Commonwealth response to 'The hidden toll: suicide in Australia'

1. Funding and governance in suicide prevention

Page last updated: 2010

At an Australian Government level, the Department of Health and Ageing has primary responsibility for suicide prevention through the implementation of the NSPS and administration of the NSPP. The NSPS was developed in 2000 to reduce the incidence of suicide and self harm in, and to promote mental health and resilience across, the Australian population.

The Commonwealth also invests extensively in suicide prevention through broader homelessness, employment, education, community welfare and mental health programs and services.

In doing this, the Government is supported by established governance structures through the Australian Suicide Prevention Advisory Council and National Advisory Council on Mental Health to continue to strengthen policy development in suicide prevention and mental health. These groups have complementary terms of reference and work programs and collaborate to enhance and better target mental health and suicide prevention initiatives.

The Senate Committee indicated the need for increased funding of programs to support those at risk of suicide and called for a doubling of investment in suicide prevention activity as well as the establishment of new governance arrangements to encourage greater community and government investment. In this response the Australian Government highlights the doubling of investment under the National Suicide Prevention Program since 2005–06, the significant new investment in suicide prevention activity under the $274 million Mental health: Taking Action to Tackle Suicide package, and the effective roles that various existing nongovernment organisations play (many fostered, encouraged and funded by the Australian Government) in drawing additional investment in suicide prevention and related activities.

Recommendation 37
Recommendation 38
Recommendation 39
Recommendation 40
Recommendation 41
Recommendation 1
Recommendation 42
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Recommendation 37

8.57 The Committee recommends that following extensive consultation with community stakeholders and service providers, the next National Suicide Prevention Strategy include a formal signatory commitment as well as an appropriate allocation of funding through the Council of Australian Governments.

Response

The Australian Government notes this recommendation and intends to consult with states and territories on a formal signatory commitment in further development of the NSPS. The Government notes that the LIFE Framework, which is the policy arm of the NSPS, is supported by all jurisdictions under the auspice of the Australian Health Ministers' Conference

Under the Fourth National Mental Health Plan, the Commonwealth is working with jurisdictions to progress Action 13 – "Coordinate state, territory and Commonwealth suicide prevention activities through a nationally agreed suicide prevention framework to improve efforts to identify people at risk of suicide and improve the effectiveness of services and support available to them". An implementation strategy for all actions under the Fourth Plan was endorsed by the Australian Health Ministers' Conference on 12 November 2010.

Detailed implementation approaches for each of the actions under the Fourth National Mental Health Plan are being finalised by the Mental Health Standing Committee (an Australian Health Ministers' Advisory Council sub-committee).

In terms of funding allocations, the Australian Government investment in the NSPP has more than doubled from $8.6 million in 2005–06 to $23.8 million in 2010–11. In the Mid Year Economic and Fiscal Outlook Statement in November 2010, a further $274m over four years (2010–2014) was committed for the Mental health: Taking Action to Tackle Suicide package.

Recommendation 38

8.60 The Committee recommends that an independent evaluation of the National Suicide Prevention Strategy should assess the benefits of a new governance and accountability structure external to government.

Response

The Australian Government notes this recommendation. A 2009 study of suicide prevention strategies found that Australia's approach is effective by international comparisons5.

The Australian Government is developing an overarching evaluation strategy for the NSPP to commence from July 2011. The evaluation strategy will include agreed data collection, information sharing between different projects and appropriate performance indicators. It will support the implementation of the new National Report Card on mental health and suicide prevention, with new investment of $9 million over three years from 2011–12.

The Government recognises and values the important contribution that organisations outside formal government structures can make to suicide prevention, mental health and wider health policy development and program implementation and provides support to these organisations through a range of initiatives delivered through the NSPP and the LIFE framework.

Recommendation 39

8.64 The Committee recommends that the Commonwealth government double, at a minimum, the public funding of the National Suicide Prevention Strategy, with further increases to be considered as the research and evaluation of suicide prevention interventions develops.

Response

The Australian Government supports this recommendation and has taken action to address it.

Funding for the NSPP has more than doubled from $8.6 million in 2005–06 to $23.8 million in 2010–11. The increase in investment through the Mental health: Taking Action to Tackle Suicide package will dramatically increase the funding available to universal and targeted interventions for high risk groups (Figure 1).

The single biggest risk factor for suicide is the presence of a mental health disorder.

On top of funding for mental health under the MBS and PBS, funding for mental health specific programs (including Indigenous programs) in the period between 2010–11 and 2013–14 will nearly triple to $1.4 billion compared to $516.3 million provided between 2004–05 and 2007–08.

Comprising fifteen measures across four key areas, the investment under the Mental health: Taking Action to Tackle Suicide package will:
  • Boost frontline services to support those at risk to provide greater access to mental health services to those at greatest risk of suicide – including 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 over three years from 2011–12);

  • Take Action to Prevent Suicide and Boost Crisis Intervention Services to increase funding for direct suicide prevention and crisis intervention services such as Lifeline and providing funding to improve safety at suicide 'hotspots' ($74.5 million over four years from 2010–11);

  • Target men who are at greater risk of suicide – but least likely to seek help to provide more services and support to men, who are at greater risk of suicide but least likely to seek help ($23.2 million over four years from 2010–11); and

  • Promote good mental health and resilience in young people to promote good mental health and resilience in young people, to prevent suicide later in life ($61.3 million over four years from 2010–11).
Top of pageFigure 1 shows the growth in funding for suicide measures since the introduction of the National Youth Suicide Prevention Strategy in 1996.

Figure 1: Inclusive of Appropriations by Financial Year for National Youth Suicide Prevention Strategy (1996–97 to 1998–99), National Suicide Prevention Program (1999–00 to 2013–14) and the Mental health: Taking Action to Tackle Suicide package (2010–2011 to 2013–14).

Text equivalent below for figure 1: inclusive of appropriations by financial year for National Youth Suicide Prevention Strategy, National Suicide Prevention Program and the Mental health: Taking Action to Tackle Suicide package
Text version of Figure 1
Figures in this description are approximate as thay have been read from the graph.

Inclusive of Appropriations by Financial Year for National Youth Suicide Prevention Strategy (1996–97 to 1998–99), National Suicide Prevention Program (1999–00 to 2013–14) and the Mental health: Taking Action to Tackle Suicide package (2010–2011 to 2013–14) ($m):
  • 1996-97 - 3.3m
  • 1997-98 - 8.3m
  • 1998-99 - 6.6m
  • 1999-00 - 8.3m
  • 2000-01 - 9.9m
  • 2001-02 - 9.9m
  • 2002-03 - 9.9m
  • 2003-04 - 9.9m
  • 2004-05 -11.6m
  • 2005-06 - 8.3m
  • 2006-07 - 16.6m
  • 2007-08 - 19.0m
  • 2008-09 - 19.9m
  • 2009-10 - 21.5m
  • 2010-11 - 33.1m
  • 2011-12 - 113.4m
  • 2012-13 - 113.4m
  • 2013-14 - 113.4m
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Recommendation 40

8.65 The Committee recommends that the Commonwealth, State and Territory governments should facilitate the establishment of a Suicide Prevention Foundation to raise funding from government, business, community and philanthropic sources and to direct these resources to priority areas of suicide prevention awareness, research, advocacy and services.

Response

The Australian Government notes this recommendation and continues to work with non government organisations to provide services to the Australian population. Many of these organisations are foundations and not for profit bodies which draw additional resources through philanthropic funding sources. The Government will continue to foster and encourage collaboration of suicide prevention effort in the sector to complement its own investment in programs and research.

Recommendation 41

8.67 The Committee recommends that, where appropriate, the National Suicide Prevention Program provide funding to projects in longer cycles to assist the success and stability of projects for clients and employees.

Response

The Australian Government supports the recommendation in principle noting the four year budget cycles of Government and the need to ensure programs are sufficiently flexible to respond to emerging trends. Tax-payer funded projects also require progressive review and evaluation in line with current and emerging Government priorities.

Currently under the NSPP , fifty six projects are in contract with the Department of Health and Ageing until 30 June 2011. The good practice and outcomes of these projects will be documented and analysed under a broad scope NSPP evaluation, in conjunction with the Mental health: Taking Action to Tackle Suicide package.

Organisations currently funded under the NSPP will be offered project continuations in order for their efforts to be systematically evaluated as part of this broad scope evaluation.

Recommendation 1

2.28 The Committee recommends that the Commonwealth government commission a detailed independent economic assessment of the cost of suicide and attempted suicide in Australia, for example by the Productivity Commission.

Response

The Australian Government notes this recommendation. The Government recognises the multitude of considerations which would need to be incorporated into the methodology when assessing the broad social impact of suicide in consideration of the economic and non-economic cost of suicide in Australia.

Consideration also needs to be given to the ongoing challenges relating to the accuracy of data collection and the actions being undertaken by Australian governments to support suicide data improvements, as outlined in Chapter 2 Suicide Reporting and Statistics.

The Australian Government would be prepared to consider this recommendation further in the future but is advised that the Productivity Commission's agenda is currently full.Top of page

Recommendation 42

8.69 The Committee recommends that the Commonwealth government as part of a national strategy with State, Territory and local governments for suicide prevention set an aspirational target for the reduction of suicide by the year 2020.

Response

The Commonwealth Government supports this recommendation in-principle noting experts have been unable to present a consistent view on the viability of a target as suicide is a multi-faceted societal issue.

Ongoing challenges relating to the accuracy of suicide data potentially impact on the efficacy of this recommendation at this time, noting that actions are being undertaken by Australian governments to support suicide data improvements, as outlined in Chapter 2.

As part of the Mental health: Taking Action to Tackle Suicide package, the Australian Government is providing $9 million over three years to establish an annual National Report Card on mental health and suicide prevention. Along with nationally consistent local reporting by Medicare Locals on the performance of mental health services, including outcomes, these measures will give those who matter most (consumers and carers) direct input into monitoring the performance of services.

Footnotes

5 Martin, G., Page, A. 2009. National Suicide Prevention Strategies – A Comparison. The University of Queensland: Brisbane