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Some lessons from the National Suicide Prevention Conference

How can people with lived experience of suicide be included more meaningfully and effectively in research and policy work? This is one of the major issues raised by discussions at the 2014 National Suicide Prevention Conference.

In his final report on the conference, Matthew Giles says participants also highlighted the need for a national suicide prevention strategy, for better support for communities affected by suicide, and for a more explicit examination of the effects of austerity policies.

***

Susan Beaton – Suicide Prevention Consultant

Q: What is your main take away from the conference?

There are a lot of community organisations doing suicide prevention, and I think my take home message was that communities really need support around this topic.

There is a lot of interest, and a lot of communities reeling from the impact of it, and those communities really need help. That requires collaboration, coordination and integration. Communities that are bereaved by suicide, unless they’re well-connected, they don’t know what to do.

I guess it was a reminder of how many people in different pockets are doing this stuff, but it could be done in a much more effective and efficient way, and those people could get some help and guidance.

Q: What is one thing you would like to do differently as a result of the conference discussion?

The strongest message that came out for change was about the inclusion of lived experience. Whenever there was the voice of someone with lived experience on a panel, or in a workshop and certainly on Saturday morning when the [SPA lived experience] draft guidelines were discussed… I think we have perhaps not made great inroads to suicide prevention, and we need to, and I think the genuine and authentic inclusion of those voices that have expertise around this behaviour, as complex as it is, is what’s going to make the difference.

I would hope the message for people at all levels would be to go home and, if they have lived experience, they have a voice that can be brought to the table and contribute in a way that no other voice can. For me, that elevation and respect for that authentic voice and the demand that it be included at all levels [is the main thing to do differently].

Q: If you were to prepare a briefing for policymakers outside of the conference, who would it be to, and what would it say?

Well, why don’t we go to the top, the PM, why mess about?

The Commonwealth has a suicide prevention framework, which is not a national strategy, although people do call it that. We do not have a mandate of every single State, an agreed national agenda and activity.

What we have now is a little piecemeal, it’s not coordinated and it’s not integrated. We need a COAG-signed on national agenda with agreed programs of activity. We have been doing bits and pieces here and there, but not in a way that addresses the system changes that need to occur.

So my statement goes to the top and says we need all of the States and the Commonwealth to agree on a strategy and program of works that will include evidence-based strategies that we know work.

****

Jill FisherStandBy National Coordinator

Q: What is your main take away from the conference?

Despite the diversity of Australian communities, populations, regions, states and territories, the issue and impact of suicide crosses social, political, cultural and economic barriers.

Every community has the ability and capacity to respond to the needs of those affected by suicide, and the willingness to reach out in a time of crisis is continually demonstrated across the spectrum of StandBy’s model of community care and support.

The growing awareness of how everyone can be a part of supporting those affected and, through those actions, demonstrably reduce the incidence of suicide was a key message of the conference that will enable and empower to act.

Q: What is one thing you would like to do differently as a result of the conference discussions?

It is not something that I would do differently as such, but rather something I will do with even greater passion and enthusiasm, and that is to place the voice of lived experience at the centre of the actions and activities of my leadership of and participation in this growing movement towards better care and response to suicide.

Q: If you were to prepare a briefing for policymakers outside of the conference, who would it be to, and what would it say?

To the Federal Health Minister, and the Federal Treasurer: the investment of support services in this area, such as StandBy, is reliable and well-targeted, with proven health and economic outcomes. Thus, it is likely to have a higher assurance of achieving its objective – to reduce suicides from those bereaved or affected by concerns of contagion.

The emergence and development of the Australian Government’s initial significant commitment to postvention shows foresight and is heartening, yet until all communities and sufficient services are coordinated to provide a community-based integrated response, the challenge for postvention services will remain.

***

Ngaree Ah Kit – Darwin Region Indigenous Suicide Prevention Network Chairperson

Q: What is your main take away from the conference?

I found that most of the conference that I attended was all about research and evaluation. Now, that’s something that doesn’t impact deeply on what I do as a community representative, so there wasn’t as much value in this conference as I thought I would get, so I used my time to connect with others and find out more detail about what other people are doing around the country, and how we can link in and support each other.

It was about finding out what other people are doing and going about their business, what other opportunities are available to support my group up here in Darwin and to make sure we’re able to promote what we’re doing, as well as finding out what other people are doing as well.

Q: What is one thing you would like to do differently as a result of the conference discussions?

I was there representing my Aboriginal suicide prevention community group, so I guess one of the best things I got out of it was hearing the lessons learned from other suicide prevention groups and networks that are operating out there and having a think about what we can do differently and add value when I got back home.

It was a way of getting invigorated and being inspired to do more, and bringing that information back to people on the ground here.

Q: If you were to prepare a briefing for policymakers outside of the conference, who would it be to, and what would it say?

I would tell them about the importance of making sure regular conferences are held, so that people who are working and volunteering in suicide prevention are able to come together and share ideas and experiences. They need to make sure that input is gathered and valued from everybody, from the community level up to those who are the researchers and evaluators, and that lived experience needs to underlie a lot of that.

Conferences like this need to make sure that everybody, no matter where they’re from, can leave with more education, more information, more value, and a clear way forward, with a validation of what they’re doing, and where to go to from there.

****

John Mendoza – Director, ConNetica

Q: What is your main take away from the conference?

While I think it was good to have a focus on social determinants (economy, racial discrimination, gender) in the program, there was little discussion or focus on the massive changes happening in health and social policy in Australia and how these will impact on suicide and self-harm.

The austerity measures announced in the federal budget, the Commission of Audit report and the interim McClure report should have been in sharper focus for this conference.

A gathering of many of the thought leaders, practitioners [and so on] in suicide prevention have a responsibility to the nation beyond their own “program/research/sectional” interests when there are some seismic shifts in public policy.

Threats to cuts to suicide prevention program funding are a concern but the main game is the public policy impacts on the social determinants of health and wellbeing.

See the articles in the current special issue of the Australian and New Zealand Journal of Public Health – that is what the conference should have being saying loud and clear.

****

Bronwen Edwards – Founder, Roses in the Ocean

Q: What is your main take away from the conference?

Lived experience is welcomed across the board of delegates, however some thought needs to go into how we cater for a larger percentage of audience with an actual lived experience of suicide, such that we can look after their well-being throughout the conference. That change is definitely underway and SPA is providing strong leadership and direction.

Q: What is one thing you would like to do differently as a result of the conference discussions?

Possibly an indication on the actual program of which sessions may contain triggers for those with a lived experience such that they can be prepared or choose a different sessions and that presenters are made more aware of the types of content that needs to be sensitively handled

Q: If you were to prepare a briefing for policymakers outside of the conference, who would it be to, and what would it say?

To the Federal Health Minister: the recent National Suicide Prevention Conference has cemented the fact that brave steps have been taken to unify the suicide prevention sector and align everyone to a common goal. The welcomed inclusion of lived experience by the sector as a whole and the desire to change the way suicide prevention is approached going forward indicates a time of change.

The sector needs the support of government now more than ever to maintain the momentum generated and to make significant inroads to the devastating suicide rate in our country.  We need you around our discussion tables to ensure adequate and well-directed funding is made available to the sector, and to sure that a truly national approach is taken.

***

Dr Mic Eales – Artist and Academic

Q: What is your main take away from the conference?

The main take away from this conference for me was the deep sense of community that was instilled through our shared lived experience of suicide. I had not felt that before and I have been to a lot of suicide prevention conferences.

As one of the delegates wrote to me and said, “years of profound silence was broken simply being surrounded by a community of people with ‘lived experience’, owning these words, owning their story, giving it a voice, giving people a space to be honest [and] just supporting each other (a community I didn’t even know existed but longed for!)”

Q: What is one thing you would like to do differently as a result of the conference discussions?

The lived experience of suicide needs to be woven into the overall fabric of the conference from day one. It is essential that at least some of the keynote speakers have a lived experience of suicide otherwise we will alienate those attending, as was the case at the end of day one.

The conference needs to be all-inclusive right from the beginning. No one voice is any more important than any other.

In the past, the conferences have been incredibly dry and academic with no “soul” to them. We need to focus on why we are there and who are the people with lived expertise in the room.

Q: If you were to prepare a briefing for policymakers outside of the conference, who would it be to, and what would it say?

There are so many issues that arose throughout the conference that I feel incredibly passionate about [such as] suicide throughout Aboriginal and Torres Strait Islander communities and the lack of support or empowerment to help them find their own culturally appropriate solutions.

Then there is the issue of mental health amongst those held in detention, and I don’t just mean the children. These are issues over which I feel a sense of powerlessness and helplessness.

As a researcher, I would like to brief the various ethics committees around the country. We need strong evidence-based research that is done in collaboration with people with lived experience. We need to encourage and support those with lived experience who wish to undertake their own research.

Whilst being mindful of the pitfalls of insider research, we need to have support mechanisms in place that care for the emotional wellbeing of researchers, and I believe that it is essential to include a peer support component. Ethics committees need to be innovative, supportive and encouraging for this type of research to occur.

***

Jaelea Skehan – Director, Hunter Institute For Mental Health

Q: What is your main take away from the conference?

I get energised by conferences.  By the discussions that happen, by the discussions that don’t happen but should have, and by being around other people who are passionate about this work. There were a couple of key messages from the conference for me.

Firstly, the conference had a strong focus on the value of lived experience in suicide prevention. While this is something that we strive to achieve at the Hunter Institute of Mental Health, I think there is further work for all organisations to do in ensuring participation and involvement is meaningful rather than tokenistic, but also safe and effective.

I think there are further national discussions around the role of people with lived experience and governance structures to support meaningful participation.

Secondly, the conference highlighted areas where there is still a gap between evidence and practice.  We know that a focus on social determinants and preventing the onset of suicidal behaviour are both valuable and important, but rarely get the same focus as crisis intervention in policy, programs or funding.

We know that many of the current approaches to risk assessment and hospital care have poor outcomes based on research evidence, but we haven’t really looked at alternative models on a national scale.

And while we talk about the critical role of health, education, emergency services, NGOs and many others services and their workers, our investment in developing the skills, knowledge and capacity of that diverse workforce has been sporadic at best.

So what do I want?  I want us to listen more than we talk, I want us to invest our money and energies in what we know is most likely to work, and I want us to have the courage to stop what we know to be ineffective.  I want us to work better together as a broad sector and I want us to always remember what is most important – people.

***

Meanwhile, in Suicide Prevention Australia’s latest e-newsletter, CEO Sue Murray gives her three conference takeaways as:

1. There is a lot of good work happening in this sector! Whether it was an interest in research, service development or community support, I was amazed at the number of delegates at the conference this year and their passion for making a difference in suicide prevention.
Just look at our LiFE Award winners for a start – a staggering example of the success and energy we see in this sector.

2. Suicide prevention is everyone’s business; something I was pleased to see recognised in the national, state and community representation at this year’s conference. There was such a range of voices from those with lived experience to those in the business world – this depth and breadth is needed for whole of community approach to suicide prevention.

3. One size does not fit all. This year’s conference program was designed to highlight the many communities that make up the social fabric of Australian society – geographical, social, cultural, online, workplace and many others. We all have different perspectives but we come together under one agenda– to halve suicides in Australia over the next 10 years. The collective passion and commitment we saw at the conference gave me hope that, together, we can achieve this ambitious goal.

***

For help or more information

For people who may be experiencing sadness or trauma, please visit these links to services and support

• If you are depressed or contemplating suicide, help is available at Lifeline on 131 114 or online. Alternatively you can call the Suicide Call Back Service on 1300 659 467.

• For young people 5-25 years, call kids help line 1800 55 1800

• For resources on social and emotional wellbeing and mental health services in Aboriginal Australia, see here.

***

• You can track Croakey’s coverage of the conference here.

Comments 2

  1. Kate Sommerville says:

    There are so many causes for suicide. Our family experienced the suicide of our youngest sister almost 25 years ago. She was just 31. I can think of many things that may have prevented it but they did not happen. It is always easy to be wise in hindsight.

    The mental health system failed our sister and then tenaciously defended itself. In some ways, our family failed as well although we loved her dearly. Some of her friends failed her too. So did her employers. Many of us also did everything we could to help. With suicide, sometimes it is just one thing and sometimes it is the accumulation of many. Hindsight is easy. Ultimately we have to forgive ourselves and others for whatever mistakes were made.

    Generally, I think that if we can work towards a fair and equitable society with employment and education and good health care available to all we will be providing the best safety net. We also need basic things like good housing as well.

    We need all those things which form the threads of a good community. I like the campaigns and community ‘things’ which are inclusive and kind and make everyone feel valued and loved. There are many groups which play a role in this ‘creation’.

    We all have responsibilities for how we act in these endeavours and in our one-to-one relationships. Even so, we will sometimes fail, or some souls will decide that they need to escape. As the poet, John O’Donohue said sometimes there is an eternal script for each life that we cannot possibly know.

  2. Kate Sommerville says:

    Sometimes people just get tired. This man did but what a life he lead and how much he shared with all of us!

    Vale Robin Williams

    http://www.theguardian.com/film/2014/aug/12/robin-williams-mercurial-talent-tinged-with-sadness

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