Verrall AyeshaHon Dr AYESHA VERRALL (Associate Minister of Health): Every suicide is one too many and suicide is far too common in our community here in New Zealand. That means that almost every New Zealander has lost someone dear to them to suicide. I certainly have and I'm grateful to parliamentary colleagues who have done the hard work to put together the Zero Suicide Aotearoa report to advance our conversation on this very important topic. I've taken time to read the report ahead of this debate and I want to congratulate the members of the working group who have put it together. It speaks well to all the efforts and the seriousness with which the topic deserves and with which you've engaged on it.I was taken by page 10 and it really presents quite a novel concept around zero suicide that zero suicide should be an organising goal for our response to suicide. It is a quality improvement and safety approach and it means that we will look in a holistic way at what is a very complicated problem. It focuses us on what we can do to prevent suicide. When I came to Parliament I spoke about how preventative health was my passion that motivated me in health and now in my work here. It still is but what a challenging problem to prevent suicide is. There's no screening test no vaccine the medicines are difficult but it is not at all a hopeless situation. What this report shows is the very practical ways in which we can organise ourselves to do much better.Interventions in health need to follow a causal model—we need to know what's wrong in order to fix it. On page 13 the group sets out a causal model. If you look at it you'll see how complicated it is. Risk factors for suicide can be found in health systems where there are barriers to accessing care; in society; in our community if that's affected by trauma discrimination war or conflict; in our relationships; and also at an individual level. Yes mental health problems are listed but also drug and alcohol problems jobs financial losses chronic pain and others. I commend the committee on presenting this issue with the true complexity that it really has. In acknowledging that complexity it means we have to recognise that our interventions will be multifactorial. These too are listed in the report. It includes yes mental health policies but also addressing some of these wider priorities: alcohol how we organise the health system the response of the media to suicides.Now the Government's response on these issues is included in our work under He Ara Oranga and we also have a suicide prevention strategy and implementation plan. It touches on areas of leadership knowledge workforce evaluation and monitoring and work on that is under way. In our Suicide Prevention Office we work on engagement and in particular a great deal of work has been done in order to engage with people with lived experience and Māori. A review of scientific literature in this complex field of suicide prevention is under way and the terms of reference for a review of the process for investigating deaths by suicide is also being undertaken. We should not shy away from the complexity of this issue that is reflected in the report but that also means that we will be active for a long time on multiple fronts in order to make a difference.This work occurs alongside the Government's wider work to transform the mental health system but what I want to touch on is Government's other priorities other work on building an inclusive society. When I think about the friend I have lost to suicide I know there's not any one thing I could pinpoint to answer the question Why?" But I do know that homophobia contributed to the immense pain that he felt. That's why I see this Government's wider actions on building an inclusive society as so important—on conversion therapy on decolonisation on meeting Pacific aspirations in New Zealand and on poverty reduction. I thank the members of the committee for their work on this report."