A new suicide prevention strategy has been launched, but it appears to be just another set of recommendations that will be ignored, writes Simon Tatz.
*Content warning: This article is about suicide.
Suicide Prevention Day has come and gone, with the usual speeches, promises, funding commitments, and other suicide prevention strategy: Advice on the draft consultation on the National Suicide Prevention Strategy.
Another year of the same approaches to suicide prevention, making the same vague recommendations that will never be implemented.
Unable to do more than request reports and consult stakeholders, governments and their designated agencies produce seemingly endless prevention strategies. They continue to fund what they know and what they know will be acceptable to a sector that is unwilling to recognize the limited effectiveness of suicide prevention strategies.
The latest draft strategy starts with grim statistics:
Suicide rates in Australia remain unacceptably high. Every year in Australia, more than 3,000 people die by suicide – that's almost nine people every day. Suicide remains the leading cause of death among people between 15 and 44 years old and the second leading cause of years of life lost.
The draft strategy continues:
It doesn't have to be like this. Most suicides can be prevented. In recent decades, the economic, health, and technological factors that contribute to suicide and suicidal distress have changed. At the same time, our understanding of suicide has increased dramatically.
In 2010, when it was proposed to the Senate Community Affairs Committee A hidden toll: suicide in AustraliaThere were 2,191 suicides, with suicide identified as the fourteenth cause of death. Note that problems with Australian Bureau of Statistics data suggest the suicide rate has not decreased significantly in 25 years. Nor has our understanding of suicide significantly increased.
One of the fundamental problems of suicide prevention strategies is the reluctance to take subjective death out of its “closed box.” This aversion to questioning the limitations of suicide prevention efforts creates a vicious cycle: more strategies, more consultations, more recommendations, more money (because that's the only answer), and then repeat.
Suicide prevention strategies should not obsess over statistics, as if measuring small fluctuations indicates “success” or not. Strategies must begin with honesty, no matter what the encounter. We don't know why some people commit suicide; There is no single factor for suicide. We cannot prevent all suicides.
In fact, self-death was first documented in ancient Egypt, two millennia before the Christian era radically transformed our view of suicide. Suicide exists in all countries and in all cultures. No country has ever “prevented” suicide, and it is doubtful that we, as a species, can prevent self-inflicted death.
If we can break the taboo, these strategies will tell us from the beginning that suicide prevention is a matter for the living. It is an understandable response to grief, tragedy, lasting loss and pain. We struggle to know why and what we could have done to avoid it. We look for answers and explanations and assign blame.
We direct our anger toward those we believe should have waited, warned, and intervened. If only we had more crisis lines, more awareness campaigns, more funded psychiatric appointments, and more apps and websites.
Suicide is not an aberration, a strange concept or phenomenon. It is not a “national disgrace”, as one former prime minister said. No State can be responsible for the actions of individuals and no State can prevent the actions of individuals.
Suicide can never be prevented, but for some, it can be stopped through physical and mental health interventions, through family, friends and support networks, and by providing safe accommodation and financial security.
Resorting to euphemisms and slogans can give family and friends some comfort. They will not feel comfortable with strategies intended to alleviate or postpone suicide. If the goal is suicide prevention, strategies must identify between those we can target to distract ourselves and postpone self-inflicted death, and those we cannot target, due to the nature of their motivations or circumstances.
Suicide prevention strategies target vulnerable groups, that is, “at risk” groups. There is no intervention for those who want to end a life of physical and mental pain, or for those who want to control their existence.
The “risk factors” that lead to suicide are so great that no government will admit that it cannot or will not make the radical transformations necessary to address them.
Australian governments have failed to address risk factors by implementing recommended repeated actions on drug reform, reducing access to alcohol, gambling addiction, financial anxiety, homelessness and housing stress, exposure to violence, racism and discrimination, genetics, lack of family support, interaction. with Criminal justice system, gender, sexuality and location.
We must be honest and stop pretending that governments can magically implement the recommendations in dozens of suicide prevention strategies. They cannot legislate or fund family support, nor make life full of hope and promise. Banning gambling and alcohol advertising and implementing drug reforms seem like a long shot for governments, but we are told these are risk factors for self-inflicted death.
We must not abandon identification and intervention. We must continue to design and implement programs and supports that reduce suicides, and fund and promote effective medical and online approaches that mitigate and postpone suicidal acts.
But we have to be honest and stop talking about “zero suicide” and suicide prevention as an outcome that can be achieved if governments invest more money and have more strategies and plans.
If you would like to speak to someone about suicide, you can contact Lifeline on 13 11 14.
Simon Tatz was Director of Communications for Mental Health Australia and Director of Policy for Mental Health Victoria.
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