I have a scholarship!

I am now the grateful and proud recipient of one of the first 6 PhD scholarships awarded from Suicide Prevention Australia’s, Suicide Prevention Research Fund.

I am undertaking research into the impact of peer support in clinical and non-clinical suicide prevention services.

I have made nearly 400 connections with people, workers, and peers in suicide prevention around the world in the past year, since I started this blog, and it has given me great encouragement. There are people among you that I may be able to interview down the track. I have to complete a Research Proposal first, which is no small task, and that (confirmation) will take up the next 6 months.

I was unemployed for most of my Master’s degree and it was hard. I once told my supervisor that the wolf was no longer at my door but had moved into the house with me on a permanent basis. I might be able to show that wolf the door now. I can live and study in relative peace and ease. I will be off the dole and independent. I can hardly believe it!

peace dove

Advertisements

“Reason for not posting” from “You will bear witness” Blog – Trigger warning

One woman’s experience of seeking help after a suicide attempt…

you will bear witness

“I haven’t been posting blogs since 14th October due to a hospital admission following a suicide attempt. I was admitted to the Acute Mental Health Ward where no computers or phones are allowed so could not post. Thank you to all the readers and new followers who visited the blog in my absence. The subscription continues to increase.

I was in a very bad space on October 13th dealing with vivid flashbacks and dissociative episodes from my childhood abusive past. On the eve on October 14th for the second time in four days, I cut my wrists deeply.

After our experience at Campbelltown Public Hospital where we were left waiting thirty hours in a chair waiting for Mental Health and then discharged despite my husband saying I was suicidal, we drove to Hornsby Public Hospital and were seen within an hour, stitched up and admitted.

The difference in treatment between the two hospitals was marked. The staff at Hornsby were respectful, kind and humane. I was fully admitted to the ward within five hours and in a bedroom safe. My partner was able to go home knowing that I was being appropriately looked after. The poor man was exhausted and traumatised from the entire event but I had dissociated into my seventeen-year old alter who is hell-bent on punishment so had no control over what I was doing. I am bitterly sorry for the anguish I cause him. I hate DID and what it is doing to my family.

As it was an Acute Ward there were some very sick and psychotic patients there. The noise level was ridiculous as some people had emotional outbursts, yelling and screaming at all times of the day and night. No amount of medication could keep you asleep throughout those times. One woman believed the only medication that would cure her was Evening Primrose Oil so Security had to be called each medication time in order to get her to take her medications. Another man had DID like me and was permanently switching between four very aggressive alters, playing scrabble with each other and fighting together over the rules. He would change seats to take turns. One woman was a member of local Opera Company and sang all the time from various Operas so hearing the television was a waste of time!!!!! Her voice was amazing but all the time was a bit much, The staff was fantastic though, really professional and compassionate.

Today I transferred to St John of God Burwood a Private Clinic. It’s heaven by comparison. I have my computer back and my phone and most of all my peace, quiet and privacy and no Opera. I had lunch with my husband which was wonderful and he brought along our dog Toby who is a Therapy Dog so I had a good dose of love from him which did me the world of good. I feel safe in this Clinic and will be glad to be seen by my psychiatrist tomorrow and debrief what has happened. I start Group Therapy tomorrow also so that will be beneficial. There is also Art Therapy here which I find really useful and a fantastic outlet for emotions. It is really well stocked so you can do just about any art form you want. I need to work very hard during this admission to reduce my suicidality and self-harm for the sake of my family. It cannot continue as it has. There has to be a breakthrough soon in therapy. I want things to go back to how they were pre 2012. I am getting a lot of professional support and have a wonderful supportive family so have to keep up the fight. I cannot let the abusers win because if I take my own life or keep harming myself that is what I am doing.

You will bear witness blog

 

For help in Australia

CAPS – Talk Suicide Support Service – Free telephone and face to face support      1800 008 255

Salvation Army Care Line     1300 36 36 22

Reach Out     http://au.reachout.com/tough-times

Headspace     Register and chat now at eheadspace, or call 1800 650 890  Headspace

Lifeline    13 11 14

Mensline Australia 1300 78 99 78 (24 hour phone counselling and referral)

Beyond Blue 1300 22 4636

Mates in Construction: 1300 642 111

QLife        1800 184 527    Phone & Chat  3.00 – 12.00 pm everyday

SANE Australia help

SANE Australia Helpline  –  Talk to a mental health professional (weekdays, 10am-10pm AEST) 1800 18 72 63

Helpline chat – Chat online with a mental health professional (weekdays 10am-10pm AEST)

Kids Help Line 1800 55 1800 (24 hour phone counselling)

Suicide Call Back Service 1300 659 467 (Professional call back service referral line operates seven days a week)

Veterans Line 1800 011 046 (after hours professional telephone crisis counselling for veterans and their families

“You Matter to Me”: 4 Reasons Why Peer Support Saves Lives

Dr. Sally Spencer-Thomas

International mental health and suicide prevention impact entrepreneur

Mile+in+Shoes

 

The person most likely to save your life from suicide is someone you already know. Sometimes it may be a family member or a supervisor. Often its a peer.

Peer support is an essential link in the chain of survival. There are many reasons for this:

  1. Peers are willing to stay with us in our darkness when others are not. They let us know we are not alone.
  2. Because of their shared group perspective, they have insights into recovery barriers, opportunities and cultural nuances others can’t see. No other agenda exists because the power balance is usually neutral.
  3. Peer are usually people who have “walked in our shoes” emotionally. This bond of vulnerability leads them to be highly trusted. They have frequently lived through similar life challenges as others in their peer group and provide a hopeful example that things can change.
  4. Because peers are around us more often than other relationships in our lives, they are often the first to know when things are not right.

Informal peer supporters are our confidants — our 3 o’clock in the morning friends. We should all have a few of those on speed dial. Sometimes knowing someone would go out of there way to support us is enough to help us through a crisis. Sometimes, however, our friends don’t always know what to do.

Formal peer supporters or peer specialists are usually highly trained and supervised to be effective and confidential listeners and wellness partners. One of the core skills they are taught early on is how to be an active and empathic listener — a skill that many of us take for granted.

Having first-hand knowledge of crisis and mental health resources, formal peer specialists can become highly influential liaisons to professional care. Because they know that sometimes referrals don’t go according to plan, they are also key in follow up care as they continue to let people in crisis know they are not alone. 

Here’s the kicker — helping others helps the peer supporter. Known as the “helper effect,” peers who support others tend to also make meaning out of their own hardship. In addition, they are more likely to stay accountable to their own well-being when they feel like they need to be the best models of resilience they can be in order to contribute most effectively to another’s healing. 

For more about the transformative power of peer support listen to my podcast interview with Eduardo Vega: https://www.sallyspencerthomas.com/hope-illuminated-podcast/9

Originally used in clinical settings, peer support is increasingly being deployed in schools, workplaces, veteran communities and more. If you are interested in starting a peer support program you can start by reviewing this toolkit developed by the Behavioral Health & Wellness Program at the University of Colorado Anschutz Medical Campus School of Medicine.

In closing, let me leave you with “some feels” about the power of peer support. This week I stumbled upon this very inspiring video by a high school student from Utah named Jordan James. His lyrics and video “U Matter” remind us how compassion can save lives:

You Matter music video

“When you don’t feel the love from no one else
And you don’t feel the love from yourself
Reach out and you’ll see
You matter to me…”

 

For help in Australia

CAPS – Talk Suicide Support Service – Free telephone and face to face support      1800 008 255

Salvation Army Care Line     1300 36 36 22

Reach Out     http://au.reachout.com/tough-times

Headspace     Register and chat now at eheadspace, or call 1800 650 890  Headspace

Lifeline    13 11 14

Mensline Australia 1300 78 99 78 (24 hour phone counselling and referral)

Beyond Blue 1300 22 4636

Mates in Construction: 1300 642 111

QLife        1800 184 527    Phone & Chat  3.00 – 12.00 pm everyday

SANE Australia help

SANE Australia Helpline  –  Talk to a mental health professional (weekdays, 10am-10pm AEST) 1800 18 72 63

Helpline chat – Chat online with a mental health professional (weekdays 10am-10pm AEST)

Kids Help Line 1800 55 1800 (24 hour phone counselling)

Suicide Call Back Service 1300 659 467 (Professional call back service referral line operates seven days a week)

Veterans Line 1800 011 046 (after hours professional telephone crisis counselling for veterans and their families

NSW begins journey towards zero suicides with $90,000,000

Media Release from the NSW Premier; 17th October 2018

Media Announcement

All people who have been admitted to hospital following an attempted suicide and those who have reached out for help will have access to follow up care and support under a new comprehensive strategy that marks the beginning of our journey towards zero suicides in NSW.

Premier Gladys Berejiklian and Minister for Mental Health Tanya Davies announced nearly $90 million for new suicide prevention initiatives during the launch of the state’s first comprehensive suicide prevention strategy.

“The tragic loss of life from suicide leaves families and communities devastated and we shouldn’t accept the current rates,” Ms Berejiklian said.

“Two to three people lose their lives to suicide in NSW each day, and this has to stop.

“Today’s announcement provides vital funding and better coordination between the various support providers and agencies to ensure no-one slips through the cracks.

“This investment in mental health is possible because of our strong economic management.”

The number of lives lost to suicide in NSW – 880 in 2017 – is more than double the State’s road toll and the leading cause of death for people aged 15 to 44 years.

Mrs Davies said communities at high risk of suicide will benefit from new or expanded initiatives from next year including:

  • Aftercare services – ensuring all people who have been admitted to hospital following a suicide attempt have access to follow up care and support
  • Emergency Department alternatives – provide a more suitable alternative for people in crisis, such as designated ‘cafes’ with trained mental health workers at hand
  • Zero Suicides in Care – strengthening practices within the mental health system to eliminate suicide attempts by people in care
  • Expand community mental health outreach teams – to increase capacity to respond to calls to the NSW Mental Health hotline
  • New support services for people bereaved by suicide – to prevent ‘clusters’ of further suicides, especially among young people.
  • Resilience building within local communities – engage communities to participate in suicide prevention, with particular focus on Aboriginal communities
  • Enhance the Rural Adversity Mental Health Program – to provide additional counsellors for people in regional and rural areas
  • Improved collection and distribution of suicide data in NSW

“We expect these initiatives to have the biggest impact on suicide in NSW the State has ever seen and will ensure that we reduce the number of lives lost to suicide in NSW,” Mrs Davies said.

“Evidence shows integrated, community-led activities are more effective in suicide prevention than standalone, isolated activities that are not well linked.

“This is about providing our communities with the most effective tools so they have the strength, resilience and capacity to prevent and respond to suicide.”

The strategy known as the Strategic Framework for Suicide Prevention in NSW 2018-2023(external link) was developed by the Mental Health Commission of NSW and the NSW Ministry of Health, in collaboration with people with lived experience of a suicide attempt or suicide bereavement, government agencies, mental health organisations and experts in suicide prevention.

For help in Australia

CAPS – Talk Suicide Support Service – Free telephone and face to face support      1800 008 255

Salvation Army Care Line     1300 36 36 22

Reach Out     http://au.reachout.com/tough-times

Headspace     Register and chat now at eheadspace, or call 1800 650 890  Headspace

Lifeline    13 11 14

Mensline Australia 1300 78 99 78 (24 hour phone counselling and referral)

Beyond Blue 1300 22 4636

Mates in Construction: 1300 642 111

QLife        1800 184 527    Phone & Chat  3.00 – 12.00 pm everyday

SANE Australia help

SANE Australia Helpline  –  Talk to a mental health professional (weekdays, 10am-10pm AEST) 1800 18 72 63

Helpline chat – Chat online with a mental health professional (weekdays 10am-10pm AEST)

Kids Help Line 1800 55 1800 (24 hour phone counselling)

Suicide Call Back Service 1300 659 467 (Professional call back service referral line operates seven days a week)

Veterans Line 1800 011 046 (after hours professional telephone crisis counselling for veterans and their families

 

tree

 

Brainstorm – never give up

A film for young people by young people, produced by the Gympie Flexible Learning Centre

Brainstorm

This film recently won the regional and national awards in the Young Film Makers category at the Heart of Gold International Short Film Festival in Gympie.

It is only 10 minutes, beautifully made; it is wonderful, worth watching and sharing.

Brainstorm

 

13 Reasons Why We MUST Talk About Teen Mental Health

Lorry Leigh Belhumeur, Ph.D is the CEO of Western Youth Services, a non-profit organization based in Orange County, CA.

It’s mission is to advance awareness, cultivate success and strengthen communities through integrated mental health services for children and their families

Teen-Mental-Health-092017-Blog-Cover

Last year, the New York Times reported that the suicide rate in the United States had hit a 30 year high, particularly affecting adolescent girls. Suicide is the third leading cause of death for young adults ages 15-24, and reports state that most teens who completed suicide have some type of coexisting mental health condition, such as depression, anxiety or drug and alcohol abuse.

The time to talk about teen mental health issues is now, and the place to start is with open conversation.

Perhaps it makes sense why 13 Reasons Why is one of the most popular shows on Netflix this year. It tells the story of a high school student named Hannah Baker, who through a series of tapes, offers a rationale for why she decided to take her own life. There is an ongoing debate on whether or not such graphic details were constructive or destructive to reveal, but what we know is that regardless, being able to identify and address warning signs and symptoms of mental health issues is very important.  Having this knowledge may very well save lives.

Toxic Stress Affects Teen Mental Health

There is a common denominator that we see in our work, toxic stress that occurs in childhood.  The 1998 landmark Adverse Childhood Experiences (ACEs) Study by the Centers for Disease Control and Prevention and Kaiser Permanente provides insight on types of toxic stress that results from childhood trauma (e.g. abuse, neglect, family dysfunction) that are predictive of mental health outcomes, such as depression and anxiety, suicide attempts and drug abuse. Our focus is on how we can help minimize the impact of adversity, bolster strengths to build resiliency, and in many cases change the trajectory of young lives.

In 2016, we conducted a review of the impact of ACEs and their relationship with collaborative youth mental health services. We sought to determine the relationship between our integrated and collaborative mental health services and mental health outcomes, specifically with children who were exposed to multiple adverse childhood experiences. The goal was to further our development of evidence-based practices and present a case for support for widespread understanding of ACEs as part of mental health treatment and prevention strategies.

The content of our report shows:

  • ACEs pose a threat to proper brain development.
  • More than half of the adults in California have at least one ACE.
  • Individuals with four or more ACEs are seven times more likely to have mental health problems and 11 times more likely to attempt suicide than individuals with zero ACEs.
  • Without intervention, the estimated weighted annual community cost per child is $18,856 in one community.
  • Western Youth Services is addressing ACEs with nearly every research-recommended strategy.

Our Version of 13 Reasons Why

Over the course of the next few months, we will be publishing a series of articles addressing the most prevalent 13 adversities and/or teen mental health conditions that our clients experience. It is our hope that the overview below and the accompanying articles in the series will serve as an informative resource to increase awareness, reduce stigma, cultivate healing, strengthen communities, and most importantly to change lives.

1. Abandonment 
Whether through divorce, death, distant parents or caregivers, or a falling out among friends, abandonment issues create emotional conditions that are not conducive for healthy development. Young adults who have been the victims of abandonment may struggle to trust others, inadequately express their needs, and experience disproportionate feelings of shame, low self-esteem and the like.

2. Abuse 
Abuse is an umbrella term for any act that aims to “diminish one’s sense of identity, dignity, or self-worth.” Abuse can be verbal, physical, sexual, or emotional, and can occur whether or not the abuser is aware that they are negatively harming someone.  Abuse can be inflicted by parents, friends, neighbors, acquaintances or strangers. Teen dating abuse and violence is a particularly big issue for adolescents and young adults today.

3. Anxiety and Depression
Although anxiety and depression are not mutually exclusive, they can both be characterized by the persistent and excessive presence of worry, sadness, irritability or unwanted/intruding thoughts. The conditions, which can often occur in tandem, may present as irrational worry, withdrawal, isolation, disinterest in activities and family/friends, changes in appearance, irritability or moodiness. Anxiety and depression are the leading causes of suicidal ideation. Over 90% of young adults who report experiencing suicidal thoughts are also being diagnosed with one or both.

4. Bullying and Cyberbullying 
Bullying is unwanted or aggressive behavior that creates a real or perceived power imbalance. Bullying can include, but is not limited to: teasing, name-calling, threatening to cause harm, leaving someone out on purpose, spreading rumors, publicly embarrassing, hitting, kicking, tripping, stealing, or insulting someone. Cyberbullying is bullying that occurs using electronic technology, and can include, but is not limited to: mean texts or emails, rumors posted publicly, embarrassing photos or videos, and the creation of fake profiles used to mock or steal the identity of an individual.

5. Drug and Alcohol Abuse
Drug and alcohol abuse is the usage or over-usage of illegal or prescription drugs or excessive alcohol intake. Studies show that there is a link between drug and alcohol abuse and suicide in teens, and some of the warning signs include having a sudden change in friends, being secretive or withdrawn from family, dropping grades, paying less attention to hygiene and new or odd behavior.

6. Eating Disorders
Eating disorders are the use of restriction, binging or purging in association with negative body image and self-esteem, or the desire to change one’s body. Behaviors may include restricting meals, not eating for long periods of time (anorexia), binging and then purging (bulimia), exercise addiction (orthorexia), overeating to the point of feeling sick (binge eating), or a combination of these. Some causes may be related to genetics, traumatic experiences, peer pressure, bullying, or having a friend or family member with an eating disorder.

7. Embarrassment and Shame 
Shame is the emotion of feeling “lesser than,” bad, wrong, or unworthy. Embarrassment is the feeling that accompanies having your individuality or inadequacy (whether real or perceived) made a point of public attention. These emotions occur often in young adulthood, as teens are developing their sense of self and finding their confidence. Research notes that it is during this time of life that our propensity to compare ourselves to others, self-reflect and feel sensitivity toward other people’s opinions is at a high. Feeling embarrassed or ashamed of oneself is one of the most overlooked connections to suicide or suicidal ideation.

8. Family Dysfunction  
There are a wide range of issues that are considered familial dysfunction.  Most people associate it only with big events such as witnessing violence at home, living through a parental divorce, separation, or death, drug or alcohol abuse, physical abuse, and family members with mental, physical, or emotional illness. There are also adversities that may seem small or even go unnoticed, yet they cause traumatic stress that can lead to depression or anxiety that negatively impacts a person for life.

9. Social Isolation and Withdrawal 
Social isolation and withdrawal are classic signs of depression and possibly suicidal ideation. It occurs when the discomfort and stress of being around other people becomes so unbearable that one prefers to be by themselves more often than not. Children and young adults who struggle to fit in and feel accepted are more prone to experiencing bouts of withdrawal than adults.

10. Learning Disabilities
Young individuals with learning disabilities reportedly experience more abuse, neglect, challenging family dynamics, peer bullying, and exclusion than anyone else. Studies state that persons with learning disabilities “are likely to be at increased risk for undetected suicidal thoughts and behaviors.” This can be due, in part, to feeling misunderstood and isolated, different thought and conversation patterns, and struggling with tasks and responsibilities that seem to come more easily for others.

11. Neglect 
Though neglect falls under the umbrella of abuse, it is different from it in that it is the failure of a parent, caregiver or other guardian to care for a child under 18. Neglect can be physical or emotional, and it also includes failure to protect against sexual abuse, as it relates to the disregard for a child or young adult’s well-being. Studies show that over half of individuals who are admitted for care due to neglect show suicidal behavior.

12. Peer Pressure
Peer pressure is the influence that individuals within the same age group or social circle project onto one another. Often, it is actually the pressure to feel perfect or to perform in a way that is out of alignment with one’s true wants, desires or values that pushes the correlation between peer pressure and suicidal thoughts or behavior. 

13. Self-harm and Suicide 
Self-harm, suicide, and other forms of intentional self-mutilation affect 15% of adolescents in the US, and 17%-35% of college-aged students, according to The Journal of the American Board of Family Medicine. Self-harm is the umbrella term for any behavior that involves intentionally harming one’s body, such as cutting or burning. It is typically a sign that a young adult does not have the coping mechanisms to deal with such intense feelings of pain or dread, which is also what drives some to feel that there is no other way to “escape” than to end their own life.

Suicide is never a solution. It is an irreversible choice regarding a temporary problem. There is help. If you are struggling with thoughts of suicide or know someone who is, talk to a trusted adult, call 1-800-273 TALK (8255), or text “START” to 741741.

Since 1972, we have aimed to advance awareness and redefine mental health to include mental health and wellness services for children, teens, and families. We are acutely aware of the signs and symptoms of intensive mental health needs.  Through our decades of work, we are knowledgeable of the common precursors to crises and the risk factors associated with mental health conditions.  We are also experts in mitigating the ravaging effects of childhood trauma through our evidence-based and evidence-informed practices and treatment.  Our 3-tiered approach provides a wide range of prevention strategies, targeted intervention and clinical treatment for those with intensive mental health needs.

We have countless stories of healing and recovery to share, in which our clients have minimized the impact of adversity, developed their resiliency muscles, and gone on to lead happy, fulfilling lives. We recognize that each story began with a conversation, and we hope that the following series provides a starting point for more families, schools, and communities to have the knowledge and resources to start talking to the young people in their lives about what’s really going on in their hearts and in their minds.

The time to talk about teen mental illness is NOW

Lorry Leigh Belhumeur PhD, CEO of Western Youth Services on Blog - Western Youth Services (WYS) Orange County - the hub of mental health care and wellness solutions for kids in Orange County, CA

Lorry Leigh Belhumeur, Ph.D.
Chief Executive Officer
Western Youth Services

 

For help in Australia

CAPS – Talk Suicide Support Service – Free telephone and face to face support      1800 008 255

Salvation Army Care Line     1300 36 36 22

Reach Out     http://au.reachout.com/tough-times

Headspace     Register and chat now at eheadspace, or

call 1800 650 890  Headspace

Lifeline    13 11 14

Mensline Australia 1300 78 99 78 (24 hour phone counselling and referral)

Beyond Blue 1300 22 4636

Mates in Construction: 1300 642 111

QLife        1800 184 527    Phone & Chat  3.00 – 12.00 pm everyday

SANE Australia help

SANE Australia Helpline  –  Talk to a mental health professional (weekdays, 10am-10pm AEST) 1800 18 72 63

Helpline chat – Chat online with a mental health professional (weekdays 10am-10pm AEST)

Kids Help Line 1800 55 1800 (24 hour phone counselling)

Suicide Call Back Service 1300 659 467 (Professional call back service referral line operates seven days a week)

Veterans Line 1800 011 046 (after hours professional telephone crisis counselling for veterans and their families

Urgent Care Centres

Speaking of ‘crisis refuges’… here’s a model

Extract from “Preventing suicide” on All In The Mind – ABC Radio National with Lynne Malcolm

Sunday 7th October MP3


David Covington is the CEO and president of Recovery Innovations International in the United States, and he’s one of the founding fathers of an initiative called Zero Suicide in Healthcare. He is a pioneer of the Zero Suicide Healthcare model. It’s the belief that robust improvement in healthcare will reduce the number of deaths. The goal is to prevent death by suicide within the system. There are now hundreds of Zero Suicide programs in the United States, England, the Netherlands, Canada and New Zealand. David Covington describes one of these programs which has been going for about a decade.

David Covington: We are seeing a model in Phoenix, Arizona, where last year 23,000 individuals were in such crisis that law enforcement was engaged. Someone called the 911 medical system, a family member called the police, the person themselves was so afraid that they reached out. In the rest of the country, every single one of those 23,000 would have gone to a hospital emergency department where they would have waited to get into a room, they would have then waited for some kind of psychiatric consult or assessment. Then would have waited for a referral to get into some kind of program somewhere, and then they would have waited for transportation to that program. All of that waiting would have landed up in a wait of 18 hours to three days, depending on where they lived. At the end of that they might or might not get into some service that was meaningful.

But in Phoenix, every single one of those 23,000 was taken directly to an urgent crisis care centre, not in the confines of a hospital, situated across five geographical locations in the county. Law enforcement doesn’t call or go on a web portal, they don’t need to make a referral, they just drive to the closest available site, they go to the law enforcement door. There is a separate entrance into a small room that connects directly to each of these five units. They go into that room, and within 3 to 5 minutes they are back on the street. So it dramatically reduces the law enforcement time in engagement, and it incentivises law enforcement to actually take people to care. In the US it’s not uncommon for them to book someone on a nuisance crime into jail, which is far faster. So we’re making it as fast as possible.

Lynne Malcolm: Once at the crisis care centre, the person is welcomed into a comfortable, warmly-lit room, which is more like a living room than a hospital ward.

David Covington: And there’s space. People are frustrated and agitated. You’ve got to give them some space so that we don’t exacerbate conflict. We are trying to calm and provide support. And then in that environment they are referred to as a guest through that program, and we have different levels of service….. {here he describes a stepped model of care}

Then, of those that we can’t resolve, we’re trying to get them into one of these urgent care facilities where many are seen briefly or

they go into our…we call it the retreat, but it’s a 23-hour program where there are recliners, open environment, they’re going to get not only peer supports but medical engagement and clinical support. We don’t focus on what is wrong, we focus on what is strong.

And what that means is we are looking at what does the person want to accomplish in their life and how do we address that success? What are the strengths that we can levy and what are the obstacles in the way? So you’re not focusing on the mental health presentation, up until the point that they say part of it is an impediment to what they are experiencing.

And then we have a level 5 on that ladder is a sub-acute. It has the services that you would see in a psychiatric inpatient program, but again, in that living room environment with peer supports embedded, and they are more likely to stay 2 to 4 days. So we find a good 60%, 65% of those in crisis who would have historically gone into even higher levels of care if they were available, their needs can be met at one of those, that 23-hour observation or that short-term stay unit.

Lynne Malcolm: David Covington and his colleagues have found that this Zero Suicide crisis model has saved hundreds of millions of dollars for hospitals and the police force in Phoenix. And it’s also cut years of unnecessary waiting time for those who are at risk of suicide.

lily pond

For help in Australia

CAPS – Talk Suicide Support Service – Free telephone and face to face support      1800 008 255

Salvation Army Care Line     1300 36 36 22

Reach Out     http://au.reachout.com/tough-times

Headspace     Register and chat now at eheadspace, or call 1800 650 890  Headspace

Lifeline    13 11 14

Mensline Australia 1300 78 99 78 (24 hour phone counselling and referral)

Beyond Blue 1300 22 4636

Mates in Construction: 1300 642 111

QLife        1800 184 527    Phone & Chat  3.00 – 12.00 pm everyday

SANE Australia help

SANE Australia Helpline  –  Talk to a mental health professional (weekdays, 10am-10pm AEST) 1800 18 72 63

Helpline chat – Chat online with a mental health professional (weekdays 10am-10pm AEST)

Kids Help Line 1800 55 1800 (24 hour phone counselling)

Suicide Call Back Service 1300 659 467 (Professional call back service referral line operates seven days a week)

Veterans Line 1800 011 046 (after hours professional telephone crisis counselling for veterans and their families

We could have had 36 suicide crisis refuges around the country

I am not alone in my disappointment.

Lobbyists dominate mental health sector

The Saturday Paper: Edition No 225, October 6 – 12, 2018

As the suicide rate rises, health experts say millions in government funding is going to unproven programs and the sector is captured by lobbyists. By Karen Middleton.

A month ago, the town of Derby in the West Kimberley held a basketball carnival and hoop-shooting contest on what happened to also be World Suicide Prevention Day.

In a region with one of the highest suicide rates in the world, where primary school-aged children have taken their own lives in the past two years, Derby’s community leaders work hard to organise events that will have a positive impact on the children in their care.

As the carnival wound up, the children were seated to listen to a visiting government-funded social worker.

The fun had ended so people as young as six could be lectured about self-harm.

Professor John Mendoza, a suicide prevention consultant who happened to be in Derby, was appalled. Giving evidence a week later to a Senate committee investigating mental health issues and suicide in rural and remote Australia, Mendoza said the event had been “hijacked”.

“It was just entirely inappropriate,” said Mendoza. “I just thought, ‘Wow, that program was funded by the federal government’… It was completely out of context and disconnected to what the community needs.”

Mendoza is among a number of experts working in the health sciences and on suicide prevention who are concerned governments are spending money on programs they allege haven’t, by any rigorous scientific evaluation, been proved to work.

Their concerns appear to extend beyond the professional jealousies and competitive tensions that affect many corners of the community sector.

Some say funding decisions are influenced more by the lobbying of high-profile organisations than by scientific research. And a few believe the current national approach to combating suicide in Australia may in fact be making the situation worse.

It’s an allegation the federal government and organisations it funds, including beyondblue and the Black Dog Institute, reject. They insist programs are being evaluated thoroughly but that after they are designed based on research, they need to be implemented and then tested in the field.

What all agree on is that the latest figures on Australia’s suicide rate published on September 26 tell a grim story.

Last year, the number of suicides rose 9.1 per cent, from 2866 in 2016 to 3128.

That is 12.6 deaths per 100,000 people, equalling the 2015 rate as the highest in a decade.

Tasmania, Victoria and South Australia were the only jurisdictions that did not record an increase.

The percentage increase was biggest in the Australian Capital Territory, where the numbers climbed from 28 to 58 in a single year – a rise of 107.1 per cent.

But on raw numbers, Queensland’s increase was greatest, from 674 deaths in 2016 to 804 last year.

Nationally, the rate remains higher for men than women, and the rate among Indigenous Australians is more than double that of the rest of the population.

While the national figures have fluctuated in recent years, during the past decade the overall trend is upward – a dreadful indictment in a country that ploughs hundreds of millions of dollars into suicide prevention.

The question nobody can answer with certainty is: Why?

The causes of suicide are hugely complex – a mix of mental ill health and other factors, including financial and relationship stress, isolation, addiction, bullying or other persecution, and situational circumstances, such as living in areas of drought, high population growth, low income or inadequate services and infrastructure.

A spokesperson for Health Minister Greg Hunt said the national figures, while fluctuating, were of deep concern. The minister has written to the Queensland government seeking a joint approach to the particular challenges in that state.

“The data highlights that there is no single reason for the rise in Australia’s suicide rates, and no simple one-size-fits-all solution,” the spokesperson told The Saturday Paper.

“Suicide is a complex issue … It is therefore important that approaches to suicide prevention provide the right interventions, at the right time, in the right locations, for the right groups. In establishing suicide prevention initiatives, the government considers a range of evidence, including outcomes from evaluations, scientific research, evidence of best practice and feedback from mental health and suicide prevention experts and people with lived experience.”

He said the services and programs offered by organisations such as Lifeline, headspace, Orygen, and the Black Dog Institute were “all already well-supported by evidence”.

But some suicide-prevention experts are querying the government’s funding priorities and suggesting they are addressing only part of the problem.

Professor Ian Hickie, who has recently finished six years’ service on the National Mental Health Commission, told The Saturday Paper he believes too much is being spent on raising awareness and informing people about how and where to seek help, but too little is going to the services to treat them when they do.

The numbers, especially of young people, presenting to hospital emergency departments experiencing mental health crises and talking about suicide has risen dramatically in recent years.

But Hickie says there is not enough effective support being offered in response, and that hospital workers aren’t well enough trained to deal with them.

He and others believe the health system’s structure puts time pressure on GPs, which can result in inadequate treatment of psychological problems.

Hickie believes there is a risk that people who have tried once to end their lives might be discouraged from seeking help in any future crisis.

Emeritus Professor Robert Goldney of Adelaide University expressed similar views in an opening address to Suicide Prevention Australia’s yearly conference earlier this year, saying he saw no proof the non-government organisations receiving large amounts of funding were actually achieving results.

“They’re not preventing suicide,” Goldney told The Saturday Paper this week. “There’s no evidence they are.”

Melbourne University Professor Anthony Jorm suggests those with the loudest voices have influenced funding priorities. “I think we’ve been driven by lobbyist-led reform rather than evidence-led reform in the mental health sector,” Jorm told The Saturday Paper.

Privately, some others agree.

Jorm queries the speed with which some programs are rolled out nationally. He says there is often too little evaluation of the pilot stage.

“The concept looks great and then when the data comes in years later, it doesn’t look very good at all,” Jorm says.

“We need to rigorously evaluate how they work in practice … We need to rigorously evaluate things rather than say, ‘That’s a good idea.’ ”

The director of the Black Dog Institute, Helen Christensen, rejects the criticisms. She suggests some experts in the field are stuck on old ways of doing things that don’t reflect contemporary needs or response requirements.

“The way people are working now using implementation science we think is a really good way to go,” Christensen says. “Let’s evaluate in the wild, while it’s really happening. We actually have to do it. It’s about development.”

BeyondBlue’s chief executive Georgie Harman, says rigorous work goes into research for her organisation’s programs and it is currently undergoing an independent evaluation, the results of which will be made public. She rejects criticism from others in the sector.

“Now is not the time to be launching an attack,” says Harman. “It is a time for the sector to be pulling together as never before. The #YouCanTalk suicide prevention campaign launched in August was the first time so many organisations had come together to drive the message that everybody has a role to play in suicide prevention.”

Harman says funding has been increased at federal, state and territory and local levels. “It is a long-term strategy,” she says. “It will take time for the impact of that funding to be felt and for the services to be fully implemented.”

Professor Patrick McGorry, the 2010 Australian of the Year who now heads Orygen, the national centre for excellence in youth mental health, takes a middle-ground position on the critical assertions.

“I think the figures really show that what is being done is not working,” says McGorry. “But that is because it’s only being done in a partial and a threadbare way.”

McGorry argues the current system works to support the low-level and the most acute cases but that the “missing middle group” is not well served.

“It’s the foundations of a house but we’ve built the front room,” he says. “We haven’t built the rest of the house.”

Similarly, Ian Hickie praises the concept of the network of 30 primary health network centres, or PHNs, that the Abbott government introduced and the Turnbull government boosted by introducing 12 suicide-prevention trial sites within them.

But Hickie says they still lack centralised coordination. “There’s no serious national implementation plan.”

Hickie says the trials also aren’t informed by predictive modelling that could tailor them better to the specific needs and stresses in their communities, although beyondblue and the Black Dog Institute dispute this.

He says that would require the collection and central availability of up-to-date detailed regional data on suicide and attempted suicide because, as Hickie says, while the national figures accurately reflect an alarming trend, the detail of them and their state breakdowns can be misleading.

“You can’t imagine any other area of public health where you don’t know the data accurately,” he says. Others say if it was a drug being tested, the trial would be cancelled.

John Mendoza, who runs private suicide-prevention consultancy ConNetica, concurs.

“If we are serious about tackling suicide, first things first: let’s learn to count and a lot quicker,” says Mendoza.

“The only complete data available at present in the public domain is 2014. That is hopeless for action by all the relevant players.”

But the Black Dog Institute rejects that assertion. The institute is conducting four trials of its own program at sites across New South Wales.

Helen Christensen told The Saturday Paper there is enough regional data on which to model programs and that her organisation both collects and holds it. She said, however, she supported “the idea that we need more national implementation into that process”.

Some who work specifically on prevention in Indigenous communities are also questioning funding priorities and suggesting the focus needs to broaden beyond health services to address deeper systemic disadvantage, noting the statistics are worst in the most disadvantaged communities.

Darwin-based Indigenous suicide prevention worker Dameyon Bonson believes funding priorities are wrong.

“Can we just see the evidence that what is actually being funded reduces the rates of suicide?” asks Bonson, adding that the question is valid in the whole sector, not just in Indigenous communities.

“The approach needs to shift away from a mental health paradigm and start treating suicide as a behaviour, which it is, not a disease or an illness.”

The minister’s office points to a federally funded centre of best practice on Indigenous suicide prevention and a range of broader programs supporting research into “what works” across the whole population.

The views emerging from Derby and the surrounding region about what would help alleviate the Kimberley’s elevated suicide rate – the subject of a Western Australian state coronial inquiry whose findings are due next month – goes beyond just health services.

The Kimberley region’s PHN suicide prevention trial oversight committee met this week.

The spokesman for the Kimberley Aboriginal Law and Culture Centre, Wes Morris, advocates greater support for preserving culture as part of it. He says that would emphasise the community’s strengths, not dwell on its weaknesses.

Some of Derby’s medical staff and health workers gave evidence to the Senate committee earlier this year, calling for more support.

Community leaders say other changes are needed, too.

After his working visit, John Mendoza told the Senate committee that the basketball carnival organisers in Derby had told him what they needed to help address the suicide risk among the town’s children was a covered court they could use through both the wet and dry seasons, not just half the year.

“When it comes to Christmas holidays and so forth, that is when the suicide rate goes up – and leading up to it,” says Mendoza.

“They need facilities which can enable them to keep young kids engaged in some form of community activity. That is suicide prevention. It is not about a bunch of whitefellas, like me, flying in and delivering some message to eight-year-olds about suicide. That does not work, full stop. But this is what I see around the country.”

Ian Hickie predicts that if governments don’t grasp the political potency of the rising national suicide rate already, they will as the election approaches.

“When the prime minister and leader of the Opposition start to tour the country … guess what?” says Hickie. “They’re going to have the same questions asked again: ‘What have you done since the 2016 election? What are you going to do going forward?’ ”

 

Ruby Williamson

Ruby Williamson
‘Puli Murpu’ 2008
acrylic on belgian linen
122 x 122 cm

http://www.gabriellepizzi.com.au/exhibitions/gallery_gabrielle_pizzi_0807williamson.html

For help in Australia

CAPS – Talk Suicide Support Service – Free telephone and face to face support      1800 008 255

Salvation Army Care Line     1300 36 36 22

Reach Out     http://au.reachout.com/tough-times

Headspace     Register and chat now at eheadspace, or call 1800 650 890  Headspace

Lifeline    13 11 14

Mensline Australia 1300 78 99 78 (24 hour phone counselling and referral)

Beyond Blue 1300 22 4636

Mates in Construction: 1300 642 111

QLife        1800 184 527    Phone & Chat  3.00 – 12.00 pm everyday

SANE Australia help

SANE Australia Helpline  –  Talk to a mental health professional (weekdays, 10am-10pm AEST) 1800 18 72 63

Helpline chat – Chat online with a mental health professional (weekdays 10am-10pm AEST)

Kids Help Line 1800 55 1800 (24 hour phone counselling)

Suicide Call Back Service 1300 659 467 (Professional call back service referral line operates seven days a week)

Veterans Line 1800 011 046 (after hours professional telephone crisis counselling for veterans and their families

$36 million for national suicide prevention projects?

My initial happiness didn’t last. When you read this article it seems that the money is already allocated to the big players, and the broader community is left out of the equation. The decisions have already been made. We need community education and doctor education, but we need local community’s empowered to  provide suicide support services on the ground. We need much more that $36,000,000!

The Hon Greg Hunt MP Minister for Health                       28th September 2018

Greg Hunt

The Australian Government will invest more than $36 million in national suicide prevention projects to raise awareness of the impact of suicide and to support Australians who may be at risk.

The Morrison Government will invest more than $36 million in national suicide prevention projects to raise awareness of the impact of suicide and to support Australians who may be at risk.

The funding, through the National Suicide Prevention Leadership and Support Program, will help to deliver important awareness and stigma reduction activities, research, and leadership through variety of projects. These initiatives aim to reduce deaths by suicide across Australia.

Fifteen highly respected organisations will receive funding including Suicide Prevention Australia who will receive $1.2 million to continue its national leadership role for the suicide prevention sector.

Suicide is a national tragedy and close to 3,000 Australians take their lives each year.

One life lost to suicide is one too many.

The support I have announced today will be vitally important in helping to reduce the number of people we lose to suicide each year.

Male suicide rates are three times greater than females and the rate among Aboriginal and Torres Strait Islander people is around twice that of non-Indigenous people.

Awareness, prevention and intervention programs for occupations where larger numbers of men typically work will be delivered by the OzHelp Foundation and MATES in Construction to give men the confidence and support to open up and seek help for themselves, and their mates, when in need.

Funding will allow the University of Western Australia to continue critical research to ensure the best support and services are being provided to Aboriginal and Torres Strait Island people in our community.

A number of organisations, including R U OK?, Everymind, and Reach Out Australia, will receive funding for communication projects such as media and online campaigns to reduce stigma, encourage conversations and provide vital support and resources to individuals and communities at risk.

Mental Health First Aid Australia and Roses in the Ocean will receive funding to provide training, education and support for medical professionals and individuals with a lived experience of suicide.

A leadership role will be provided by Suicide Prevention Australia to build partnerships across the mental health sector and the community to change behaviour and attitudes to suicide behaviour.

The National Suicide Prevention Leadership and Support Program was launched in 2017. This funding boost today brings the total funding for the program to $79.9 million.

The Morrison Government is committed to investing in mental health services for all Australians. It is a key pillar of our Long Term Health Plan.

In the 2018–19 Budget, mental health funding increased by $338.1 million to boost support for suicide prevention, research and programs for older Australians.

 

For help in Australia

CAPS – Talk Suicide Support Service – Free telephone and face to face support      1800 008 255

Salvation Army Care Line     1300 36 36 22

Reach Out     http://au.reachout.com/tough-times

Headspace     Register and chat now at eheadspace, or call 1800 650 890  Headspace

Lifeline    13 11 14

Mensline Australia 1300 78 99 78 (24 hour phone counselling and referral)

Beyond Blue 1300 22 4636

Mates in Construction: 1300 642 111

QLife        1800 184 527    Phone & Chat  3.00 – 12.00 pm everyday

SANE Australia help

SANE Australia Helpline  –  Talk to a mental health professional (weekdays, 10am-10pm AEST) 1800 18 72 63

Helpline chat – Chat online with a mental health professional (weekdays 10am-10pm AEST)

Kids Help Line 1800 55 1800 (24 hour phone counselling)

Suicide Call Back Service 1300 659 467 (Professional call back service referral line operates seven days a week)

Veterans Line 1800 011 046 (after hours professional telephone crisis counselling for veterans and their families

fighting fish