Many Voices One Goal - suicidepreventionaust.org · to say that we are enjoying a long period of...

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Y E A R S

Many VoicesOne Goal

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To our SPA Founderspast and present Board Directors and Staff Members

To our MembersOrganisations, Associates and Lived Experience Network Members

who share their expertise and experiences

To our AmbassadorsWho regularly speak up for suicide prevention in their communities

To those in the business communitywho make wellbeing a priority in the workplace and who have kindly made pro bono

services available to us

To our Champions for LifeIn the community who have raised funds and awareness

To our volunteerswho generously donate their time, expertise and energy

SPA gratefully acknowledges all of those who make the work we do possible.

Our thanks to our many donors and supporters including but not limited to those listed below:

Thank you

Thank you to our Donors and Supporters

Become a MemberWhether you are an individual or an organisation, becoming a Member of SPA opensthe door to opportunities to have your say on suicide prevention in Australia.

Visit http://suicidepreventionaust.org/membership/ to join today.

A Lived Experience perspective 4

From Our CEO 6

From Our Chair 7

The Australian context 8

Snapshot of Australia’s performance 10

Lived Experience 11

Strategy, Oversight and Coordination 12

Data 14

Media 16

Means Restriction 18

Timeline 20

Training and Education 22

Access to Service 24

Treatment 26

Crisis Intervention 28

Postvention 30

Awareness and Stigma Reduction 32

A Lived Experience perspective 34

We remember those we have lost to suicide and we acknowledge the

suffering that suicide brings when it touches our lives. We are brought together

by experience and are unified by hope.

Suicide Prevention Australia acknowledges the traditional owners

of Country throughout Australia, and their continuing connections to land, sea and

community. We pay our respects to them and their cultures, and to Elders

past, present and emerging.

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“But he had nothing to be sorry about. People in crisis don’t choose to feel like this.

Yet my feelings of guilt and inadequacy every time crisis struck remained bubbling

just below the surface.”

“And each time I share my story, I forgive myself a little more. We are all connected by invisible threads of suicide and mental illness. I learned this through being part of SPA’s Lived Experience community.”

A Lived Experience perspective“I think I’m suffering with depression and have been possibly for the last four or five months, maybe longer thinking about it, but especially because I can relate to a lot of the symptoms of depression especially including suicidal thoughts. I have a few ideas to what has triggered it all but I’m not 100% sure. I want to go to a doctor or even just tell a teacher at school but I feel if I do so, I’m betraying my mother because she’s my mother and deserves to know. It’s not that my mother wouldn’t be understanding because I know she would but I know how much it will break her if I tell her and I don’t want to do that to her.

I hate myself for it all because so many other teens around my age have it so much worse than me and all I can think about is ending my life. I’m only 16 and I still have a life ahead of me I know, but I just don’t want to live anymore. Though I have so many suicidal thoughts and so often, I don’t think I’ll act on my thoughts or at least for now. I really need ideas of who to tell first, when, how, and if I do decide to tell my mother how do I do so and when. I really appreciate any help because any help is better than no help.“ Kylie (not her real name)

As a mother of a son who has experienced suicidal thoughts and past episodes of self-harm I can relate to this story. I too have seen the pain on my son’s face as he has struggled opening up to me.

Initially these conversations were peppered with “I’m sorry”. But he had nothing to be sorry about. People in crisis don’t choose to feel like this. Yet my feelings of guilt and inadequacy every time crisis struck remained bubbling just below the surface.

In so many areas of life we are not given a second chance, but I feel like our family (and importantly my son) have been given one. I am pleased to say that we are enjoying a long period of wellness. I’m so proud of him. I’m so proud of us. And each time I share my story, I forgive myself a little more. We are all connected by invisible threads of suicide and mental illness. I learned this through being part of SPA’s lived experience community.

“The media has an important role to play in shaping and reinforcing social attitudes towards, and perceptions of, suicide and mental illness. For more than 20 years, the media has been actively working with the Mindframe National Media Initiative to promote reporting and portrayals that reduce potential harm and enhance community understanding about suicide and mental illness. The evidence shows reporting of both issues has increased and improved in quality since the introduction of the Mindframe initiative.” The advocacy and support they provide in addressing suicide prevention has been a big factor in our family’s journey. Jen Coulls

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In 1992, venerable suicide prevention advocate Alan Staines returned from an international conference with an ambitious plan to establish Australia’s first national voice for suicide and suicide prevention. His passion won over clinicians and advocates alike and Suicide Prevention Australia was born.

From the start, Suicide Prevention Australia had some lofty goals. Their purpose was a world without suicide and they aimed to tackle the issue through leadership, collaboration, education and advocacy. Today, Suicide Prevention Australia is a peak body that represents more than 80members and hundreds of associate members nationally, as well as holding productive partnerships with individuals and organisations across the world.

As an organisation, we have directly influenced how suicide is perceived by the community and our relationships with all levels of government have increased investment and driven improved policy. We foster collaboration and shared experience through our National Suicide Prevention Conference and recognise those who have made a difference through our LiFE Awards. The establishment of the first national Lived Experience Network in 2013 led to significant improvements in how those with personal experience of suicide engaged with clinicians, researchers and policy makers.

We believe that the best suicide prevention involves the integration of lived experience, scientific evidence and clinical best practice. To this end, we led a sector-wide process to develop the first national suicide prevention research strategy and have created new partnerships to improve data collection and service evaluation. In 2017, the hard work and national advocacy of our membership paid off with suicide prevention becoming

one of the key pillars of the Fifth National Mental Health and Suicide Prevention Plan. Acknowledging the potential held by our researchers,

the Commonwealth Government and Suicide Prevention Australia has established the first National Suicide Prevention Research Fund. Of course, these achievements have come about from the hard work of many. As the current CEO, I am so very grateful for the vision of my predecessors. I cannot possibly name everyone but I would like to especially acknowledge our Founder Alan Staines and the group of those he called upon to join him in the early days including Professor Brent Walters, Dr John Howard, Dr Michael Dudley, Professor Martin Harris, Professor Ian Webster AO, Professor Bob Goldner, Sheila Clark, Jonine Penrose-Wall, Mercy Baird, Professor Graham Martin AO, Tony Humphrey, Paul Moulds, Wayne Magee – and so many others who have contributed to the leadership of SPA

since day one. We could not have made the impact we have without the passion and dedication of our staff and volunteers, and I would

like to especially thank all the past and present staff for their dedication and commitment to communities across Australia.

Finally, I would like to emphasise that Suicide Prevention Australia would not exist without our Organisation Members and Associate Members.

Their collaborative spirit and collective insight has enabled this tidal wave of change. Twenty-five years down the line and Suicide Prevention Australia still stands for the same principles and purpose. Every suicide is a tragedy and the impact is felt across families, workplaces and whole communities.

Sue Murray Chief Executive

The last twenty-five years have seen great strides made in suicide and suicide prevention.

We’ve shifted away from simply seeing suicide as a medical problem. Our understanding of suicidal behaviours has advanced and significant improvements have been made in how we deliver suicide prevention programs in both clinical and community settings. We have seen Australia take the lead in many areas of suicide prevention, particularly in media and means restriction.

Community awareness has increased dramatically and support for those experiencing crisis has vastly improved. Importantly, we have incorporated the valuable contributions of those with lived experience and realised that suicide prevention is everybody’s business.Unprecedented government and philanthropic investment into suicide prevention has led to the establishment of vital infrastructure and supported world class research.

Of course, there is still so much to be done and I am immensely proud to be part of an organisation that is leading this life-saving work.

Stopping suicide takes a village, and I would like to pay tribute to all those folk - past and present Board members, staff and volunteers - who have worked tirelessly to bring about change. Many of the advances we have seen over the past twenty-five years have been personally driven by these incredibly talented and passionate people.

As we open the next chapter, Suicide Prevention Australia will continue to put the lives of people first. We will use the experiences of our supporters and advocates to inspire and teach us. We will persist in our efforts to ensure the best suicide prevention programs are accessible to any Australian in need. Finally, we will never stop working towards a world without suicide.

Murray Bleach Former Chair and current Board Director

“We will never stop working

towards a worldwithout suicide”

From OurChair

Murray Bleach with co founder of PPP4SPA Ben Higgs

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Sue MurrayCEO

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Suicide is a serious public health issue in Australia and across the world.

Every day, approximately 6 men and 2 women will die by suicide in Australia. Hundreds more will consider taking their life or be hospitalised following an attempt. Suicide is now the most common cause of death for young people and consistently high rates are seen in the elderly. Vulnerable groups such as Indigenous Australians are experiencing suicide at twice the rate of non-indigenous individuals.

Yet we know that suicide is mostly preventable, and action can be taken to save lives. Over the past 25 years, Australia has had considerable increases in government investment into suicide prevention. Recognising that previous approaches have been fragmented and often inconsistent, addressing suicide has become a major priority in the most recent Fifth

National Mental Health and Suicide Prevention Plan and this is further enhanced by similar focus across all States and Territories.

Change is being seen across the sector. Traditionally the domain of clinical and mental health services, suicide prevention programs can now be seen in schools, workplaces and high-risk communities. Research into suicide and its prevention has increased, with both government and philanthropic funds supporting several significant new programs. Importantly, we have also seen the powerful voice of lived experience become integrated into suicide prevention activities.

With better knowledge, increased resources and improved collaboration, we believe that the momentum generated by the sector will translate into a meaningful reduction in our national suicide rate.

DISCUSSION PAPERONE WORLD CONNECTED:AN ASSESSMENT OF AUSTRALIA’S PROGRESS IN SUICIDE PREVENTION

SEPTEMBER 2014

NATIONAL COALITION FOR SUICIDE PREVENTION

RESPONSE TO WORLD HEALTH ORGANISATION WORLD SUICIDE REPORT

‘PREVENTING SUICIDE: A GLOBAL IMPERATIVE’

TheAustraliancontext

In 2016, 2,866 Australians died

by suicide.

2,866

Indigenous Australians

are experiencing suicide at twice the rate of non-

indigenous individuals.

twice

89% of Australians know someone

who has attempted suicide and 85% know someone who has died

by suicide.

89%85%

Incidence of suicide is 30%

higher in regional areas and twice as high in remote

areas

30%twice

While men are more likely to die

by suicide womenare more likely to be hospitalised

following a suicide attempt.

The World Health Organisation (WHO) has called for suicide prevention to be a global imperative.

“Indigenous Australians describe their physical and mental health as having a foundation in ‘social and emotional wellbeing’.

We must broaden our definitions of health to include the physical, mental, and spiritual wellbeing of entire communities, not just the symptomatic treatment of the individual – and provide pathways of care that reflect this.

In the spirit of ‘prevention rather than cure’, building on culture and social and emotional wellbeing would be at the heart of any overall response to our mental health and suicide rates.”

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Professor Tom Calma AOSPA Ambassador

We believe that lived experience is an integral component of suicide prevention research, policy and practice. Australia is one of the first countries to prioritise this valuable contribution.

Suicide Prevention Australia’s Lived Experience Committee was established in 2012. The Committee provided Suicide Prevention Australia with advice and guidance on how to incorporate lived experience into our strategy, policy and activities.

The Committee has been instrumental in the development of the first Australian Lived Experience Network Strategy and, at the 2014 National Suicide Prevention Conference, launched the ‘Guiding principles for the inclusion of lived experience in suicide prevention’. These principles should guide organisations and individuals to more effectively engage those with lived experience of suicide in relevant activities. A range of activities are now underway across the sector to look at what this means in practice, educating organisations in their duty of care in engaging lived experience, building the capacity of those with lived experience to contribute as well as evaluation of meaningful inclusion.

The draft principles are as follows:

People with a lived experience have a valuable, unique and legitimate role in suicide prevention.

Lived experience helps change the culture surrounding suicide and to preserve and promote life through compassion and understanding.

Inclusion and embracing diversity of individuals, communities and cultures enriches suicide prevention.

Empower and support those with lived experience to share their insights and stories with a view to preventing suicide.

Utilise our lived experience to educate, promote resilience, inspire others and instil hope.

People with lived experience support, advocate for and contribute to research, evidence-based practice and evaluation.

All suicide prevention programs, policies, strategies and services will at all levels include genuine meaningful participation from those with lived experience.

Encourage and nurture collaboration and partnerships between organisations and stakeholders.

We are honoured to draw upon the knowledge and wisdom of our national Lived Experience Network and are particularly grateful to lived experience advisors from across the country who work with us to amplify these voices.

Visit www.suicidepreventionaust.org to access the full report

Strategy, oversight and coordination Creation of a national strategy to prevent suicide. Establish institutions or agencies to promote and coordinate research, training and service delivery in respect of suicidal behaviours. Strengthen health and social system responses to suicidal behaviour. The recently released Fifth National Mental Health and Suicide Prevention Plan calls for a national implementation strategy.

Access to service Promote increased access to comprehensive services for those vulnerable to suicidal behaviours. Remove barriers to care.

Means restriction Reduce the availability, accessibility and attractiveness of the means to suicide (e.g. firearms, high places). Reduce toxicity/lethality of available means.

Crisis intervention Ensure that communities have the capacity to respond to crises with appropriate interventions and that individuals in a crisis have access to emergency mental health care, including through telephone helplines or the internet.

Media Promote implementation of media guidelines to support responsible reporting of suicide in print, broadcasting and social media.

Postvention Improve response to and caring for those affected by suicide and suicide attempts. Provide supportive and rehabilitative services to persons affected by suicide attempts.

Training and education Maintain comprehensive training programs for identified gatekeepers (e.g. health workers, educators, police). Improve the competencies of mental health and primary care providers in the recognition and treatment of vulnerable persons.

Awareness and stigma reduction Establish public information campaigns to support the understanding that suicides are preventable. Increase public and professional access to information about all aspects of preventing suicidal behaviour. Promote use of mental health services, and services for the prevention of substance abuse and suicide. Reduce discrimination against people using these services.

Data (Surveillance) Increase quality and timeliness of national data on suicide and suicide attempts. Support the establishment of an integrated data collection system which serves to identify vulnerable groups, individuals and situations.

Treatment Improve the quality of clinical care and evidence-based clinical interventions, especially for individuals who present to hospital following a suicide attempt. Improve research and evaluation of effective interventions.

“Suicide Prevention Australia started with heart, driven by the passion that comes from the pain of suicide. I came into the organisation to manage a pioneering suicide prevention and mental health awareness activity called Cycle for Life in the late 90s. I ended up helping set up the SPA Board with Alan ‘Superman’ Staines, bring together people, from academics to government to work on common suicide prevention goals including advocating for responsible reporting. In those early years, I saw so many people struggling to express their experiences with suicide, and a media and country that desperately needed to learn how to speak more openly. For me, this was about inspiring hope and supporting recovery.

This was the catalyst for Suicide Prevention Australia to make the move from passion to leading coherent action and a national conversation. This was about people impacted by suicide driving stakeholder engagement at all levels of prevention. As someone who has lived with suicidal ideation since age 17 and searched for that sense of connection and recovery to stay alive, I am proud to see that work progress and more of our voices amplified in prevention.”

Snapshot of Australia’s performanceSnapshot of Australia’s performance

In reviewing the World Health Organisation’s global report on suicide (2014), Suicide Prevention Australia and its Members (via the National Coalition for Suicide Prevention) identified several areas that require resourcing. These are summarised below using the traffic light system. We have drawn out the typical components of national suicide prevention strategies – as set out in the WHO Report – to structure its Australia-specific rating and commentary.

1.2.

3.4.5.6.7.

8.

Brad FarmerFormer SPA Executive Officer

Think about how you and your organisation or community can better embody the National Principles for meaningful inclusion of lived experience. How do you know that you are authentically engaging the very people you mean to serve?

Visit www.suicidepreventionaust.org to access the full reportLived ExperienceLived

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National Coalition for

Suicide PreventionSuicide Prevention Australia introduced the

National Coalition for Suicide Prevention with members from across the suicide prevention and mental health sectors. Through the principles of

collective impact, members have aligned programs and committed to a common agenda. This has

resulted in a greater national voice at a time when collective advocacy and Government

engagement was necessary to move suicide prevention forward

in Australia.

Zero Suicides in Healthcare

In 2015, a diverse group of advocates, peer leaders, government policy makers, and healthcare providers signed an international declaration to reduce suicide in healthcare

settings to zero.Suicide Prevention Australia was proud to represent Australia in this group and will be working with local and international

colleagues to implement best practice within our local

healthcare system.

Since 1992, Suicide Prevention Australia has worked to unite and strengthen the suicide prevention sector through partnerships, collaboration and joint advocacy. Whilst our activity may have changed, our goal has remained the same – To reduce suicide in Australia.

Suicide and suicide prevention are significant public health issues that require national oversight with a community focus. The complexity of suicide means there are many voices to be heard yet resources are finite. In partnership with national Member organisations, Suicide Prevention Australia is driving the national suicide strategy and coordinating meaningful change through the following endeavours.

National Committee

for Standardised Reporting on Suicide

Research has shown that Australian suicide statistics are underreported and inconsistent

with implications for policy development, monitoring and evaluation. Convened by Suicide

Prevention Australia, the National Committee for Standardised Reporting on Suicide aims

to address this through law reform, police reporting and suicide data

registers.

Zero Suicides in Healthcare

In 2015, a diverse group of advocates, peer leaders, government policy makers, and healthcare providers signed an international declaration to reduce suicide in healthcare

settings to zero.Suicide Prevention Australia was proud to represent Australia in this group and will be working with local and international

colleagues to implement best practice within our local

healthcare system.

“The sector itself has become a lot more integrated over the years, and Suicide Prevention Australia plays a very important part in supporting the sector to work together. One idea we had to encourage collaboration, that came from the successful joint submission to the the Senate Inquiry into Suicide (2010) was establishing the National Coalition with Suicide Prevention in 2011. Since then, it is clear that the sector is working together for better outcomes.

It is great to see so many of the projects that were only ‘seedlings’ when I left SPA, such as the Lived Experience Network, grow to what they are today. The vision Dr Michael Dudley and myself had for Suicide Prevention Australia as a leadership body hasn’t changed. It is great to see the custodians of the organisation that followed, stay true to this vision and have certainly built on it!”

Ryan McGlaughlin,former CEO of Suicide Prevention Australia

Suicide Prevention Australiaand its Members are working with Government to ensure the Fifth National Mental Health and Suicide Prevention Plan is implemented in a way that is informed by those with lived experience and those working to prevent suicide.

NationalSuicide Prevention

Conference Held annually, this conference is the premier

event for Australian suicide prevention researchers, clinicians and advocates. It provides an invaluable platform for the

exchange of ideas.

Strategy, Oversight and Coordination

NationalLived Experience

Network The Lived Experience Network provides a

pathway for those touched by suicide to inform, improve and contribute to suicide prevention

policies, programs and initiatives. It also offers opportunities to tell individual stories and sharing lessons learned at local,

state and national levels.

NationalSuicide Prevention

Research FundExperts agree that gaining a better understanding of

suicide and suicidal behaviour is critical. The Fund aims to provide sustainable financial support for Australian

research and ensure outcomes have the greatest impact by addressing nationally agreed priorities. Suicide

Prevention Australia is proud to manage the Fund in partnership with leading experts from research,

government, clinical service delivery and the lived experience community.

Ryan McGlaughlinFormer SPA CEO

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While numbers and statistics can seem far removed from human lives, they play a vital role when it comes to making decisions on policy, funding and service provision. Measurement of suicide has long been fragmented and inconsistent, making it difficult to measure change across time, location and population. The coordination of comprehensive national data collection and storage protocols will provide essential information about who needs help, and when and where they need it.

What have we achieved?Suicide death statistics are now collected via the National Coronial Information System (NCIS) and publicly reported through the Australian Bureau of Statistics (ABS) on an annual basis.

Improvements have been made to data quality with investment by the ABS into coding practices and reporting timeliness. Comprehensive state-based suicide registers exist in Queensland, Victoria and WA, with work is underway by other States/Territories to establish registers.

The National Committee for Standardised Reporting of Suicide (NCSRS), a multidisciplinary group led by Suicide Prevention Australia, has been convened to improve data quality issues across Australia. One of its priority projects was the development of a National Minimum Data Set to identify knowledge gaps and ensure data compatibility.

The National Mental Health Commission has identified the need for data surveillance system improvements as an area of high national priority.

New programs addressing stigma amongst health professionals, emergency workers and the general community have the potential to improve the accuracy of cause of death reporting.

What is still to be done?The collection of suicide data needs to be expanded to shed greater light on vulnerable groups, individuals and situations including the collection of prompt standardised data on items such as LGBTI status, Indigenous identity and employment status.

Improvements to timeliness and accessibility of suicide death data is required. There is currently a delay of up to two years before death data is publicly available and this delay limits potential to respond to emerging trends with appropriate interventions.

Data systems require the input of expert monitoring to identify and interpret whether data fluctuations are a result of collection protocols or an actual change in suicide rates.

There is an urgent need for legislation reform and political support to drive changes in standardised data collection and improve consistency in suicide data across States and Territories. At the current time, there are no clear targets for this under the Fifth National Mental Health and Suicide Prevention Plan.

“We don’t track (suicide) like we do public

infections, like the outbreaks of epidemics. We should be looking at

what is happening in real time, using data to have real time responses.

Technology offers tremendous new opportunities that we need to learn

how to use and harness to bring into people’s lives to reduce

suicidal behaviour.”

Professor Ian Hickie AM

Thanks to continued advocacy of the suicide prevention sector, data is a key pillar within prevention plans at all levels of Government.

How are you contributing to the collection of timely and consistent data on suicide and, more importantly, how will you ensure the work

you do is informed by what that data tells you?

As we improve data quality it is not unreasonable to expect that we will see an increase in the rate and number of suicide deaths. Expert interpretation of suicide data that considers contextual changes is critical to protect the community from unhelpful and sensational interpretation of statistics.

Data14

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What have we achieved? The implementation of two national media initiatives - Mindframe and StigmaWatch - have significantly improved the quality and safety of media reporting of suicide through development of evidence-based resources, training and ongoing media evaluation.

Several collaborative relationships have been established between social media providers and suicide prevention organisations to encourage and simplify online help-seeking.

Leading Australian research into the impact of social media, technology and e-mental health programs has led to the development of safe and effective new online programs.

Organisations such as Suicide Prevention Australia and the National Mental Health Commission are driving sector-wide collaboration and agreement on suicide messaging for online communications and public awareness events such as World Suicide Prevention Day.

Australian Office of the Federal Safety Commissioner is advancing the development of programs to support and educate young people in the safe use of the internet and social media.

What is stillto be done? Where we need to do better:

As more and more people look to the internet for information on mental health and suicide prevention, we need to gain a greater understanding of how we can safely and effectively utilise this channel for help-seeking and monitoring of mental health.

Further research is necessary to understand the interaction between cyberbullying and suicide risk, as well as the development of education programs to mitigate this risk.

Funding for robust and sustainable evaluation is required to measure the impact of both online and traditional media in the context of a rapidly changing world.

“The media has an important role to play in shaping

and reinforcing social attitudes towards, and perceptions of, suicide and mental-

illness. For more than 20 years, the media has been actively working with the Mindframe National Media Initiative to promote reporting and portrayals that reduce potential harm and

enhance community understanding about suicide and mental illness.

The evidence shows reporting of both issues has increased and improved

in quality since the introduction of the Mindframe initiative.”

Jaelea Skehan

While thoughtful media coverage of suicide can raise awareness and

encourage help seeking, research shows it can also increase suicide risk. Over the past decade, media

management, codes of practice and journalist training have been

powerful suicide prevention strategies. The challenge for the

future is how we adapt these strategies for an unregulated

online world.

Media isn’t just about traditional news reporting these days. We are also seeing citizen journalists, bloggers, vloggers, etc. publishing opinion pieces and personal reflections on suicide and its prevention. We want to see more reporting on suicide and more stories of hope and recovery. How can we ensure every person is aware of safe language and responsible reporting?

Media

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Everymind DirectorJaelea Skehan

Everymind team members with their LiFE Award for Excellence in Suicide Prevention

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“The best strategies address the issue of access to means. When we come to consider changes in the suicide rate, we can see that suicides increased steadily from about 1978 to a peak in suicides in 1997. Subsequently there has been a reduction to

date to below the rates of the late 1970s.

Within this, non-firearm suicides account mostly for the shape of the graph. Firearm suicides, in fact, have been reducing

steadily for many years, with a small peak in the 1980s, but with a steady reduction ever since. A further factor must be related

to the gun ‘buy back’ scheme, begun in Australia after the Port Arthur massacre. The evidence for Australia suggests

that our ‘natural experiment’ has worked to not only reduce gun-related suicides, but has contributed to an overall reduction

in the rate of suicide and homicide.”

Professor Graham Martin OAM

Means Restriction

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Reducing or restricting access to lethal means is a highly effective, population–level strategy for reducing suicide. Australia is recognised as being a leader in means restriction with a history of significant reforms that have had positive impact on suicide rates.

What have we achieved? There has been an expansion in research expertise in means restriction and the identification of ‘suicide hotspots’.

Reforms such as the restriction of firearms legislation and fencing of suicide hotspots have resulted in reduced suicide rates.

New, multidisciplinary interventions have been implemented at well-known suicide hotspots.

What is stillto be done? Monitoring of emerging trends in suicide method, supported by timely availability of suicide data, are urgently required so rapid action can be taken to restrict access to means wherever possible.

Restriction of access to means of suicide must be coordinated and consistently implemented across local government authorities and by all those with responsibility for infrastructure development. Requisite funding and training and education programs are required to support this.

Community education is needed to build understanding of suicide prevention and to improve acceptance of means restriction activities such as barriers on bridges.

Means restrictionis proven to prevent suicide. Are you developing a community, health district or workplace suicide prevention plan? Make means restriction, including hotspot intervention measures a part of your plan.

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POSITION STATEMENTAlcohol, Drugs and Suicide Prevention

June 2011

PO Box 729, Leichhardt NSW 2040

Phone + 61 2 9568 3111 Fax + 61 2 9568 3511

www.suicidepreventionaust.org

POSITION STATEMENT Supporting Suicide Attempt Survivors

Suicide Prevention Australia September 2009


Phone + 61 2 9568 3111 Fax + 61 2 9568 3511


The Parliamentary Friends Group for

Suicide Prevention

Founding Member

Co-Chair Co-Chair

Julian Leeser

Suicide and Suicidal Behaviour in Women – Issues and Prevention

July 2016

A Discussion Paper


SEPTEMBER 2014





June 2011


Phone + 61 2 9568 3111 Fax + 61 2 9568 3511





Phone + 61 2 9568 3111 Fax + 61 2 9568 3511



Suicide Prevention

Founding Member

Co-Chair Co-Chair

Julian Leeser


July 2016

A Discussion Paper


SEPTEMBER 2014





June 2011


Phone + 61 2 9568 3111 Fax + 61 2 9568 3511





Phone + 61 2 9568 3111 Fax + 61 2 9568 3511



Suicide Prevention

Founding Member

Co-Chair Co-Chair

Julian Leeser


July 2016

A Discussion Paper


SEPTEMBER 2014





June 2011


Phone + 61 2 9568 3111 Fax + 61 2 9568 3511





Phone + 61 2 9568 3111 Fax + 61 2 9568 3511



Suicide Prevention

Founding Member

Co-Chair Co-Chair

Julian Leeser


July 2016

A Discussion Paper


SEPTEMBER 2014





June 2011


Phone + 61 2 9568 3111 Fax + 61 2 9568 3511





Phone + 61 2 9568 3111 Fax + 61 2 9568 3511



Suicide Prevention

Founding Member

Co-Chair Co-Chair

Julian Leeser


July 2016

A Discussion Paper


SEPTEMBER 2014





June 2011


Phone + 61 2 9568 3111 Fax + 61 2 9568 3511





Phone + 61 2 9568 3111 Fax + 61 2 9568 3511



Suicide Prevention

Founding Member

Co-Chair Co-Chair

Julian Leeser


July 2016

A Discussion Paper


SEPTEMBER 2014





June 2011


Phone + 61 2 9568 3111 Fax + 61 2 9568 3511





Phone + 61 2 9568 3111 Fax + 61 2 9568 3511



Suicide Prevention

Founding Member

Co-Chair Co-Chair

Julian Leeser


July 2016

A Discussion Paper


SEPTEMBER 2014





June 2011


Phone + 61 2 9568 3111 Fax + 61 2 9568 3511





Phone + 61 2 9568 3111 Fax + 61 2 9568 3511



Suicide Prevention

Founding Member

Co-Chair Co-Chair

Julian Leeser


July 2016

A Discussion Paper


SEPTEMBER 2014





June 2011


Phone + 61 2 9568 3111 Fax + 61 2 9568 3511





Phone + 61 2 9568 3111 Fax + 61 2 9568 3511



Suicide Prevention

Founding Member

Co-Chair Co-Chair

Julian Leeser


July 2016

A Discussion Paper


SEPTEMBER 2014




22 23

What have we achieved?Comprehensive workplace gatekeeper programs supported by clear pathways to care have been developed by some industries.

Increased support and training is being provided to employers to assist them to meet their obligations in mental health via organisations and businesses.

There are a wide range of local training providers who deliver suicide intervention training to key professions.

Evaluation of local and international scientific evidence has enabled the identification of effective training programs.

What is still to be done?A quality standard for suicide prevention training programs is required to assist individuals and organisations make an informed choice when engaging training service providers.

Strategically target gatekeepers in the community and provide them with training and support.

A national minimum competency level is required for health workers, mental health workers or other occupational groups that interact with groups known to be vulnerable to suicidal behaviours

Suicide prevention training needs to be built into pre-service tertiary education.

First responders and other gatekeepers need to be trained and supported to manage their own needs as well as the needs of those they are assisting.

“I came back from a conference from overseas and I thought it’s an urgency that Australia have a national organisation to push the barrow in suicide prevention. It’s wonderful that we were first cab off the rank to start anything in suicide prevention, to any degree, and we produced this training manual called “Let’s Live”. We organised the first national suicide prevention conference on a shoestring budget and it is great to see that conference still going today 25 years later.

A great memory for me is being National Secretary of the International Suicide Prevention Committee back in 1997 in Adelaide. It was a partnership between the International Association of Suicide Prevention and Suicide Prevention Australia.

Looking forward, there must be a greater education and awareness in the community. That is the big challenge for us. The challenge is there, and we have to go to it.”

For many years, a lack of knowledge and a fear of doing damage meant many health, community and workplace gatekeepers would avoid discussion of suicide. Today we have a far greater understanding of the impact that others can have on suicidal behaviours. With appropriate training, we know it is possible to build a protective safety net for people considering suicide, facilitate access to care and reduce stigma.

SPA FounderAlan Staines

Suicide prevention is everybody’s business.Think about how you can upskill yourself and your community by accessing websites like communitiesmatter.com.au to look at how to act in your small town or local community and learn a little more about common suicide myths and facts. Think about raising money to offer suicide first aid training to local gatekeepers such as teachers and sporting coaches.

TrainingandEducation

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There is no point investing in suicide prevention activities if they are not accessible to those who need them. Consistent and quality mental health care, crisis counselling and associated social supports are powerful tools for suicide prevention. Access to these services is essential for the identification and treatment of suicidal behaviours.

What have we achieved?

Walk-in, phone and internet-based youth mental health and crisis programs have been implemented across Australia.

Government has acknowledged the complexity around access for some vulnerable groups and have diversified programs to sit within more relevant departments (for example, Defence Force personnel and veterans and their families) as well as investment in innovative regionally based suicide prevention trials focused on meeting the needs of some of these groups.

Australian leadership in the development of clinically effective e-mental health and wellbeing programs has alleviated some barriers to care including geographical isolation and stigma.

Some targeted suicide prevention and counselling services have been developed for vulnerable groups including the LGBTI community and returned service people.

Increased awareness of suicide through campaigns such as World Suicide Prevention Day and Mindframe have improved awareness of available crisis and counselling services.

An increase in shared personal stories of those with lived experience of suicide is working to reduce stigma and therefore improve help-seeking.

What is stillto be done?

Many vulnerable groups still experience significant barriers to care including a lack of culturally safe and effective services, exacerbating suicidal behaviour.

Greater understanding is required of how and when vulnerable groups access care, and health policies, need to be reviewed considering this. Of note are refugees and asylum seekers who are in critical need of specialised care yet are often denied access.

Where programs are in place to support vulnerable groups, for example national mental health promotion programs for secondary schools, evaluation is required to assess the effectiveness and efficiency.

Prevention efforts need to extend beyond the health system with better access required to services assisting with common life stressors such as financial hardship, relationship breakdown, child custody issues and unemployment.

We need to remove barriers to accessing primary care which affect the vulnerable members of our community the most.

Professor Ian Webster AO

Are you awareof the services available to you and those around you, either in person in your region or online? And, if you are, how can you ensure you are accessing a quality service? Suicide Prevention Australia is working with its Members and the Federal Government to launch a Suicide Prevention Hub in early 2018. This will an online database of evidence based programs and services to improve access to appropriate, quality services for every Australian.

“There are many communities that

we need to connect with much more directly

if we’re going to see substantive reduction

in suicide rates and in attempted

suicides.”

Accessto Service

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“We do really well in acute stuff, but we don’t do well when people relapse, and there needs to be a lot more effort put into aftercare and aftercare in the community.There has also been, and I feel and others do too; that we are always looking at what’s wrong with a person, so if they come and they say they have some mental illness or there is some sort of social determinant, that’s being looked on, the person is being looked on from the negative perspective, and how can we get you out of that particular space, or that weakness, or however you want to view that. Rather than in fact focusing on, ok what is good within this person, that can be already be good and sustainable with that person, that can be further nurtured, a little bit more positive psychology I suppose”

Whilst the last two decades have seen some major advances in the treatment of mental illness, access to tailored treatment programs for suicide is still limited. Research is advancing our understanding of how to effectively identify and treat suicidal behaviours but there is still much to be done. The ongoing support of health professionals and government is critical in this area.


An accumulation of local and international research findings, and improved data collection, has facilitated the development of some new treatment programs and supported the use of novel delivery methods (such as websites or SMS).

The integration of research and clinical services at centres has sped up the research process to allow faster translation of findings into better clinical outcomes.

Improvements in both gatekeeper training and access to care have also improved treatment provision, with new national standards on how to manage mental illness and suicidal behaviours developed by groups such as RACGP.


Despite improvements, the level of care an Australian receives when experiencing a suicidal crisis still comes down to chance. This is not good enough.

There is still a lack of consistency and efficacy in risk assessment processes in health care settings, especially in hospital Emergency Departments.

Suicide ‘safe houses’ (or alternative care accommodation) that offer stepped care models for those in suicidal crisis should be available in every capital city and major regional centre.

Mental health services urgently need to be better coordinated with other health and social services to ensure a consistent network of care.

We need more mental health professionals, GPs and first responders to have specialist skills in managing suicidal crisis.

There is limited evidence on the types of interventions that work. We need increased and sustained investment in research to identify what works in suicide prevention.

Services delivering evidence-based, frontline suicide interventions on the ground require funding continuity to retain trained staff and guarantee service availability.

Services must provide culturally safe and respectful practice to all clients. Education and training, supported by robust policies, are required to ensure staff do not discriminate against any client based on past suicidal behaviour, mental illness, race, sexual or gender identity, Aboriginal and Torres Strait Islander status or any other characteristic.

Zero Suicidein Healthcare is the relentless pursuit of excellence to reduce suicides and improve care for those who chose to seek help. Have you explored this model? Can you see potential to influence your hospital leadership to test the model and achieve zero suicides in your healthcare setting?

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Former SPA ChairDr Michael Dudley

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Crisis intervention exists to offer immediate assistance to those in desperate need. The individuals and organisations that provide these services are an essential, core component of suicide prevention infrastructure as they provide a vital direct link to support. As demand for crisis services increases, there is an urgent need for service expansion and funding.

What have we achieved?National crisis support services provide free 24/7 support via telephone or internet to individuals in crisis situations.

The early adoption of emerging technology has enabled services to be provided to geographically isolated communities.

There has been a partial integration of telephone helplines with national treatment initiatives such as the “Access to Allied Psychological Services” program.

Crisis service providers and mental health organisations have developed training programs for service volunteers and gatekeepers.

What is still to be done?There is no specific policy or program recognition of the place of crisis lines and crisis support services in the Australian national suicide prevention strategy:

The evaluation of crisis intervention services should incorporate the effectiveness of pathways that link crisis intervention with other treatment strategies determined.

There are currently no national protocols in existence to establish linkages between crisis services and mainstream hospital, health or mental health services. This severely limits the opportunities for crisis support services to operate collaboratively with other services, and create effective pathways for suicidal persons and their carers.

The universal establishment of personal support services in emergency departments, hospital wards and during transitions between care should be considered. These services ensure suicidal patients receive emotional support and are not left alone.

Develop service responses that better address the needs of those members of the community who frequently and solely rely on crisis services.

Technology-based crisis support services (including telephone helplines, online chat services and mobile app resources) need to be recognised as key components of the national E-Mental Health Strategy and related funded programs, reflecting their status as essential help-seeking channels for individuals in crisis.

Consideration should be given to the classification of emergency services as suicide prevention service providers.

Crisis Intervention“Reaching out to people who are struggling to cope with life is a necessary and obvious technique to engage with those who are vulnerable to suicide. The timing and context also matters: when ‘negative life events’ occur, that is when the offer of help and support is most needed.

In Australia, we have been good at recognising this in our provision of practical support for those affected by bushfires, flood and drought, but we have not been as good at promoting crisis support when emotional and psychological struggles affect those around us. As a minimum crisis support must be core funded infrastructure.

We must focus on the Digital Gateway and national crisis line/online crisis support services for help seekers, together with hospital, emergency services and health services, so that all parts of Australia have immediate, accessible and effective responses for suicidal persons, and enhanced follow-up to suicidal behaviour.”

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If you are in crisis or at risk of immediate danger,

call Lifeline - 13 11 14 or 000

If you are experiencing great pain, perhaps feeling hopeless, helpless, worthless, and that there is nothing to live for,

there is help and support available.

Do you have someone you can talk to? A person you trust and feel comfortable with?

Are you alone? Could you call someone?

Go and visit them or invite someone to visit you?

Seek professional and/or peer support and help; there are options, small steps that can help you feel better and get you

through this painful time. Try to distract yourself, perhaps by playing some music, going for a walk, talking

to a peer, journaling. You don’t have to experience this alone. Support is available.

Be kind and gentle with yourself.

headtohealth.gov.au

Alan WoodwardSPA Director and Lifeline Research Foundation Director

Postvention involves bereavement support for those who have lost a loved one by suicide as well as support following a suicide attempt.

A previous suicide attempt is one of the biggest risk factors for future suicide death, and there is evidence to show that tailored postvention is

an effective means of reducing individual suicide risk in the long term.

Postvention

What have weachieved?

Australia is recognised as being a leader in postvention, and there are several localised examples of effective and evidence-based programs providing care, contact and referral pathways post-discharge from hospital after a suicide attempt.

Suicide bereavement support groups are now available in many communities across Australia and there is considerable momentum within the sector to grow community postvention activities.

The growing voice of lived experience is shedding greater light on the needs of those impacted by suicide attempts including the individual and those providing support.


There is no reliable and valid measure of the number of individuals exposed to or bereaved by suicide in Australia: This data is simply not collected. Given the existing research evidence suggests that those bereaved by suicide are at elevated risk of suicidal behaviour, the ongoing collection of national data on exposure to suicide is a priority.

Suicide bereavement support is a relatively new area of suicide prevention and requires investment in research to determine the best way to target effective interventions to those at risk.

Follow-up care after discharge from hospital is a proven suicide prevention strategy. It is still relatively rare however has been identified by this Government as a priority in suicide prevention. There is an urgent need for new models of coordinating care post-discharge to be developed and evaluated.

Suicide ‘safe houses’ (or alternative care accommodation) that offer stepped care models for those in suicidal crisis should be available in every capital city and regional centre.

Former Australian Institute for Suicide

Research and Prevention Director Professor Diego de Leo planted the seed

that became World Suicide Prevention Day in 2004. The positive ripple effect of beginning

an international day of awareness of this problem is immeasurable.

“We still need to address the stigma

associated with suicide.Unless you become sick because of your bereavement process there is very

little attention towards you and your problems. We believe that it is something that society

has an obligation (to address).”

Professor Diego de Leo

Suicide Prevention Australia (SPA)in collaboration with the University of New England has published a ground-breaking research report on Understanding the Exposure and Impact of Suicide in Australia. This national research project highlights the far-reaching impact of suicide as a public health issue in Australia. The research is based on the input of more than 3,000 respondents from across the country who have been affected by suicide. This valuable information allows us to better understand how individuals are impacted by suicide and to inform where funds and expertise need to be directed in suicide prevention.

Download the full report at www.suicidepreventionaust.org

A research collaboration between Suicide Prevention Australia and University of New England

THE RIPPLE EFFECT: UNDERSTANDING THE EXPOSURE AND IMPACT OF SUICIDE IN AUSTRALIA

Diego de LeoProfessor

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The past decades have seen a significant change in how we recognise and talk about suicide. Much of this change can be attributed to a new wave of awareness programs that aim to educate and address the harmful stigma that often prevents people from seeking the help that they need.


Government initiatives such as beyondblue and Living is For Everyone (the LiFE Framework) have resulted in significant and measurable improvements in community awareness and attitudes towards mental illness and suicide.

Community initiatives such as R U OK?Day are encouraging conversations about mental health and suicide with the aim of reducing social isolation and improving help-seeking.

Targeted awareness-building activities for some vulnerable groups have been implemented (e.g. LGBTI, ex-serving personnel, veterans, and their families).


There is a need to raise awareness that suicide is intrinsically linked with many social factors that can often be addressed to prevent suicide. It should not be simplified to be the result of mental illness.

Campaigns that educate the general community on what to say and do when an individual displays suicidal behaviours, as well as publicly promoting help-seeking pathways, are essential and must be continued.

More targeted awareness campaigns are required to educate professionals who are likely to come into contact with individuals in suicidal crisis

Specific campaigns designed for vulnerable groups such as Aboriginal and Torres Strait Islander people, culturally and linguistically diverse populations, men, youth, and the elderly are needed.

Awareness campaigns must always be accompanied with clear pathways to care to ensure those who seek help, receive help.

“We have such a long way to go in reducing the stigma around suicide and mental illness. Stigma remains a huge barrier to a person getting help early on. It can also stop a family from seeking help when a loved one first becomes unwell. Getting early help is absolutely critical if we are to save more lives. When we reduce stigma, we help prevent suicide. SPA was founded in the year my young cousin took his life. He lived with schizophrenia on our family farm in northeastern Victoria. Following his death, I reached out to SPA’s founding members who were such big-hearted individuals and who inspired me enormously in establishing what is today ReachOut Australia. Twenty-five years on, I’m proud to continue the association through SANE Australia and congratulate SPA on all that it has achieved.”

Awarenessand Stigma Reduction Did you know?

Australia is a world leader in smoking control. We have multi-pronged, sustained approaches involving awareness raising, education, environmental controls and legislative changes. These are reinforced by all levels of government, community action and individual effort. We need the same long-term, sustained, multi-faceted approaches to achieve our goal of zero suicides. One suicide is a tragedy!

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Jack Heath, SANE Australia CEO

Trent is a Youth Outreach worker in Broome (WA), a headspace National Youth Mentor, a suicide attempt survivor, a gifted artist, a member of Suicide Prevention Australia’s National Lived Experience Network and a young person who has been through the toughest of times but still holds an immense amount of hope for the future.

“There is a war raging in many young minds right now and it wasn’t until I started fighting my own mental health battles that I realised how awful this war really can get.

If I could tell a young person one thing, it’s that I’ve learned a lot about what it really means to be tough. It isn’t about how many dangerous situations you put yourself in. It’s about fighting through the trials life throws

at you. It’s not about acting like you’re invincible; it’s about being brave enough to ask for help when you

need it.

If I’d reached out earlier, decided that help was possible and gone to get help sooner, a

lot of my pain could have been prevented. As individuals we need to get to know ourselves better and understand what the signs may be that we’re not coping before it gets to crisis point.

In the future, I want anyone who reaches out for help for themselves or someone they know, to be able to get that help when and where they need it. I want there to be compassion in how we treat each other and less self-stigma in how we treat ourselves.

I tell the young people I work with that they have the purpose and potential to

achieve well beyond their wildest dreams. I believe these, often forgotten youth, have

more potential than most and their pasts have developed them to a level of unique

resilience. If they are given the opportunity they can literally change the world.

I believe this is also true for suicide prevention in this country. We have a shared purpose of supporting

more Australians to live. We have seen so much change in the past 25 years and have learned so much about what needs to happen in suicide prevention. We have the potential to change the world over the next 25 years.

While ever we have hope, we have a future that can be better than today. Together, we can do this.”

Trent Caldwell

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Support UsThank you for your ongoing support.

To continue making our work possible, please donatewww.suicidepreventionaust.org/donate

Get In Touchwww.suicidepreventionaust.orgGPO Box 219, Sydney, NSW 2001

+61 2 9262 [email protected]

Connect

facebook.com/SuicidePreventionAustralia

@SuicidePrevAu

linkedin.com/company/suicide-prevention-australia

Get HelpThe following services offer phone(24 hours a day, 7 days a week)

and online support:

For more information, visit www.suicidepreventionaust.org

and click on Get Help

Lifeline

MensLine

Suicide Call Back Service

Kids Helpline

beyondblue

13 11 14

1300 78 99 78

1300 659 467

1800 551 800

1300 22 4636

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