Government Of Western Australia Mental Health Commission
Government of Western AustraliaMental Health Commission
CONTENTSMinister’s forewordCall to action from the Ministerial Council for Suicide PreventionIntroduction256Suicide Prevention 2020: Action areas at a glance8Key Principles10Understanding the problem of suicideCurrent data on suicideMajor factors in suicideVulnerability to suicide across life stagesPriority populationsOther challenges121216181922Evidence-based approaches to prevent suicideResilience and protective factors2424Western Australian model28What we will do - Key action areas1. Greater public awareness and united action2. Local support and community prevention across the lifespan3. Coordinated and targeted services for high-risk groups4. Shared responsibility across government, private and non-governmentsectors to build mentally healthy workplaces5. Increased suicide prevention training6. Timely data and evidence to improve responses and services3232343639Implementation for Suicide Prevention 202045Appendix A: Current mental health reform46Appendix B: Suicide prevention evidence-based modelsInternational best practiceAustralian collaborative approaches505051Suicide Prevention 2020: Together we can save lives41431
Minister’s forewordawareness, training and resilience achievedthrough local community activities and workplacepartnerships.It is a fact that in Western Australia the suicide rateexceeds the road toll. In much the same way thatI believe every death on our roads can be avoided,I also believe that suicide is preventable. While Iacknowledge that it is unlikely we can achievea zero rate of suicide in my lifetime – just as it isunlikely that there will be no fatalities on our roads– it is something we need to strive towards.Hon Helen Morton MLCOn average one person loses their life to suicideevery day in Western Australia. The impact ofthis statistic is felt deeply and spans the entirecommunity.Preventing suicide and suicidal behaviour is a keypriority for the Government of Western Australia,which launched the first statewide SuicidePrevention Strategy in 2009. The Western AustralianSuicide Prevention Strategy 2009 – 2013 achievedsignificant community engagement. Muchgood work was done, with greater community2Suicide Prevention 2020: Together we can save livesSuicide Prevention 2020:Together we can savelives aims to halve the number of suicides in tenyears, which is aligned with the National Coalitionfor Suicide Prevention. The new strategy takes anevidence-based approach to reduce suicide riskacross the lifespan, which reflects current researchby the World Health Organization.The biggest risk factor for suicide and self-harmis having a mental illness and a previous suicideattempt. Young people, Aboriginal people andpeople who use alcohol or other drugs are also atgreater risk of suicide than the general population.Targeting these groups through specific initiatives,as well as intervening early and at key stagesthroughout the lifespan is imperative to effectivesuicide prevention. To address the multitude of
social determinants including the reduction ofviolence, dysfunction, homelessness and poverty,Suicide Prevention 2020 will deliver initiatives thatfoster resilience and strengthen families to improvemental health and reduce the suicide rate in thelong term.A key feature of Suicide Prevention 2020 is itsemphasis on evidence-based training for communityfacilitators who are often the first point of contactfor mental health problems and suicide. Communityfacilitators include coaches, teachers, chaplains,general practitioners, aged care workers and childhealth nurses, and local community leaders.Training community facilitators to become‘gatekeepers’ will help to disseminate informationon depression and suicide risk, support earlyintervention and ensure pathways to professionalsupport.The previous One Life partnerships to promotesuicide prevention among workplaces will bestrengthened. Employers can play a significant rolein improving the mental wellbeing of their staff byproviding mental health and suicide preventiontraining; and creating a supportive environmentwhich enables people to fulfill their potential andcope with life’s challenges.The State Government is working to improvemental health services, including systemicand legislative change, and structural reform.The merger of the Mental Health Commissionwith the Drug and Alcohol Office will seek toaddress some of the issues around co-occurringmental health and substance use problems thathave been demonstrated to increase the riskof suicide. Improving access to services andsupports, increasing workforce capacity andsystemic change, will be addressed through theimplementation of The Western AustralianMental Health, Alcohol and Other DrugServices Plan 2015 – 2025.The prevention of suicide is not something thatcan be achieved by one organisation in isolation –it is something that must be tackled by the entirecommunity. Suicide Prevention 2020 provides theframework and governance structure for suicideprevention in Western Australia. However, it is up toindividuals, community, government and businessto implement the changes and directions neededto create lasting change. Suicide is preventable,together we can save lives.Hon Helen Morton MLCMinister for Mental HealthSuicide Prevention 2020: Together we can save lives3
InWesternAustralia1person died everyday BY SUICIDEin 2012 –a total of366people4Suicide Prevention 2020: Together we can save lives
Call to action from the MinisterialCouncil for Suicide PreventionOur vision is that by 2025we will have the services,supports and communitycapacity to achieve a 50%reduction in the currentnumber of suicidesand suicide attempts inWestern Australia.(1)We believe that every lifeis valuable and suicideis preventable. We urgeeveryone – family, friends,neighbours, schools, workplaces, communities andservices – to work together to save lives.Dr Neale Fong,ChairmanWhile there has been significant investment andactivity in suicide prevention across a range ofcommunities, we remain deeply concerned aboutsuicide rates in Western Australia. On averagealmost one person suicides every day in WesternAustralia.(1) In 2012, 366 people took their lives incommunities across the State. These deaths meanwe are forever robbed of the unique qualities andcontribution of hundreds of Western Australiansand families are forever bereaved.to mental health issues that can result in self-harmor suicide.(3) Every child has the right to grow upin a healthy family and safe community, withopportunities to live a meaningful life, developpositive relationships and achieve their goals.We mourn the unnecessary loss of life by suicide.For every suicide death there are many familymembers, friends and colleagues experiencingimmense grief, loss and sadness. We know thatthese people are then at higher risk of dyingby suicide themselves. Responsive services,understanding and compassion are essentialto support people who have lost loved onesto suicide.This extent of loss and trauma cannot continue.We must continue to work together to save lives.Suicide Prevention 2020 is a call for unitedaction to save lives now and in the future.Dr Neale Fong, Chairman,Ministerial Council forSuicide PreventionFor each adult death by suicide there are around20 other people who have attempted suicide.(2)Continuing care and services for people who aresuicidal need to be significantly improved.Everyone dealing with life’s challenges – such ashealth issues, relationship problems, alcohol orother drugs, job and financial worries, or loneliness– should be able to access assistance to resolveproblems and reconnect with the community.For every suicideIn Western Australiathere are approximately20suicide attemptsWe are profoundly saddened by the currentyouth suicide rate. Suicide is the main cause ofpreventable deaths for 15 – 24 year olds in WesternAustralia. Research indicates that cumulativetrauma from abuse and neglect can contribute1The reduction rate will be relative to the 366 deaths by suicide recorded by theAustralian Bureau of Statistics in Western Australia in 2012.Suicide Prevention 2020: Together we can save lives5
INTRODUCTIONSuicide prevention is a major public health issue.The suicide rates in Western Australia are amongthe highest in the nation, with 13.5 deaths per100,000 population in 2008-2012.(4) In Australia,suicide deaths result in an average loss of 34 yearsof life per person.(4) Every life lost to suicide is onetoo many; we must all work together to preventthese tragic deaths.Suicide Prevention 2020: Together we can savelives (Suicide Prevention 2020) provides a strategyfor prevention based on suicide statistics in WesternAustralia, contributing factors to suicide acrosslife stages and evidence-based prevention andintervention approaches. It was developed utilisingcurrent data, research, evaluation and reports onThe Western Australian Suicide Prevention Strategy2009-2013 and the expertise of members of theMinisterial Council for Suicide Prevention, some ofwhom have lost loved ones to suicide.This new suicide prevention strategy builds onthe State Government’s continuing commitmentto improve the mental health and wellbeing ofthe community, evidenced by the creation of theMental Health Commission; the new Mental HealthAct 2014; the establishment of the StatewideSpecialist Aboriginal Mental Health Service;implementation of recommendations in the 2012Review of the admission or referral to and thedischarge and transfer practices of public mentalhealth facilities/services in Western Australia byProfessor Bryant Stokes; and other key initiatives asdetailed in Appendix A.6Suicide Prevention 2020: Together we can save livesIn addition, Suicide Prevention 2020 actionsrespond to key recommendations of importantreviews such as: Auditor General (2014), The Implementationand Initial Outcomes of the Suicide PreventionStrategy (Auditor General’s Report); Ombudsman Western Australia (2014),Report on investigation into ways that Stategovernment departments and authorities canprevent or reduce suicide by young people(Ombudsman’s Investigation); and Centrecare and Edith Cowan University (2014),Research, Development and Evaluation ofthe State Suicide Prevention Strategy 2009-13(Strategy Research, Evaluation and DevelopmentReport).Suicide Prevention 2020 continues to be informedby the Living is for Everyone Framework (LIFEFramework) and the National Aboriginal and TorresStrait Islander Suicide Prevention Strategy (2013),but has been updated to align with the WorldHealth Organization directions outlinedin Public Health Action for the Prevention ofSuicide: A Framework (2012); Preventing Suicide:A global imperative (2014); and Social Determinantsof Mental Health (2014). It is proposed that acoordinated range of activities will be deliveredthrough collaborative partnerships, localcommunity prevention programs and integratedservices. The key outcomes and action areas arelinked to the prevention priorities in The WesternAustralian Mental Health, Alcohol and Other DrugServices Plan 2015 – 2025.
Since 2009, the State Government has invested 21 million in suicide prevention across the State.This includes significant funding for CommunityAction Plans and suicide prevention, crisiscounselling and postvention services such asLifeline and Youth Focus. There is much moreto be done and Suicide Prevention 2020 seeksto balance investment in community awarenessand stigma reduction, mental health and suicideprevention training and coordinated servicesfor high-risk groups. The strategy’s successfulimplementation requires both financial and humanresources, along with commitment to a sharedvision and collaboration at many levels.Our target groups for united action to preventsuicides are:A KPMG Report The economic cost of suicide inAustralia highlights the high cost to our economyfrom lives cut short by suicide. More people diedby suicide in 2012 than from skin cancer or carcrashes, and the majority were men aged 15-44.The economic cost of these deaths is estimated byKPMG at 1.657 billion and far exceeds investmentin suicide prevention.(5)However, suicide is not just a mental healthissue. It is a public health issue that requirescoordinated and combined efforts from all levelsof government, health care systems, clinicians,workplaces, education and corporate sectors,community groups, insurers and the media; alongwith family, friends and peer networks.(6) It isenvisaged that these diverse stakeholders will beable to adapt the priority action areas outlined inthis strategy to effectively meet the needs of theircommunities, employees, members and networks.Suicide Prevention 2020 outlines key partnersand priority action areas for suicide prevention inWestern Australia. The development of these focusareas has been informed by the Ministerial Councilfor Suicide Prevention, evaluation and reviews ofthe previous Western Australian Suicide PreventionStrategy 2009-2013, current suicide data andcomprehensive research undertaken by the MentalHealth Commission. People with a history of mental illness and theirfamilies; High-risk groups in the community; People bereaved by suicide; Local communities; Key decision makers across business,government and community organisations; Schools, education and training sectors; Providers of health services; and Media and opinion leaders.Our work together can achieve:12Greater public awareness and united actionacross the community;3Coordinated and targeted responses forhigh-risk groups;456Local support and community preventionacross the lifespan;Shared responsibility across government,private and non-government sectors tobuild mentally healthy workplaces;Increased suicide prevention training; andTimely data and evidence to improveresponses and services.Suicide Prevention 2020: Together we can save lives7
Suicide Prevention 2020Action areas at a glance1.Greater publicawareness andunited action2.Local support andcommunityprevention acrossthe lifespan3.Coordinated andtargeted servicesfor high-risk groupsThis action area will beachieved through:This action area will beachieved through:This action area will beachieved through:1.1 Implementing acomprehensivecommunications strategy,including multimediaresources and mediapartnerships.2.1 Promoting and supportingevidence based andculturally informed mentalhealth literacy programs.3.1 Facilitating effectiveinteragency coordination toaddress social determinantsfor suicide prevention acrossthe lifespan.1.2 Delivering a comprehensivepublic education campaignand resources tailored tospecific age groups andpopulations.1.3 Promoting the use of mentalhealth, counselling, alcoholand other drugs services,and reducing stigma anddiscrimination against peopleusing these services.1.4 Facilitating events to createcommunity dialogue andinspire action.1.5 Profiling the stories ofbereaved families to createunderstanding and empathy,and reduce stigma aroundseeking help.1.6 Providing opportunities forpeople with lived experienceto share their stories toreduce stigma aroundaccessing services.82.2 Strengthening communitybased suicide preventionactivities, local capacitybuilding and leadership.2.3 Collaborating with localstakeholders to strengthensuicide prevention protocols,establish ways to reduceaccess to means of suicideand map pathways to careto appropriate services andsupport.2.4 Partnering with primary careproviders to address mentalhealth needs and risk factors.2.5 Ensuring communities havethe capacity to respondto crises and can accessemergency services, crisissupport and helplines.2.6 Improving postventionresponses and care for thoseaffected by suicide andsuicide attempts.Suicide Prevention 2020: Together we can save lives3.2 Co-producing new programswith the at-risk groupsthemselves, including peoplewith lived experience, familymembers and carers.3.3 Delivering responsive, highquality treatment and supportfor those with mental illness,aligned with the MentalHealth and Alcohol andOther Drug Services Plan2015-2025.3.4 Improving policies, protocols,discharge planning andcontinuing care for peoplewho have self-harmed and/or attempted suicide.3.5 Strengthening earlyintervention services andfamily counselling to preventand address cumulative traumain children and young people.3.6 Supporting interagencypostvention responses forindividuals and communitieswho have lost someone tosuicide.
4.Shared responsibilityacross government,private and nongovernment sectorsto build mentallyhealthy workplaces5.Increased suicideprevention training6.Timely data andevidence to improveresponses and servicesThis action area will beachieved through:This action area will beachieved through:This action area will beachieved through:4.1 Assisting organisations tofulfil their responsibilitiesand legal obligations for themental wellbeing and safetyof their employees.5.1 Promoting training andself-help activities forhigh-risk groups, andpeer support.6.1 Collating, analysing anddisseminating the latestresearch and evaluationreports on risk and protectivefactors and evidence-basedprograms.4.2 Developing implementation,monitoring and accreditationsystems for workplacemental health and suicideprevention initiatives.4.3 Setting minimumrequirements for mentallyhealthy workplaces,including training to identifyand support people at risk.4.4 Acknowledging anddisseminating best practiceapproaches to creating amentally healthy workplace.4.5 Encouraging largegovernment and corporateorganisations to have mentalhealth and suicide preventionas a key outcome measurewith adequate resources andmonitoring.5.2 Supporting mental healthand suicide preventiontraining in schools,vocational and tertiaryeducation sectors andcommunity groups.5.3 Coordinating Gatekeeperand other programs forprofessionals and paraprofessionals includingGeneral Practitioners, healthworkers and frontline serviceproviders.6.2 Monitoring and evaluatinginitiatives for ongoingimprovement.6.3 Establishing a taskforce tomonitor, improve and utilisesuicide related data to informplanning, intervention andpostvention responses.5.4 Embedding trauma informedpractice in the mental healthworkforce.5.5 Backing up training withadequate supervision andde-briefing mechanisms.Suicide Prevention 2020: Together we can save lives9
KEY PRINCIPLESBest-practice principles have guided the development of Suicide Prevention 2020 and its associatedaction areas, specifically the World Health Organization Social Determinants of Mental Health (2014);the Australian lived experience guiding principles (2014) drafted by Suicide Prevention Australia’sadvisory committee and endorsed by the National Coalition for Suicide Prevention; and the WesternAustralian strategic mental health policy Mental Health 2020: Making it personal and everybody’sbusiness (2010) (7, 8). Throughout the implementation phase the principles below will continue tounderpin decision making and initiatives under the priority action areas.101.Valuing andincludingpeople withlivedexperiencePeople with a lived experience, including those who have attempted suicide,bereaved by suicide or affected by suicide, have a valuable, unique andlegitimate role in suicide prevention. Lived experience helps change the culturesurrounding suicide by creating empathy and understanding. People with livedexperience will be supported to share their insights and stories with a view topreventing suicide. All suicide prevention programs, policies, strategies andservices will, at all levels, include genuine meaningful participation from thosewith lived experience.2.ActionacrosssectorsRisk and protective factors for mental health operate at an individual,family, community, structural and population level. A social determinantsapproach will be led by the mental health sector; however it requires action,collaboration and leadership from education, primary care, social services,employment, justice and housing sectors at all leve
Current data on suicide 12 Major factors in suicide 16 Vulnerability to suicide across life stages 18 Priority populations 19 Other challenges 22 Evidence-based approaches to prevent suicide 24 Resilience and protective factors 24 Western Australian model 28 What we will do - Key action areas 32 1. Greater public awareness and united action 32 2.
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