This response to the House of Representatives Standing Committee on Health and Ageing's report, Before it's too late, outlines the Australian Government's initiatives to tackle the issue of youth suicide.

Suicide is a national tragedy that has a devastating impact on individuals, families and communities – an impact not always obvious or recognised. People from all walks of life take their own life, and the causes appear to be a complex mix of adverse life events, social and geographical isolation, cultural and family background and supports, socio-economic disadvantage, genetic makeup, mental and physical health, coping skills and resilience. Youth suicide is a particular tragedy, in which young lives are cut short and enormous potential is lost.

While the causes and precipitating factors for every individual suicide are likely to be different, there are well recognised risk factors for suicide, and conversely, evidence based protective factors which reduce the likelihood of suicide for individuals and across the population.

The House of Representatives Standing Committee has acknowledged the preceding Senate Inquiry into Suicide in Australia, The Hidden Toll: Suicide in Australia, and recognises Before it's too late to be complementary to The Hidden Toll. Both reports identify that effective suicide prevention responses require a sustained whole of government approach to suicide, including a combination of universal, population based initiatives and community-led initiatives that target those at particular risk of suicide, underpinned by the best available evidence.

As such, this response focuses on early intervention efforts and efforts to promote good mental health and build resilience and resourcefulness in children and young people, to reduce the incidence and seriousness of problems that develop later in life, and to provide an effective suicide prevention response. Because of the strong relationship between resilience, vulnerability and crisis, the Australian Government targets its suicide prevention efforts across a continuum of suicide prevention activity, supported by early intervention and clinical mental health initiatives.

With mental illness remaining the largest risk factor for suicide and psychological distress often being the 'tipping point' to spontaneous acts of suicide and self-harm, the Australian Government plays a national leadership role in improving the lives of Australians living with mental illness, their families and carers. It achieves this through articulating a vision for reform for Australia's mental health system and driving collaborative effort across the different levels of government, non-government organisations (NGOs) and the private sector.

On 7 December 2012, COAG agreed to release the Roadmap for National Mental Health Reform (the Roadmap), which strongly re-affirms the ongoing commitment of all governments to national mental health reform. The Roadmap sets out the shared vision and aspirations of governments for mental health reform over the next ten years, and includes a number of important strategies that will help Commonwealth, State and Territory governments tackle mental health issues that are relevant to youth suicide. These include:

  • Support for the development and maintenance of appropriate suicide prevention actions
  • Enhancement and implementation of mental health and social and emotional wellbeing programs in parenting, perinatal care, early childhood development, pre-school and school communities
  • Better equipping early childhood and education workers and institutions to support and assist children and young people who may be at risk of developing mental illness and their families
  • Building the competency of early childhood and education workers and institutions to identify and respond effectively to early signs of mental health issues and
  • Expanding early intervention services for young people, ensuring national availability.Top of page
To drive mental health, COAG also agreed to establish new governance and accountability arrangements for national mental health reform. This includes the new COAG Working Group on Mental Health Reform (the Working Group), which will oversee implementation of the Roadmap and ensure that mental health reform remains a key priority of the COAG agenda. Recognising the importance of collaboration, the Working Group will also be supported by an Expert Reference Group (ERG), to ensure that the views, expertise and experiences of the mental health sector are embedded in ongoing mental health reform.

A key task for the Working Group and ERG will be to build on the preliminary set of indicators and targets contained in the Roadmap and determine the best set of national indicators and targets to measure government progress towards national mental health reforms. The Working Group and ERG will also develop a successor to the Fourth National Mental Health Plan, for consideration by COAG in 2014, which will convert the high level aspirations of the Roadmap into medium-term actions.

The Australian Government's mental health reform package totals $2.2 billion over the period 2011-12 to 2015-16. This reform package includes the expansion of youth-focussed mental health and wellbeing initiatives through:

  • $31.3 million over five years commencing 1 July 2011, to establish a nationwide network of school support teams to provide direct support to secondary schools and surrounding communities impacted by suicide or concerned about students at risk. The teams work with schools to minimise the distress caused to staff and students, and to coordinate the appropriate services and resources required. The Outreach to Schools project is being delivered through headspace
  • $197.3 million over five years, on top of a current commitment of $133.3 million to 2013-14, to expand existing and establish new youth focused mental health services through the headspace program. Specifically, the 2011 Budget measure provides funding which will see 90 headspace sites funded across Australia by 2014-15
  • $222.4 million over five years to establish up to 12 youth early psychosis sites, based on the Early Psychosis Prevention and Intervention Centre (EPPIC) model. This built on a 2010-11 Budget measure that provided $25.5 million over four years to establish up to four sites, bringing the total number of sites to be funded to 16, and the total Commonwealth investment in the measure to $247.9 million over six years. The EPPIC model promotes early detection and management of psychosis and holistic support resulting in better mental health and social outcomes for young people experiencing early psychosis and their families and
  • An additional $61 million over five years to establish 40 new Family Mental Health Support Services announced in the 2011-12 Budget. These new community based services are being rolled out progressively, with the first 13 funded from mid-2012. They will provide family focussed early intervention support to assist children and young people who are at risk of, or affected by, mental illness.
Appropriate prevention and early intervention activities for younger children can prevent more serious mental illnesses developing. To this end, such services are being enhanced for younger children, through:
  • $33.9 million over five years for services for children with mental health and developmental issues through the Access to Allied Psychological Services (ATAPS) program and to support linkages between relevant medical service providers.
  • $11 million over five years for the expanded Medicare Healthy Kids Check, which will include consideration of social and emotional wellbeing and development, and bring forward the check from four to three and a half years of age.Top of page
The National Mental Health Commission is another key element of the Government's commitment to long-term mental health reform. The Commission was established to report and advise on mental health to enable more effective planning to meet the needs of the community; create greater accountability and transparency in the mental health system; and give mental health reform national prominence.

In its first year the Commission focussed on developing the inaugural National Report Card on Mental Health and Suicide Prevention. In its first 12 months, the Commission has also met with over 800 stakeholders and established a variety of partnerships, including Batyr & the Young and Well Cooperative Research Centre on youth specific mental health research.

The Government welcomed the release of the inaugural Report Card, titled 'A Contributing Life', on 27 November 2012. The Report Card makes a number of recommendations aimed at governments, service providers and the broader community covering a range of areas important to mental health consumers and their carers. The Government will consider the Report Card and its recommendations carefully as part of the ongoing reform process.

On 23 May 2013, the Government also released Australia's first National Aboriginal and Torres Strait Islander Suicide Prevention Strategy, supported by $17.8 million over four years (2012-13 to 2016-17).

The Strategy identifies six broad action areas, which are:

  • Building strengths and capacity in Aboriginal and Torres Strait Islander communities
  • Building strengths and resilience in individuals and families
  • Targeted suicide prevention services
  • Coordination approaches to prevention
  • Building the evidence base and disseminating information and
  • Standards and quality in suicide prevention.
The new funding will aim to help to reduce the longer term incidence of suicidal and self-harming behaviour amongst Aboriginal and Torres Strait Islander peoples. Activities will include the establishment of culturally sensitive, local community based suicide prevention networks, a national centre of best practice to provide support to Aboriginal and Torres Strait Islander suicide prevention projects, share learnings and showcase best practice models.

Through the existing National Suicide Prevention Program, the Commonwealth funds two universal school based initiatives for mental health promotion, illness prevention and early intervention, KidsMatter Primary and MindMatters for secondary school.Top of page

There are a number of programs under the Taking Action to Tackle Suicide package that target young people under broader population based initiatives. Such initiatives include:

  • Community prevention for high risk groups, which is delivering strategic responses for high risk communities which incorporate known high risk youth, such as the lesbian, gay, bi-sexual, transgender and intersex (LGBTI) population and Aboriginal and Torres Strait Islander peoples and
  • Targeting men who are at greatest risk of suicide measure which will deliver a targeted beyondblue campaign on mental health for 15-25 year old men to reduce stigma associated with mental illness and encourage more young men to seek help.
This investment in our young people is responding to the following data:
  • In 2011, 321 young people aged 15-24 years are reported to have taken their own lives (ABS: Causes of Death Australia, 2011).
  • While the 2011 age-specific death rate for young males aged 15-19 years (10.4 per 100,000) was the lowest age-specific death rate for men overall, because young people are less likely to die from other natural causes, suicide still accounts for a high proportion (25.8%) of deaths among young males. This has been true each year in the last decade.
  • Young women are three times as likely as young men, and twice as likely as the total population, to experience suicidal thoughts, make a suicide plan or attempt suicide (2007 National Survey of Mental Health and Wellbeing).
  • Only 43.5% of young people who reported suicidal behaviour in the 12 months prior to the 2007 survey used services for help with their mental health problems over that same year.
Within the Causes of Death Australia, 2011, the ABS also released data for deaths by suicide for children and adolescents under the age of 15. Over the five year period from 2007 to 2011 there were 53 deaths of children and adolescents under the age of 15 recorded as suicide. 30 of these were males and 23 females. One third of these were Aboriginal and Torres Strait Islanders under 15 years of age.

It should be noted that these data are highly affected by additional sensitivities surrounding these deaths, coronial practices at the state/territory level, and individual coroners' views about intent, specifically the age or developmental stage at which deaths among the young can be attributed to suicide.

While the number of youth suicides officially reported has generally been declining over the last decade, in line with the trend across all age groups, young people continue to be identified as a priority high risk group for suicide (see figure 1).Top of page

Figure 1: Suicide deaths among 15-24 year olds per 100,000 population, 1998-2011

Refer to the following text for a text equivalent of Figure 1: Suicide deaths among 15-24 year olds per 100,000 population, 1998-2011

Source: Australian Bureau of Statistics, 3303.0 - Causes of Death, Australia, 2011
(a) Data for 2006, 2007, 2008 has been finalised see 3303.0 - Causes of Death, Australia, 2011 Technical Notes 2 (www.abs.gov.au)
(b) Data for 2009 and 2010 have been revised. See 3303.0 - Causes of Death, Australia, 2011 Technical Note 2 and Explanatory Notes 92-95 (www.abs.gov.au).
(c) Data for 2011 is still preliminary and subject to a revisions process. See 3303.0 - Causes of Death, Australia, 2011 Explanatory Notes 92-95.(www.abs.gov.au)

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Text version of figure 1

Suicide deaths per 100,000 population:
  • 1998 - 17.1
  • 1999 - 14.6
  • 2000 - 12.9
  • 2001 - 12.8
  • 2002 - 11.8
  • 2003 - 10.9
  • 2004 - 9.5
  • 2005 - 10.2
  • 2006 - 10.3
  • 2007 - 10.1
  • 2008 - 9.4
  • 2009 - 8.8
  • 2010 - 9.5
  • 2011 - 10.1

Source: Australian Bureau of Statistics, 3303.0 - Causes of Death, Australia, 2011
(a) Data for 2006, 2007, 2008 has been finalised see 3303.0 - Causes of Death, Australia, 2011 Technical Notes 2 (www.abs.gov.au)
(b) Data for 2009 and 2010 have been revised. See 3303.0 - Causes of Death, Australia, 2011 Technical Note 2 and Explanatory Notes 92-95 (www.abs.gov.au).
(c) Data for 2011 is still preliminary and subject to a revisions process. See 3303.0 - Causes of Death, Australia, 2011 Explanatory Notes 92-95.(www.abs.gov.au)