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Suicide Prevention – Australia and R U OK Day

Australia has had a National Suicide Prevention Strategy since 2017. In 2018, 3128 people lost their lives to suicide and another 65,000 attempted to end their lives, making it a serious health concern, especially as the rate has continued to increase. It remains the leading cause of death among young Australians between 12 – 25 and several other groups are also over -represented such as men of working age, Aboriginal and Torres Strait Islander People and members of the LGBTI community. The latest plan for the the next five years (2020 -2025) aims high.  It hopes that “With the right systems in place and support easily accessible, no Australian in suicidal distress should see suicide as their only option.” 

As with other national strategies around the world, there are proposals for programs and interventions to increase resilience, to increase awareness and well -being, to reduce stigma and bullying, to promote social cohesion and specific programs for at risk groups. It also promises to evaluate such programs and to promulgate those which work well. Some programs are especially relevant to Australia. These include those which seek to address rural adversity, homelessness and financial stress and the training of so -called ‘gatekeepers’ such as community leaders, coaches, Elders and teachers,who may be among the first to notice when people are in emotional distress.

Another rather unique and important aspect is the focus on workplace initiatives. This is because three quarters of those who die by their own hand in Australia are middle aged men (median age 44.5).  The purpose of R U OK Day (Are You OK? Day) is to check in on colleagues and friends to see how they are doing. However, some people would find it very intrusive to be quizzed about their mental health, especially at work and I can't help wondering what happens to those people who receive some support at work but then lose their jobs?  One of the biggest barriers we have is the 'blokey' culture which values a high degree of independence and stoicism and makes it difficult to admit to not being able to cope.

As far as employers are concerned, workplace efforts to improve mental health can also help to reduce absenteeism as well as increasing productivity and engagement. By way of example, Worksafe NSW has funded free programs via The Black Dog Institute to train managers in frontline industries such as transport, postal services and warehousing.

Here’s an example of how to help a workmate

Most of these are excellent and well intentioned ideas, however there are limitations.

1.       While funding for mental health and suicide prevention has increased in recent years, many people still fall through the cracks. As it is, of the 37,341 calls received by Australia’s specialised suicide helpline, The Suicide Call Back Service in 2017 – 2018, 13,259 could not be answered. Men particularly seem to appreciate both the anonymity of helplines and the after hours availability of such services. Rural areas where isolation contributes to feelings of helplessness unfortunately have even fewer support services. While digital services hold promise in future, their success depends on intended recipients having both good internet access and sufficient computer skills to be able to access them.

2.       Most people who end up in hospital emergency departments are usually only able to be given more than short term relief. Hospital services in general are overloaded and do not always meet the needs of those in distress.  It is widely recognised that far more follow – up is needed. While counselling may be offered during a crisis, it rarely extends beyond  6 – 10 weeks although at least twelve months is considered necessary. It should also include those who have lost a loved one to suicide. Greater recognition is starting to be given to survivors of suicide attempts and those who have overcome similar difficulties. Using them as peer support workers has been shown to be effective so long as their circumstances are similar to that of the person who needs help.

 4.   Many people who are facing practical problems or adverse life events may be better served in the community or by other services such as relationship counselling, financial assistance,   housing or employment, many of which are also under funded and not able to respond adequately.

5.   The underlying problems which cause people to despair also receive little attention. We still have people living in tents after being burnt out in last summer's bush fires. Homelessness or being able to find an affordable place to live remain problematic for those on low incomes. Under -employment, insecurity of employment  and elder care were problems long before the pandemic and we also  had things like Robodebt - the harassment of poor people, over real or imaginary debts created by an algorithm, which would certainly add to  people's stress. More diffuse issues such rising inequality, growing competitiveness and the environment generally,don't rate a mention at all.
  As  one Twitter respondent wrote: 
“It’s sure weird how depression and anxiety are huge problems for young people in a society where everything costs more every year and every single human act gets monetized, on a planet that is boiling alive, must be a coincidence.”
Even the most hardened economic rationalists among us should realise that the loss of lives to suicide has economic costs too. I don't have figures for Australia, but the  CDC estimated that a single suicide costs the US approximately $ 1,329,553 - mostly in lost productivity, and the combined cost of suicide and suicide attempts costs the US economy in the order of $70 billion a year. Perhaps in the long run it would be cheaper to address some of the structural problems than having to spend more and more on mental health.

In the meantime however despite these shortcomings, there are many people and organisations who can help, especially in the event of an immediate crisis. Some of the Australian organisations are listed below and most of their websites offer additional resources. R U OK has tips on how to approach friends, family, workmates and others and how to recognise if someone may not be alright. Do be a be a bit sensitive here though. If people don’t want to talk, don’t push, but as R U OK says, " A conversation can change someone's life " 
Below are their suggestions as to how school students can help each other

Don’t forget the elderly either. They may not admit to being depressed or stressed but they may have been isolated during lock down or have lost people close to them. Beyond Blue has suggestions on  how to help older people. Just knowing that you care enough to ask will be a comfort to some  people, but be sure to follow up. Don't just  be sensitive on one day of the year.

Where to get Help

Lifeline 13 11 14

MensLine Australia 1300 78 99 78

SANE Australia Helpline 1800 187 263

QLife 1800 184 527 - (LGBTI Helpline)

Kids Helpline 1800 551 800

Bereavement Support 

StandBy Response Service 0418 575 680

National Indigenous Critical Response Service 1800 805 801