DISCUSSION PAPER ONE WORLD CONNECTED: AN ASSESSMENT OF AUSTRALIA’s PROGRESS IN SUICIDE PREVENTION NATIONAL CoaLITION FOR SUICIDE PREVENTION RESPONSE TO WORLD HEALTH ORGANISATION WORLD SUICIDE REPORT ‘PREVENTING SUICIDE: A GLOBAL IMPERAtive’ 10 SEPTEMBER 2014 We remember those we have lost to suicide and we acknowledge the suffering that suicide brings when it touches our lives. Our aim is to ensure that we provide for all people a future that inspires & empowers individuals & communities, and is filled with hope and meaning. Suicide Prevention Australia © 2014 Suicide Prevention Australia acknowledges the For more information contact funding provided under the Suicide Prevention Australia Australian Government National Suicide Prevention GPO Box 219, Sydney NSW 2001 Program. P: 02 9223 3333 Suggested citation: Suicide Prevention E: [email protected] Australia (2014). Discussion Paper: W: www.suicidepreventionaust.org One World Connected: An assessment of Australia’s progress in suicide prevention. TABLE OF CONTENTS FOREWORD 4 INTRODUCTION 5 SNAPSHOT OF AUSTRALIA’S PERFORMANCE 7 SETTING THE CONTEXT: AUSTRALIAN EPIDEMIOLOGY OF SUICIDE AND SUICIDE ATTEMPTS 8 SIX KEY ELEMENTS SUPPORT NATIONAL SUICIDE PREVENTION STRATEGIES 11 1. Make suicide prevention a multisectoral priority, regardless of resources 11 2. Tailor for diversity 12 3. Establish best practices 14 4. Allocation of resources (finances, time, staff) 15 5. Effective planning and collaboration 15 6. Use of evaluation findings and sharing lessons learned 16 DETAILED REVIEW OF AUSTRALIA’S PERFORMANCE 17 Data (Surveillance) 17 Means restriction 18 Media 18 Training and education 19 Access to services 19 Treatment 20 Crisis intervention 21 Postvention 22 Awareness and Stigma reduction 23 APPENDIX A: National Coalition for Suicide Prevention members 24 APPENDIX B: Terminology 24 APPENDIX C: Current Suicide Prevention Strategy in Australia 26 © 2014 Suicide Prevention Australia For more information contact Suicide Prevention Australia GPO Box 219, Sydney NSW 2001 P: 02 9223 3333 E: [email protected] W: www.suicidepreventionaust.org FOREWORD First and foremost, we congratulate the We see excellence in suicide prevention Last but certainly not least, a notable World Health Organisation (WHO) for throughout Australia but, often in isolation. It exclusion from the WHO Report is the releasing the first international report on is essential that we have a national strategy inclusion of the voices of lived experience suicide prevention (herein referred to as in place to connect these efforts and to build in suicide prevention . In this paper we the WHO Report). Suicide prevention is a momentum and encourage creativity. The have included some information about global imperative and, while some of this value of the sum is far greater than that of how Australia is embedding those whose information may be known by those working its parts. lives have been touched by suicide in the in the sector, this is the first time a full and development of suicide prevention actions. Despite these limitations the beauty of our transparent picture of global efforts to reduce Embracing the constructive voice of lived country is its diversity – a mix of different suicide has been published. experience into all of our suicide prevention landscapes, cultures and lifestyles – and our activities will help us do a better job of A special thanks to our esteemed colleagues suicide prevention programs must embrace helping all Australians lead a contributing life. who contributed on behalf of Australia, this diversity rather than adopt a ‘one size fit Professor Diego De Leo, Director of the all approach’. This is an issue that the WHO Once again, we commend the WHO for Australian Institute for Suicide Research and Report has reinforced – the need to have putting together an informative, thought Prevention, a WHO Collaborating Centre for a strategy that allows for local and cultural provoking and easily digestible World Suicide Research and Training in Suicide Prevention, strengths to be recognised in planning and Report. We appreciate the work done by Brisbane, and other expert reviewers from implementation. It is also an area we need to Australia’s leaders in suicide prevention, and Australia such as Suicide Prevention Australia urgently address in Australia, particularly in look forward to discussing what we, as a Board Directors Michael Dudley and relation to Australia’s Aboriginal and Torres country and as a specialist sector, need to do Myf Maple. Strait Islander population and immigrants to realise our ambition to reduce suicides by in detention. In this paper we have included 50% in ten years. The National Coalition for Suicide Prevention a specific section on the disturbingly (members listed in Appendix A), is pleased to disproportionate rates of suicide in this group offer this perspective on the report, focusing and call for urgent action to be taken to on areas where Australia is leading the way, address contributing factors. and where significant work is required to improve outcomes for the community. The WHO Report mentions Australia’s relatively high quality data. While this may The report follows the adoption of the be so on a global scale, we do not believe Comprehensive Mental Health Action Plan that suicide death and suicide attempt data 2013-2020 by the World Health Assembly, Sue Murray in Australia is of adequate quality nor is it which commits all 194 member states Convenor, National Coalition for Suicide Prevention readily accessible to inform prevention efforts to reducing the suicide rates by 10% by CEO, Suicide Prevention Australia and deliver improvements. We do not have 2020. The National Coalition for Suicide a clear picture of suicide in this country and Prevention has sought a further reduction until we have access to that information we target of 50% in the next ten years. As an are limited in how we can affect change. This ambitious group, we are seeking to achieve remains one of the National Coalition for a greater reduction and believe this revised Suicide Prevention’s top priorities. goal is appropriate for one of the world’s higher income countries with the capacity Reading the WHO Report has also to implement learning from other countries emphasised that we need to look beyond aspirational target. our borders. What can we learn from other countries? For example, lessons We believe Australia needs a clear national from Indigenous friends in America and suicide prevention strategy that includes Canada, the work the USA has done with specific outcome measures that underpin the defence forces and veterans, Germany’s Government and local efforts. Without clear multicomponent program targeting measurable outcomes we will not know if we depressive disorders, the Choose Life strategy are progressing toward our goal – what is in Scotland – just to name a few. The WHO working and what may not be working? Report is correct: Suicide prevention is a global imperative. 4 | One World Connected: An assessment of Australia’s progress in suicide prevention INTRODUCTION World Suicide Prevention Day in 2014 is significant because it marks the release by the World Health Organisation (WHO) of the first international suicide report, ‘Preventing suicide: A global imperative’. This WHO World Suicide Report is the In the report Foreword, Margaret In this response paper, the National most comprehensive, up-to-date record Chan, Director-General World Health Coalition for Suicide Prevention looks at of the current status of suicide prevention Organisation states: the report findings in relation to Australia internationally. The report: and suicide prevention, it explores what “This report encourages countries to we are doing well and what we need to • Outlines the epidemiology of suicide, continue the good work where it is do differently. presenting the most recent data already ongoing and to place suicide from countries across the world; prevention high on the agenda, In the WHO report, the World Health • Discusses major risk and protective regardless of where a country Organisation (WHO) recognises Australia factors for suicide, paying particular stands currently in terms of suicide as a high income country and is using attention to those which are rate or suicide prevention activities. national statistics from 2012. This paper modifiable. It presents the evidence With timely and effective evidence- assumes WHO Report terminology as set for key interventions that show based interventions, treatment and out in Appendix B and on page 12 of the promise in reducing suicidal acts; support, both suicides and suicide Report. Where Australian terminology is • Describes the overarching national attempts can be prevented. used beyond this, it is defined within or suicide prevention strategies lists an appropriate reference. that have been introduced in a The burden of suicide does not number of countries, highlighting weigh solely on the health sector; their common features; and it has multiple impacts on many • Then collates this information sectors and on society as a whole. and makes recommendations Thus, to start a successful journey about the future direction of towards the prevention of suicide, suicide prevention activities in countries should employ a multi- different countries and cultures. sectoral approach that addresses The WHO report aims to be an invaluable suicide in a comprehensive manner, resource for those working to prevent bringing together the different suicide