Helping people hold on to life

Date

April 5, 2014

Every one of these deaths is a tragedy for the person involved, and for their family and friends. If we assume that 50 people are directly affected by each death, that would more than fill the MCG on grand final day. More than 1 million Australians will be directly touched by suicide over the course of their lifetime.

So how should we respond to this latest information? How should we respond as individuals, as mental health professionals, as non-profit organisations working in suicide prevention, and as governments?

Last week in Melbourne, Dr Marsha Linehan gave a presentation to more than 600 mental health professionals. Dr Linehan, now at the University of Washington in Seattle, has spent more than 30 years developing a therapeutic approach known as Dialectical Behaviour Therapy (DBT). She embarked on this journey after her own experience of mental illness, suicide attempts and hospitalisation.

DBT has been shown to reduce suicide attempts, self-harm, depression, hopelessness, anger, substance abuse and impulsiveness. Trials have shown DBT can be more effective than other forms of therapy with 50 per cent lower rates of suicide attempts, 53 per cent less visits to emergency and 73 per cent less admissions to hospital. More and more clinical services in Australia are now offering DBT, which has also been shown to be cost effective.

Dr Linehan had a warm heart, a cool head and an unshakeable belief – borne of her own experience – that real change is possible even for those who have endured the most severe traumas and illnesses. Her deep sense of caring was backed up with a scientific rigour determined to measure the impact of treatment and achieve the best outcomes for those with least hope.

Our response to the latest suicide figures should take a similar approach – warm heart, cool head and a belief that things can be done better.

Suicide remains the leading cause of death for people aged 15-44. The highest rates of suicide lie with middle-aged men, and men overall are three times more likely to die from suicide than women. The rate of suicide among the oldest in our community is also increasing. Overall, the national rate of suicide remains stubbornly, and unacceptably, high at more than 11 people per 100,000 of population.

One has to be careful looking at statistics on a year to year basis but the 63 per cent increase in suicides by young women warrants special investigation – a task that the Human Rights Commission will begin shortly.

There are five things we can do to reduce suicide.

1) Mental health professionals need to be better equipped to deal with people who are suicidal. Research by SANE Australia has revealed that many mental health professionals do not receive specific suicide prevention training and so lack confidence to deal with people at risk.

2) Lived experience must inform program design and implementation. People who have attempted suicide are at high risk within a year of having left the mental health system. SANE Australia and others, including the Black Dog Institute, are conducting specific research with people who have attempted suicide to understand what would have helped them more.

3) Collaboration is essential. Non-profit organisations, clinicians and government agencies need to evaluate their programs and focus on collective effort. The National Suicide Prevention Coalition, led by Suicide Prevention Australia, is an important non-profit sector initiative designed to co-ordinate effort as never before. Last week, the federal government made the welcome decision to rollover funding for 49 national suicide prevention projects while the National Mental Health Commission completes its mental health review at the end of the year.

4) We must reduce stigma around mental illness and suicide. Stigma prevents people from getting the help they need early on. We need to prevent small problems from becoming big ones.

5) We need to set a national goal to reduce suicide. Last year, the Expert Reference Group (ERG) chaired by the NHMC recommended that the federal and state governments to adopt a goal to halve suicide over a 10-year period. That means reducing the suicide rate by 7 per cent each year. The Federal and state governments should adopt this ambitious but realistic goal.

Jack Heath is chief executive officer of SANE Australia.