Little AndrewHon ANDREW LITTLE (Minister of Health): I move That the House take note of the report of Zero Suicide Aotearoa. And I say that it is a distinct privilege as Minister of Health to lead off this I think important and difficult debate on this topic. It's important because the reality is in New Zealand we have a major challenge when it comes to the incidence of suicide. In 2019 680 people died by suicide in New Zealand. I think the statistics show that there is a distinct profile to those who die by suicide in New Zealand. We see more young men more Māori more folks from the rural sector dying by suicide. The rates for 15- to 19-year-olds who have died by suicide has increased considerably in the last three years. It's a difficult debate too because as a country as a people like most countries around the world we are not used to talking about suicide. We're not used to discussing it. In fact over time we've put many restrictions in place that have prevented public discussion and debate about suicide. So the way this House conducts itself the way this House discusses this important and difficult topic will be a lead for the rest of the country. It is also undoubtedly difficult because unquestionably our minds turn to those people we know who have died by suicide and we think of them and we think of the families who have been left bereft by that loss. So let's make this debate in honour of them. Our minds also turn to those who we know who have attempted suicide and this is a moment that we can hold them just a little closer in our hearts. I want to acknowledge the Cross-Party Parliamentary Mental Health and Addiction Wellbeing Group. That was a recommendation from the He Ara Oranga report. I want to thank those members on all sides of the House who have volunteered for the task of participating in that group—and I might add just as I look around the House and I look at the report that includes former members of this House. I acknowledge Jenny Marcroft as well who has contributed to those discussions in that group and to this report. As I say thank you for taking on that task and for creating a forum in which all members of this House regardless of the party can have a discussion about these important issues about the sort of policy that we think Governments of whatever stripe should be employing as we deal with the challenge ahead of us.I want to acknowledge the report that has been produced: Zero Suicide Aotearoa. I want to particularly acknowledge the ambition that is represented in the title of the report: zero suicide. When the Government came to consider the report of He Ara Oranga and particularly their recommendation that said that we should set a target for the reduction in the number of suicides. That was a fiercely debated recommendation and in the end the Government settled on a position of not accepting that recommendation. We didn't accept that it was right to set a target. If as the report argues the proposition is that suicide is preventable—if we accept suicide is preventable—then no suicide is acceptable. That's the premise on which this Government has developed its policy and I believe that is a sentiment that this House also accepts in accordance with the report. As the report also acknowledges suicide is complex. The pathways to suicide are complex and differ between different population groups. Preventing suicide is complex. There are three responses that we typically turn to at least in Government and in Parliament and I'll go quickly through each of those. Obviously we want good mental health services. Questions of access and availability of services and services for the full range of mental unwellness are important—so services to deal with mild conditions anxieties mild depression to the deeply unwell psychiatric and psychotic conditions. We have to have services that that are available to everybody regardless of the level of unwellness.The reality is and this is no reflection on any party in this House at any time in this country's history but I think if we reflect on it we will accept that mental health whether an area of health investment or Government investment generally has been the poor cousin of our general health services for a long long time. I think we are more enlightened now. We are better at talking about mental unwellness. We are better at talking about what it means to have better mental health and better mental wellbeing. But the reality is given what we now know and given what we now observe and what we have experienced along with many families over many generations there is now no excuse to neglect our services and facilities that are there to look after those who are mentally unwell and in mental distress. The measures that this Government has taken in the time it has been in office includes adding leadership in this area. We've established the Mental Health and Wellbeing Commission which provides advocacy but also monitoring and oversight. We've established the Suicide Prevention Office that now has a $40 million budget just for programmes for prevention and postvention and is commissioning those programmes right now. It's also got the job of reviewing the processes for investigating suicide because we know many families are distressed by the way sometimes district health boards handle it by the way the police sometimes handle deaths by suicide and by the way the Coroner's Court handles it. I think we all agree we can do better to assist families who are left bereft. There's also the services and one of the principal investments that this Government has made is in primary healthcare and addiction. Through the access and choice programme we've added 520 fulltime-equivalent roles at the front line to deal with those with mild to moderate mental health conditions. Just in the month of May alone this year more than 20000 sessions were offered to New Zealanders who are in that position. We currently have a population coverage of those services of about 1.4 million and over the next two years we'll add that and increase it to about 3.7 million. We've put more investment in youth services and services for our rainbow community and for children at school and out of school. And of course we are investing and upgrading our acute facilities. We have more to do in providing spaces in the community where there is a greater and better peer support and we're piloting initiatives in that regard.Outside of services there is then suicide prevention strategies and plans. I note two things from the report—observations that the report makes. One is that countries with nationwide and comprehensive suicide prevention strategies demonstrate that they have a much better chance of reducing the incidence of suicide although the report also notes the Scottish experience is that the path to doing that can be somewhat volatile. Then of course the report also notes it is possible for some well-intentioned programmes to actually do harm. So we have to be careful about what we support what we invest in and what we do. The third element that we have to consider is striving for wellbeing. That goes beyond a health framework for mental health and wellbeing. It looks at the social determinants that we know affect mental health and wellbeing—so things like housing things like our health services things like having a job things like people's family circumstances and whether or not there is violence and abuse. We know those things that can precipitate a sense of despair a sense of not having hope: things like isolation deprivation and poverty discrimination social insecurity financial insecurity—all of these things can lead a person to think about their place and their worth. We have the benefit in New Zealand of something very special and it is our national lodestar. It's the Treaty of Waitangi. The ambition and the dream of the Treaty was a country at peace with itself: two peoples coming together respecting each other being able to live their culture their identity their lives. That's what the Treaty represents. Now we've completely failed to live up to that up until more recently and we're now striving to fulfil that dream. But if we see the Treaty as our lodestar on health issues on wellbeing issues and on mental health issues a nation that respects each other a nation that welcomes each other a nation that forges ahead in partnership a nation that cares about its people and cares about each other—that sets us up for a country that is well and truly at peace with itself.