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Focus on the systemic drivers of suicide – including hazardous workplaces

Introduction by Croakey: Calls for system change in suicide prevention and accountability, from government across all portfolios, employers, and the sector itself, will ring loud at next month’s Suicide Prevention Australia national conference in Canberra.

The 1-4 May event comes at a time of rising national distress, on the eve of a Federal Budget under pressure, and as the Federal Government has ordered an inquiry into the workplace culture at the National Mental Health Commission over claims of bullying and dysfunction.

Hopes that the Treasurer will hear calls to #RaiseTheRate on income support, including from the Federal Government’s own Economic Inclusion Advisory Committee in a report released overnight, appear set to be dashed again, amid grave warnings for the health and wellbeing of recipients.

The Federal Government’s Women’s Economic Equality Taskforce has also delivered a list of specific and urgent recommendations for consideration in the 2023 Budget, including reinstatement of the Parenting Payment for women with children over eight and a boost in Commonwealth Rent Assistance.

In other key reports this week, the Australian Council of Social Services said its research show that community services, including disability, family violence and homelessness organisations, are “at breaking point and facing a staffing crisis due to years of inadequate government funding”.

Below, Marie McInerney previews #NSPC23 for the Croakey Conference News Service. Follow the conference Twitter list and Suicide Prevention Australia on Twitter for discussions.


Marie McInerney writes:

Systemic drivers of suicide – including colonisation, toxic workplaces, the housing crisis, rising costs of living, transphobia, racism, and the crushing impact of harmful government policies like Robodebt – will be centre-stage at the upcoming Suicide Prevention Australia (SPA) conference.

The conference will be held in Canberra, on the traditional lands of the Ngunnawal and Ngambri peoples, on the eve of the 9 May Federal Budget.

Suicide Prevention Australia is calling for a $60-100 million “relief package” for frontline suicide prevention services in the Budget and an additional $43 million over two years to support those most at risk of suicide such as the LGBTQIA+ community, Aboriginal and Torres Strait Islander people, men, and older people.

But Suicide Prevention Australia CEO Nieves Murray told Croakey the organisation is not just urging increased funding. It wants systemic change and whole of government accountability.

With a coalition of organisations and individuals, the peak body is calling for a National Suicide Prevention Act that can ensure that every government department and official, whether in housing, education, social security or health, “must look at their work through a suicide prevention lens”.

The call, which will be discussed at the conference, is inspired by similar legislation in Japan, where it says suicide numbers have declined by 40 percent over 15 years. South Australia passed a Suicide Prevention Act in 2021 and the new Labor New South Wales Government has promised to do so.

Urging the Federal Government to also step up, Murray said a Suicide Prevention Act might have prevented the Robodebt disaster, which unlawfully pursued hundreds of thousands of welfare recipients for payments, leading to a number of suicides. The program represents “the worst-case scenario when government fails to consider the human impact of policy decisions”, she said.

#NSPC23 will bring together more than 600 people at the first national gathering of suicide prevention experts since 2019.

It will have a big focus on the role of workplaces in suicide prevention, feature multiple sessions on issues and priorities for LGBTQIA+ people, and hear from a strong lineup of Aboriginal and Torres Strait Islander speakers, including former rugby and boxing champion Joe Williams, journalist Stan Grant and Sydney University Public Health Professor Maree Toombs.

Other keynote speakers include Dr Michelle Lim, scientific Chair of Ending Loneliness Together and Dr Sarah Hetrick, Associate Professor in Youth Mental Health at the University of Auckland in Aotearoa/New Zealand on getting suicide prevention right for young people.

The conference also has a big focus on research, plus sessions addressing support after suicide, lived experience in the workforce, research and the boardroom, online safety, support for CALD communities, people with autism and those who are deaf, and gambling related suicide.

Many innovative suicide prevention programs are on the agenda, including novel ways that the ifarmwell.com.au project has worked with the Loxton community in South Australia to enable farmers to maintain or improve their own wellbeing, including through recruiting a group of Vocal Locals and staging a musical ‘Kick off Ya Boots’, written by a local farmer and performed to sell-out crowds.

Kick off Ya Boots, photo by ifarmwell. Used with permission

Murray says the conference takes place in a worrying landscape, in the wake of pandemic lockdowns, devastating bushfires and flooding and amid the country’s worst cost of living pressures in decades.

Suicide Prevention Australia’s most recent Community Tracker recorded a five point rise over just three months in the number of people (46 percent) of people reporting elevated distress from cost of living pressures. It says recent data from the Australian Institute of Health and Welfare suggests suspected suicide rates in Victoria are at a five year high and that New South Wales saw an eight percent rise in suicides from January to October 2022 compared to the same time in 2021.

According to the Tracker, Australians ranked the top three risks to suicide rates increasing in the next 12 months as: cost-of-living and personal debt (69 percent, +4 points); housing access and affordability (53 percent, +4 points); and unemployment and job security (51 percent, +5 points), overtaking social isolation (51 percent) and relationship breakdown (51 percent).

“We need to take that broader view and move suicide prevention outside of the portfolio of the Health Minister,” Murray said, noting that the findings underline that suicide prevention is about more than a person’s mental health, but also their financial situation, housing, relationships, and many other factors.

The sector is also having to look at its own backyard too, after the Federal Government this week launched an inquiry into claims of dysfunction and bullying at the National Mental Health Commission, following investigations by journalist Rick Morton in The Saturday Paper.

Murray said the inquiry was further proof of the need for a National Suicide Prevention Act, and a reminder that “accountability is key”.

Toxic work and work culture

What do we do when work kills?

That’s a question that United States suicide prevention expert Dr Sally Spencer-Thomas, a keynote speaker at #NSPC23, and colleagues at the International Association for Suicide Prevention Workplace Special Interest Group (IASPWIG) are asking as they investigate the need for better international understanding, data and action on work-related suicide.

The conference will feature multiple sessions on workplace approaches to suicide prevention, including from Chris Lockwook CEO of MATES in Construction initiative to reduce high levels of suicide among Australian construction workers.

Presentations will also focus on other at-risk heavy industries, including transport and logistics, as well as paramedics. This session will also look at the NSW Justice Health and Forensic Mental Health Network’s Zero Suicides in Custody Initiative.

Speaking ahead of the conference, Spencer-Thomas, told Croakey she had been working in the mental health space for some time when her brother died from suicide in 2004.

Afterwards, it was a revelation to her that the majority of people who died by suicide “were just like my brother: working age men who have one attempt and it’s fatal”.

It led her into suicide prevention work and to focus on workplaces as the place to provide mental health support to these men, who were “out of the education system and not really accessing healthcare in a significant way” — men with “double jeopardy”: carrying multiple risk factors for suicide, but least likely to reach out and seek help.

That in turn introduced her to pioneering work in Australia led by Jorgen Gullestrup, co-founder of MATES in Construction, who will also speak at #NSPC23.

Spencer-Thomas is impressed with the way industries like construction have approached suicide prevention — “see a problem, solve a problem”, willing to “try stuff and just see whether it helps”, versus “waiting for 10 peer reviewed journal articles to come out”, which she says stymies urgent work needing to be done in other sectors, such as healthcare and academia.

Workplaces can be both conduits and/or convenors in suicide prevention, connecting employees to support if they need it and “where the workplace can be a mobiliser or (place) to build skills, build awareness, build community”, Spencer-Thomas told Croakey.

She will focus at #NSPC23 on a certification program that “kicks the tyres” on workplace programs, to test their value and commitment, recognising and rewarding those doing their best to implement best practice versus those who are just ticking the boxes.

But she says work and workplaces can also play direct roles in suicide: amazing buffers that provide purpose, meaning, identity and connection when they work well, but are direct contributors to suicide when they create “psychosocial hazards” for employees.

A recent podcast that she hosted with Jorgen Gullestrup and UK academic/author Professor Sarah Wates explores one of the most stunning examples of work-related suicides — the “suicide epidemic” revealed among employees in France’s Telecom in the 2000s, which resulted finally in guilty verdicts of executives for “moral harassment“.

Dr Sally Spencer-Thomas, screenshot from a TEDx talk

Culturally unsafe work

It’s in workplaces too that University of Queensland Adjunct Professor Joe Williams, a Wiradjuri/Wolgalu man and former National Rugby League player and former World Boxing Foundation champion, works to address harm and risk for Aboriginal and Torres Strait Islander people.

Williams, who founded The Enemy Within after years of suicidal ideation and being diagnosed with bipolar disorder, will also be a keynote speaker at #NSPC23 and part of a “fireside chat” with Assistant Minister for Mental Health and Suicide Prevention Emma McBride and former Coalition Minister Anne Ruston.

Williams told Croakey that his work in cultural supervision seeks to help Aboriginal and Torres Strait Islander people manage the challenges of cultural and family obligations versus work demands and responsibilities, providing cultural support to walk “the two worlds” (Indigenous and non-Indigenous).

“For many of our mob, working in systems that don’t understand or even cater to cultural needs can be challenging,” he said.

Especially problematic are workplaces in the justice, child protection or health areas that can pit Aboriginal and Torres Strait Islander people against their cultural values, responsibilities and identities, to carry out roles or directions “that fracture and devastate our families”.

“We are finding that a hell of a lot of workplaces are culturally unsafe,” he said.

Williams, who was a joint winner of the 2019 Australian Mental Health Prize, has written of his struggles and recovery in Defying The Enemy Within: How I silenced the negative voices in my head to survive and thrive, tracing extreme ups and downs through his sporting career that he tried to manage or hide with alcohol and drugs.

Now the father of five, who is based in Dubbo in New South Wales, is celebrating 18 years of being alcohol free and of having a new direction in his work.

In his early days of advocacy and support, he focused on adults who were in mental and emotional pain. But much of his work now is in schools, with a new focus on child development and healing generational trauma cycles, inspired by traditional Indigenous ways of raising families, connection, healing and living with the values of the ancient dreaming stories.

“Young people who are in pain and don’t receive or connect to healing, grow to be old people who are also in pain; and the cycle continues,” he said.

“The large majority of behavioural issues in First Nations communities where I work are predominantly the product of trauma, and the challenges of moving away from the way we lived for thousands of years into a world where we struggle to walk between two worlds.”

As we speak by phone, he’s wearing a t-shirt with the slogan, ‘Behaviours tell the story of our past’.

It applies to individuals and to Australia, where intergenerational trauma has led to an ongoing national tragedy, with the Aboriginal and Torres Strait Islander suicide rate  double that of non-Indigenous Australians, Williams said.

At the heart of that is systemic racism, to be seen also in disproportionate rates of over-incarceration and removal from families for young Aboriginal and Torres Strait Islander people, according to Williams.

As a former sports champion, Williams is often contacted by media to comment on racism rows, where sporting codes speak in shocked tones about player or fan behaviour and protest that “this is not who we are as Australians”.

“In fact, it’s everything to do with who we are as a country because this country is grounded in racism,” Williams said. “It was founded on racism and, in report after report, we see that it is one of the biggest killers of Aboriginal people”.

Williams told Croakey he doesn’t speak at many conferences anymore because he finds it more productive to be out in community. However, he makes an exception for organisations like SPA because they embraced him early, at a time when lived experience wasn’t valued as highly as it is today.

Still he expects his talk may make many at the conference uncomfortable, with a message that it is time for mainstream organisations to be accountable for the lack of significant progress on Aboriginal and Torres Strait Islander suicide rates.

Target 14 under the National Agreement on Closing the Gap aims to get to zero, with a commitment to prioritise First Nations-led and community driven responses.

“It’s our mob that are still dying more than anyone else in the world, it’s our mob still getting incarcerated more than anyone else in the world, but not a hell of a lot of our mob are getting the funding to do the work in community to fix it,” Williams said.

Mental health funding has never been higher, he said, yet Australia has yet to put a real dent in suicide numbers, particularly for Aboriginal and Torres Strait Islander people.

“I’m a sportsperson,” he said, “if I was coaching a team that lost week after week, year after year…I’d struggle to keep my job, but we continue to fund these organisations…”

Joe Williams. Photo supplied

Discrimination in healthcare

#NSPC23 will also hear a call to action from the University of Melbourne’s Trans Health Research Group and leading LGBTQIA+ organisations ACON, Switchboard and DISCHARGED for better funding and understanding to meet the needs of Australian trans community, and the barriers transgender people face in accessing timely, trans-affirming mental health support.

Trans Health Research Group Research Fellow Dr Sav Zwickl told Croakey that nearly half of trans people have attempted suicide in the face of extremely high rates of discrimination, harassment and violence, including bullying and rejection by family and friends, and unemployment.

Many are reluctant to access mainstream health services because of past negative experiences or fears they will face discrimination, so they are forced to rely on underfunded LGBTQIA+ organisations and peer support groups that simply cannot meet demand, they said.

“LGBTQIA+ community-controlled organisations urgently require more funding, and mental healthcare professionals require more training in how to better support trans people,” said Zwickl, who will present at the conference in two sessions.

“This should be involve inclusion of trans health in university curriculums and the upskilling of mainstream services,” they said.

This is the only article to be published from #NSPC23 by the Croakey Conference News Service. We encourage readers to follow the hashtag on Twitter.

For assistance

Lifeline 13 11 14 www.lifeline.org.au
Suicide Call Back Service 1300 659 467 www.suicidecallbackservice.org.au
beyondblue 1300 224 636 www.beyondblue.org.au
13Yarn 13 92 76 13yarn.org.au
Kids Helpline 1800 551 800 kidshelpline.com.au
QLife 1800 184 527 https://qlife.org.au/
Check-In (VMIAC, Victoria) 1800 845 109 https://www.vmiac.org.au/check-in/
Lived Experience Telephone Line Service 1800 013 755 https://www.linkstowellbeing.org.au/


 

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