Since the 1970s, rates of suicide in Indigenous communities have shown a marked increase and are now disproportionately high. In 2012 the age-standardised death rate for suicide was 2.5 and 2.4 times higher for Aboriginal and Torres Strait Islander males and females compared with non-Indigenous males and females. 55
This target population therefore requires specific consideration. Understanding Indigenous suicide requires an understanding of the complex historical, political and social context of contemporary Aboriginal life.
Identified factors that contribute to high levels of suicide in Indigenous populations include:
- Exposure to known environmental risk factors (including poverty, poor education, poor employment prospects, limited access to services, living in rural or remote communities, domestic violence or abuse, alcohol and other drug abuse).
- Many people have been exposed to suicide, which can lead to situations of 'bereavement overload' where suicidal behaviours can become socially contagious.
- Ever-present trauma and grief as a result of continuing loss and traumatisation from past dislocation and mistreatment.
- Disproportionately high numbers of Aboriginal and Torres Strait Islander people in Australian prisons.
- Relatively poor health compared with the wider Australian community.
- Lack of access to culturally appropriate services.
- Loss of cultural identity and cultural disintegration.56
Summary of current evidence/best practiceInterventions that show promise in suicide prevention in Aboriginal and Torres Strait Islander populations include:
- Gatekeeper training to improve skills in risk assessment and working with highly distressed individuals57
- Community-based strategies that aim to promote resilience and strengthen protective factors
- Proactive bereavement support to contain suicide clusters
- Sport or apprenticeship-based suicide prevention programs for Indigenous youth
- Community healing approaches that include traditional cultural approaches58,59
- Efforts to improve 'cultural continuity' by preserving and rehabilitating traditional cultures may be protective against youth suicide in particular.60
Findings in relation to NSPP-funded activitiesAs indicated in section 6.4.8 and section 6.5.10, Aboriginal and Torres Strait Islander people accounted for 14.7% of individual activity participants and 19.4% of group activity participants, which exceeds the proportion of Aboriginal and Torres Strait Islander people in the Australian population. This over-representation is entirely appropriate, given the extremely high rates of suicide in this population. Indeed, as outlined in Section 3.9, NSPP-related activity represents only one part of a concerted national response to address the disproportionately high rates of suicide in Aboriginal and Torres Strait Islander populations.
NSPP-funded projects that target Aboriginal and Torres Strait Islander communities reported use of a number of the promising interventions outlined above. These include gatekeeper training, community-based approaches to promote resilience and community healing approaches that promote cultural practices and cultural continuity, such as 'return to country' trips. Most of these interventions were developed using extensive community consultation which helped improve cultural appropriateness.
While a number of the projects that targeted Indigenous Australians included bereavement support as a key activity, it is not clear whether this was sufficiently flexible or adequately resourced to be able to be responsive to suicide clusters.
Key findingsNSPP-funded projects that target Aboriginal and Torres Strait Islander communities reported using culturally appropriate interventions that included gatekeeper training, community-based approaches to promote resilience and community healing approaches that promote cultural practices and cultural continuity, such as 'return to country' trips.
55 Australian Bureau of Statistics, Causes of Death, p29.
56 Department of Health and Ageing, Promoting Good Practice in Suicide Prevention: Activities Targeting Men, DoHA, Canberra, 2008, p23, accessed 19 December 2012.
57 K Capp, F Dean & G Lambert, 'Suicide prevention in Aboriginal communities: application of community gatekeeper training', Australian and New Zealand Journal of Public Health, vol 25, no 4, 2001, pp315-21.
58 K Kolves, A Milner, K McKay & D De Leo (eds), Suicide in rural and remote areas of Australia, Australian Institute for Suicide Research and Prevention, Griffiths University, Mt Gravatt, 2010.
59 S Silburn, B Glaskin, D Henry & N Drew, 'Preventing suicide among Indigenous Australians', in N Purdie, P Dudgeon & R Walker (eds), Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice, Department of Health and Ageing, Canberra, 2010, pp91-104.
60 M Chandler & C Lalonde, 'Cultural Continuity as a Hedge Against Suicide in Canada's First Nations', Transcultural Psychiatry, vol 35, no 2, June 1998, pp191-219.