Journal of Youth Studies

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Young people's explanations for youth suicide in

New Zealand: a thematic analysis

Jessica Stubbing & Kerry Gibson

To cite this article: Jessica Stubbing & Kerry Gibson (2019) Young people's explanations for
youth suicide in New Zealand: a thematic analysis, Journal of Youth Studies, 22:4, 520-532, DOI:
10.1080/13676261.2018.1516862

To link to this article: https://doi.org/10.1080/13676261.2018.1516862

Published online: 03 Sep 2018.

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JOURNAL OF YOUTH STUDIES
2019, VOL. 22, NO. 4, 520–532
https://doi.org/10.1080/13676261.2018.1516862

Young people’s explanations for youth suicide in

New Zealand: a thematic analysis
Jessica Stubbing and Kerry Gibson
School of Psychology, University of Auckland, Auckland, New Zealand

ABSTRACT ARTICLE HISTORY

New Zealand has one of the highest youth suicide rates in the Received 4 March 2018
developed world and dominant approaches to prevention do not Accepted 15 August 2018
always take into account the views of young people. The purpose
KEYWORDS
of this research was to update our understanding of young Suicide; adolescents; youth;
people’s explanations of suicide in order to inform suicide mental health
prevention efforts. Focus groups were conducted with 38 young
people, including 30 young women and 8 young men aged 15–
22. The data was analysed thematically to identify the range of
explanations young people ascribe to youth suicide. Five themes
were identified by the analysis including that suicide could be
explained by inescapable difficulties, constant pressure, emotional
distress and could also be seen as a cry for help. In contrast to
these normalised experiences, participants also expressed the
view that mental illness might also account for suicide. The
findings suggest that young people recognise suicide as a
complex problem with multiple causes. While they recognised
mental health problems as contributing, youth suicide was
primarily understood by young people as a normal response to
emotional distress and pressure. Prevention programmes should
address the full range of explanations that young people give for
suicide in order to promote their engagement in prevention
programmes.

Introduction
It is widely accepted that to address the problem of youth suicide, we must understand
what causes it (Gould et al. 2003; World Health Organisation 2014). While there is a vast
body of literature purporting to explain suicide and identify associated risk factors, a
better understanding of young people’s own explanations of this phenomenon is vital
to facilitating their increased engagement with prevention strategies (White and Kral
2014).
Explanations for suicide are often presented as the product of increasing scientific
knowledge, but as Marsh (2010) argues, these reflect the assumptions of their time and
place. Marsh traces historical transformations in the way suicide has been explained,
from its depiction as a sin, then a crime and, in recent times, as a mental health
problem. The latter has become the norm, underlying policy and practice in most

CONTACT Kerry Gibson [email protected]

© 2018 Informa UK Limited, trading as Taylor & Francis Group
 JOURNAL OF YOUTH STUDIES 521

Western, industrialised countries (Hawton, Saunders, and O’Connor 2012). From this per-
spective, suicide is explained as a product of mental illness and strategies to address it
commonly focus on the identification of a psychiatric disorder with the aim of enabling
timely professional intervention (Morris 2016). Some critics have, however, noted the
shortcomings of this approach to understanding youth suicide. Previous research indicates
that 40% of suicide completers under 16 years old do not have a diagnosable psychiatric
disorder (Brent et al. 1999) and that only around 40% of all youth suicides may have a diag-
nosable depressive disorder (Fleischmann et al. 2005). While other more recent research
continues to assert an established relationship between youth suicide and mental
health problems (McLoughlin, Gould, and Malone 2015), this is contested on the basis
of evidence and research methodology (Hjelmeland and Knizek 2017). Regardless of the
position taken on the role of mental health problems in suicide, there are important ques-
tions about whether this model of suicide is a good fit with young people’s own under-
standing of suicide and whether it increases rather than reduces the stigma of seeking
help for suicidality (McDermott and Roen 2016).
While the mental health approach to suicide risk currently dominates the scientific and
policy literature, there are range of other theoretical approaches which offer somewhat
different explanations for suicide. Psychological models, for example, explain suicide as
a response to personal vulnerabilities and an inability to cope with stress (Gould et al.
2003; Collings and Beautrais 2005; Bridge, Goldstein, and Brent 2006). The role of hopeless-
ness in suicide has also been given particular attention (Beck et al. 1990). Psychological
theory has, more recently, come to be dominated by Joiner’s interpersonal theory of
suicide which locates the vulnerability to suicide in two individual factors; perceived bur-
densomeness and thwarted belongingness (Joiner 2005). While this explanation references
the impact of social relationships, the emphasis is on the individual’s own experience of
these and the way in which this personal vulnerability increases the risk of suicide.
Other explanations of suicide shift responsibility for suicide away from the individual to
the broader social context. Social theories of suicide which recognise this as a product of
more widespread problems in society have a long history in suicide studies as exemplified
in Durkheim’s work (1997/1897). This approach has, however, fallen out of favour in con-
temporary views which favour medical and psychological representations of suicide. Nar-
rower social conceptualisations of risk such as suicide contagion have received some
attention in recent decades, particularly in accounting for youth suicide, a group who
are thought to be particularly susceptible to social influence (Collings and Beautrais
2005). Other socio-cultural factors identified in research have included family risk
factors, peer risk factors, and relational risk factors, as well as social and economic disad-
vantage (Cash and Bridge 2009; Hawton, Saunders, and O’Connor 2012). Specific life
events such as academic pressures, relationship losses, and illness have also been impli-
cated in youth suicide (Wilburn and Smith 2005). In recent years, there been increasing
awareness of bullying as a cause of youth suicide (Kim and Leventhal 2008) as well as dis-
crimination associated with gender or sexual diversity (McDermott and Roen 2016).
Social constructionist approaches to suicide highlight the importance of understanding
the specific way in which suicide is given meaning within any cultural context in order to
understand how to prevent it (White et al. 2016). In the case of youth suicide, it is particu-
larly important to understand how suicide is constructed in youth culture. Schwartz et al.
(2010) suggest that the explanations that young people give for suicide might be different
522 J. STUBBING AND K. GIBSON

to those considered important by professionals and researchers. There is a limited, but

growing, body of research which explores the explanations young people ascribe to
suicide (Lake et al. 2013). This research suggests young people face a tension between
two sets of explanations; one in which mental illness is seen to explain suicide (Roen,
Scourfield, and McDermott 2008; Lachal et al. 2015) and another in which difficult life
events are seen as being more important in accounting for suicide (Eskin 1995; Lake
et al. 2013). The former positions suicide as necessarily pathological and the latter as a nor-
malised response to difficult circumstances.

The New Zealand context

New Zealand has reason to be concerned with the issue of youth suicide. This country’s
youth suicide rates are the highest in the OECD and have recently been deemed a
‘suicide crisis’ by the Prime Minister’s Chief Science Advisor (Gluckman 2017). As in
other countries, New Zealand’s youth suicide rates are particularly high for young, indigen-
ous Māori and Pacific Island people (Ministry of Health 2016). The response to this, in the
last several decades, has been an increasing commitment to a mental health approach to
understanding and dealing with suicide and concerns to prevent the ‘normalisation’ of
suicide as a way of coping with adverse circumstances (Beautrais and Fergusson 2012).
This approach is recognised in a range of policies and practices affecting young people
in New Zealand (Ministry of Education 2013; Ministry of Health 2013).
There is limited research which investigates youth explanations for suicide in the New
Zealand context. The small number of studies available suggest a tension similar to that in
the international literature between explanations which emphasise mental illness as the
cause of suicide (Bennett, Coggan, and Adams 2003) and an emphasis on difficult life
events (Heled and Read 2005). A survey conducted by Heled and Read in 2005 found
that that young people saw cultural pressure to not talk about distress, and the resulting
failure to teach young people how to deal with stress, as contributing to youth suicide.
They also identified pressure to conform to expectations, worries about money and
work, abuse or neglect, and boredom as reasons for suicidal behaviour. The researchers
in this study noted that young people did not identify mental health problems or social
contagion as a cause of suicide despite these being common theories at the time. Since
this time, there has, if anything, been increasing emphasis on mental health as a
primary explanation for youth suicide in New Zealand but it is not clear whether this dis-
course has been adopted by youth themselves (Pridmore 2015). It would be helpful to
understand to what extent young people in New Zealand have adopted some of the domi-
nant professional explanations for youth suicide or whether they invoke a different set of
explanations.
In addition, while this existing body of research identifies some factors young people
see as important in accounting for suicide, the findings of these studies may not have
kept pace with the substantial changes to youth culture in recent decades. Youth research-
ers have noted the increasing responsibility young people feel in neo-liberal societies
associated with pressure to succeed in the face of a less certain social and financial
future (Furlong and Cartmel 2007; Wyn and Andres 2011). Recent transformations in
youth culture also include the widespread use of digital communication which exposes
young people to a greater range of perspectives on suicide (McDermott and Roen
 JOURNAL OF YOUTH STUDIES 523

2016). This medium has given young people increased opportunity to share and discuss
sensitive issues like suicide in their own social networks (Gibson et al. 2017). These cultural
changes raise questions about the extent to which established medical, psychological and
social explanations are adopted, transformed, or challenged in the reasons young people
currently ascribe to suicide.
This article explores the reasons young people give for suicide in the context of contem-
porary New Zealand. The research is positioned within a social constructionist epistem-
ology, recognising the significant role played by youth culture in constructing the
meaning of suicide and, potentially, opening up avenues for its prevention (Roen, Scourfi-
eld, and McDermott 2008; White and Kral 2014). In our approach to this issue, we are also
influenced by a growing movement which accepts the legitimacy of young people’s views
on important issues affecting their lives and aims to empower them to be actively involved
in addressing these (Coughlan et al. 2013).

Methodology
Recruitment
Recruitment was conducted through a small number of schools and youth organisations. It
was aimed at young people who were not suicidal themselves, but interested in providing
a perspective on youth culture and suicide. Each young person who expressed interest in
participating was assessed for suicide risk by a mental health professional and allowed to
participate if there were no concerns about their current mental health or suicidality.

Participants
Nine focus groups were conducted with a total of 38 young people. 30 participants were
young women and eight were young men. Participants were between the ages of 15 and
22 with most aged 16 to 18. Thirteen participants identified as New Zealand European, six
as Māori, eight as Pacific Islander, and 11 were migrants from various parts of Asia, Britain,
and South Africa. The ethnic diversity of the group reflected the diversity of the Auckland
Urban Area from which participants were recruited, with Māori and Pacific Island partici-
pants slightly over-represented (Statistics New Zealand 2013). This was beneficial given
the higher suicide rates in youth of these ethnicities (Ministry of Health 2016).

Data gathering
Qualitative research was used to capture a rich understanding of suicide in cultural
context. A focus group method was specifically chosen to reduce the power imbalance
between the researcher and the young participant (Punch 2002) and because this form
of data gathering enables socially shared knowledge consistent with the aims of this
research (Willig 2008). Focus groups lasted 90 minutes and were facilitated by a mental
health professional. One group consisting of Māori youth was facilitated by a Māori clin-
ician in order to provide cultural safety. The size of the focus group varied from three par-
ticipants to nine, in one case. Facilitators used an open-ended interview protocol to guide
discussion in three broad areas – participants’ awareness of youth suicide in society , how
524 J. STUBBING AND K. GIBSON

young people talk about suicide among themselves and online, and how society could
address youth suicide.
This article is specifically focused on what participants felt could cause youth suicide.
This included answers to specific questions, such as ‘What do you think makes young
people commit suicide?’ and ‘Why do you think the youth suicide rate in New Zealand
is so high?’ Facilitators also used prompts for discussion including extracts from social
media in order to encourage reflection on the role this played in facilitating youth under-
standing of this issue.

Data analysis
The thematic analysis took a theoretical, deductive approach which sought to identify
themes in the data related to our specific research question (Braun and Clarke 2006).
The data was analysed using Braun and Clarke’s (2006) framework for thematic analysis,
which involves identifying themes that reflect important trends in the data relevant to
the research question.
Prior to analysis, all identifying information was removed from the transcripts. The
analysis began with immersion in the data and the full transcripts of the focus groups
were read several times. All statements that related to causes of or explanations for
suicide were then extracted. These statements were coded and then tentatively
grouped into overarching categories that related to similar subjects. These were then
refined and shaped into themes. These themes were reviewed by both researchers until
it was felt they accurately reflected the data.
To ensure trustworthiness of the analysis, the themes were discussed, reviewed, and
refined by both researchers at each stage of the analysis to ensure consensus and increase
fidelity (Hill 2015). Examples that illustrated the beliefs of participants within each theme
were extracted from the transcripts. Any remaining identifying information included in the
examples was removed. Descriptors such as ‘many’ and ‘a few’ were used to indicate how
frequently themes or specific ideas within a theme were addressed by participants but are
not intended to imply the possibility for statistical generalisation.
Reflexivity is regarded as an important criteria for establishing the quality of qualitative
research (Morrow 2005). The first author is of mixed Māori and European heritage. She is a
student on a doctoral clinical psychology programme and a young person who fits in the
age range of our participants. The second author, a South African migrant to New Zealand,
is a researcher and psychologist with experience of working clinically with young people.
Given our professional positioning, it was important to resist and challenge tendencies to
confine the accounts of participants into dominant scientific explanations of suicide and to
pay attention to the different ways that young people were understanding suicide.

Ethical consideration
Ethics approval was granted by the University of Auckland Ethics Committee. The
researchers recognised the sensitivity of the research and care was taken to establish
the safety of participants. All potential participants participated in an individual interview
with a mental health professional designed to assess any risks involved in their partici-
pation. Focus groups were facilitated by trained mental health professionals, who
 JOURNAL OF YOUTH STUDIES 525

monitored the conversation for signs of distress and could refer any participant who
needed psychological support as needed.

Findings
Five themes were identified through the thematic analysis. While these themes are con-
sidered separately for the purpose of this analysis they were not mutually exclusive and
many participants emphasised the multiplicity of explanations that might account for
suicide, including some that appeared to be in contradiction with one another.

Inescapable difficulties: ‘You get stuck with that’

The most pervasive view expressed through the focus groups was that young people
suicide because of negative experiences in their life, emphasising their helplessness in
the face of these. As one participant put it: ‘I think the reason why people commit
suicide is due to experiences that were obviously caused by others.’
The most common experience that young people felt could contribute to suicide was
relationship problems including with family, such as parental separation or death, and
with intimate relationships, such as break ups. Focus groups discussions also identified
experiences of abuse, including sexual, physical, verbal and domestic, and bullying, par-
ticularly cyberbullying or bullying because of sexual identity as contributing to youth
suicide.
Focus group discussion indicated that the most challenging aspect of these experi-
ences was a young person’s powerlessness to escape these difficult circumstances. This
was exemplified by the following extract:
I know especially if you have difficulties at home, obviously you get stuck with that because
you can’t exactly leave home when you want.

Focus group discussion emphasised external events and particularly other people’s behav-
iour as a source of suicidality, depicting young people as trapped by circumstances seldom
of their making.

Constant pressure ‘Lots of things we do these days are to keep others happy’
Many participants spoke about continuous pressure on young people and how this could
lead to suicide. These comments often emphasised the difficulty of trying to meet other
people’s expectations, as described by the following participant:
I guess that people are constantly trying to kind of meet that expectation … like school and
then you have work and so much workload over you, and family, everything, one after the
other.

Several participants spoke about pressure from families. Māori and Pacific Islander partici-
pants particularly felt that pressure from family could cause suicide, as expressed by the
following participant:
For, like Island families, for my own experiences, like doing the career that your parents want
but you don’t want and it just gets too much for that person, it just, they can’t deal and it’s
quite hard.
526 J. STUBBING AND K. GIBSON

Participants also spoke about school as an on-going source of pressure on young people,
as the following participant describes: ‘There’s all this pressure to just keep doing really,
really well and this whole idea of failure is just really hard for them to take’.
Some participants spoke about specific cultural sources of pressure, including pressure
to present a happy persona, and pressure on young men to fit the stereotypical model of
the ‘Kiwi Bloke’. This is described by the following participant:
I think for guys there’s a lot of pressure that isn’t acknowledged … like to be this tough guy
who plays rugby and who is good looking and isn’t feminine at all. They’ve got to really fit
the stereotype.

In general, the discussions highlighted the way that young people face a continuous set of
social pressures that might contribute to suicidality.

Emotional distress: ‘The pain inside’

Many participants emphasised the desire to escape distressing emotions as driving young
people to suicide. In this they depicted suicide as an understandable way of managing
unbearable pain as the following extract suggests: ‘It feels better than what they feel
inside. So, they would rather do that than feel the pain that they feel inside.’
Participants spoke about a combination of emotions that could cumulatively lead to
suicide, the most common of which was loneliness as expressed by the following partici-
pant: ‘ … Like an inherent belief in them, ingrained into their minds, that no one cares
about them, or that everyone hates them, and that no one likes them.’
Other emotional states that participants linked to suicide were hopelessness and help-
lessness as one participant described: ‘I think people commit suicide because they are so
overwhelmed with hopelessness … they cannot see beyond that hopelessness.’
Other participants spoke about feelings of deep, overwhelming sadness: ‘Sometimes
people just become impossibly sad and they can’t overcome that.’ These participants dis-
tinguished this state of sadness from depression. As this participant explains, this distress
was seen as a normal response rather than as a sign of pathology:
I feel like there is a distinction between like a mental illness … and like mental instability. So, I
am not sure if everything stems from depression as a mental illness or severe anxiety but I also
think that just instability in general, so self-worth and stuff like that, is just a big a cause of it.

Discussion conveyed the intensity of painful emotions that might drive young people to
suicide, presenting suicide as an understandable way of dealing with this.

Mental illness: ‘I mean, depression and suicide are intrinsically linked’

In spite of emphasising difficult experiences and their associated emotions as reasons for
suicide, participants also mentioned the relationship between mental illness and suicide in
a way consistent with the dominant psychiatric discourse. Many participants voiced the
view that depression was the major cause of suicide, as demonstrated by the following
participant: ‘The only real reason I know is depression. I don’t really know anything else.’
To support this argument some participants relied on biological theories of depression,
suggesting that they implied a biological basis for suicide:
 JOURNAL OF YOUTH STUDIES 527

The brain is low on serotonin and dopamine or like other chemicals that make a person happy
… a person who is suicidal is like dangerously lacking in those chemicals. So, I think that it is
scientific.

However, this topic also seemed to engender debate in the focus groups about the extent
to which mental illness was sufficient to account for suicide. As one participant put it:
‘Depression and suicidality, it’s not just those things. It’s so variable and so different for
each person who experiences it.’ The role of mental illness in suicide also seemed to
raise discussion in the focus groups about whether the depiction of suicide as a necessarily
irrational action or whether it could be seen a reasonable choice as the following extract
suggests: ‘They see it as a rational way to get out of something worse than dying.’ Partici-
pants also often referred to the stigma associated with having a mental health problems,
suggesting that this representation could deter young people from seeking help. On the
whole, discussions about the contribution of mental health problems to youth suicide
appeared to invite polarisation and controversy in the focus groups.

A cry for help: ‘People obviously reach out in very different ways’
Many participants referenced the belief that young people attempt suicide to attract
attention, as described by the following participant: ‘Other people would just notice
them, and they feel good because of other people noticing … they feel like some
people are actually caring about them.’
While there was some debate about the ‘genuineness’ of these expressions of suicidal-
ity, most participants expressed the view that this was this was a way to communicate real
distress. This view is described by the following participant: ‘That person may need atten-
tion, like they may need someone to speak to. Like that could actually be like a cry for help
rather than a cry for attention.’
Participants often felt those who posted about suicidal behaviour and thoughts on
social media platforms were calling for help because of their difficulty in finding help in
other places:
They are trying to send a message out because they can’t talk to anyone … it’s easier for them
to send it out in the media, like social media, because I know personally people that do it every
day but it’s hard for them to talk about it.

Participants contextualised these difficulties in reaching out for help in New Zealand
society, noting that there was a general reluctance to talk about this issue outside of
the formal mental health system.

Discussion
Our analysis identified five diverse themes that captured the explanations young people in
this study offered to account for youth suicide including ‘inescapable difficulties’, ‘constant
pressure’, ‘emotional distress’, ‘mental illness’ and ‘a cry for help’. While these themes were
separated for the purpose of analysis, participants felt the causes of youth suicide were
multifaceted, and usually spoke to several of the themes rather than ascribing to one.
The findings of this study suggest that young people were more comfortable with an
explanation of suicide as an understandable response to emotional or life difficulties. The
emphasis that young people in our study placed on difficult circumstances corresponds to
528 J. STUBBING AND K. GIBSON

the findings of other research which suggest that young people frame suicide as an under-
standable response to, and way of escaping from, life’s difficulties (Fullagar 2003; Roen,
Scourfield, and McDermott 2008; Lachal et al. 2015). The experiences young people
linked to suicide match many of those identified in past research – including family
factors, bullying and the stigma associated with minority sexual orientation (Bridge, Gold-
stein, and Brent 2006; Cash and Bridge 2009; Epstein and Spirito 2009; Hawton, Saunders,
and O’Connor 2012). Crucially, they also emphasised the relative powerlessness that
young people face in escaping these circumstances. Interestingly there was little reference
to poverty as a contributor to suicide which is well recognised in the literature (Page et al.
2014). This may be function of this particular sample or young people’s general lack of
awareness of the significance of this issue.
The existing literature has tended to focus on the significance of negative life events on
suicide but has paid less attention to the everyday pressures faced by young people.
However, this theme emerged strongly through our results. Participants felt there was con-
siderable pressure on young people to live up to the expectations of their schools and
family. This is consistent with research which highlights the less overt and more insidious
pressure to succeed that young people face in neo-liberal societies (Furlong and Cartmel
2007; Wyn and Andres 2011).While this literature is limited at present, our results suggest
these pressures may be a significant stressor or explanation for suicide for contemporary
young people in New Zealand. Participants also suggested that this may be particularly
relevant to Māori and Pacific Islander young people, which is notable given the heigh-
tened suicide risk facing these groups, and further research is needed to explore this.
The theme of emotional distress has some features in common with psychological
explanations of suicide insofar as it references important issues like loneliness and feelings
of helplessness and hopelessness (Beck et al. 1990; Van Orden et al. 2010). However, in our
study, young people normalised these negative emotions, rather than viewing these as a
sign of pathology (Lachal et al. 2015). In contrast to most academic literature, the young
people’s accounts also highlighted the experienced pain associated with these feeling
states and the difficulty of tolerating this level of distress.
It is unsurprising that participants referenced mental illness as an explanation for
suicide given the current dominance of this view (White et al. 2016). What was notable
about these accounts, however, was the narrow conception young people seemed to
hold of the relationship between mental illness and suicide. In contrast to the literature,
which suggests the greater likelihood of suicide being associated with impulsive disorders
(Van Orden et al. 2010), depression was the only mental health problem explicitly ident-
ified as accounting for suicide and this explanation relied on a somewhat simplistic and
mechanistic view of this relationship. This suggests that while young people reproduce
this explanation as a scientific ‘fact’, they may lack a nuanced and meaningful understand-
ing of the relationship between suicide and depression. This explanation also seemed to
engender considerable debate and young people conveyed their awareness of a tension
between the mental health explanation and other, more normalised, explanations of
suicide.
The significance of suicidality as an appeal for help has been recognised in previous
research (Jacobson et al. 2013), but is not usually given priority in scientific explanations
of suicide. Participants in our study seemed to view expressions of suicidality as a legiti-
mate way of communicating distress to others in spite of difficulties in distinguishing
 JOURNAL OF YOUTH STUDIES 529

between genuine distress and ‘attention seeking’. This explanation for suicide appears to
have been lent momentum by the ease of communicating through social media. Research
has found young people may find sharing distress online easier than sharing face to face
(Moreno et al. 2012) and this may be particularly significant in New Zealand where open
conversation about suicide is actively discouraged (Gibson et al. 2017). While suicidal
behaviour as an appeal for help may be seen as a valid approach by many young
people, there is a tension between this and the perspective of most adults. Some research
has suggested that being able express suicidal feelings online can be very important for
young people, who may otherwise struggle to articulate their feelings (McDermott
2015). The impact of social media on young people’s ability to communicate and
respond to distress is an area which requires further investigation.
This analysis suggests that young people engage with a wide variety of explanations for
young suicide rather than adopting only one approach or another. It also highlights areas
of overlap as well as difference in the way that young people represent the reasons for
youth suicide in New Zealand in comparison with the established scientific and pro-
fessional explanations. While mental health explanations of suicide have established
some traction with young people, most themes implied that suicide was a normal
response to difficulties and an attempt to deal the painful feelings associated with these.

Limitations
Our study investigated the perspectives of young people in New Zealand. The gender imbal-
ance in the sample could have impacted the relevance of these findings, especially as
suicide rates in young men are twice as high as young women in New Zealand (Ministry
of Health 2016). However more young women than men may express suicide ideation there-
fore making their opinions on the topic equally important (Fleming et al. 2014). The poor
representation of young men in this sample may be telling in itself, reflective of the con-
straints of masculinity on men’s willingness to talk about suicide (Cleary 2012). In addition,
the young people included in our study were all from urban Auckland. This may limit the
extent to which our findings can be extrapolated to rural settings. Additionally, our partici-
pants were all interested in the issue of suicide and showed a strong social commitment to
helping others, therefore their perspectives may differ from other young people. Their
opinions may also differ from those who do suicide, as all our participants were deemed
to not be at current risk of suicide based on psychological assessment.
There were slight differences in the discussion in each of the focus groups. The Māori-
led focus group did seem to enable greater discussion of the cultural pressures, as well as
the resources, for Māori youth suggesting this as an area for further exploration. Beyond
this there were no noticeable pattern differences that could be attributed to the differing
venues and sites of recruitment. It must acknowledged, however, that focus groups are
particularly susceptible to the influence of dominant speakers or powerful ideas and it
is likely that different groups in other settings might produce other findings.

Implications for youth suicide prevention

There are significant challenges in engaging young people in suicide prevention efforts. As
suicide is constructed differently in different cultural contexts, it is important that
530 J. STUBBING AND K. GIBSON

interventions are developed which match the understanding and needs of the group
being targeted (White et al. 2016). This research suggests that an approach which recog-
nises suicide as a complex issue with multiple explanations may be a better fit for young
people than the current emphasis on mental illness as the single most salient issue
(McDermott and Roen 2016).
There have been fears in New Zealand about the potential to normalise suicidality out
of fear that this would legitimise suicide and increase the already high suicide rates.
However, it is important to develop strategies that speak to the ways that young
people themselves understand suicide. This can provide a valuable starting point for
suicide prevention strategies that are a better fit for this hard-to-engage population (Rick-
wood, Deane, and Wilson 2007). This research suggests that suicide prevention campaigns
might, for example, explicitly target the distressing feelings that young people face such as
loneliness or despair. They might engage young people by acknowledging the ubiquitous
nature of the pressures they deal with and facilitate their ability to extract themselves from
difficult situations in which they experience little power. They might also recognise the
expression of suicidality as a form of help-seeking and educate people to respond to
this accordingly. In this way, young people are less likely to see their suicidal feelings as
a source of shame and more likely to seek help. Suicide education programmes should
also be supplemented by professional support for young people that does not pathologise
and stigmatise suicidality but instead facilitates young people’s engagement with support.
This research also challenges the positioning of young people as passive recipients of care
and control, highlighting the potential of this group to be active participants in suicide
prevention efforts.

Disclosure statement
No potential conflict of interest was reported by the authors.

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