Acknowledgements
We acknowledge those people with a lived experience of mental health issues and suicide, their families, friends and supporters who provided input into the process and shared stories, along with the many people from different organisations and the general public who hold an interest in mental health and suicide prevention.
We also acknowledge Aboriginal and Torres Strait Islander people as the traditional owners of this country throughout Australia and their connection to land, waters and community. We pay respect to them and their cultures, and to the Elders both past and present. We thank the contribution of local Aboriginal communities to help shape our knowledge of their country and identity. We benefit from their generosity in sharing their country and their culture as part of these consultations.
We acknowledge and thank the more than 500 people who contributed to the National Suicide Prevention Trial community consultations; your voice and feedback has formed this report.
Background
While suicide is an infrequent occurrence in Australia, the effects and aftermath can be both traumatic and longlasting for families and communities alike. Across Australia, people residing in rural and remote communities have a higher risk of suicide than those living in metropolitan cities. Particular rural communities across the state experience significantly higher rates of attempts and deaths. Compared to the national average, South Australia’s suicide rate is slightly higher at 13.4 deaths per 100,000 compared to 12.61
Suicide can affect any person at any time, however there are sub groups of individuals that remain at higher risk than others. The reasons for suicide are complex and multifaceted, influenced by the vulnerabilities, risk factors and events in a person’s life and their interactions with other social, cultural, economic and environmental factors2
For people aged 15-44 years, suicide remains a major cause of death. Furthermore, across all age groups Aboriginal people are more than twice as likely to die by suicide compared to their non-Aboriginal counterparts1 In terms of gender, males account for the majority of deaths by suicide, while females often attempt at a higher rate. Males aged 25-44 years are dying at a higher rate than all other age groups in regional SA 1
The key aims of the trial are to respond to local needs and identify new learnings in relation to suicide prevention strategies. To achieve this aim, an established evidencebased suicide prevention model was selected, the LifeSpan model.
LifeSpan is an innovative, evidence-based, world-class approach to suicide prevention developed by the Black Dog Institute. Based on scientific modelling, LifeSpan is predicted to prevent 20% of suicide deaths and 30% of suicide attempts. The model involves the implementation of nine strategies simultaneously within a localised area. Active strategies that form part of the trial will include:
• Training for frontline workers, community members, young people and leaders;
• Coordination of referral networks and multidisciplinary teams; and
• The development of systems that can reduce suicide attempts and deaths in communities.
1 Government of South Australia (2018) South Australian Suicide Prevention Plan 2017-2021, SA Health. 2 World Health Organisation. (2014) Preventing Suicide: A Global Imperative. Geneva. WHO
About the National Suicide Prevention Trial
Country SA PHN is one of twelve sites nationally taking part in the trial which aims to reduce suicide at a local level.
The Federal Government is providing $4 million which will enable Country SA PHN to implement evidence-based integrated approaches to suicide prevention.
The three-year trial will adopt a systems-based approach to the delivery of suicide prevention services, targeting populations identified as ‘at-risk’.
The trial brings significant resources, activity and funding to areas of established need across the country. The selected area in South Australia is the Country North region, including Port Augusta, Whyalla, Port Lincoln, Port Pirie and the Yorke Peninsula.
The population targets within these regions were selected based on the Country SA PHN Needs Assessment in addition to state and national data sets in relation to death and/or suicide attempts due to intentional self-harm. The three populations are:
• Youth (15-24 years)
• Adult Males (25-54 years)
• Aboriginal and Torres Strait Islanders
The trial will work closely with local suicide prevention networks, state government and the Office of the Chief Psychiatrist to implement effective strategies and programs across the region. The consultation that forms the basis of this report will support the design of localised action plans that will continue after the trial end date in June 2020. All research, programs and strategies used within the trial will be evaluated upon completion to help inform policy and programs nationally.
Aims
The aims of the community consultations were to gauge the current community knowledge of suicide prevention, services available and areas of need within the Country North region as a prelude to the development of a community action plan.
To meet the aim, the following objectives were addressed in each of the consultations:
• Determine the level of need and service availability in the local regions
• Identify key barriers and obstacles to help-seeking and service access
• Brainstorm solutions to create multidisciplinary links between service providers, and
• Create achievable recommendations in conjunction with the LifeSpan model
Methodology
Design
The project adopted a two-stage approach involving:
• Paper-based and online self- administered survey; and
• Face-to-face community consultations in six regional centres in Country South Australia.
Paper-based and online survey
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.
Between late November 2017 and early February 2018, the CSAPHN conducted a survey, available online and as a paper-based version. The survey was promoted through social media and distributed in a paper-based 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 National Suicide Prevention Trial (NSPT).
Community consultation
During the same period, face-to-face consultations were facilitated across the Country North region. To complete this process in a timely manner, Sevenseas Creative Australia was contracted to work with the Country SA PHN
Suicide Prevention Project Officer to conduct six Regional Suicide Prevention Forums. The aim of the forums was to gather community members who could contribute to the development of an effective regional approach to suicide prevention, with a focus on building the capacity of organisations and the community to better support individuals.
For the Aboriginal component of the consultation, interviews and group yarning sessions were utilised in addition to the six forums. The results of these are incorporated below.
The forums included leaders and influencers from the community, including Suicide Prevention Networks (SPNs), community groups, sporting clubs, government and non-government agencies, business, health, education, hospital, emergency responders, GPs, researchers, industry stakeholders, people with lived experience, consumers and carers who collectively identified the needs and actions required for the region in relation to suicide prevention.
Promotion of the community forums was through advertisements in local newspapers, formal invitations, Cash Classifieds and media campaigns via Facebook and the Country SA PHN website.
Results
Online survey findings
The survey was the first stage of the consultation process and was opened for a three-month period in line with the face-to-face community forums. During this period, 337 responses were collected from both community representatives and forum participants.
Age of respondents Demographics
45% of Port Pirie respondents had cared for someone who attempted suicide. 11-20 years
41-50 years 51-60 years
The survey in its entirety consisted of 26 questions identifying demographics, workforce capacity, level of need for suicide prevention and alignment with the nine LifeSpan strategies. The key findings are summarised below.
82% of Port Pirie respondents identified as having a lived experience of suicide.
Access to suicide prevention services in Port Pirie
Clients with access: Adults and youth were believed to have the highest level of access to suicide prevention services in Port Pirie. The lowest level of access was for males specifically and children and families.
Barriers to access: Availability of services and waiting times for suicide prevention services were the main perceived barriers for access according to respondents in Port Pirie.
Needs and gaps: The three predominant needs and gaps highlighted in the Port Pirie community were:
• Follow up care for attempted suicide
• Suicide Prevention Training Opportunities
• Perceived Stigma around mental health services
To further measure community perceptions of suicide prevention services in Port Pirie, a series of statements were listed allowing respondents to answer with agree, unsure or disagree. The following was found:
Knowledge of where to go for help is low
There are services for family and friends after a suicide ...
Support for someone feeling suicidal is easily accessible
Services are available for youth experiencing suicidal...
Support is available to carers and family
Access to social support is good
Access to psychiatrists is generally poor
GP’s are appropriately equipped with Suicide...
Suicide Prevention promotion and education is provided
Early intervention is easily accessible
The top five factors contributing to suicide in Port Pirie were:
• Family breakdown
• Unemployment
• Lack of community coordination regarding mental health services
• Distance to appropriate services
• Poor understanding of suicide and mental health
