Australia Suicide Prevention 2020 Strategy Final
Australia Suicide Prevention 2020 Strategy Final
Australia Suicide Prevention 2020 Strategy Final
Minister’s foreword 2
Call to action from the Ministerial Council for Suicide Prevention 5
Introduction 6
Key Principles 10
1
person died every
day BY SUICIDE
in 2012 –
a total of
366
people
Our vision is that by 2025 to mental health issues that can result in self-harm
we will have the services, or suicide.(3) Every child has the right to grow up
supports and community in a healthy family and safe community, with
capacity to achieve a 50% opportunities to live a meaningful life, develop
reduction in the current positive relationships and achieve their goals.
number of suicides
and suicide attempts in We mourn the unnecessary loss of life by suicide.
Western Australia.(1) For every suicide death there are many family
members, friends and colleagues experiencing
We believe that every life immense grief, loss and sadness. We know that
Dr Neale Fong,
Chairman is valuable and suicide these people are then at higher risk of dying
is preventable. We urge by suicide themselves. Responsive services,
everyone – family, friends, understanding and compassion are essential
neighbours, schools, workplaces, communities and to support people who have lost loved ones
services – to work together to save lives. to suicide.
While there has been significant investment and This extent of loss and trauma cannot continue.
activity in suicide prevention across a range of We must continue to work together to save lives.
communities, we remain deeply concerned about
suicide rates in Western Australia. On average Suicide Prevention 2020 is a call for united
almost one person suicides every day in Western action to save lives now and in the future.
Australia.(1) In 2012, 366 people took their lives in Dr Neale Fong, Chairman,
communities across the State. These deaths mean Ministerial Council for
we are forever robbed of the unique qualities and Suicide Prevention
contribution of hundreds of Western Australians
and families are forever bereaved.
For each adult death by suicide there are around For every suicide
20 other people who have attempted suicide.(2)
Continuing care and services for people who are
In Western Australia
suicidal need to be significantly improved. there are approximately
Everyone dealing with life’s challenges – such as
health issues, relationship problems, alcohol or
other drugs, job and financial worries, or loneliness
– should be able to access assistance to resolve
20
suicide attempts
problems and reconnect with the community.
1 The reduction rate will be relative to the 366 deaths by suicide recorded by the
Australian Bureau of Statistics in Western Australia in 2012.
Suicide prevention is a major public health issue. In addition, Suicide Prevention 2020 actions
The suicide rates in Western Australia are among respond to key recommendations of important
the highest in the nation, with 13.5 deaths per reviews such as:
100,000 population in 2008-2012.(4) In Australia,
suicide deaths result in an average loss of 34 years • Auditor General (2014), The Implementation
of life per person.(4) Every life lost to suicide is one and Initial Outcomes of the Suicide Prevention
too many; we must all work together to prevent Strategy (Auditor General’s Report);
these tragic deaths. • Ombudsman Western Australia (2014),
Report on investigation into ways that State
Suicide Prevention 2020: Together we can save
government departments and authorities can
lives (Suicide Prevention 2020) provides a strategy
prevent or reduce suicide by young people
for prevention based on suicide statistics in Western
(Ombudsman’s Investigation); and
Australia, contributing factors to suicide across
life stages and evidence-based prevention and • Centrecare and Edith Cowan University (2014),
intervention approaches. It was developed utilising Research, Development and Evaluation of
current data, research, evaluation and reports on the State Suicide Prevention Strategy 2009-13
The Western Australian Suicide Prevention Strategy (Strategy Research, Evaluation and Development
2009-2013 and the expertise of members of the Report).
Ministerial Council for Suicide Prevention, some of
whom have lost loved ones to suicide. Suicide Prevention 2020 continues to be informed
by the Living is for Everyone Framework (LIFE
This new suicide prevention strategy builds on
Framework) and the National Aboriginal and Torres
the State Government’s continuing commitment
Strait Islander Suicide Prevention Strategy (2013),
to improve the mental health and wellbeing of
but has been updated to align with the World
the community, evidenced by the creation of the
Health Organization directions outlined
Mental Health Commission; the new Mental Health
in Public Health Action for the Prevention of
Act 2014; the establishment of the Statewide
Suicide: A Framework (2012); Preventing Suicide:
Specialist Aboriginal Mental Health Service;
A global imperative (2014); and Social Determinants
implementation of recommendations in the 2012
of Mental Health (2014). It is proposed that a
Review of the admission or referral to and the
coordinated range of activities will be delivered
discharge and transfer practices of public mental
through collaborative partnerships, local
health facilities/services in Western Australia by
community prevention programs and integrated
Professor Bryant Stokes; and other key initiatives as
services. The key outcomes and action areas are
detailed in Appendix A.
linked to the prevention priorities in The Western
Australian Mental Health, Alcohol and Other Drug
Services Plan 2015 – 2025.
community groups, insurers and the media; along Shared responsibility across government,
with family, friends and peer networks.(6) It is
envisaged that these diverse stakeholders will be
4 private and non-government sectors to
build mentally healthy workplaces;
able to adapt the priority action areas outlined in
this strategy to effectively meet the needs of their
communities, employees, members and networks.
5 Increased suicide prevention training; and
1.
Greater public
awareness and
united action
2.
Local support and
community
prevention across
3.
Coordinated and
targeted services
for high-risk groups
the lifespan
This action area will be This action area will be This action area will be
achieved through: achieved through: achieved through:
1.1 Implementing a 2.1 Promoting and supporting 3.1 Facilitating effective
comprehensive evidence based and interagency coordination to
communications strategy, culturally informed mental address social determinants
including multimedia health literacy programs. for suicide prevention across
resources and media the lifespan.
2.2 Strengthening community
partnerships.
based suicide prevention 3.2 Co-producing new programs
1.2 Delivering a comprehensive activities, local capacity with the at-risk groups
public education campaign building and leadership. themselves, including people
and resources tailored to with lived experience, family
specific age groups and 2.3 Collaborating with local
members and carers.
populations. stakeholders to strengthen
suicide prevention protocols, 3.3 Delivering responsive, high-
1.3 Promoting the use of mental establish ways to reduce quality treatment and support
health, counselling, alcohol access to means of suicide for those with mental illness,
and other drugs services, and map pathways to care aligned with the Mental
and reducing stigma and
to appropriate services and Health and Alcohol and
discrimination against people
support. Other Drug Services Plan
using these services.
2015-2025.
2.4 Partnering with primary care
1.4 Facilitating events to create
providers to address mental 3.4 Improving policies, protocols,
community dialogue and
health needs and risk factors. discharge planning and
inspire action.
continuing care for people
2.5 Ensuring communities have
1.5 Profiling the stories of who have self-harmed and/
the capacity to respond
bereaved families to create or attempted suicide.
to crises and can access
understanding and empathy,
emergency services, crisis 3.5 Strengthening early
and reduce stigma around
support and helplines. intervention services and
seeking help.
family counselling to prevent
1.6 Providing opportunities for 2.6 Improving postvention
and address cumulative trauma
people with lived experience responses and care for those
in children and young people.
to share their stories to affected by suicide and
reduce stigma around suicide attempts. 3.6 Supporting interagency
accessing services. postvention responses for
individuals and communities
who have lost someone to
suicide.
8 Suicide Prevention 2020: Together we can save lives
4.
Shared responsibility
across government,
private and non-
5.
Increased suicide
prevention training 6.
Timely data and
evidence to improve
responses and services
government sectors
to build mentally
healthy workplaces
This action area will be This action area will be This action area will be
achieved through: achieved through: achieved through:
4.1 Assisting organisations to 5.1 Promoting training and 6.1 Collating, analysing and
fulfil their responsibilities self-help activities for disseminating the latest
and legal obligations for the high-risk groups, and research and evaluation
mental wellbeing and safety peer support. reports on risk and protective
of their employees. factors and evidence-based
5.2 Supporting mental health
programs.
4.2 Developing implementation, and suicide prevention
monitoring and accreditation training in schools, 6.2 Monitoring and evaluating
systems for workplace vocational and tertiary initiatives for ongoing
mental health and suicide education sectors and improvement.
prevention initiatives. community groups.
6.3 Establishing a taskforce to
4.3 Setting minimum 5.3 Coordinating Gatekeeper monitor, improve and utilise
requirements for mentally and other programs for suicide related data to inform
healthy workplaces, professionals and para- planning, intervention and
including training to identify professionals including postvention responses.
and support people at risk. General Practitioners, health
workers and frontline service
4.4 Acknowledging and
providers.
disseminating best practice
approaches to creating a 5.4 Embedding trauma informed
mentally healthy workplace. practice in the mental health
workforce.
4.5 Encouraging large
government and corporate 5.5 Backing up training with
organisations to have mental adequate supervision and
health and suicide prevention de-briefing mechanisms.
as a key outcome measure
with adequate resources and
monitoring.
Best-practice principles have guided the development of Suicide Prevention 2020 and its associated
action areas, specifically the World Health Organization Social Determinants of Mental Health (2014);
the Australian lived experience guiding principles (2014) drafted by Suicide Prevention Australia’s
advisory committee and endorsed by the National Coalition for Suicide Prevention; and the Western
Australian strategic mental health policy Mental Health 2020: Making it personal and everybody’s
business (2010) (7, 8). Throughout the implementation phase the principles below will continue to
underpin decision making and initiatives under the priority action areas.
1.
Valuing and People with a lived experience, including those who have attempted suicide,
including bereaved by suicide or affected by suicide, have a valuable, unique and
people with legitimate role in suicide prevention. Lived experience helps change the culture
lived surrounding suicide by creating empathy and understanding. People with lived
experience experience will be supported to share their insights and stories with a view to
preventing suicide. All suicide prevention programs, policies, strategies and
services will, at all levels, include genuine meaningful participation from those
with lived experience.
2.
Action Risk and protective factors for mental health operate at an individual,
across family, community, structural and population level. A social determinants
sectors approach will be led by the mental health sector; however it requires action,
collaboration and leadership from education, primary care, social services,
employment, justice and housing sectors at all levels.
3.
Life course Taking a life course perspective recognises that mental health is influenced
approach by unique and common factors at each stage of life, and these factors
accumulate throughout life. A life-course approach also seeks to address the
intergenerational transfer of inequality, by improving conditions for future
generations.(8) Organisations in which people are involved at different stages
of life are the most appropriate to deliver appropriate interventions – such as
early year settings, schools, family services, employers and seniors groups.
4.
Early There is a strong evidence base and scientific consensus that giving every
intervention child the best possible start in life will generate the greatest societal and
mental health benefits.(8) Actions should support parents and early childhood
development; and enable children and adolescents to maximise their potential
to create a mentally healthy adulthood.
6.
Allocating Actions and interventions to prevent suicide and self-harm will support the
resources whole population, with targeted responses and appropriate resources for
where they high-risk groups. State funded public mental health services treat individuals
are most with severe mental health issues. However, the State will advocate for
needed and in other parts of the system, including community managed organisations
a coordinated and primary health care, to deliver the full continuum of suicide prevention
way interventions.
7.
Prioritising Increased awareness and understanding of mental health and suicide
mental health prevention should coincide with appropriate direction of resources towards
and suicide tackling mental illness, recognising that there are significant cost benefits in
prevention investing in mental health and suicide prevention.
8.
Long term and Improving mental health across the life-course requires long term and
sustainable sustained policies and actions that focus on reducing inequalities in health
approaches through community development, and strengthening local leadership and
collaboration.
9.
Knowledge Systems and processes to gather and provide information must be built to
for action at support local actions. Information helps to identify, understand and respond
the local level to mental health risks at a regional level; build knowledge of local resources
and services, and evidence-based interventions; assess impacts of local
initiatives; and support regional interagency collaboration to prevent suicide.
10.
Quality and Suicide prevention programs are informed by evidence of outcomes being
best practice achieved and contemporary best practice; easily accessed; and delivered in
a timely and collaborative way.
2 Co-production ensures the general public (the receivers of services) and government (the providers of services) work together to achieve common
goals of increased awareness about mental health, suicide prevention and services available to access help. Co-production includes community
consultation and mutual responsibility to achieve goals. It aligns with strategic directions
Suicidein Mental Health
Prevention 2020.Together we can save lives
2020: 11
Understanding the
problem of suicide
40
30
Rate per 100,000
20
10
15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+
Age Groups (years)
Male Female
Source: Australian Bureau of Statistics, 2014
3 Years of life lost are calculated for deaths of persons aged between 1 to 78 years.
4 Figures for 2012 are preliminary.
20.0
18.0
16.0
14.0
per 100,000 population
12.0
Age-standardised rate
10.0
8.0
6.0
4.0
2.0
0.0
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Years
Male Female
Source: Steering Committee for the Review of Government Service Provision, 2014
16.0
15.0
14.0
13.0
per 100,000 population
Age-standardised rate
12.0
11.0
10.0
9.0
8.0
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Years
Aust WA
Source: Steering Committee for the Review of Government Service Provision, 2014
30.0
25.0
Rate per 100,000
20.0
15.0
10.0
5.0
0.0
NSW VIC QLD WA SA TAS ACT NT AUST
Source: Steering Committee for the Review of Government Service Provision, 2014
90
80
70
hospitalisation rate
60
Age-adjusted
50
40
30
20
10
0
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Years
Poisoning by drugs Poisoning by other means Hanging, strangulation & suffocation Sharp object Other means
10
9
8
Age-adjusted mortality
7
6
5
4
3
2
1
0
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Years
Poisoning by drugs Poisoning by other means Hanging, strangulation & suffocation Other means
* Excludes tobacco
to treat.(25) This highlights systemic barriers and Other contributing aspects are an individual’s
stigma towards service users that needs to be access to lethal means of suicide; cultural and
addressed. Both suicide and alcohol and other social factors including attitudes towards suicide;
drugs-related harm share common risk factors contagion effects or clustering of suicide; impulsive
that can be targeted at a social level, and through or aggressive behaviour; and an inability to deal
integrated service delivery and systems. with distressing emotions.
Interpersonal factors
More recently, researchers have examined
interpersonal factors that diminish a person’s Figure 7: Intersection of desire for
natural instinct for self-preservation from death. suicide and acquired capacity for suicide
A person becomes more vulnerable when they are
socially isolated or feel they are a burden to others Desire for suicide
due to long term unemployment, chronic illness,
homelessness or other difficulties.(26) Their suicide
risk increases when this social disconnection
Perceived
is combined with fearlessness towards death burdensomeness
(acquired capacity). Over the course of a lifetime,
acquired
they may become less afraid of pain and death
capacity
due to trauma and abuse; high-risk behaviours; for suicide
injuries from contact sport or dangerous work; thwarted
or familiarity with lethal means such as firearms belongingness
or drugs.(26)
High risk for suicide
Addressing these intersecting issues requires quality completion or serious
mental health, alcohol and other drugs services and attempt
ongoing support; along with holistic approaches
across the lifespan to address the interpersonal, Joiner, T. (2005) Why People Die by Suicide.
Cambridge, MA: Harvard University Press
social, psychological and situational issues
contributing to mental illness, suicidal behaviours
and preventable deaths.(15)
Most suicide attempts by LGBTI people occur while In Western Australia reforms to the justice
still coming to terms with their sexuality and/or system and court diversion programs are being
gender identity, and often prior to disclosing their implemented to refer people with mental illness
identity to others or seeking counselling. Some and alcohol and other drug issues into treatment
people may experience homophobia, bullying and rehabilitation rather than prison. In addition,
or a lack of acceptance by family and peers. This the Department of Corrective Services delivers
marginalisation erodes protective factors that comprehensive Gatekeeper suicide prevention
would usually support vulnerable people. training to staff and peer supporters, and there
are focused efforts to reduce Aboriginal deaths in
custody. However the risk of suicide among people
in prison remains high.
To reduce the risk of suicide, first responders In 2012 the Mental Health Commission oversaw
should have access to appropriate debriefing research into the stigma associated with mental
following a traumatic situation, as well as illness and effective strategies to create behavioural
professional counselling on-hand as needed. change. Over 1500 Western Australians were
Education on the risks, warning signs and surveyed, including 300 people who had
symptoms of suicidal thoughts, as well as experienced mental illness. Key findings included
effective self-care techniques, can also be greater experiences of stigma by people who had
beneficial to reducing suicide amongst those suicidal behaviour; more stigmatising attitudes
working in these professions.(54) among men aged 16 to 44 years and those who
had no contact with people with mental illness;
and people were less likely to disclose mental
Suicide and gender illness in their workplace due to fear of impacts
Across Australia, men are three times more likely on their career.(52)
to die by suicide than women. In 2012, suicide
accounted for 366 deaths in Western Australia, Effective strategies to change stigmatising
269 men and 97 women.(4) Male suicide death behaviour included developing the leadership
rates increase with remoteness. Men living in inner of people with mental illness and sharing their
regional areas experienced death rates that personal stories; peer based education; and
were 8% higher than in major cities and in very collaborating with general practitioners, who
remote areas 78% higher.(50) Suicide rates for men are often the first point of call for people with
born outside Australia are slightly lower than for mental illness.
Australian-born men, whereas corresponding rates
Raising community awareness and breaking
for women are very similar.(19)
down the taboo is essential to make progress in
Thirty percent of men and half of the women in preventing suicide. Taboo, stigma, shame and guilt
Western Australia who suicide, have previously obscure suicidal behaviour. By proactively enabling
tried to suicide before their death. Historically men people to openly discuss mental illness, suicidal
attempting suicide have used more fatal means; behaviour and self-harm, supportive health systems
however, there is now a trend for women to also and societies can help prevent suicide.(2, 53)
use more severe means leading to greater adverse
effects and increased fatalities.(4) Media reporting, including social media
The media, including online and social media,
Suicides are a disproportionate cause of death for
can play a significant role in suicide prevention
young women.(4) Factors associated with suicide by raising awareness of issues, profiling people’s
among girls and women include bullying, body lived experience and promoting services available
image dissatisfaction, sexual abuse and intimate to people in crisis. Media reporting on positive
partner violence, alcohol and other drug use, coping strategies in adverse circumstances, such
postnatal depression and other difficulties in as overcoming suicidal ideation, can have
parenthood, as well as experiences of inequality protective effects.(53)
due to gender, sexuality, disability or cultural
background.(51) Therefore, gender, and age However, irresponsible reporting and dissemination
group, needs to be considered in the design and of information that sensationalises or glamourises
implementation of suicide prevention initiatives. suicide can increase the risk of ‘copycat’ (imitation)
suicides or trigger vulnerable people.(53) Exposure
Vicarious trauma
Staff or care-givers who are supporting people
who have experienced trauma, may themselves
be vulnerable to secondary trauma and burn-out
that can affect their wellbeing. Symptoms of
burn-out include apathy, feelings of hopelessness,
rapid exhaustion, disillusionment, melancholy,
forgetfulness, irritability, experiencing work as a
heavy burden, and a tendency to blame oneself
for perceived failings.(54)
Resilience and good mental health enable people to establish healthy relationships, fulfill their potential,
overcome difficulties and recover from major illness or loss. Families, friends, peers and communities have
a vital role in building individual resilience and protective factors across the life stages.(8) They can also help
to reduce stigma around seeking help for mental health problems or difficult life experiences; and help
people stay connected, with meaningful roles and opportunities to improve their quality of life.(6)
The foundation for a long-term view to preventing suicide is to actively improve individual mental health
across the life course, foster community connections and build the capacity of support networks to protect
vulnerable people from harm.
School age
• Development of good self-esteem, communication and coping skills;
• Supportive relationships with family, peers and the wider community;
• Engagement in school, education and recreation activities;
• Development of self-worth, personal safety and healthy boundaries; and
• Significant adult who is a positive role model.
Young adults
• Ability to care for their own health and wellbeing and access support;
• Capacity to create satisfying personal and social relationships;
• Skills to cope with difficult emotions or problems;
• Development of skills to live independently and reach personal goals; and
• Successful transition from school to work or study.
Older age
• Staying mentally, physically and socially active;
• Opportunities to contribute and be valued by family and the community;
• Managing health issues and accessing services;
• Positive transition from work and family responsibilities into retirement;
• Financial security, safe housing and social support; and
• Drawing on own beliefs, values and wisdom to deal with change or loss.
Figure 8: The spectrum of interventions for mental health problems and mental disorders
Early intervention
Engagement
with
longer-term
Case Early Standard Long-term
Universal Selective Indicated treatment Postvention
identification treatment treatment care
(including
relapse
retention)
Barriers to accessing health care Health reform, service coordination and clear
referral pathways
Stress from cultural dislocation or Gatekeeper Training for GPs, teachers and Selective
discrimination professionals
Harmful use of alcohol or Peer support for individuals, families and carers
other drugs
Chronic pain, illness or disability Integrated health and mental health programs and
self help
Individual Exposure to suicide Counselling and peer support after loss by suicide
Early care and
Experience of trauma Trauma informed care and workforce training,
treatment
cultural healing
The Auditor General also found that Kimberley The Western Australian Auditor General’s
Community Action Plans reported that: recommendations for improvement were:
• A dedicated suicide prevention coordinator was 1. Develop quantifiable and objective measures
needed and the Community Coordinator was a to complement qualitative reporting and
first point of contact; allow more consistent assessment of suicide
• Community events such as football matches, prevention activities to inform strategy
coffee morning and music workshops were development;
happy occasions that brought people together,
2. Develop an overarching implementation plan;
rather than just funerals;
3. Review the governance structure and clearly
• Training programs such as ASIST, Gatekeeper
define roles and responsibilities of all parties;
and Mental Health First Aid were useful and
and
were used in successful suicide interventions;
and 4. Identify, collaborate and coordinate with
existing suicide prevention efforts to increase
• Participating in the Aboriginal Leadership and
efficiencies and the likelihood that benefits will
Empowerment program had been life changing
be sustained.
for some people and enabled them to develop
important life skills.
Further, the Western Australian Ombudsman’s
Areas for improvement that were identified in the Investigation into suicides of 13-17 year olds in
Strategy Research, Development and Evaluation Western Australia, found that universal suicide
Report included: prevention activities were beneficial. However,
given the cumulative trauma experienced by the
• Adequate planning to establish realistic majority of teenagers who suicide, the next suicide
outcomes, ensure the needs of at-risk groups prevention strategy should prioritise increased
are met and specific strategies are developed for resources and efforts on early intervention,
Aboriginal communities; treatment and continuing care for vulnerable
• Develop a management plan to document young people.
policies, procedures and responsibilities for
These findings have been addressed in Suicide
implementation;
Prevention 2020.
• Assessing community readiness for suicide
prevention activities and better defining
sustainability as behaviour change, community
engagement or active involvement;
• The need for longer term resourcing of
community activities and implementation
over five years and adding value to existing
effective programs;
1 2 3 4 5 6
Greater Local support Coordinated Shared responsibility Increased Timely data and
public and community and targeted across government, suicide evidence to
awareness prevention across services for private and non- prevention improve
and united the lifespan high-risk groups government sectors training responses and
action to building mentally services
healthy workplaces
Suicide Prevention 2020 identifies six key action 1.5 Profiling the stories of bereaved families to
areas for united action across communities, sectors create understanding and empathy, and
and government agencies. These action areas and reduce stigma around seeking help.
early priorities are intended to build on previous
1.6 Providing opportunities for people with lived
suicide prevention activities in Western Australia,
experience to share their stories to reduce
and are informed by recent evaluations, current
stigma around accessing services.
data, and international and Australian evidence-
based approaches.
Early priorities
1.1.1 The Mental Health Commission will
develop a comprehensive communications
1.
Greater public awareness and
united action
strategy, with the One Life website
(www.onelifewa.com.au) acting as a
hub for suicide prevention information,
Educating the public about suicide risk factors and
research and services. Partnerships with
what to do when someone is suicidal is an integral
Mindframe will promote responsible
part of effective suicide prevention. Mobilising the
reporting of suicide in the media.
community and creating an appetite for change
is achieved through effective communication and 1.2.1 The Mental Health Commission will
community engagement. continue strategic partnerships to promote
universal suicide prevention awareness.
This action area will be achieved through:
1.3.1 The State Government will build on the
1.1 Implementing a comprehensive and strong community engagement achieved
communications strategy, including 1.4.1 through the previous State Suicide
multimedia resources and media Prevention Strategy by continuing to
partnerships. provide small grants for local community
1.2 Delivering a comprehensive public activities, including public forums and events.
education campaign and resources tailored 1.5.1 To tackle stigma and misunderstanding,
to specific age groups and populations. and the experiences of individuals and families
1.3 Promoting the use of mental health, 1.6.1 affected by suicide will be profiled on the
counselling, alcohol and other drugs One Life website, in multimedia resources
services, and reduce stigma and discrimination and through media partnerships.
against people using these services.
1.4 Facilitating events to create community
dialogue and inspire action.
Research highlights that participation in sport and recreation builds considerable social capital,
including “networks of mutual support, reciprocity and trust that may benefit health, education and
employment outcomes for individuals while also fostering community strength and resilience.” (57)
According to the ABS 2006 General Social Survey, among people aged 18 years and over, sports
participants had more frequent contact with family and friends, a greater number of friends to confide
in and greater ability to obtain support in times of crisis.(57) Suicide Prevention 2020 will, therefore,
continue to utilise the Western Australian Football Commission (WAFC) and Netball WA’s extensive
networks to promote One Life suicide prevention messages and services to reach a combined
audience of around 68,000 Western Australians.
Since 2011 the One Life and WAFC partnership has targeted over 50,000 Western Australian
football players across the State. WAFC coaches, players, volunteers and executive undertake suicide
prevention training and engage in mental health campaigns. To increase the resilience and well-being
of young males, a typically at-risk group, are 2,800 coaches trained to recognise and respond to signs
of suicidal behaviour and promote healthy choices.
In 2014, a new partnership between One Life WA and Netball WA enabled 400 coaches to be
trained in mental health and suicide prevention through Youth Focus and Relationships Australia.
Their increased understanding and skills will ensure coaches and players are confident in supporting
teammates, family or friends in need of help. Netball WA’s One Life Ambassadors will reach 18,000
netball players.
A marketing research report, Community attitudes toward mental illness was undertaken in
2012.(52) The Mental Health Commission contracted TNS Social Research (TNS) to survey over 1500
West Australians, including 590 people who self identified as consumers. The results highlight current
community attitudes towards mental illness, and support for strategies to reduce stigma and create
positive behaviour change.
Questions were asked about mental illness generally and specific conditions to identify priority target
groups. Consumers were asked additional questions about their experiences of stigma, accessing
services and help-seeking behaviours. Communication approaches and messages were tested with
consumers and community members using online bulletin boards.
A strong theme in creating behaviour change was the importance of humanising issues, such as
showing the faces of people with a mental illness, their personal stories and journeys, and recovery.
Personal stories, panel discussions and documentaries were easier to relate to.
Messages that resonated with audiences highlighted the positive contributions of people with a
mental illness; making a difference by challenging discrimination; the importance of connecting with
peers to reduce isolation; and taking positive action to improve individual mental wellbeing.
The Mental Health Commission is utilising the research to enhance existing stigma reduction
activities including the Music Feedback youth anti-stigma campaign (www.musicfeedback.com.au)
and peer-based programs.
The FIVE Project is a two-year partnership between Disability in the Arts, Disadvantage in the Arts
and Rio Tinto to engage communities in discussions around mental health. It focuses on Fly-In,
Fly-Out and residential workers, and their families, as well as young people, Aboriginal people and
farming communities. FIVE works through a series of community arts and cultural development
projects in Paraburdoo, Busselton, Geraldton, Derby and Esperance that combat social isolation
and stigma for groups at-risk of mental illness. FIVE projects stimulate community dialogue about
mental illness, community wellbeing and provides opportunities to improve social connections and
communication skills.
The Regional Men’s Health Initiative (RMH) is a project that aims to educate men in rural Western
Australia on mental health and suicide through community education. Developed in 2002 in
response to the increased suicide risk in regional men, RMH aims to empower men, their families
and communities to take responsibility for their wellbeing and mental health. RMH presents at over
150 events a year to speak about support mechanisms for men and those affected by traumatic
events, as well as to establish sustainable support mechanisms that reduce social isolation and
encourage help-seeking behaviour. RMH also offers the Fast Track Pit Stop Program which teaches
men about health awareness and listening. More information on RMH can be found on their website
at www.regionalmenshealth.com.au.
This FIFO Life is an online resource for FIFO workers, their families and friends in Western Australia,
funded by the Mental Health Commission. The website, focusing on the strength and resilience of
FIFO workers, features resources and tips for staying mentally healthy. The website uses a mixture
of pictures, videos, blogs, articles and links on the many issues relating to mental health and FIFO
workers. The website was co-produced through consultation and profiles the voices of people
with lived experienced of mental illness. This FIFO Life promotes access to services and recognises
the unique needs of FIFO workers as a priority group for mental health in Western Australia.
This FIFO Life is available at www.thisfifolife.com.
2.1.2 Training in Gatekeeper suicide prevention 2.4.1 Increased services for people who have
and trauma informed care will be increased and attempted suicide will be established.
for frontline workers, health professionals 2.6.1 This will include support to general
and para-professionals. practitioners and their patients who
present with suicidal or self harm ideation
2.2.1 The Mental Health Commission
and patients discharged from hospital
and will phase in qualified suicide prevention
Emergency Departments that have
2.3.1 coordinators within mental health and/or
attempted suicide, engaged in self harm
drug and alcohol services across regions in
or present with ideation around self-harm
need. The suicide prevention coordinators
or suicide. An intensive case management
will be integrated into mental health and
system will provide comprehensive
alcohol and other drug services, with
assessment, face to face and telephone
stronger connections to interagency
counselling, through care and a co-case
government, health and community service
management model with the patient’s
committees to consolidate collaboration
general practitioner, as well as linking the
across sectors. This is consistent with
client with health and social services in
recommendations contained in the
response to identified needs.
evaluation of the 2009-13 Strategy and
will strengthen sustainability of localised,
strategic community coordination
by improving local coordination. The
Centrecare and Edith Cowan University
evaluation of Community Action Plans
suggested that community coordinators
should be overseen by the Mental Health
Commission and co-located with relevant
mental health services.
This will be a phased in approach to
ensure community readiness, service
responsiveness and ongoing improvement.
The qualified suicide prevention
coordinators will initially be located in
north and east metropolitan Perth, and
the Kimberley, South West and Wheatbelt
regions. The program design will adopt
the best elements of the previous
Community Action Plans and existing
alcohol and other drugs prevention model
in Western Australia.
Crisis counselling and national mental health programs are key resources for local communities
to promote and access. They are free to use and can provide several phone and online sessions
or referrals for face-to-face counselling and programs. The following services are not for profit and
funded by State and/or Commonwealth Governments.
Lifeline services include a 24/7 telephone crisis line, online crisis support, service directories, mental
health resource centres and information. Visit www.lifeline.org.au or call 13 11 14 for support.
beyondblue aims to raise awareness of depression and anxiety, and increase the mental wellbeing
of all Australians at all stages of life by increasing access to support. beyondblue delivers counselling
support and has information for individuals, families and the Aboriginal community on overcoming
suicidal thoughts or attempts. For more information visit www.beyondblue.org.au or
phone 1300 22 4636 for support.
The Suicide Callback Service (SCS) provides 24/7 phone and online counselling to those
experiencing a mental health crisis. It is available to people 15 years and over who are suicidal, are
caring for someone suicidal, have been bereaved by suicide, or are health professionals supporting
people affected by suicide. SCS offers up to six further counselling sessions with the same counsellor,
to address the ongoing needs and time-based risk factors for vulnerable individuals.
Phone 1300 659 467 or visit www.suicidecallbackservice.org.au.
3. Coordinated and targeted services to high-risk groups and across the lifespan is
for high-risk groups essential to preventing loss of life to suicide.
The Response to Self-Harm and Suicides in Schools, is a coordinated interagency model funded
by the State Government. It comprises:
• specialist clinicians at Child and Adolescent Mental Health Service to provide assessment,
treatment and counselling;
• specialist psychologists at the Department of Education to improve suicide prevention, crisis
responses and postvention support across the three school systems; and
• Youth Focus (non-government youth mental health service) school liaison coordinator, three
specialist psychologists and a mental health trainer. This will assist priority school communities
and provide intensive counselling to hundreds of at-risk young people.
The Living Proud Suicide Prevention Community Action Plan addressed the significantly higher
rates of suicide and mental illness that affect the lesbian, gay, bisexual, transgender and intersex
(LGBTI) community. The project sought community input with the LGBTI community themselves to
develop its response, aiming to reduce stigma and discrimination against LGBTI people as well as
increase awareness of the issues that LGBTI people face. Members of the community were trained
in courses designed to increase resilience, competency in responding to suicide, and education in
mental illness, including Training4Trainers and Applied Suicide Intervention Skills Training. Resources
that featured information on support specifically for LGBTI people were created and distributed.
Living Proud – Opening Closets training program was delivered to frontline mental health workers
in Perth. Funded by the Mental Health Commission, the free training aims to increase knowledge of
LGBTI needs, issues and understanding. The program also develops the capacity of individuals and
workplaces to respond to LGBTI individuals. More information is available at www.livingproud.org.au.
The LGBTI action plan was further supported through research from the national Mindout project by
the LGBTI Health Alliance and the QLife service (www.qlife.org.au) which provides early intervention,
peer-supported telephone and web based services for LGBTI people.
The Youth Affairs Council of Western Australia Suicide Prevention Community Action Plan was
created to support suicide prevention efforts for homeless young people in Western Australia, as
they face significantly higher suicide risks than the general population. The action plan involved
direct engagement with the homeless community through peer support workers. Guidelines and
recommendations were developed for Youth Service Providers working with young homeless people
at risk of suicide were developed and distributed to inform best practice and address gaps in service.
It utilised existing networks and workshops to advertise referral pathways for homeless young people
based on their complex needs.
When Someone Takes Their Own Life… What Next? is a resource developed by the Mental Health
Commission designed to offer practical advice and support to a person who has lost someone to
suicide. The resource provides information on coping with grief and loss, counselling and support
services; and practical matters such as the role of the Coroner’s office, finance, how to talk to children
and funeral arrangements. The resource was created with extensive consultation from people who
have lost someone to suicide in the past, and includes personal tips and quotes from those consulted.
It is available at www.onelifewa.com.au.
4.3 Setting minimum requirements for mentally 4.4.1 The Workplace Suicide Prevention
healthy workplaces, including training to and Program will build on previous One Life
identify and support people at risk. 4.5.1 agency initiatives and link to current
workplace mental health and suicide
4.4 Acknowledging and disseminating best prevention training and tools developed by
practice approaches to creating a mentally organisations such as beyondblue, SANE
healthy workplace. and Black Dog Institute. The Mental Health
4.5 Encouraging large government and Commission will provide guidelines and
corporate organisations to have mental resources which assist workplaces to plan,
health and suicide prevention as a key implement and monitor suicide prevention
outcome measure with adequate resources activities.
and monitoring. 4.4.2 The State Government will continue to
and support initiatives such as the Regional
4.5.2 Men’s Health Initiative and Mates in
Construction to reach men in regional
areas and working in Fly-In, Fly-Out
communities. Collaboration with
corporations, local government and
services will ensure employees and their
families can access counselling, peer
support, education and crisis support.
Suicide Prevention Action Plans for the workforce were established to prevent suicide under the
State Suicide Prevention Strategy by numerous organisations and professional bodies.
MATES in Construction (MATES) has an industry approach to suicide prevention in workplaces in the
construction industry, which face high rates of suicidal thoughts. MATES aim to enhance support,
open discussion of suicide, and make better connections between workers and external professionals.
MATES delivers three types of training programs on-site, including Connector Training to train workers
to be competent in responding to crises and connecting others with help, General Awareness
Training, and ASIST Training which trains workers to respond to someone contemplating suicide and
increase their safety. MATES has on-site access to peer connectors to help workers access relevant
services. Nearly 6,000 construction workers in Western Australia have completed MATES training,
and over 300 have received individual support from a MATES case manager. MATES draws from
contemporary evidence on suicide prevention and practice-based experience. It has a clear theory of
change which draws on community development practice.
The Department of Fisheries formed a Suicide Prevention and Awareness Working Group, comprised
of volunteers representing different sectors of the department, in May 2011. The Working Group
conducted a mental health and wellbeing survey with numerous follow-ups and aimed to build
individual resilience, capacity for self-help, and take a coordinated approach to suicide prevention
in the workplace. The Working Group developed an agency plan to improve mental health,
communicated resources to staff through email and intranet, and provided Gatekeeper and Mental
Health First Aid Training to its staff. Results of follow-up surveys showed a great improvement in staff
knowledge of where to access services and self-reported wellbeing.
The Australian Veterinary Association (AVA) has adopted a strong commitment to suicide prevention
in the workplace through their action plan. Veterinarians face a suicide rate four times higher than that
of the general population. Veterinarians experience unique work stressors which are compounded by
24/7 access to lethal drugs. The AVA established mentoring for new veterinary graduates to prevent
isolation and to link them to support networks within their profession. With a model geared towards
fostering positive psychology and encouraging resilience, the AVA has created projects to connect
veterinarians to each other between metro and rural areas such as the Australian Veterinary Orchestra.
The State Government employs around one fifth of Western Australia’s workforce. The Public Sector
Commission and Western Australian Mental Health Commission produced the Supporting Good
Mental Health in the Workplace resource for the public sector to highlight the importance of good
mental health in the workplace. It provides information about:
• the legal and ethical responsibilities of employers;
• activities and strategies for creating a trusting and inclusive work environment;
• steps to reduce the stigma of mental health problems; support and retain staff; and improve
the working environment; and
• resources and support services for HR staff and line managers.
Visit the Public Sector Commission website to find out more.
There are a range of effective mental health training programs and tools available.
Developed by the Mentally Healthy Workplace Alliance and beyondblue, Heads Up calls on
business leaders to make a commitment and start taking action in their workplaces. One of the key
features of the website is a tailored action plan tool for organisations to identify specific ways they can
make their workplace more mentally healthy. Visit: www.headsup.org.au.
Mental Health in the workplace and wellbeing program The Black Dog Institute provides flexible,
customisable training and online resources to suit staff at all organisational levels. Delivered by
experienced mental health clinicians, programs focus on measurable data and results.
Visit www.blackdoginstitute.org.au.
5.
Increased suicide prevention Early priorities
training 5.1.1 The State Government will continue to
and provide training grants and coordination
Suicide prevention training aims to upskill the 5.2.1 to enable local communities to access
community in order to increase personal resilience evidence-based mental health and suicide
and competence in supporting and identifying prevention training.
someone with suicidal ideation or suicidal
5.3.1 Evidence-based training programs are key
behavior. Education in suicide prevention can
to skilling the community in how to deal
cover understanding common mental illnesses
with suicide risk and behavior effectively.
and reducing stigma; how to discuss suicide
A well-trained and competent emergency
with someone who may be at risk; identifying
services workforce can greatly contribute
warning signs and referring people to appropriate
to suicide prevention efforts. Gatekeeper
professional help.
training will be expanded across the State
This action area will be achieved through: with frontline workers in education, health,
police, welfare and corrective services
5.1 Promoting training and self-help activities for receiving training every three years.
high-risk groups and peer support.
5.4.1 Trauma informed care and specialist
5.2 Supporting mental health and suicide suicide prevention training for at-risk
prevention training in schools, vocational groups such as people who are bereaved
and tertiary education sectors and by suicide, young people, Aboriginal
community groups. communities, first responders and LGBTI
5.3 Coordinating Gatekeeper and other groups will be supported.
programs for professionals and para- 5.5.1 The Mental Health Commission will
professionals including General Practitioners, promote supervision and de-briefing
health workers and frontline service guidelines and best practice on the
providers. One Life WA website.
5.4 Embedding trauma informed practice in the
mental health workforce.
5.5 Backing up training with adequate
supervision and de-briefing mechanisms.
The Ministerial Council for Suicide Prevention has developed a Directory of Mental Health and
Suicide Prevention Programs available on the One Life WA website (www.onelifewa.com.au) which
have been assessed as demonstrating evidence informed practice and are appropriate for various
settings and target groups such as young people, Aboriginal communities and service providers.
The Council has also revised the Gatekeeper Suicide Prevention Training which is tailored for
Western Australian professionals and para-professionals whose roles bring them into regular
contact with young people and adults at risk of suicide. The two day course teaches participants to
identify and respond to people at risk of suicide and provides a framework for risk assessment and
intervention. Gatekeeper training draws on national and international research and a large evidence
base, using the Western Australia Coroner’s database and the Australian Bureau of Statistics data for
trends and suicide patterns. It is widely delivered across schools, health and corrective services.
Engaging frontline workers In 2015 the Western Australian Ministerial Council for Suicide Prevention
hosted a forum for emergency services personnel, mental health emergency workers and school
psychologists to enhance their skills to effectively address suicide and critical incidents. Former US
Police Sergeant Kevin Briggs delivered the keynote presentation and spoke of his experience patrolling
San Francisco’s Golden Gate Bridge and successfully intervening in hundreds of suicide attempts.
Sergeant Briggs provided insights into effective communication approaches for suicide prevention and
first responders. He also spoke of his own experience with depression and encouraged professionals
to look after their mental health through self-care, support systems and professional care.
This followed a previous presentation in 2014 where Mr Briggs spoke to front line responders at a
forum via a Skype presentation.
Trauma Informed Care can significantly help people who have experienced severe trauma to recover
from mental illness and related problems; and also prevent further harm through inappropriate
organisational practices or culture. In 2014, the Mental Health Commission coordinated training
by Adults Surviving Child Abuse for 335 staff of public mental health services, along with staff from
alcohol and other drug services. Training was also provided for clinicians and managers from
community managed organisations in the mental health sector. The training covered system-wide
application of trauma-informed care and practice. Research shows that because large numbers of
people who experience trauma-related problems access broad services beyond mental health, it is
critical that the full range of human service delivery is based on trauma-informed principles.
Australian Bureau of Statistics (ABS) is the statutory agency responsible for analysis and reporting
of mortality data in Australia, including suicide. Data on suicide deaths is sourced from the State
and Territory Registrars of Births, Deaths and Marriages and supplemented by information from the
National Coroners Information System. Published data on suicide are retrospective with up to an 18
month lag due to the time required for coronial processes. Annual statistics on suicide are published
through the ABS Causes of Death (cat. no. 3303.0) publication and the Productivity Commission’s
Report on Government Services. More detailed information is available through the ABS publication,
Suicides, Australia (cat. no. 3309.0). These statistics provide comparisons across jurisdictions and are
the most robust comparisons over time, with age-standardised rates.
Department of the Attorney General The Western Australia Department of the Attorney General’s
Coroner’s Office prepares a quarterly report on suicides statistics that is sent to the Minister for Mental
Health. This report, of which the Mental Health Commission receives a copy, contains statistics
sourced from the National Coronial Information Service (NCIS) and provides cases where a death has
been reported to the Coroner’s Office as a suspected suicide or where a coroner has made a final
determination of a finding of suicide. Data is provided by Aboriginality, region and age group (under
and over 25 years).
These statistics are more timely than those sourced through the ABS, and include the number of
suspected suicides. They include useful breakdowns such as Aboriginality by broad age group and
region. However, the current data management systems at the Coroner’s Office limit the ability to
undertake more detailed analysis on other factors relating to the suicide. This is a priority area for
improvement.
Ministerial
Partnerships with
Council for
Commonwealth, State and Mental Health Commission
Suicide
Local Government agencies
Prevention
Families and communities • Family physical, emotional and • Development of positive self esteem,
have a vital role in building psychological wellbeing communication and coping skills
protective factors • Caring and healthy relationships • Supportive relationships with family,
• Effective parenting and coping skills peers and the wider community
• Extended family and community • Engagement in school, education
support and recreation activities
• Positive early childhood development • Development of self-worth, personal
and healthy attatchment safety and healthy boundaries
• Significant adult who is a positive role
model
1. Priority Action 1:
Greater public awareness
and united action across
the community
2. Priority Action 2:
Local support and community
prevention across the lifespan
3. Priority Action 3:
Coordinated and targeted
responses for high-risk groups
4.
Priority Action 4:
Shared responsibility across
government, private and non-
government sectors to build
mentally healthy workplaces
5. Priority Action 5:
Increased suicide
prevention training
6.
Priority Action 6:
Timely data and evidence to
improve responses and services
• Ability to care for their own health • Strong identity, with a sense of • Staying mentally, physically and
and wellbeing and access support purpose and agency over one’s life socially active
• Capacity to create satisfying personal • Activities and support for ongoing • Opportunities to contribute and be
and social relationships wellbeing and health or healing valued by family and the community
• Skills to cope with difficult emotions • Maintaining deeper family and social • Managing health issues and
or problems relationships and responsibilities accessing services
• Development of skills to live • Opportunities to make a meaningful • Positive transition from work and
independently and reach personal contribution or show leadership at family responsibilities into retirement
goals home, work or in the community • Financial security, safe housing and
• Successful transition from school to • Stable finances, employment and social support
work or study safe housing • Drawing on own beliefs, values and
wisdom to deal with change or loss
The Plan is based on agreed national models and The Mental Health Network was launched
frameworks with system changes to be progressed in October 2014. It is a partnership between
over the next ten years. Priorities are separated Western Australia Health and the Mental Health
into the sections of prevention and mental Commission and provides a forum for consumers,
health promotion. Community support services. carers, clinicians and stakeholders to participate
Community treatment services. Community in decisions about mental health planning and
bed based services; hospital based services. development.
Suicide Prevention 2020 draws on the World 1. Training and practice support for General
Health Organization intervention approaches and Practitioners in detecting and treating
key strategic actions in the 2014 report Preventing depression;
suicide: A global imperative to: 2. General public awareness campaign including
information on depression and stigma
• Engage key stakeholders;
reduction;
• Reduce access to means;
3. Training sessions on depression and suicidality
• Conduct surveillance and improve data quality; for community facilitators such as priests,
pharmacists, social workers, aged-care workers,
• Raise awareness;
teachers and journalists who are gatekeepers
• Engage the media; in a position to direct vulnerable people to
• Mobilise the health system and train health effective treatment;
workers; 4. Offers of support for high-risk groups (people
• Change attitudes and beliefs; who have previously attempted suicide or self-
harm) and their families, with establishment of
• Conduct evaluation and research; and help lines and self-help activities; and
• Develop and implement a comprehensive 5. Restricting access to lethal means.
national suicide prevention strategy.
Collective impact has shown great promise in 7. High quality treatment for those with mental
United States communities addressing intractable illness, including cognitive behaviour therapy,
social problems and members of the Coalition dialectical behaviour therapy and online
firmly believe that it has the potential to make treatment; and
a difference in suicide prevention in Australia. 8. Appropriate and continuing care once people
Similarly the most successful initiatives in the leave emergency departments:
United States have been those that engaged all
- 24/7 call out emergency teams experienced
three sectors – community – businesses (small,
in child/adolescent suicide prevention
medium and large) – and government (local, state
and federal). At its heart, collective impact enables - Crisis-call lines and chat services for
us to solve challenging social problems with the emergency callers
resources we already have at our disposal.
- Assertive outreach for those in Emergency
It identified that a systems approach to suicide Departments and discharged including those
prevention produces the best outcomes. This hard to engage with
requires that key initiatives are implemented locally; - E-health services of web programs through
with the involvement of medical, health and the internet.(9)
community agencies; and together at the same
time.(9)
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onelifewa.com.au