Submission: Draft Advice on the National Suicide Prevention Strategy

Introduction:

Suicide and suicidality is a significant social problem in Australia, having resulted in 3,249 deaths in 2022 as well as being the 15th leading cause of death overall. Furthermore, suicide affects both family and broader community members, with research suggesting that the subsequent grief, loss, and trauma from a suicide death adversely affects up to 125 other persons. Economically, estimates best suggest that between $1.6 billion to $6 billion per annum in Australia is lost due to the direct and indirect costs of suicide deaths and attempts. Australia also has a significantly higher suicide rate than the worldwide age-standardised suicide rate (13.2 and 9.0 per 100,000 respectively in 2019). 

Research shows that more immediate mental health distress and the longer-term existence of an underlying mental health condition are both significantly associated with higher suicide rates. Depression, substance use disorders, and psychosis are the most relevant risk factors in worldwide deaths by suicide, and the existence of anxiety, personality-, eating-, and trauma-related disorders, as well as organic mental disorders are significant contributors. Moreover, psychosocial risk factors were existent in almost two-thirds of all deaths by suicide from 2018 to 2022, making psychosocial hazards the leading risk factor in suicidal deaths in Australia. It is clear that mental ill-health and suicidality are inextricably linked, which makes the NMHCCF’s voice vital to the National Suicide Prevention Office’s (NSPO) public consultation on the draft Advice and its recommendations will be key in strengthening the final Advice.

Key Themes and Recommendations:

Through a consultation process with members of the NMHCCF, this submission uncovers ten key issues relating the draft Advice, including:

• The purpose and timeline of the Strategy – broad ambition but lacking specifics.
• Gaps in public awareness and access to services.
• Challenges and vulnerability un rural and marginalised communities.
• Lived Experience and the importance of the Peer Workforce.
• Postvention and aftercare – a lack of support following suicides.
• Cultural competence, sensitivity, and inclusivity.
• The Mental Health and Suicide Prevention divide – the false dichotomy.
• A lack of effective implementation and structural challenges.
• The role of spiritual and non-clinical, community-based interventions.
• Minimising support for carers and families.

With the NMHCCF being the national voice for and by people with lived and living experience of mental-ill health and their family, supporters, kin, and carers, it is in a unique position to provide the following recommendations for the draft Advice:

1. Develop a clear, phased approach for strategy implementation that identifies milestones, timelines, and tracks progress through consistent monitoring.
2. Create a well-structured national awareness campaign aimed at consumers, families, and communities.
3. Offer structured, community-based intervention, postvention, and aftercare programs through improved funding arrangements and tailored service provision that are context-specific and culturally appropriate. Special focus should be on those in rural and remote areas, Indigenous peoples, LGBTQIA+, the elderly, Defence and Veteran, as well as farming populations.
4. Implement the National Stigma and Discrimination Reduction Strategy to tackle stigma and discrimination of mental ill-health and suicide, for which consultation was undertaken by the National Mental Health Commission from November 2022 to February 2023.
5. Create safety surrounding disclosure by developing peer-based care services, covered by the Commonwealth Privacy Act 1988.
6. Provide greater funding, training opportunities, support, capacity-building, and mental health resources for peer workforces.
7. Support a unified approach to suicide prevention and support that addresses marginalised voices and diverse communities while respecting their unique contexts.
8. Promote an integrated approach between the domains of suicide prevention and mental health, rather than separating them.
9. The Australian Government must commit to implementing an actionable national strategy rather than leaving it in ‘draft Advice’ form.
10. Recognise the role of spiritual care and religious leadership as important support services for suicide prevention in the national strategy and dedicate resources to these groups tied specifically to suicide prevention outcomes, especially in rural and remote areas.
11. Promote and fund research into the suicidality of carers and family members.
12. Amend the proposed model in the draft Advice to include carer/family support as an overarching theme underpinning all aspects of the proposed model: prevention, support, and critical enablers.

The NMHCCF offers its standing as the national voice for mental health lived experience and its lived experience expertise to the NSPO to assist where it can in terms of providing evidence and consultation to inform its final Advice on the National Suicide Prevention Strategy. It also welcomes the opportunity to work in conjunction with the Australian Government to improve suicide prevention and support in this country.

The Submission:

Draft Advice on the National Suicide Prevention Strategy