ATSISPEP suicide prevention report released: ‘what the evidence and our people tell us’

**WARNING: Aboriginal and Torres Strait Islander readers are warned that this article contains an image of a deceased person **

The long-awaited report of the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) has been released, with the clear title: Solutions that work: what the evidence and our people tell us.

Public health practitioner and regular contributor Summer May Finlay reported for Croakey from ATSISPEP’s inaugural Aboriginal and Torres Strait Islander Suicide Prevention Conference in May, and outlines the main recommendations, responses and her observations from the report in the post below.

The Australian Psychological Society (APS) also welcomed the release of the report and called for a quick implementation of the recommendations from the report.

The APS, which recently issued a formal apology to Aboriginal and Torres Strait Islander people, called on other systems that contribute to the trauma or marginalisation of Aboriginal and Torres Strait Islander people, and particularly Indigenous youth, such as the juvenile justice system, to “re-examine their processes and provide trauma-informed care”. See its full statement here or below.

Summer May Finlay writes:

This comprehensive, community focused, landmark report was launched at a ceremony in Parliament House in Canberra earlier this month.

The ATSISPEP team leaders – Indigenous National Mental Health Commissioner Professor Pat Dudgeon, Professor Jill Milroy, Dean of the School of Indigenous Studies at the University of Western Australia, and Professor Tom Calma, Expert Adviser and Convener of the ATSISPEP National Advisory Committee – said they hope the Federal Government agrees they have placed Indigenous suicide prevention activity “on a firm foundation” through the report which:

• summarises the evidence-base for what works in Indigenous community-led suicide prevention, including responses to the social determinants of health that are ‘upstream’ risk factors for suicide, and
• presents tools to support Indigenous suicide prevention activity developed by the project.

In their handover letter to the Federal Government, they say:

“The ATSISPEP Team believes that this Report should be considered by all Government agencies, particularly in relation to social and cultural determinants of health. The tools related to planning, assessment and evaluation should be considered by all parties involved in suicide prevention, including the Primary Health Networks, particularly in relation to the implementation of the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy.”

Among the resources included in the report to support Indigenous suicide prevention activities is a Discussion Paper on the persistence of institutional racism in the Australian health and mental health systems, and anti-racist interventions.

At the ceremony, Indigenous Affairs Minister Nigel Scullion, Health Minister Sussan Ley and Assistant Health Minister Ken Wyatt, the first Indigenous Minister in Australia, officially released the report, saying in a joint statement:

“The report  sets out a new blueprint to improve suicide-prevention services and programmes for Aboriginal and Torres Strait Islander people based on the principle of prioritising community-led, culturally-appropriate services.”

Ley said the Coalition Government has committed to trialling the community-led approaches recommended in the report. See the full statement below.

The main recommendations and other highlights from the report are listed below, but here are some quick observations:

• The report recommends a multifaceted approach for a variety of ages from primordial prevention, primary prevention, selective and indicated interventions. It does not suggest that there is a silver bullet.
• It notes that a common success factor in community-based interventions or responses to Indigenous suicide is “their development and implementation through Indigenous leadership and in partnership with Indigenous communities.”
• The ATSISPEP project produced a range of practical tools with a range of different target audiences. This is fantastic as it is clear from the report that there is no one size fits all approach. Solutions need to be tailored to suit every community Also, practical tips and tools take the guessing game out of it.
• Given the lack of evidence on what works to reduce suicide among Aboriginal and Torres Strait Islander people it is fantastic to see that one of the recommendations is to build into all programs an evaluation component. This will assist us to improve programs over a period of time. This does need to be adequately funded though.
• The report takes a strength-based approach which makes community, culture and wellbeing central to any solution. This an important component of an Aboriginal and Torres Strait Islander policy or program. and aligns with the Aboriginal and Torres Strait Islander Health Plan.
• It recommends that an Implementation Plan be created to complement the report. This would require genuine government partnership with Aboriginal and Torres Strait Islander peak bodies and communities as well as adequate funding to be successful. Solutions require a long term plan and vision which means bipartisanship is vital to success so that if there is a change of government the plan isn’t ditched.
• Aboriginal community controlled health organisations (ACCHOs) have been recommended as the preferred provider. Questions need to be asked about whether this will be an expectation of the Primary Health Networks (PHNs) given they have a significant proportion of the Commonwealth mental health money?

Also attending the launch were Aboriginal family members who have been affected by suicide, including Norma Ashwin who spoke recently on ABC TV about the pain and grief of losing her son. See them photographed below with Prime Minister Malcolm Turnbull.

Main recommendations

Statement from the Ministers

The Coalition Government today released the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) report, Solutions that Work: What the Evidence and Our People Tell Us.

The report was released at a ceremony in Parliament House attended by members of the project team, key stakeholders, the Minister for Indigenous Affairs, Nigel Scullion, Minister for Health and Aged Care, Sussan Ley, and Assistant Minister for Health and Aged Care, Ken Wyatt.

The report sets out a new blueprint to improve suicide-prevention services and programmes for Aboriginal and Torres Strait Islander people based on the principle of prioritising community-led, culturally-appropriate services.

Minister Scullion said the Government welcomed the report, but did so with a very heavy-heart.

“The ATSISPEP report was commissioned by the Coalition Government to look into what is working and what is not working in the services we fund to help prevent suicide in Indigenous communities,” Minister Scullion said.

“It breaks my heart that almost every one of the communities I have visited has been touched by suicide. We know that Indigenous suicide rates are double that of non-Indigenous people, five times higher for young Indigenous Australians and the rate in the Kimberley is one of the highest nationally.

“This report is a critical first step in helping to understand what works in Indigenous communities to tackle what has become an epidemic in some places.

“It builds on the Coalition Government’s commitment to do things with Aboriginal and Torres Strait Islander communities. To this end, we recently attended a roundtable in the Kimberley to work with the local community on the report’s findings and how to trial some of the approaches it recommends.”

Minister Ley said the Government had worked closely with the report’s authors to ensure recommendations could be quickly implemented on the ground.

“The Coalition Government has committed to trialling the community-led approaches recommended in the report,” Minister Ley said.

“This is reflected in our election commitment to invest $192 million in mental health and suicide prevention, which includes the establishment of 12 suicide-prevention trial sites, including one in the Kimberley.

“The Government is also establishing a Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention to continue to build the evidence base of what works to ensure we are continuously learning and adapting to what is working on the ground.

The report’s findings will also inform future funding decisions for suicide prevention and mental health programmes and how best to deliver them for Indigenous communities.”

Assistant Minister Wyatt thanked the University of Western Australia’s School of Indigenous Studies for its work on the project.

“Your report shows that Aboriginal and Torres Strait Islander Australians want to have their health needs met in ways that are tailored to their circumstances and that recognise their unique needs, including their cultural needs,” Assistant Minister Wyatt said.

ATSISPEP is one of several Indigenous-specific suicide prevention initiatives supported by the Coalition Government. Others include the Critical Response Project which is addressing suicide-related trauma in Western Australia and the Aboriginal and Torres Strait Islander Mental Health First Aid training which is being rolled out in more than 60 remote locations across Australia.

More photos (by Irene Dowdy) from the launch

Statement from the Australian Psychological Society (APS)

Act now on ATSISPEP report recommendations – Psychologists

As a strong supporter of efforts to close the gap, the Australian Psychological Society (APS) welcomes the recent release of the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) report.

The APS is calling for a quick implementation of the recommendations from the report which aims to reduce the high rate of suicide among Aboriginal and Torres Strait Islander Australians.

The APS recognises the need for suicide prevention initiatives to be supported by Government but overseen by Aboriginal and Torres Strait Islander people. This includes ensuring that Indigenous people in local communities are trained in a range of peer support, mental health and suicide prevention roles and that Aboriginal-controlled health services are the preferred provider of suicide prevention activities.

In addition, it is necessary that other systems that contribute to the trauma or marginalisation of Aboriginal and Torres Strait Islander people, and particularly Indigenous youth, such as the juvenile justice system, re-examine their processes and provide trauma-informed care.

APS Fellow Professor Pat Dudgeon, a member of the ATSISPEP project, said, “Suicide in Aboriginal communities is a huge issue that requires a tailored culturally specific and sensitive response.

“All attempts to address suicide must also come from an understanding of the existing and ongoing trauma experienced by Aboriginal people and the institutional racism that affects the social and emotional wellbeing of Aboriginal people.   This isn’t just a health issue – it is a social issue, a justice issue and an economic issue.”

APS President Anthony Cichello said, “The APS is committed to working with our Aboriginal colleagues to address suicide. Earlier in the year the APS issued an apology to Aboriginal and Torres Strait Islander people as we recognise this issue is more than just a mental health issue, it is about addressing also the social conditions that have led and still lead to high rates of trauma among Indigenous people.”

APS Executive Director, Professor Lyn Littlefield, says the APS aims to ensure that psychologists have knowledge in working with Indigenous peoples so they can help close the gap in culturally safe and responsive ways, and that it is working on a range of related initiatives including:

• The APS Reconciliation Action Plan
• The Indigenous Psychology Advisory Group (IPAG) to the APS Board
• The Australian Indigenous Psychologists Association (AIPA)
• The Australian Indigenous Education Project (AIPEP)
• The Bendi Lango bursary for Indigenous psychology students
• The Aboriginal and Torres Strait Islander Peoples and Psychology Interest Group
• APS apology to Aboriginal and Torres Strait Islander people