Preventing suicide: what are we missing?

Ivan Frkovic
Queensland Mental Health Commissioner

Featured in this month’s eNews is my opinion piece on suicide prevention.

Tell me your thoughts—with rates not declining, despite investment, what are we missing?

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What are we missing with suicide prevention?

There is no doubting that suicide is a major public health challenge.

In Queensland, we know that around 650 people die by suicide each year. For every suicide there are at least 20 attempted suicides.

The impact of suicide and suicide attempts on family, friends, co-workers and peers can be immense and long lasting. The impact of suicide also takes a toll on police, ambulance, health workers and many others across the community.

It has been conservatively estimated that the annual cost of suicide and suicidal behaviour to the Australian economy is $1.7 billion [1] in years of lost life, lost productivity, services and other costs.

While the economic cost can be estimated, the personal trauma cannot. I recognise the many thousands of people who struggle with or have lost someone to suicide each year.

Growing attention to suicide, but rising rates

Over recent years, the attention on, and investment in, suicide prevention has increased substantially.

The Queensland Government has made much needed investments in suicide prevention in the health system.

Our police, ambulance and rail services, education, justice and child protection departments have all committed resources to improving the way they respond to those at risk.

Our state’s Primary Health Networks are working alongside Hospital and Health Services and other community stakeholders to develop and implement local suicide prevention plans.

At the national level, the Commonwealth government has increased funding for stigma-reduction initiatives, support services for those who have attempted suicide, and sharing evidence-based practice.

Workplaces, schools, local governments, community networks, volunteer organisations and many others have embraced the need to tackle the challenge of suicide—some have been engaged in this for many years.

And yet, despite significant and growing attention, investment and the good efforts of many, Queensland’s suicide rate continues to rise, with the rate currently the highest it’s been in many years.

This begs the question: what are we missing?

A whole-of-population approach

I know there may be many different views, but I think there are a number of areas where, collectively, we could be putting in greater effort and attention.

For one, we could be doing better at supporting our communities, workplaces, schools and communities to promote wellbeing and build mentally healthy environments, so people don’t end up in crisis.

We could also be doing better at reducing and helping people navigate the many and varied stressors that increase their risk of suicide.

While it’s tempting to see suicide as just a mental health issue, the fact is that many people suicide in the context of financial stress, loss of employment, trauma, relationship breakdowns, discrimination and social isolation.

We can only get so far in suicide prevention without serious efforts to reduce the impact of these stressors on people’s daily lives.

Pathways to support and care

In my view, there are equally important opportunities to improve the support we provide to those in crisis and their families—whether it be mental health or other types of support.

High on the priority list, is to continue exploring ways to see that people have a more positive experience of care and support in a crisis.

This includes looking at alternatives to standard emergency department care for people at risk, providing assertive follow-up care and support following a suicide attempt, and providing treatment options for people with complex suicide behaviours.

Just as importantly, we need to ensure our services and supports are relevant and accessible to all community members, including LGBTI, culturally and linguistically diverse, and Aboriginal and Torres Strait Islander, and rural and remote communities, and men.

And when the worst does happen, and we do lose someone to suicide, those impacted should not be left to pick up the pieces alone.

Working together

And then there is the issue that is highlighted in this year’s theme for World Suicide Prevention Day—the need to work together.

In many respects, the suicide prevention landscape is much more complex and crowded than ever before, involving a wide range of government and non-government bodies operating at a federal, state, regional and local level.

While this presents opportunities, it also raises the potential for a fragmented approach, with different levels of government and different agencies and individuals working at cross purposes.

Coordinating our different efforts is possibly the biggest challenge we face in suicide prevention today.

The increased investments and attention to suicide are unlikely to make a substantial difference if key stakeholders are not working in an integrated and coordinated way.

We need to ensure that we have the planning architecture in place to support a clear whole-of-population strategy, backed by joined-up decision making and well-coordinated implementation.

We must keep suicide prevention on the agenda as a state and national priority and work together with renewed drive if we are to turn the tide on suicide.

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

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