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Introduction

Between late November 2017 and early February 2018, Country SA PHN conducted an online survey as part of the National Suicide Prevention Trial (NSPT). The survey was promoted through social media and distributed in a paper base form at community consultations throughout the region. The targeted catchment locations for the survey were Port Lincoln, Whyalla, Port Augusta, Port Pirie and the Yorke Peninsula in line with the targeted region for the NSPT. However, an ‘other’ region option was available for individuals who did not reside or work within the targeted areas.

During this period, 337 responses were collected from both community representatives and service providers alike. The purpose of the survey was to assess the perceived needs and barriers in relation to suicide prevention in the regional hubs of South Australia.

The survey results are part of a suite of documents being produced under the trial:

• NSPT Community and Stakeholder Consultation Report

• 5x Regional Suicide Prevention action plans

• 5x Regional survey and data result reports

This is the largest scale ‘in place’ suicide prevention consultation regional South Australia has seen, placed at a regional level to better identify and respond to local needs.

The survey social media post:

Reached over

16,000 people

link clicks through to survey overall

Post was shared 64 times & commented on 20+ times

A high percentage of comments were responded to via private message on social media, with topics including help seeking and NSPT information exchange.

Demographics

Social Demographics

The general demographics gathered from the survey highlighted just under three quarters of respondents were aged between 31 and 60 years (73%) (Graph 1). A majority were straight or heterosexual and a small percentage identified as Aboriginal (6.9%). It was acknowledged that surveys are not the preferred method of engagement for the Aboriginal population, therefore additional methods were used to capture feedback not summarised in this document. In terms of Aboriginal status by region, Port Augusta had the highest number of Aboriginal respondents (22.4%), followed by Whyalla and Yorke Peninsula with 8.2% and 4% respectively.

The gender breakdown was consistent across all locations, whereby respondents were predominantly female.

Port Augusta Port Lincoln Port Pirie

Whyalla

Yorke Peninsula

Graph 1: Age range breakdown across the region

Sexual Identity

The majority of respondents identified as straight or heterosexual, with approximately 5.5% preferring not to disclose their identity.

Lived Experience

Most survey respondents had a lived experience of some kind, with Port Augusta, Port Lincoln and Port Pirie showing the highest proportions of all the regional locations as summarised below (Table 2).

Port Augusta: Respondents with lived experience tended to be bereaved by suicide and/or had experienced suicidal thoughts.

Port Lincoln: Fifty percent of respondents in Port Lincoln had experienced suicidal thoughts with a further 44% having cared for someone who had attempted suicide.

Port Pirie: Forty five percent of respondents in Port Pirie had cared for someone who attempted suicide and had the highest proportion of lived experience in the ‘Other’ category.

Table 2: Breakdown of lived experience across regional locations

Services and Access

Organisation Type

The top three organisations types represented through the survey were:

• Non Organisation- Community Member

• State/territory government service

• Not for Profit Organisation (Graph 2)

Graph 2: Organisation type represented through survey respondents

Telephone based support services

Headspace centre

Indigenous organisation including ACCHOs

Higher education

School based services

Suicide Prevention Network

Commonwealth Department of Health funded service

Not for Profit organisation

State/territory government service

No organisation - community member

For each of the region locations the following proportions were found regarding organisation type:

Port Augusta had the highest proportion of representation from ACCHOs, school based services and Headspace centres.

Port Lincoln had the highest proportion of representation from telephone based support services and Not for Profit organisations.

Port Pirie had the highest proportion of representation from the Commonwealth DOH funded services.

Whyalla had the highest proportion of representation from Higher Education Services.

The Yorke Peninsula had the highest proportion of representation from Suicide Prevention Networks and community members.

The Other category had the highest proportion of representation of State/Government services.

Services Currently Provided

Counselling Support, Mental Health Services (not suicide prevention specific) and brief intervention services were the most commonly perceived services available across the region (Graph 3). To gain a better understanding, the perceived service availability was examined by each location. Notably, the Yorke Peninsula reported the lowest proportions of availability across the majority of services (Table 3).

Counselling support services

Acute services for people at risk of suicide attempt

Table 3: Perceived service availability by region

Graph 3: Most commonly perceived services available across the region

Client groups with access to services

Youth specific services were the most prominent across the region, while male specific access to services was uniformly the lowest across all locations (Graph 4). Surprisingly, people bereaved by suicide were believed to have limited access despite community counselling services being perceived as the most available across the regions. Furthermore, support for individuals/community after suicide was perceived as available and accessible in most communities.

For all client groups, service was most accessible in Port Lincoln and Port Pirie. The Yorke Peninsula comparatively reported the lowest accessibility across all client groups with the exception of Indigenous populations, where accessibility proportions were lowest in Whyalla.

Funding

Just under half of all respondents believed that with additional funding and/or resources, they would be able to deliver more services and address alternative client groups to expand the scope of Suicide Prevention in their areas. This pattern was reflected in each location.

Workforce Collaboration

Workforce collaboration was identified as an area where there is opportunity for change to occur. The survey highlighted large proportions of respondents perceiving little to no collaboration between local organisations resulting in disjointed services overall.

Level of Need and Service Gaps

The perceived level of need for suicide prevention for the overall region was high, this was further mimicked for each location with the perception of need being moderate to high

The key gaps highlighted within the region regarding suicide prevention were:

1. Follow up care;

2. Stigma around suicide; and 3. Suicide Prevention training opportunities.

When data was broken down into each location, trends remained similar to the overall region results. The top three priorities for each region are highlighted in Table 4.

Youth (12-25)

Adults (25 years+)

Indigenous populations

Children and families

People bereaved by suicide

Males specifically

Graph 5: Level of Suicide Prevention need in the region

Graph 4: Client groups with access to Suicide Prevention Services across the region

Table 4: Perceived gaps and needs around Suicide Prevention by location

Main Barriers to Accessing Services

In terms of access to appropriate suicide prevention services, the main barriers identified (Graph 6) were:

1. Availability of services;

2. Waiting times; and

3. Travel distance.

When broken down into location, Port Augusta and Whyalla both highlighted Culturally Appropriate Services as a barrier over travel distance. This was despite the majority of Indigenous and Aboriginal Health Services being located within these two region hubs. Furthermore, travel distance was a considerable barrier highlighted for the Yorke Peninsula and Port Pirie region hubs, when both are located closer to metropolitan services compared with other hubs in the region.

Key factors contributing to suicide in the community

Overall, drug and alcohol use, family breakdown and poor understanding of mental health were the leading three perceived contributors to suicide in the trial region. All the factors listed however, were perceived as significant contributors (Graph 8).

When information is broken down and made location specific, Drug and Alcohol use was the leading contributor for all regions but one. Unemployment was a key factor in Whyalla, Port Augusta and Port Pirie.

Suicide Prevention Training Undertaken

Overall, a small percentage of respondents had undertaken suicide prevention training. The most common training completed was the ASIST training (23%), followed by Wesley Life Force Suicide Prevention Training and ‘Connecting With People’, with 12% and 10% respectively.

Availability of services

The proportion of Wesley Life Force Trained respondents was significantly higher in Port Pirie compared to other regions; likewise, Port Augusta had the highest proportion of respondents trained in ASIST.

When respondents were asked if there was a suicide prevention training they were interested in completing, the following courses were suggested most frequently:

• ASIST

• Connecting with People

• BDI Advance Training

• You Me, Which Way

Drug and Alcohol use

Family breakdown

Poor understanding of suicide and mental health

Unemployment

Lack of support for families and carers of persons with ongoing suicidal thoughts

Lack of adequately trained healthcare providers in suicide prevention

Lack of community coordination regarding mental health services

Distance to appropriate services

Stigma associated with suicide

Discrimination associated with those who have attempted suicide

Culturally inappropriate services

Graph 8: Key factors contributing to suicide in the region

Graph 6: Main barriers to accessing services within the region

LifeSpan

The LifeSpan model is a new, innovative evidence-based approach to integrated suicide prevention. It combines nine strategies in one community-led approach incorporating health, education, frontline services, business and the community. Questions were added to the survey to determine the current alignment of services in the region with some of these strategies.

Awareness of LifeSpan Model

The majority of respondents were not aware of the LifeSpan model or its key principles. This was despite approximately 300 respondents being briefed on the model at the face-to-face consultations held in each location.

LifeSpan Strategy Alignment

In regard to how to improve suicide prevention within the region, the nine key strategies were taken from the LifeSpan

model and respondents were asked to either agree or disagree on whether they thought these strategies would be effective. Overall, all strategies were well received; however, promoting help seeking, training the community and equipping primary care workers to identify and support individuals in crisis were the most favoured.

As an addition, a series of phrases were asked regarding services in each location, these results are summarised in Graph 7. Perceived issues highlighted included:

• Access to services including psychiatrists, early intervention and social support is poor;

• GPs were not adequately equipped with suicide prevention knowledge and skills; and

• Services and support are not accessible to carers and families.

Access to psychiatrists is generally poor

Knowledge of where to go for help is low

Services are available for youth experiencing suicidal thoughts

Suicide prevention promotion and education is provided

GPs are appropriately equipped with suicide prevention knowledge and skills

There are services for family and friends after a suicide attempt

Support is available to carers and families

Access to social support is good

Support for someone feeling suicidal is easily accessible

Early intervention is easily accessible

Agree Disagree

Graph 7: In my local community for people experiencing suicidal thoughts

Summary

The data collected has provided a snapshot of perceived gaps and service needs within the country North region. Respondents were receptive to the LifeSpan strategy principles and therefore the implementation of the model should be effective within the individual communities.

For future surveys, a targeted approach at the LGBTIQ community, Males and Aboriginal persons should be instigated to ensure these client groups are adequately represented.

The information gathered via the online survey will be used to complement data obtained from the face-to-face community consultations held during the same period and build overall recommendations for the region as a whole.

As such, these key findings will form part of our needs assessment. They will be overlayed with additional regional and state data sets and key stakeholder and sector engagements to inform our decision making and commissioning of all NSPT activity.

Communities are comfortable engaging with suicide prevention on social media; it has proven to be an effective engagement strategy that will be used in future NSPT communications.