Introduction
Work to date
Work ahead

Introduction

This response to the Senate Committee's report The Hidden Toll: Suicide in Australia outlines the Australian Government's new plan for suicide prevention in Australia. This approach is centred on the $274 million Mental health: Taking Action to Tackle Suicide package announced in July 2010, but also articulates how the Government will work across service systems to prevent suicide and to support those at risk of suicide.

A summary of individual responses to each of the Committee's 42 recommendations is in appendix C.

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 ages and 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.

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.

As the Senate Committee's report The Hidden Toll: Suicide in Australia identifies, an effective suicide prevention response requires a sustained whole of government, whole of community response and a combination of universal, population based approaches and community-led responses that target those at particular risk of suicide, all underpinned by the best available evidence.

These at-risk sub-population groups include Indigenous Australians, men, young people, gay, lesbian, bisexual, transgender and intersex communities, those bereaved by suicide and those living with mental health disorders and people living in rural areas. Encouraging help seeking in these groups, and providing them with access to appropriate and accessible services, is often challenging but not insurmountable with the right approach.Top of page

Early intervention efforts, and efforts to promote good mental health and build resilience and resourcefulness in children and young people, reduces the incidence and seriousness of problems that develop later in life and are critical to an effective suicide prevention response.

A well educated, trained and supported workforce across many service systems is also a critical success factor, as is continuous improvement in the identification, data collection for and accurate reporting of suicides.

The Senate Committee has also highlighted the importance of effective public awareness programs that address stigma, provide information about crisis and other support services, and encourage help-seeking and social connectedness in people, families and communities to protect against the risk factors for suicide; and of reducing access to means of suicide.

Some key facts are:
  • More than 2,000 Australians each year take their own lives; more than one in eight Australians have thought about taking their own life; 4% have made suicide plans and 3% have attempted suicide during their lifetime.

  • Some groups are at much higher risk of suicide than others: men are much more likely to take their own lives than women: men account for around 75% of suicide deaths in Australia. Other groups, including Indigenous Australians, people in rural and remote areas, gay, lesbian bisexual and transgender people, and children and young people are also at greatest risk.

  • Men are at greatest risk of suicide but least likely to seek help: While men account for three-quarters of deaths from suicide, an estimated 72% of males don't seek help for mental disorders.

  • About one in seven children aged 4 to 14 years are estimated to experience a mental health condition in a year, with one in ten children having a long term mental or behavioural condition.

A new plan for suicide prevention in Australia: the Mental health: Taking Action to Tackle Suicide package

The Australian Government's plan to tackle suicide addresses these strategic challenges by increasing national suicide prevention efforts and providing better coordinated intervention and postvention support.

It aims to strengthen and build on proven approaches, through a combination of universal, population based approaches and direct and immediate investments in community-led responses that target high risk groups and stop suicides taking place.

The Mental health: Taking Action to Tackle Suicide package provides new funding of $274 million over four years commencing in 2010–11. Four strategic actions are advanced:
  1. More frontline services and support for those at greatest risk of suicide – including people who have already attempted suicide or who have severe mental illness. This will mean more psychology and psychiatry services, as well as non-clinical support, to assist people with severe mental illness and their carers with their day-to-day needs ($115 million);

  2. More to stop suicide and support communities affected by suicide: providing increased funding for direct suicide prevention and crisis intervention including through boosting the capacity of counselling services such as Lifeline, supporting communities – including Indigenous and school communities – affected by suicide, and to improve safety at suicide 'hotspots' ($74.5 million);

  3. Targets men who are at greatest risk of suicide – but least likely to seek help. More targeted crisis support services, workplace programs and anti-stigma and help-seeking campaigns will better support men ($23.2 million); and

  4. Promotes good mental health and resilience in young people, to prevent suicide later in life: providing more services for children with mental health problems, as well as in promoting resilience and good mental health in young people – so the children of today are less likely to develop problems later in life ($61.3 million).
More detail on each of the components of the package is at appendix B.

The Government's plan will be supported by broader social policy agendas and systems and service delivery reforms – in primary care and hospitals, in housing and schools, in better supporting youth and families and investing in Australia's infrastructure.

A key aim is to increase the number of individuals seeking help to support their emotional and social wellbeing and increase the identification, referral and treatment of at risk individuals by service systems and health and other professionals.
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Work to date

This new package builds on the previous work by the Commonwealth, states and territories, local and non-government agencies to identify population groups at higher risk of suicide and put in place appropriate assistance for those affected by suicide.

Since 2000, the Australian Government's National Suicide Prevention Strategy (NSPS) has worked to reduce the incidence of suicide and self harm, and to promote mental health and resilience across the Australian population.

It has four inter-related components:
  • The Living is For Everyone (LIFE) Framework, which sets an overarching evidence-based strategic policy framework for suicide prevention in Australia. The framework has been adopted by all states and territories as the basis for their own suicide prevention policies, frameworks and strategies so that Australia has, for the first time, a nationally consistent approach.

  • The National Suicide Prevention Strategy Action Framework, which provides a time-limited work plan between the Australian Suicide Prevention Advisory Committee and the Australian Government for taking forward suicide prevention investment.

  • The National Suicide Prevention Program (NSPP), which is the Australian Government's own funding program, dedicated to suicide prevention activities within the areas of its current roles and responsibilities. It supports broad population health approaches which have proven effective and provides targeted assistance to groups identified at higher risk of suicide.

    • Currently, the NSPP funds over 50 national and local community programs and projects directly aimed at reducing suicide. Australian Government investment in the NSPP has more than doubled from $8.6 million in 2005–06 to $23.8 million in 2010–11.

  • Mechanisms to promote alignment with and enhance state and territory suicide prevention activities, particularly through national frameworks such as the COAG National Action Plan for Mental Health 2006–111 and the Fourth National Mental Health Plan: an agenda for collaborative government action in mental health 2009–20142 (the Fourth National Mental Health Plan).
The Australian Government also contributes extensively to suicide prevention through broader homelessness, employment, education, community welfare and mental health programs and services.

Since 2007, there have been significant effort to provide a sustainable and more evidence-based foundation upon which future national suicide prevention activity can be based – in particular, through a $176 million new investment to fill service gaps in the mental health system; the establishment of new governance structures through the Australian Suicide Prevention Advisory Council; and the establishment of the National Centre of Excellence in Suicide Prevention to increase the emphasis on research and to share evidence and findings. Targeted research activities and project evaluations across a range of government portfolios, universities and communities are building the evidence base for suicide prevention and intervention activities in Australia.
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Work ahead

The Australian Government will work as a priority to implement the 15 measures under the $274 million Mental health: Taking Action to Tackle Suicide package detailed at Appendix B.

The Government recognises that to achieve long term reforms that provide improved outcomes for people at risk of suicide, and those living with mental illness, requires a strong commitment to whole-of-government collaboration and to working in partnership with state and territory governments, community organisations and consumers and carers.

The Fourth National Mental Health Plan3 further guides mental health reform outlined in the National Mental Health Policy 20084. It also has a strong focus on social inclusion.

Finally through recent Council of Australian Governments (COA G) reforms to the health and hospitals system delivered through the 2010 Commonwealth Budget, the health system will be strengthened and reformed to enable improved efficiency and effectiveness, an increased number of sub-acute care beds – of critical importance to people affected by mental illness – better coordination and integration of services based on local and individual needs and clearer roles and responsibilities including for primary care with the Commonwealth assuming 100% policy and funding responsibility.

These structural, governance and financing reforms provide a foundation for further improvements in mental health and suicide prevention. In addition, there are targeted measures through the $178.5 million expansion of the Access to Allied Psychological Services Program to address some specific gaps for at risk groups, through early intervention services for young people and tailored coordinated packages of care for those who are most vulnerable.

Additionally, the Government is actively working across Commonwealth portfolios toward Service Delivery Reforms which aim to improve the way in which the government agencies interact with and deliver services to Australian citizens.

Together this combination of existing and planned new work will provide a stronger platform on which to build effort to reduce suicides and improve resilience and access to effective and targeted services to enable sustained improvement in this area.

Footnotes

1 National Action Plan on Mental Health 2006-2011: Fourth progress report on the Council of Australian Governments website (www.coag.gov.au)
2 Fourth National Mental Health Plan: an agenda for collaborative government action in mental health 2009–2014, Department of Health and Ageing: Canberra
3 Fourth National Mental Health Plan: an agenda for collaborative government action in mental health 2009–2014, Department of Health and Ageing: Canberra
4 National Mental Health Policy 2008, Department of Health and Ageing: Canberra