Subscriber update: LIFE Transition to Life in Mind at the Hunter Institute of Mental Health

So much is happening in suicide prevention in Australia right now. The landscape around us is constantly changing. The federal Health Department has handed over responsibility for it’s ‘Living is for everyone’ website and resources to the Hunter Institute of Mental Health as of the 1st July 2017.

You can subscribe to their newsletter on the link in the correspondence below…

 

Dear colleague,

I am writing to inform you that as of 30 June 2017, the Living is for Everyone (LIFE) project has been transferred to the Hunter Institute of Mental Health.

Previously managed by On the Line, the LIFE project is aimed at improving access to suicide and self-harm prevention activities, as well as improving communication between suicide prevention stakeholders in Australia.

The LIFE project including resources and website will be absorbed into a new national project, Life in Mind.

The purpose of Life in Mind will be to connect organisations, programs, researchers and professionals working in suicide prevention in Australia, by providing a comprehensive online portal. Aims include supporting coordinated, consistent messaging around suicide prevention through the operationalisation of the National Communications Charter, linking policy to practice, communities to help-seeking and practitioners to the evidence base. It is anticipated that Life in Mind will better support people to communicate about, and respond to, suicide and its impacts.

A comprehensive national consultation process is currently underway to inform the development of the new portal and associated resources.

While the new online portal is being developed, the www.lifeinmindaustralia.com.au splash page is now available. This includes some basic information about Life in Mind, the LIFE Framework and selected fact sheets. You are currently a subscriber to LIFE Communications which is no longer hosted due to the transition. If you would like to subscribe to Life in Mind, please go to the www.lifeinmindaustralia.com.au and complete the subscriber section at the bottom of the page.

The Hunter Institute of Mental Health would like to acknowledge the hard work of the LIFE Communications team at On the Line over the past 10 years and thank them for their support in this transition period.

If you have any questions about Life in Mind, please contact Project Lead, Melinda Benson at melinda.benson@hnehealth.nsw.gov.au or on (02) 49246900.

Kind regards

Melinda Benson
Acting Program Manager Suicide Prevention

Project Lead Suicide Prevention

Hunter Institute of Mental Health
PO Box 833 Newcastle NSW 2300
Tel 02 4924 6941   Mobile 0434863427 | melinda.benson@hnehealth.nsw.gov.au

Visit: www.himh.org.au

 

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The Hunter Institute of Mental Health aligns itself with the goals of the National Closing the Gap Strategy. We acknowledge Aboriginal and Torres Strait Islander peoples as the traditional owners and custodians of the land

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Suicide is a society-wide problem that needs a society-wide solution

People across our communities need the confidence and skills to speak openly about suicide.            03/04/2017 11:09 AM AEST

Huffington Post

The weekend before Greg Hunt got his fellow health ministers from the states and territories to agree to a national plan to reduce suicide, I watched people with paper butterflies in Bendigo trying to heal the sorrowful hurt of our national suicide emergency.

At a community event there, I saw affected family members and friends queue up — young and old, townies with tattoos and country conservatives in Akubra’s — to pin their homemade personal tributes onto a net that symbolised holding hope.

I counted some 50 butterflies and some 800 participants.

I listened to a local GP who regularly deals with people with suicidality say: “People aren’t dying to die. People are dying from the pain of not being heard.”

Now, as governments and stakeholders consider what a national suicide prevention plan should include, and we finally join the other 28 countries who currently have one, we would be wise to listen and learn from the hard-earned and heartfelt lessons of those of ‘lived experience’. Those who directly deal with suicidal people, those impacted on by suicide death, and those who have overcome suicidality.

The vast majority of those who experience suicidality do not die.

For the 3027 deaths by suicide in the past statistical year — a 10-year high at a time of 25 straight years of economic growth — there were likely more than 100,000 attempts. The vast majority of those who experience suicidality do not die.

Let’s start our listening there, where hope lives. We know from overseas successes that suicide is practically preventable. For many, suicidality is an experience of being overwhelmed by pain at a point in time. This ‘psych-ache’ is contributed to by isolating factors such as loss of work, lack of access to services, relationship breakdown, addiction, and, in some but certainly not all cases, mental illness.

If we can hear people in that critical period and respectfully support them through what’s happening for them, many go on to live positive and prosperous lives. Therefore, the infrastructure for crisis support is vital to recognise in a national plan. We believe we contribute to saving some 1100 lives per week by being unconditionally there for people in intense pain and confusion.

Part of our contribution needs to be about matching our tradition of empathy with greater effectiveness. This year, to compliment the near 1 million phone and Internet interactions we fielded from around 300,000 Australians in crisis, we will seek to introduce crisis text and messaging.

A large portion of Australian communications activity is by SMS or some form of messaging, and that’s where we need to be to help. That’s especially true of men (about 75 percent of all suicides), and younger people (where rates are rising again), who may be more likely to use text or messaging in the first instance to seek help. Plus, it may make crisis support more accessible to rural and regional communities with weaker signals for mobile coverage, which typically have the most frightening suicide rates in Australia. We have at least enough money from the Feds and some very dedicated corporates to trial this year.

People across our society need the confidence and skills to speak openly about suicide, to remove the barriers such as shame and blame, and to encourage help-seeking.

Another key message from people with ‘lived experience’, especially those who have sadly seen loved ones die, is the need for greater skills in the community to address suicide among our family, friends, workmates and neighbours. Organisations such as Mates in Construction are currently doing a great job of training people in the high-susceptibility industry that is construction.

But we need to do more to destigmatise suicide and empower more people to have suicide-related conversations. That includes more involvement by the broader business community, especially where suicide risk is higher. Focus should be on male-dominated professions, and ‘gatekeeper’ sectors such as education, social welfare, employment organisations and the judiciary. People across our society need the confidence and skills to speak openly about suicide, to remove the barriers such as shame and blame, and to encourage help-seeking.

On the other hand, ‘spotting the signs’ of suicide is a difficult proposition that often eludes trained professionals, and there’s limited return in training people in this method of prevention. It’s likely to be more effective to empower the community to ask the critical question, “Are you suicidal?”, that Lifeline asks an average of 2500 times per day.

We need to use what we know about speaking about suicide from our 54 years of experience and share it with a community that has come to trust us to a truly humbling extent. We need more support for school and university programs, and businesses are literally crying out for help for their employees, contractors, suppliers and stakeholders.

Another ‘lived experience’ voice that is vital to hear is the one that consistently says this to Lifeline crisis supporters: “I’ve just left the hospital after a suicide attempt and don’t know what to do.” There is a massive gap in services and support for the group that is much more likely to be suicidal: those who have already made an initial attempt. As overseas evidence suggests, many of the deaths of this group of people are preventable through better ‘postvention’ and recovery, including improved discharge procedures, after-care facilities, follow-up services, and peer-to-peer support.

This we can do and it’s an area Hunt is very focused on. It’s a group of people who number in their hundreds and we literally know them by name. They have been to hospital; we can deliver hope directly to them by breaking down the barriers between hospital systems and charities, and by using the best of what modern technology offers us, such as e-health.

A national strategy can’t be up to the mental health and emotional well-being sectors alone, because it will fail.

Whether it’s ‘lived experience’ or others, a key aspect is co-ownership. A society wide problem needs a society wide solution. A national strategy can’t be up to the mental health and emotional well-being sectors alone, because it will fail.

As an alternative approach, The Huffington Post Australia, Twitter, Accor, and Lifeline will soon hold a #stopsuicide summit with 50 CEO-level executives and leaders from multiple sectors such as financial services, public administration, media, transport, tourism, agriculture, the law, resources and ICT to discuss their ideas for innovation and problem solving around suicide.

Ultimately, it’s this continuum of compassion and innovation that we need to have a go at, or as the World Health Organisation recommends, from ‘universal’ strategies to fight stigma to ‘selective’ strategies to reduce risks in vulnerable communities to ‘indicated’ strategies for specific people who need immediate support. As a colleague describes it: more of what works and more of what we need to try. And, in that respect, the principle of co-design, the use of evidence, the inclusion of measurement and evaluation, and the identification of accountability structures are simply non-negotiables in good policy and practice.

While a national plan is a good and necessary thing, the truth is much suicide will be prevented not by change in public policy but change in personal perspective. The disconnectedness and toxic loneliness that drives much suicide is given space to exist when we don’t go out of our way to look after each other and connect.

When the pervasive narcissism of our times negates our niceness to each other. When vanity blocks our values. When our practice of empathy goes without everyday practice. When our compassion is doled out in convenient clicks rather than acts of kindness. When we don’t speak plainly about the very real social disadvantages that at least compound suicidality in many people.

In the months ahead, we have the chance to make a real plan to save Australian lives. But, in this very moment, we have the chance to make a real promise to ourselves to care and connect with those who most need it. One bereaved mother in Bendigo told me that’s what she now devotes her life too; we should look at our own actions too.

___________
If you need help in a crisis, call Lifeline on 13 11 14. For further information about depression contact beyondblue on 1300224636 or talk to your GP, local health professional or someone you trust.

http://www.huffingtonpost.com.au/peter-shmigel/suicide-is-a-society-wide-problem-that-needs-a-society-wide-solu_a_22022910/

AISRAP’s World Suicide Prevention Day Community Forum Friday 8 September 2017

 Registrations and payments can be made via Griffith Pay on or before Friday 1 Sept

REGISTER NOW

AISRAP’s World Suicide Prevention Day Community Forum

 

Friday 8 September 2017

 

“Changing lives …. Responding to the impact of suicide for caregivers”

Jill Fisher

Whilst there has been increasing emphasis on the importance of timely individual, family and community support for those bereaved or exposed to suicidal behaviours (Moore, Maple, Mitchell & Cerel, 2013) only recently the impact of suicide beyond those directly affected been the subject of discussion and review. Responding to suicide loss and providing postvention support is a developing area of practice within the community and health sectors. The growing numbers of those who work or volunteer to support those affected and their own secondary exposure is a natural sequelae to this welcome workforce expansion. Whilst there have been many calls for the need to develop evidenced based and theory driven postvention models to support those affected (Law, Yip. Wong & Chow 2017), only recently has the area of ‘postvention workforce exposure’ and models of care for responders been recognised as an emerging area of need. This presentation will discuss the importance of supervision, self-care and values based reflective practice to encourage further discussion about effective peer support systems and other examples of professional care.
Internationally recognised for her work in the areas of suicide prevention, postvention and mental health, Jill Fisher has a special interest in the areas of crisis and traumatic loss & grief. Her media background and professional experience in research and national community development has further enhanced her skills in establishing integrated community responses to traumatic events. With active memberships on a number of national and international committees, Jill has also served as a professional advisor or peer reviewer to several national suicide prevention initiatives. Jill has been honoured to receive the 2011 IASP Norman Farberow Award, the 2013 National Suicide Prevention Australia Leadership & Innovation Award  and was a 2016 Griffith University Outstanding Health Alumnus of the Year Finalist.

Jill’s interest and passion in addressing the needs of those affected by suicide, including the emerging workforce sector, has been greatly advanced by achieving her Masters of Suicidology with the Australian Institute for Suicide Research & Prevention at Griffith University, under the directorship of internationally renowned suicidologist Professor Diego De Leo. Jill also completed her Masters in Health Studies (Grief & Loss) at the University of Queensland, under the directorship of Associate Professor Judith Murray.   Jill is currently undertaking Professional Doctorate studies to research aspects of the emerging suicide postvention and mental health workforces.

 

Guest Speakers

Guest Speakers include:

  • Mr Ivan Frkovic, Queensland Mental Health Commissioner
  • Dr Peggy Brown, CEO, National Mental Health Commission
  • Mr David Morton, Director General, Mental Health, Psychology and Rehabilitation Branch, Department of Defence
  • Professor Sheena Reilly, Pro-Vice Chancellor (Health), Griffith University
  • Professor David Crompton OAM, Director, Australian Institute for Suicide Research and Prevention
  • Ms Cynthia Morton, Bestselling author, blogger, speaker and founder of the multi-award winning Emotional Fitness Program
  • Adjunct Professor John Mendoza, Adjunct Professor, University of the Sunshine Coast and Adjunct Associate Professor, Brain and Mind Centre, University of Sydney
  • Detective Chief Inspector Gary Raymond APM, OAM (Retired)
  • Ms Janet Martin,  Director, Clinical Governance, Office of the Chief Psychiatrist, Mental Health Alcohol and Other Drugs Branch, Department of Health
  • Mr Michael Burge OAM, Consumer Advocate/Wellness Warrior
  • Mr Jorgen Gullestrup, CEO, Mates in Construction Queensland
  • Ms Jill Fisher, Suicidologist, 2011 winner of International Association for Suicide Prevention Norman Farberow Award
  • Mrs Jacinta Hawgood, Senior Lecturer, Program and Course Convenor for the Graduate Certificate in Suicide Prevention and Master of Suicidology Programs
  • Mr Mark Davis, Operations Manager, Roses in the Ocean
  • Ms Pam Barker, General Manager, Open Doors Youth Service

 

Registration and Payment

Registration on the day will begin at 8:00am, with the event commencing at 9:00am sharp.

Venue:  The Greek Club, Edmonstone Street, South Brisbane.

Payment Details:

$66 (incl GST) for full day attendance (8:00am – 4:15pm, includes morning/afternoon tea and lunch).

Why not book a table for your workplace colleagues?

Registrations and payments can be made via Griffith Pay on or before Friday 1 Sept 2017. To use Griffith Pay, please register as a user.  Please email aisrap@griffith.edu.au should you require assistance.

Please note: this event will be photographed for teaching, learning, marketing and promotional purposes. Please see Registration Desk on the day, for any queries.

Choose Life – Tom de Sousa

Tom de Sousa Pages 1, 2 and 3.pdf 27.28.8.2017

l was 14 the first time I injected ice. It was a sticky summer’s afternoon in a dingy block of East Perth flats. Stale sweat and tobacco smoke lingered in the clammy room; my veins bulged in the heat. The man crouching before me with the syringe drew blood and pushed the plunger to the bottom of the barrel. Hot liquid burst up my throat; then a searing cough, gasping for air, eyes wide and wobbling; brain pulsing with pure sensation and a cool creek of ice rushing beneath my skin. I spent the next five years chasing that feeling.

I came from a good family home. We spent the first eight years of my life in London where my father earned excellent money as a foreign currency trader. I was the eldest of four privileged kids; a bright but unsettled child. I was gifted in many facets of life – music, sports, academia – and my brilliance was nurtured by a caring family. I remember it as a happy time. Then we moved to Perth. My Australian parents wanted to come home. Dad struggled to find work and my mother became the breadwinner while he sought opportunity elsewhere. In his absence, our tight-knit family unit began to drift apart I struggled to fit the mold of the Australian schooling system.

Feelings of angst and discomfort were aggravated by the onset of adolescence. I was a raging outcast and turned to pot, alcohol and graffiti. My parents had no control, no answers. My defiance began to infect their marriage. Their relationship already had problems but as they devoted most of their time, energy and money to dealing with me, it became doomed. They divorced. It was a torturous affair. A poisonous atmosphere enveloped the household and I expressed my anguish in violent fits of rage. My younger siblings were caught in the crossfire of three warring parties.·One day, my mother discovered a large bag of white powder and a bundle of cash in my room. I’d stolen the cash from my parents and the powder was a faux bag of crushed cold-and-flu tablets from their medicine cabinet, but she believed her worst nightmares had materialised and she called the cops. I refused to co-operate. Bail was denied.

I was sent to the Range-view Remand Centre – short term juvenile detention for kids awaiting trial – to face the magistrate the following morning on a charge of possession of methamphetamine with intent to supply. I was 13. I was stripped, showered, searched and locked in a concrete cell with 10 other boys. Most were charged with car thefts, burglaries and violent crimes. I cut an odd figure in the crowd; a middle -class white kid locked away beside society’s forgotten children. After a few days inside, I was bailed to live with my aunt on a strict 24-hour curfew. My embattled parents were incapable of caring for me. I was alone and exiled. After two weeks imprisoned in a strange house, I absconded. I spent a few days roaming the streets, stealing to fund my freedom.

When the cops caught up with me I’d earned two new charges after stealing a tourist’s backpack. The court decided I would be placed on a strict supervision order and sent to a residential rehab for young offenders. It was a grave mistake. I had only begun a brief foray into the drug world, and real issues of anger and self-loathing went unaddressed
while I entered into a school of crime. I spent three months under the guidance of counsellors, youth workers, and experienced users. I graduated far shrewder than I’d entered.

My father had moved out of the family home, and I was sent to live with him. For the first few months we hardly spoke and I relished every opportunity to defy him. At the local high school I quickly established myself as a truant and a thief. One afternoon, a mob of us still in school uniform robbed an innocent by-passer. We were swiftly caught and charged. My schoolmates were sent home in disgrace, but I was sent back to Range-view. I was becoming a serial offender. My father bailed me out and sent me 600km from home to work on the furniture trucks. I needed a circuit breaker, he thought. There were depots in Albany and Esperance, and I’d spend the working week shifting furniture between country towns. I came home after a few weeks. I’d been inducted into working life by ruthless truckies and I vowed never to return. Instead, I used my hard earned wages to invest in an ounce of pot. My quest led me to the East Perth train station, where I met Mado, a veteran junkie in his late thirties.

His shaved head was emblazoned with tattoos of skulls, and he had an erratic demeanor from years of meth abuse. Up in his flat he marched around wide-eyed, fists clenched, preaching drug wisdom to anyone who’d listen. I was intrigued. Young and pliable, I grew to admire Mado. He taught me the specifics of selling pot, reducing the extortionate prices in exchange for stolen goods. I learned the drug world was bound by a strict code of ethics. Inexpiable violations included interfering with children, infecting another with a blood borne virus, and injecting someone for the first time. Even the most morally corrupt had boundaries; but there were plenty of less readily enforced taboos, such as injecting in the company of non -addicts. Strangely, selling ice to kids was permissible, but witnessing the vile act of Mada’s habit was forbidden. As an apprentice, I held special privilege – Mada openly advertised the rush. I soon built a prosperous pot trade under his tuition.

School was full of potential customers and I’d wander in at recess or lunch to peddle my wares. A good day yielded $300. When I began using ice I was convinced I had a handle on it. It filled me with fake courage and appeased my insecurities. Then it began keeping me awake. The longer I went without sleep, the worse the comedown would be, and the only thing that could ward away my demons was more ice. I began to stay awake on ice binges for days at a time. My father despaired at his helplessness. The ice was corroding my soul. He had a great deal of resources available to him but I was impervious to any assistance. There was nothing he could do, except keep me close. If he could guide me down to rock bottom, he thought, he’d be there to help push me back up. But he was treacherously close to the shrapnel of my addiction, and the ice began corroding his soul too.

My granny was the only one I confided in. She lived on the other side of the continent, but we spoke regularly on the phone. Like the ice, our conversations were a warm emotional sanctum where I could retreat from a turbulent reality. Often, she was all I relied upon to keep me sane. Meanwhile, my father reveled in novel freedom as a single man. A new mistress offered release, and her supportive shoulder obscured dangerous warnings signs. I knew she was bad news. It was palpable. One day, I was rifling through their room when I discovered a box of fresh syringes. A few weeks later, when I stole in
there again, they’d been used. I confronted my father. He blamed me. I felt faith slipping away. Those watching my demise from afar wrongly assumed I’d been led astray by a bad crowd. I was the crowd, until one night everything changed I was on an empty bus, coming home from a late night mission to Mado’s. Two boys boarded and joined me at the back. Initial wariness eased once we established we shared a mutual friend. I invited them back to my house.

Buska and Crops were cousins. Buska was 23the eldest and more imposing of the two. He’d recently been released from prison and he was shrewd, hawk-eyed and calculating. He respected the same qualities in me. Crops was 19, shy and wistful. When his mother had passed away a few years earlier, Buska assumed the unofficial role of guardian. We were united by personal hardship, and a lust for drugs and crime. Once I got to know them, I introduced Buska and Crops to Don. I’d been mates with Don for a few years. At 25, he was 10 years my senior and we connected on level deeper than drug culture. He was the only positive role model I was open to, but as the four of us grew close, he often succumbed to our influence. I assembled my new band of brothers and introduced them to Mado, who by now had moved into a flat in a grotty West Perth block. Parliament House was directly across the street. It was thrilling. We were right on the back veranda of The System’s very control centre! As our association and drug use became more frequent, we came to know our lives as The Game. Daily missions comprised three levels: hustling the cash, sourcing the gear, and finding a way to collect it. Actually injecting the drugs was a fleeting anti-climax, a short breather at the finish line of an exhilarating chase. It was The Game we were addicted to. The drugs just kept us playing.

My bedroom at dad’s house became our headquarters. It was small and often crowded in there with all of our big egos jostling for space. I was the youngest and most instigative user. Paradoxically, our association influenced each other’s ice use but helped regulate our habits. We were brothers, and we looked out for each other. It wasn’t until we were disbanded that I realised the true loneliness of drug addiction. Buska was due in court on an assault charge, and I didn’t hear from him for a few days I presumed he’d gone back to jail, a fact he confirmed via a phone call from Hakea Prison. Around the same time, Don decided to go on an adventure course in New Zealand. He wanted a fresh start. Meanwhile, my ice use spiraled out of control away from the watchful eye of my older mates.

Twelve days. No sleep. Convulsing, twitching, foaming at the mouth. Coming down; living hell. Psychosis. No state for interaction with the outside world, or to be left alone in my room. Crops’ company was slight consolation. Valium and pot took the edge off. Suicidal delirium. Eventually I looped out, grabbing a meat cleaver and sprinting up the street in search of an illusory figure. Next thing I knew, a red dot beamed onto my chest. I was cornered in a shopping centre car park by four policemen. Two were wielding Tasers; another had a ferocious German Shepherd on a leash. I brandished the weapon in a quivering hand. The dog handler was screaming at me, “DROP THE WEAPON OR I’LL LET THE DOG GO!” Once’ handcuffed and in the back of the paddy wagon, I jolted back to reality.

The next morning I was dragged up from the cells to face the magistrate. I’d been on bail – awaiting sentencing for a long string of offences – when I was arrested during the  psychotic episode. Now, a new serious charge was added to the list. My father was in the courtroom. He refused to sign bail. Throughout years of pandemonium he’d always believed I’d be OK, but a few days prior he’d envisioned himself standing over my grave. He had to cut me loose. I was a runaway freight train intent on derailment, and he wasn’t about to jump in front of the tracks. He later told me it was the hardest decision he ever had to make.

I was taken back to Range-view, where I spent a month waiting to reappear in court on six separate drug, weapon and stealing charges. With no prospect of bail, I felt hope ebbing away. My father had given up on me, my granny was powerless on the other side of the continent, and my mother had three other kids to protect. Still, I pleaded with my mum for 4 final chance. She was all I had to grasp onto. Our relationship was severely strained but she agreed to help, with strict supervision from the Drug Court program.

Relatively speaking, quitting drugs is easy. The most difficult part of rehabilitation is learning how to live again. After a violently emotional roller coaster ride through total ecstasy and living hell, it takes years of relearning before you can appreciate life’s simple pleasures again. At the beginning I substituted ice for furious physical activity. I joined the local football team and began to rediscover surfing, but boxing was my preferred outlet. I didn’t have to wait for the waves to show up or my team mates to pass the ball; I could box five, six, seven times a week! Exercise became an imbalanced obsession; the rush of ice replaced with a daily dose of endorphins.

Aged 16 and back at the local high school, I confronted the same social disharmony that had triggered my initial angst. Despite strict supervision, I was still heavily involved in the business side of The Game. It was a bridge between the two worlds, and a substitute for the thrills of ice use. A few months in, Don returned from New Zealand and Buska was released from jail. The brothers were reunited, but life was different A year had passed. We no longer had headquarters to convene in. Don was determined to stay on the straight and narrow and Crops had slipped into opiate addiction. Buska had emerged from prison with a new, callous resolve. When he and I were subject to urine tests, we delighted in cheating The System. Soon, we scheduled a getaway. My school mates were headed to a folk festival for three days of fun and I brought Buska, a few grams of high grade ice and a sheet of acid. I returned home a suicidal wreck. I strung up a noose on a metal beam in the garage and kicked the chair. Suddenly, I found myself slumped on the floor. The beam had snapped.

This encounter with death was a terrifying awakening, and the catalyst for change. My mother told the Drug Court of my suicide attempt and I failed my next drug test. I was sent to Range-view for two weeks, but the real lesson had already been learnt – life is too precious to waste. Midway through Year 11, I graduated from the Drug Court program. Life was looking up; I had rekindled a relationship with my mother and younger siblings, and was showing promise in re-engaging with my peers. School finished for the year and my granny decided I should join her overseas for the holidays. We spent two months in Europe, exploring the cities and staying with extended family. She introduced me to a different way of life and I began to discover freedom. It was a major turning point. Away from emotional distractions at home, I began to reflect deeply on my past and reconsider my future. When I returned home, though, I found little had changed. Late one night, I received a phone call from Don. “Bro, we need your help,” he said. He was with Buska,  his tone hushed and desperate. “Can’t talk about it on the phone, but it’s serious. You ever seen the movie The Italian Job? This is the real deal. We’re coming to get you now. Keep your phone on you.” I waited up until 4am, but when they hadn’t arrived I went to sleep. Two weeks later, I saw their mugshots plastered across the news. They were wanted for murder. Both were later convicted and sentenced to life in prison. For me, it was a Rubicon moment I decided to leave this life behind for good, knuckle down and finish schooling.

I made an effort to reconnect with my father. We hadn’t spoken for two years; his girlfriend was now out of the picture. As our visits became more regular, our relationship gradually improved. Nearing the end of Year 12, I began to spend hours after school ·with my grandfather. He was teaching me to drive, but over time it developed into something greater. My grandfather was an artist and a man with a deep spiritual aura. He imparted his philosophies to me, and taught me to cook, create, and live life on my own terms.

Almost 18, I acquired a driver’s licence and a car. I began to make the pilgrimage to Margaret River every weekend, where I fell in love with surfing, the outdoors, and the open road. Just before my birthday, I cashed out of The Game and booked an extended trip overseas. Travelling alone, I spent three months in Switzerland, Holland, and Morocco. I became comfortable with who I am, and discovered writing and photography as a means of cultivating my difference.

I’m 22 now. It’s been three years since I’ve touched ice. At the end of last year I completed a journalism degree, and now I work to optimise my freedom though a career as a freelance journalist. Storytelling has the power to change the world, and I hope to redeem myself by sparking positive change through my stories. I still deal with the consequences of addiction on a daily basis. Drugs have robbed me of joy. After a long period above the clouds, I struggle to appreciate life’s simple pleasures back down on Earth. Rebuilding relationships with loved ones is a lengthy process. But I’m alive and free, mostly thanks to the love, support and understanding of those who fought a terrible addiction alongside me. Without them, I wouldn’t be here to tell this story. This experience has chiselled the strength and endurance of my spirit, and awakened me to the vitality of life. The blessing is in the struggle. •

The Australian Weekend 27-28th August 2017

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Preventing Suicide in the Emergency Department

August 25, 2017
News Type:  Weekly Spark, Weekly Spark Research

 

Emergency departments (EDs) can reduce suicide attempts among high-risk patients by delivering a combination of interventions that includes suicide risk screening, discharge resources, and a brief intervention. A multi-site study found that when compared to treatment as usual, the combined interventions resulted in a five percent decrease in the proportion of patients who attempted suicide in the 52 weeks after their ED visit and a 30 percent drop in the total number of suicide attempts in that period.

The intervention targeted patients who were identified as being at risk through an initial universal screening, and included the following components:

  • A secondary screening that allowed ED physicians to better assess suicide risk.
  • A self-administered safety plan and information on suicide prevention provided to the patient by ED nursing staff.
  • A series of up to seven brief telephone calls to each patient and up to four brief telephone calls to a significant other identified by the patient, if available, in the 52 weeks after the first ED visit. These calls helped patients identify risk factors, clarify values and goals, engage in safety planning, assist with treatment engagement and adherence, and facilitate problem-solving with their significant other.

EDs that only implemented universal screening increased the number of patients identified as being at risk for suicide, but did not reduce the proportion of patients attempting suicide or the number of suicide attempts.

Miller, I. W., Camargo, C. A., Arias, S. A., Sullivan, A. F., Allen, M. H., Goldstein, A. B., . . . Boudreaux, E. D. (2017). Suicide prevention in an emergency department population: The ED Safe study. JAMA Psychiatry, 74(6), 563–570.

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Editorial Comment

Key Points

Question  Do emergency department (ED)–initiated interventions reduce subsequent suicidal behavior among a sample of high-risk ED patients?

Findings  In this multicenter study of 1376 ED patients with recent suicide attempts or ideation, compared with treatment as usual, an intervention consisting of secondary suicide risk screening by the ED physician, discharge resources, and post-ED telephone calls focused on reducing suicide risk resulted in a 5% absolute decrease in the proportion of patients subsequently attempting suicide and a 30% decrease in the total number of suicide attempts over a 52-week follow-up period.

Meaning  For ED patients at risk for suicide, a multifaceted intervention can reduce future suicidal behavior.

Abstract

Importance  Suicide is a leading cause of deaths in the United States. Although the emergency department (ED) is an opportune setting for initiating suicide prevention efforts, ED-initiated suicide prevention interventions remain underdeveloped.

Objective  To determine whether an ED-initiated intervention reduces subsequent suicidal behavior.

Design, Setting, and Participants  This multicenter study of 8 EDs in the United States enrolled adults with a recent suicide attempt or ideation and was composed of 3 sequential phases: (1) a treatment as usual (TAU) phase from August 2010 to December 2011, (2) a universal screening (screening) phase from September 2011 to December 2012, and (3) a universal screening plus intervention (intervention) phase from July 2012 to November 2013.

Interventions  Screening consisted of universal suicide risk screening. The intervention phase consisted of universal screening plus an intervention, which included secondary suicide risk screening by the ED physician, discharge resources, and post-ED telephone calls focused on reducing suicide risk.

Main Outcomes and Measures  The primary outcome was suicide attempts (nonfatal and fatal) over the 52-week follow-up period. The proportion and total number of attempts were analyzed.

Results  A total of 1376 participants were recruited, including 769 females (55.9%) with a median (interquartile range) age of 37 (26-47) years. A total of 288 participants (20.9%) made at least 1 suicide attempt, and there were 548 total suicide attempts among participants. There were no significant differences in risk reduction between the TAU and screening phases (23% vs 22%, respectively). However, compared with the TAU phase, patients in the intervention phase showed a 5% absolute reduction in suicide attempt risk (23% vs 18%), with a relative risk reduction of 20%. Participants in the intervention phase had 30% fewer total suicide attempts than participants in the TAU phase. Negative binomial regression analysis indicated that the participants in the intervention phase had significantly fewer total suicide attempts than participants in the TAU phase (incidence rate ratio, 0.72; 95% CI, 0.52-1.00; P = .05) but no differences between the TAU and screening phases (incidence rate ratio, 1.00; 95% CI, 0.71-1.41; P = .99).

Conclusions and Relevance  Among at-risk patients in the ED, a combination of brief interventions administered both during and after the ED visit decreased post-ED suicidal behavior.

 

http://jamanetwork.com/journals/jamapsychiatry/article-abstract/2623157

article in google scholar

 

Settings:  Health Care, Emergency Departments
Strategies:  Identify and Assist, Screening and Assessment, Effective Care/Treatment

Critical failure

https://radio.abc.net.au/programitem/pg16pYAWjV?play=true

Critical failure: the preventable deaths that keep happening in hospitals on Sunday Extra: Background Briefing

with Tom Switzer on Radio National

Sunday 27th August, 2017


Summary

How a series of blunders and the death of an 18-year-old girl have fed a wave of anger over the treatment of suicidal patients in hospitals. Tim Roxburgh investigates.

Image: ABC Newcastle: Robert Virtue

Podcast

 

See Coroner’s Report

RAFTERY Ahlia – Coroner’s Findings – redactedv3

http://www.coroners.justice.nsw.gov.au/Pages/Search.aspx?k=Ahlia%20Raftery

Image: Ahlia Raftery’s parents, Kirstie and Mike. (ABC Newcastle: Robert Virtue)