Participants at community consultations consistently called for community-focused, holistic and integrated approaches to suicide prevention, with intervention strategies that reduce the likelihood of suicide and related problems over the lifespan. This is consistent with evidence emerging from research, which now shows that environmental and biological influences shape brain development in early life and have much greater effects on adult outcomes in physical and mental health and social and emotional wellbeing than was previously understood. Within this overall context account needs to be taken of the risk and protective factors for Aboriginal and Torres Strait Islander peoples which may have different characteristics to that of the rest of the population. For example, the effect and impact of chronic disease and poor physical health, broader social determinants and the relationship this has to social and emotional wellbeing. This knowledge has led to a new emphasis on investment in activities to strengthen the capacity of communities to prevent psychosocial and behavioural problems in childhood and adolescence.
A greater proportion of prevention effort needs to be invested "upstream" in preventive policies and services which build community, family and individual resilience. This can be achieved by a strategic alignment of policies and targeted investment in early prevention in health, family and children's services, education and mental health at key points across the lifespan. Strategies to support children's social and emotional learning including issues relating to Aboriginal and Torres Strait Islander individual identity, to improve self-regulation and resilience can reduce vulnerability to future outcomes, including antisocial behaviour, mental illness, social withdrawal and suicide, alcohol and drug misuse and crime.
Communities that have been successful in reducing youth problem behaviours have initiated local action to minimise the early development and progression of social and emotional problems. In these communities, families, schools and organisations support each other in placing a high value on the following:
- Minimising children's exposure to biological and psychological harmful events such as child maltreatment, family violence and substance abuse
- Teaching, promoting and actively reinforcing pro-social behaviour, including self-regulatory behaviours and the skills needed to become productive adults of the community and society
- Monitoring and reducing opportunities for problem behaviour to occur
- Fostering the development of mental flexibility, problem solving and the capacity for emotional self-regulation and self-reflection in children and young people.
For each developmental period including transition across life stages such as from adolescence to early adulthood, there is a range of known risks that should be a priority focus of those agencies responsible for the services most relevant to that stage of development. At each stage, specific preventive interventions for parents, children, families or youth need to be based on strategies of engagement that acknowledge cultural and individual differences in families and communities.
Figure 5: Opportunities for prevention: Modifying causal pathways to youth problems and suicide (adapted from Robinson et al, 2012)
Enlarged version of Figure 5 (PDF 389 KB)
Text version of figure 5
|Services most relevant to stage of development||Factors that may influence risk||Risk Factors||Preventative measures||Outcomes|
|Primary health care, child development, child care, early learning, family support services||
||Parent mental health, secure attachment, healthy development.|
|Early learning, school, TAFE, youth programs, activities and services||Increasing psychosocial difficulties, including
||Parenting, social-emotional learning, school readiness.|
|Employment and training, SEWB, AOD, health, mental health, family, police, justice services||Acute stress, trauma, significant loss/ relationship crisis leading to intoxication||
||Families, community, cultural and social supports.|