We are implementing a Suicide Prevention Strategy targeting the primary mental health care sector and in particular general practice.
Our GP-centric depression management program approach aims to help improve the care of people with depression and prevent suicidal behaviour.
We remain committed to using the European Alliance Against Depression (EAAD) 4-pillar framework, to inform our approach. The 4 pillars are designed to be implemented simultaneously within a community, to achieve a greater effect rather than implementing activities in isolation.
- Pillar 1: Primary care and mental health care
- Pillar 2: General awareness campaign
- Pillar 3: Community stakeholders
- Pillar 4: At-risk patients, their families and carers
If you or someone you know needs help, call Lifeline on 13 11 14. In an emergency, call 000.
Suicide Prevention Strategy
At the core of our Suicide Prevention Strategy is the implementation of the EAAD systems-based approach, which is primarily a GP depression management program.
The integral role of GPs
Our approach targets the primary mental health care sector and in particular general practice, to support quality care. GPs play an integral role in this approach because:
- GPs are the health professionals accessed most often by those experiencing mental health issues and/or engaging in suicidal behaviour.
- GPs have consistently reported that depression and anxiety are two of the most common health issues they manage.
- Depression is highly correlated with suicidal behaviour and accounts for the highest population attributed risk for suicide.
Australian Institute of Health and Welfare data (2010 – 2017) shows that GPs are the most likely health service that people visit in their last year of life. Both females (90% v 59%) and males (79% v 48%) who died by suicide were considerably more likely to have used MBS services than hospital services in their last year of life.
Activities:
The aim of pillar 1 activities is to provide knowledge on depression (diagnosis, treatment) and suicidal behaviour (exploring, monitoring) particularly for depressed people who present to primary and mental health care.
WA Primary Health Alliance (WAPHA) is establishing a GP focus group to consult on the most effective and efficient way in building the capacity of GPs to improve the diagnosis and treatment of people with mild to moderate depression. WAPHA has collaborated with Telethon Kids Institute to obtain information specific to GP needs through the WA Aftercare Survey.
WAPHA will consider the feedback from both these sources and progress to commissioning activities that are appropriate to the needs and wants of GPs.
Once developed, WAPHA will attempt to reach as many GPs as possible across WA implementing these activities, with focus locations receiving additional targeted activities.
The aim of pillar 2 activities is to reduce personal and public stigma of depression and enhance help seeking behaviour of the consumer.
WAPHA is currently investigating mediums for a general awareness campaign, using the 4 key messages of EAAD as its guiding principles. These key messages are:
- Depression has many faces (symptoms),
- Depression is a real disorder,
- Depression can be treated, and
- Depression can affect anyone.
WAPHA will use these guiding principles to build upon the Inside My Mind general awareness campaign, that was released during the National Suicide Prevention Trials.
WAPHA will endeavour to communicate these key messages through the campaign to vulnerable populations using appropriate and relatable language for each group and at-risk population.
The aim of pillar 3 activities is to provide key community stakeholders with knowledge and basic intervention skills for supporting someone with depression and suicidal behaviour. In addition, this pillar aims to improve knowledge of the local referral pathways and local health system, to direct people to support and treatment.
WAPHA has committed to working with other state and commonwealth funded suicide prevention coordinators to enable their existing community capacity building plans. This will be done through commissioning activities included in these plans or identified gaps in activity that align to pillar 3. These coordinators are (but not limited to):
- Suicide prevention coordinators (MHC funded)
- Community liaison officers (MHC funded)
- Culture Care Connect coordinators (Commonwealth funded)
- StandBy coordinators (Commonwealth funded)
The aim of pillar 4 activities is to support at-risk consumers, families and carers.
As of January 2023, the WA Government committed to jointly fund universal aftercare services to support individuals following a suicide attempt and/or suicidal crisis. Arrangements under the National Mental Health and Suicide Prevention Agreement provide flexibility for WA to develop models of aftercare services to meet the needs of local communities.
A best practice aftercare model of service is currently being developed by the WA Mental Health Commission.
In WA, postvention services are provided by the StandBy program, that supports anyone who has been bereaved or impacted by suicide at any stage in their life. The StandBy program receives annual funding from the Australian Government Department of Health and Aged Care.
Locations identified for the implementation of activities using Targeted Regional Initiatives for Suicide Prevention (TRISP) funding, are yet to be confirmed.
The following variables are currently being considered to identify these locations:
- Data analysis to identify the areas with the highest need,
- Consultation with the WA Mental Health Commission,
- Existing structures in place to support the approach of WAPHA, and
- Community readiness and placed based feedback.
Some activities commissioned using TRISP funding will be generic and available to all WA communities.
It is recognised that not everyone who experiences suicidality or dies by suicide has lived experience of mental ill health, rather the causes that lead to suicidal distress are multifactorial and strongly linked to broader social determinants of health and wellbeing. Due to this complexity, a one-size-fits-all approach to suicide prevention is not suitable on a national scale. The causes of suicide, as well as resources and services required to prevent it, are unique for each region and community.
The World Health Organisation (WHO) emphasises a need for national suicide prevention strategies that are adapted to engage local communities and are multisectoral. A broad systems-based approach to preventing suicidality enables a pathway to promote protective factors, respond compassionately to early signs of distress, and promote social, emotional and cultural wellbeing.?
The essential elements of a systems-based approach can be derived from the WHO‘s Preventing suicide: A global imperative, and are included in The Fifth National Mental Health and Suicide Prevention Plan:
- Surveillance—increase the quality and timeliness of data on suicide and suicide attempts.
- Means restriction—reduce the availability, accessibility and attractiveness of the means to suicide.
- Media—promote implementation of media guidelines to support responsible reporting of suicide in print, broadcasting and social media.
- Access to services—promote increased access to comprehensive services for those vulnerable to suicidal behaviours and remove barriers to care.
- Training and education—maintain comprehensive training programs for identified gatekeepers.
- Treatment—improve the quality of clinical care and evidence-based clinical interventions, especially for individuals who present to hospital following a suicide attempt.
- Crisis intervention—ensure that communities have the capacity to respond to crises with appropriate interventions.
- Postvention—improve response to and caring for those affected by suicide and suicide attempts.
- Awareness—establish public information campaigns to support the understanding that suicides are preventable.
- Stigma reduction—promote the use of mental health services.
- Oversight and coordination—utilise institutes or agencies to promote and coordinate research, training and service delivery in response to suicidal behaviours.
Many of these elements overlap with the EAAD model, while some are beyond the PHNs’ scope (eg, reducing access to means; media reporting guidelines).
Implementing a systems-based approach is highly complex and requires strong local partnerships and community buy-in. Strategically planned, well-resourced stakeholder engagement, community consultation and genuine co-design with adequate timeframes to build and maintain relationships and community trust are essential to the successful implementation of systems-based suicide prevention.
- 30 Jan 2023 – Targeted regional initiatives for suicide prevention
This activity has been made possible through funding provided by the Australian Government under the PHN Program.