chancellor, Massey University
• Dr Huirangi Waikerepuru, Taranaki Kaumatua
THE CLIENT - MENTAL HEALTH FOUNDATION
• Materoa Mar, Chair, Mental Health Foundation
• Judi Clements, CE, Mental Health Foundation
• Witi Ashby, Manager, Māori Resource Development, Suicide
Prevention and Information
MĀORI SUICIDE PREVENTION CLINICIANS
• Eliza Snelgar, Clinician, CASA
22. Key Informants List
MĀORI SUICIDE PREVENTION RESEARCHERS
• Professor Sunny Collings, Dean, University of Otago, Wellington School
of Medicine
• Associate Professor Jo Baxter, Director Ngāi Tahu Māori Health
Research Unit, University of Otago
• Dr Nicole Coupe, Director, Te Ira Tangata, Māori Suicide Prevention
Programme, CEO Hapai te Hauora Tapui Limited
• Keri Lawson-Te Aho, Lecturer, Hauora Māori, University of Otago, Māori
suicide prevention policy writer, PhD candidate
• Keri Newman, Master’s graduate, Victoria University of Wellington
• Paea Paki, Clinician, Multi-level Intervention Suicide Prevention Study
• Dr Denise Steers, Clinician , Multilevel Intervention Suicide Prevention
Study
23. Key Informants List
MĀORI COMMUNITY DEVELOPMENT EXPERTS (WHĀNAU, HAPŪ, IWI
DEVELOPMENT)
• Pahia Turia, Director, Taipak Development Aotearoa
• Emma Kutia, Project Manager, Te Ao Hou, Kia Piki Te Ora, Eastern Bay of
Plenty
• Michael Naera, Project Manager, Kia Piki te Ora, Ngāti Pikiao
• Irene Walker, Te Ao Hou, Kia Piki Te Ora, Eastern Bay of Plenty
INDEPENDENT MĀORI EXPERTS
• Mike King, TV personality and mental health commentator
• Gordon Matenga, Coroner
24. Social Marketing: The Benefits
Increases
population
awareness
Reaches a
large and
widespread
population
Encourages
conversation
and reduces
stigma
Social
Marketing
Provokes
thought and
discussion
Online
support
forums
Education
Promotion
leading to
intervention
25. Social Marketing: The Disadvantages
$$
May burden
downstream
services if illprepared
Contagion risk
Social Marketing
Ineffective if no
access to media
Most effective if
culturallytargeted
Lack of
supporting
evidence as
suicide
intervention
Organisations
involved
inexperienced
with media
26. “(there is) a concern that suicide can be contagious”
- Professor Sir Mason Durie
“Those don’t work for Māori (cigarette packet graphic pictures) but if you put a
picture of mokopuna on them, that would work.”
- Michael Naera
27. Community Development: The
Benefits
Addresses
proximal and
distal
determinants
Self-sustaining
Connection
with family
and
community
Uses the
intrinsic
resources of
the
community
Community
Development
Designed by
the
community for
the
community
Shifts power
to the people
Builds
resilience and
selfdetermination
Specifically
targeted
interventions
28. ‘”Community development is revolutionary; it
is about change, it is about relocating the
locus and power of control into the hands of
those most affected by the issue”
Keri Lawson-Te Aho
29. Community Development: The
Disadvantages
Time
consuming
Requires good
communication
Little evidence
of
effectiveness
$$ & Resource
demanding
Community
Development
Difficult to
monitor
Slow to
change
Geographically
confined
Problematic
for rurally
isolated
families
30. Other Important Themes
Every case
is different
Causes of
suicide
Te Ao
Māori
Other
Themes
Positive
healthcare
interactions
Normalisation
of risky
behaviour
Emotional
suppression
in Māori
men
31. Te Pae Mahutonga
• Health model based on the Southern Cross.
• Four central stars used to represent the four key tasks of
health promotion:
Mauriora – cultural identity
Waiora – physical environment
Taiora – healthy lifestyles
Te Oranga – participation in society
• Two pointers:
Ngā manakura – community leadership
Te Mana Whakahaere – Autonomy
33. Cost-Benefit Analysis
• Potential value:
Concrete quantitative evidence
Informing policy makers
Better design of interventions for the future
• Challenges:
Lack of quantifiable data
Future research needed
34. Economic Costs of Suicide
• Economic Cost:
$448,250 (Des O’Dea 2005)
Māori likely to be more due to younger
age of suicide.
• Life-years Lost:
39.68 DALY for non-Māori vs. 44.02 DALY
for Māori.
35. Political, Social and Cultural Costs
of Suicide
Costs
Political
Low priority issue for political parties.
“Political hot potato”.
Social
Grief for whānau and friends.
Potential conflict among dealing with suicide.
Devalues life.
Cultural
Loss of cultural identity.
Some Māori believe that those who commit
suicide should be condemned.
37. Research Strengths
• Culturally respectful kaupapa.
• Key informants interviewed were selected
across a variety of fields – providing insight
into both sides of the argument;
community development and social
marketing.
38. Research Limitations
• Lack of objective comparison – due to
insufficient objective data.
• Exclusion of logistics modelling.
40. Recommendations I
• Due to deficits identified within the published literature, we
recommend that further research needs to be done into the
effectiveness of social marketing and community development
interventions as Māori suicide prevention strategies.
• Future suicide prevention initiatives need to utilize both social
marketing and community development strategies in order to
have the most successful outcomes in preventing Māori suicide.
41. Recommendations II
• When designing suicide prevention strategies it is important to
design them around a Māori health framework to ensure they
are culturally relevant to Māori people.
• When designing suicide prevention strategies at the
community level, involve community leaders and harness the
strengths already present within the community. This aids to
ensure wide dissemination and utilization of these services by
the members of the community.
42. Acknowledgements
E ngā iwi, e ngā reo, tēnā koutou ngā rau rangatira ma. E ngā tini aitua kua wheturangitia ki te
kupenga wairua, haere, haere, haere atu ra. Nā rātou i whakatakoto tēnei kaupapa, ko te
hauora, hei huarahi mō ngā tamariki mokopuna e whai ake nei.
Tēnei te mihi ki ngā pukenga kua tautoko i tēnei kaupapa. Tēnā koutou mō tō whakapau kaha ki
te hapai i tēnei kaupapa oranga whānau. He taonga katoa te whānau.
He mihi kau atu ki te Mental Health Foundation, Te Tari Hauora Tūmatanui, me Te Rōpū
Rangahau Hauora a Eru Pomare. Tēnā koe Kerry Hurley mō tō tautoko i a mātou.
He mihi hoki ki a mātou kaiako, ko Keri Lawson Te Aho rātou ko Sarah Mckenzie ko Pania Lee, mō
tō mahi tautoko kia oti pai. Ka nui te aroha ki a koutou.
Ko te pae tawhiti, whāia kia tata.
Ko te pae tata, whakamaua kia tina.
43. Hutia Te Rito
Hūtia te rito
Hūtia te rito o te harakeke
Kei hea te kōmako e kō
Kī mai ki ahau, ahau
He aha te mea nui
He aha te mea nui, o te ao
Maku e kī atu
He tangata, he tangata, he tangata
Hi!