Suicide is the leading cause of death in New Zealanders aged 15–19 years. Advocates are calling for better approaches to prevention and support. Sophie Cousins, Clive Aspin, and Suzy Taylor report.
Nicky Stevens was just 21 years of age when he died by suicide as a mental health inpatient at a hospital in the North Island of Aotearoa New Zealand. He was an artist and philosopher, funny, and much loved by an eclectic range of friends.
He had been in and out of the mental health system since he was aged 15 years, after several suicide attempts. But what the family wanted and needed to support their son was never provided, his mother, Jane Stevens, said. “He never had a doctor there that was from his Māori culture. Essentially it became clear to me that they were medication managers, rather than people to work with him to explore what he needed to heal and be well”, she told The Lancet.
“It’s a system that also immediately alienated whānau [extended family]; it’s set up so we have no power, no say. There’s a level of tolerance that sees suicide as inevitable, but it’s not. There’s a wealth of knowledge in this country, yet it continues to be ignored.”
Stevens believes that if her son had been provided culturally safe and appropriate Māori-focused care, the outcome could have been different. Following an inquest into Nicky’s death in 2015, in 2018 the coroner ruled that his death was “avoidable” and that his care was “well short” of expectations. The hospital did not respond to requests for comment.
The Lancet spoke with another Māori mother who also lost a child to suicide. She couldn’t share her story publicly for legal reasons but expressed similar feelings. “Sadly, it’s not just us. It’s easy to say it’s a one-off, but it’s not. For all of us who’ve lost whānau members, our catch phrase is that we don’t want it to happen to others, but it keeps happening”, Stevens said. Every year, approximately 600 people die by suicide in Aotearoa New Zealand, and it is the leading cause of death for people aged 15–19 years. Indigenous Māori are disproportionately impacted. Māori are roughly twice as likely to die from suicide compared with non-Māori, with it signfiicantly impacting more men than women.
The situation among Māori—who, before colonialisation, rarely took their own lives—mirrors other countries with Indigenous populations, such as Australia and Canada. Jemaima Tiatia-Siau, Professor of Māori and Pacific Studies at the University of Auckland and Board member for the Mental Health and Wellbeing Commission, told The Lancet that suicide among the Māori population was driven by a range of complex, intertwining factors. “Suicide is multifaceted and there is no single explanation. The complexities are shaped by structural, historical, socioeconomic, and cultural factors”, she said. “In light of the concerns around our rates, particularly for Māori…the evidence has clearly demonstrated that suicide risk is higher due to colonisation, inequity, inequality, and barriers to culturally appropriate support and care mechanisms, all of which intersect and tend to be intergenerational.”
Land dispossession, suppression of language and Indigenous cultural knowledge systems, disruption of whānau (family) structures, and historical trauma passed down through generations, she added, had contributed to suicides. Experts stressed the need to examine the factors—and statistics—that can contribute to a person taking their own life. For example, 46% of rangatahi (Māori young people) who died by suicide between 2002 and 2016 had received a Child, Youth and Family notification at some point in their lives, compared with 23% of non-Māori, non-Pacific children and young people who died by suicide. In addition, 43% of rangatahi had been temporarily removed from school, compared with 22% of non-Māori, non-Pacific children and young people. Māori are also severely over-represented at every stage of the criminal justice system: despite constituting less than 18% of the population, 50% of male prisoners and 63% of female prisoners are adult Māori.
“The devastating impact of colonialisation continues. It didn’t just go away. It’s felt in so many different areas of young people’s lives—in the way in which they have access to basic fundamentals such as housing, food, and education”, said Professor Terryann Clark, Cure Kids Chair of Child and Youth Mental Health based in the School of Nursing at the University of Auckland.
“Māori are more likely to be removed from their families and removed from their culture and language, which then gives them the message that they are not worthy. Responding to suicide is complicated because it’s layered and defined by policies that categorise it as a mental health problem. But it’s a societal problem. It’s not just about making sure they have a counsellor available.”
Experts who spoke with The Lancet all agreed there was a need for a fundamental shift in how suicide is viewed and responded to—from a narrowly focused illness to a community and societal problem, which they believe is particularly crucial for Indigenous populations.
Responding in such a way would also relieve pressure on the mental health workforce, which cannot keep up with demand. Mental health services in Aotearoa New Zealand are experiencing a rolling crisis, with high demand causing long waiting lists, especially for youth and specialist care. A recent report from the Mental Health and Wellbeing Commission found that between 2023–24 and 2024–25, fewer rangatahi and young people accessed specialist services. In addition, it found that children, young people, tamariki (Māori children), and rangatahi aged 0–18 years had the longest waits for a first specialist appointment and the longest wait times to treatment, with 40% waiting longer than 8 weeks for a third appointment.
Gabrielle Jenkin, a Research Associate Professor in the Suicide and Mental Health Research Group at the University of Otago, Wellington, said that determinants of suicide must be addressed if deaths were to substantially decrease.
“We need to stop saying suicide is due to mental illness because it puts the focus on the mental health system and a counselling response, rather than addressing the much bigger factors like unemployment, family violence, poverty, and lack of a strong identity”, she said.“We need to be asking questions such as: has this person been exposed to family violence, and what are we doing about it? Are they well supported in gaining employment? Can young Māori speak te reo Māori? How are we strengthening young Māori’s cultural identity and removing barriers such as racism? This is where the research needs to go.”
Clark stressed the need to integrate mental health in all aspects of policy, including in education, housing, and the economy. “Mental health and suicide are everyone’s business, not just the health sector’s. That’s the direction we want to go”, Clark said. Jenkin said embedding mental health policy within the police and criminal justice system was particularly crucial. The country has a 10-year Suicide Prevention Strategy and Action Plan (2019–29), with one of the central elements being the establishment of a Suicide Prevention Office. Although it has been established, some experts lament it has become just a name on paper. In 2025, the country launched its Suicide Prevention Action Plan 2025–29, which sits alongside the 10-year strategy, recognising that “addressing suicide requires a systems-level, whole-of-government, whole-of-society response that addresses structural determinants”.
The Plan also stressed the need for more kaupapa Māori approaches (by Māori, for Māori) to suicide prevention. As part of this approach, community suicide prevention funds have been established with the aim of empowering providers to create community-led solutions that strengthen resilience, mental health, and cultural identity. Suicide prevention training workshops have also been run.
Clark said this was a step in the right direction and that there was growing recognition that Māori need specific strategies, policies, and interventions.
“Most people recognise that the universal system doesn’t work for everyone. We need culturally specific and safe services and strategies. But it’s more than just Māori delivering services, it’s a philosophy in the way we recognise that people need care, support, and encouragement in different ways”, she said.
“Mainstream services have a very different way of thinking about mental health and suicide. Māori do not see it the same way—we see it as more of a balance between a whole range of factors. Giving someone [a selective serotonin reuptake inhibitor] for depression isn’t really changing anything about the person’s life and situation.” Some point to the Icelandic Prevention Model—an evidence-based, community-driven approach that has substantially reduced adolescent substance use by changing the social environment—that Aotearoa New Zealand could learn and benefit from; for example, through stricter alcohol control measures to reduce harm, and reduced access to methods of suicide.
Source
“We don’t want it to happen to others”: suicide in young Māori – The Lancet https://share.google/OHa2SHizEDG2KLZ5N
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