YORKE PENINSULA COMMUNITY CONSULTATION REPORT - NATIONAL SUICIDE PREVENTION TRIAL: Country SA ...
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NATIONAL SUICIDE PREVENTION TRIAL: YORKE PENINSULA COMMUNITY CONSULTATION REPORT JULY 2018 Head Office PO Box 868 NURIOOTPA SA 5355 SA Rural Health Network Limited trading as Country SA PHN ABN 27 152 430 914
National Suicide Prevention Trial: Yorke Peninsula Community Consultation Report 2
Contents
3
Acknowledgements
4
Background
5
Aims
5
Methodology
6
Results
Access to suicide prevention services in Yorke Peninsula 7
Community forum findings 8
10
Discussion
Key recommendations 11
National Suicide Prevention Trial: Yorke Peninsula Community Consultation Report 3
Acknowledgements
We acknowledge those people with a lived experience
of mental health issues and suicide, their families, friends
and supporters who provided input into the process and We acknowledge and
shared stories, along with the many people from different
organisations and the general public who hold an interest
thank the more than 500
in mental health and suicide prevention. people who contributed
We also acknowledge Aboriginal and Torres Strait Islander
people as the traditional owners of this country throughout
to the National Suicide
Australia and their connection to land, waters and Prevention Trial community
community. We pay respect to them and their cultures,
and to the Elders both past and present. We thank the
consultations; your voice
contribution of local Aboriginal communities to help shape and feedback has formed
our knowledge of their country and identity. We benefit
from the generosity in sharing their country and their this report.
culture as part of these consultations.
National Suicide Prevention Trial: Yorke Peninsula Community Consultation Report 4
Background
While suicide is an infrequent occurrence in Australia, the About the National Suicide Prevention Trial
effects and aftermath can be both traumatic and long-
Country SA PHN is one of twelve
lasting for families and communities alike. Across Australia,
sites nationally taking part in the trial
people residing in rural and remote communities have
which aims to reduce suicide at a
a higher risk of suicide than those living in metropolitan
local level.
cities. Particular rural communities across the state
experience significantly higher rates of attempts and
The Federal Government is providing
deaths. Compared to the national average, South
$4 million which will enable Country
Australia’s suicide rate is slightly higher at 13.4 deaths
SA PHN to implement evidence-based
per 100,000 compared to 12.61.
integrated approaches to suicide
Suicide can affect any person at any time, however there prevention.
are sub groups of individuals that remain at higher risk
than others. The reasons for suicide are complex and The three-year trial will adopt a
multifaceted, influenced by the vulnerabilities, risk factors systems-based approach to the delivery
and events in a person’s life and their interactions with of suicide prevention services, targeting
other social, cultural, economic and environmental populations identified as ‘at-risk’.
factors2.
For people aged 15-44 years, suicide remains a major The trial brings significant resources,
cause of death. Furthermore, across all age groups activity and funding to areas of
Aboriginal people are more than twice as likely to die by established need across the country.
suicide compared to their non-Aboriginal counterparts1. The selected area in South Australia is
In terms of gender, males account for the majority of the Country North region, including Port
deaths by suicide, while females often attempt at a higher Augusta, Whyalla, Port Lincoln, Port Pirie
rate. Males aged 25-44 years are dying at a higher rate than and the Yorke Peninsula.
all other age groups in regional SA 1.
The population targets within these
The key aims of the trial are to respond to local needs and
regions were selected based on the
identify new learnings in relation to suicide prevention
Country SA PHN Needs Assessment in
strategies. To achieve this aim, an established evidence-
addition to state and national data sets in
based suicide prevention model was selected, the
relation to death and/or suicide attempts
LifeSpan model.
due to intentional self-harm. The three
LifeSpan is an innovative, evidence-based, world-class populations are:
approach to suicide prevention developed by the Black
• Youth (15-24 years)
Dog Institute. Based on scientific modelling, LifeSpan is
• Adult Males (25-54 years)
predicted to prevent 20% of suicide deaths and 30% of
• Aboriginal and Torres Strait Islanders
suicide attempts. The model involves the implementation
of nine strategies simultaneously within a localised area.
Active strategies that form part of the trial will include:
• Training for frontline workers, community members, The trial will work closely with local suicide prevention
young people and leaders; networks, state government and the Office of the Chief
• Coordination of referral networks and multidisciplinary Psychiatrist to implement effective strategies and programs
teams; and across the region. The consultation that forms the basis of
• The development of systems that can reduce suicide this report will support the design of localised action plans
attempts and deaths in communities. that will continue after the trial end date in June 2020. All
research, programs and strategies used within the trial will
1
Government of South Australia (2018) South Australian Suicide Prevention Plan be evaluated upon completion to help inform policy and
2017-2021, SA Health. 2 World Health Organisation. (2014) Preventing Suicide: A Global
Imperative. Geneva. WHO
programs nationally.National Suicide Prevention Trial: Yorke Peninsula Community Consultation Report 5
Aims
The aims of the community consultations were to gauge To meet the aim, the following objectives were addressed
the current community knowledge of suicide prevention, in each of the consultations:
services available and areas of need within the Country
North region as a prelude to the development of a • Determine the level of need and service availability in
community action plan. the local regions
• Identify key barriers and obstacles to help-seeking and
service access
• Brainstorm solutions to create multidisciplinary links
between service providers, and
• Create achievable recommendations in conjunction
with the LifeSpan model.
Methodology
Design
The project adopted a two-stage approach involving: Suicide Prevention Project Officer to conduct six Regional
Suicide Prevention Forums. The aim of the forums was
• Paper-based and online self-administered surveys; and
to gather community members who could contribute
• Face-to-face community consultations in six regional to the development of an effective regional approach to
centres in country South Australia. suicide prevention, with a focus on building the capacity
Paper-based and online survey of organisations and the community to better support
The purpose of the survey was to assess the perceived individuals.
needs and barriers in relation to suicide prevention in the For the Aboriginal component of the consultation,
regional hubs of South Australia. interviews and group yarning sessions were utilised
Between late November 2017 and early February 2018, in addition to the six forums. The results of these are
the CSAPHN conducted a survey, available online and as incorporated below.
a paper-based version. The survey was promoted through The forums included leaders and influencers from the
social media and distributed in a paper-based form at community, including Suicide Prevention Networks (SPNs),
community consultations throughout the region. The community groups, sporting clubs, government and
targeted catchment locations for the survey were Port non-government agencies, business, health, education,
Lincoln, Whyalla, Port Augusta, Port Pirie and the Yorke hospital, emergency responders, GPs, researchers, industry
Peninsula in line with the targeted region for the National stakeholders, people with lived experience, consumers and
Suicide Prevention Trial (NSPT). carers who collectively identified the needs and actions
Community consultation required for the region in relation to suicide prevention.
During the same period, face-to-face consultations were Promotion of the community forums was through
facilitated across the Country North region. To complete advertisements in local newspapers, formal invitations,
this process in a timely manner, Sevenseas Creative Cash Classifieds and media campaigns via Facebook and
Australia was contracted to work with the Country SA PHN the Country SA PHN website.National Suicide Prevention Trial: Yorke Peninsula Community Consultation Report 6
Results
Online survey findings
The survey was the first stage of the consultation process The survey in its entirety consisted of 26 questions
and was opened for a three-month period in line with identifying demographics, workforce capacity, level
the face-to-face community forums. During this period, of need for suicide prevention and alignment with the
337 responses were collected from both community nine LifeSpan strategies. The key findings are
representatives and forum participants. summarised below.
Demographics Workforce and need
Age of respondents Gender Level of suicide prevention need
11-20 years
21-30 years
1.69%
5.08%
27% male 16%
31-40 years 6.78% 73% female 4%
High
Moderate
41-50 years 23.6% 44.07% 48%
Low
51-60 years 23.73% 32% Unsure
61-70 years 6.9% 16.95%
71-80 years 1.69%
Lived experience Collaborative workforces
14%
No 22% Yes
Yes No
86% 78%
86% of Yorke Peninsula
respondents identified as
having a lived experience
of suicide.
38% of Yorke Peninsula
respondents were bereaved
by suicide.National Suicide Prevention Trial: Yorke Peninsula Community Consultation Report 7
Access to suicide prevention services in Yorke Peninsula
Clients with access: Youths and adults were perceived
to have the highest level of access to suicide prevention Needs and gaps: The three predominant needs
services in the Yorke Peninsula. Additionally, males and and gaps highlighted in the Yorke Peninsula
Children and families were perceived to have the lowest community were:
level of access to services.
• Perceived stigma around mental health services
Barriers to access: Availability of suicide prevention • Youth specific services
services and waiting times were the main perceived
• Follow-up care for attempted suicide
barriers to access for survey respondents in Yorke
Peninsula.
To further measure community perceptions of suicide prevention services, a series of statements were listed allowing
respondents to answer with agree, unsure or disagree. The following was found:
Knowledge of where to go for help is low
There are services for family and friends after a suicide ...
Support for someone feeling suicidal is easily accessible
Services are available for youth experiencing suicidal...
Support is available to carers and family
Access to social support is good
Access to psychiatrists is generally poor
GPs are appropriately equipped with Suicide...
Suicide Prevention promotion and education is provided
Early intervention is easily accessible
0% 10% 20% 30% 40% 50% 60% 70% 80% 100%
Agree Unsure Disagree
Notably, access to psychiatrists was perceived as poor by a high percentage of respondents as well as knowing where to
go for help in a suicidal crisis. Furthermore, a need for more support for youths and their families during a crisis.
The top five factors • Poor understanding of • Lack of support for families and
contributing to suicide suicide and mental health carers of persons with ongoing
in Yorke Peninsula were: • Lack of adequately trained suicidal thoughts
health care providers • Distance to appropriate services
• Drug and alcohol use.National Suicide Prevention Trial: Yorke Peninsula Community Consultation Report 8
Community forum findings
In the second stage of the methodology, six community GPs to identify patients in need of support and tailor a
forums were conducted across major regional centres. treatment plan specialised to them without extending
An estimated total of 500 people engaged in the forums consultation times.
and provided their feedback on the current state of suicide
The community had a range of ideas regarding how to
prevention in their region, key needs/ gaps and future plans
improve service gaps within their region, one of which
to reduce suicidality.
being workforce development and multidisciplinary
In addition to community and service providers, local forums. These opportunities were perceived to encourage
mayors were also engaged to form partnerships and services to collaborate, upskill and create awareness of
strengthen the community focus. Fraser Ellis MP had the what is available within their region.
following to say on suicide in the region:
The upskilling of youth workers, teachers, school
“Suicide in country areas impacts the counsellors and school aged children was reiterated
throughout the forum, where participants believed
whole community, but thankfully the
additional training such as YAM could be beneficial and
Yorke Peninsula community wants help reduce the stigma around suicide and mental health
to play a role in recognising risk and in general.
supporting those who are struggling. Follow-up care and discharge planning following a
I found the information and round suicide attempt
table discussion both enlightening Concern was raised by the community around discharge
and a call to action and have since planning with the belief that follow up care was not being
followed closely the activities of the undertaken. This was resulting in patients falling through
two Suicide Prevention Networks the gaps and not receiving the treatment they required.
that are doing such great work in the Suggestions to improve this problem included a review and
Narungga electorate – the Yorkes redesign of current aftercare services and the development
of a local multidisciplinary network with information
SOS group and the Copper Coast SOS sharing to provide follow-up care for individuals and their
network.” FRASER ELLIS MP families following a suicide attempt.
Each forum highlighted ideas and issues unique to their Youth education and resilience building
specific region and key themes were deliberated. For the
Yorke Peninsula, the key themes from the community Youth mental health was also a priority area raised for the
forum were: region, particularly regarding education and resilience
training. The incorporation of suicide prevention and
• Workforce development and upskilling mental health education into school curricula was
• Follow-up care and discharge planning suggested to reduce stigma and build resilience, and
• Youth education and resilience building was strongly supported within the community forums.
Upskilling for school counsellors and teachers alike to
• Referral pathways and early intervention
recognise the signs of suicide and to respond accordingly
Workforce development and upskilling was thought to also complement this process.
The need for upskilling and suicide prevention training for Referral pathways and early intervention
frontline workers, allied health professionals and GPs was a
The community perceived a need for better collaboration
key priority highlighted in the Yorke Peninsula community.
between services to streamline referrals, reduce waiting
Suggestions were made for new targeted education times and create a ‘no wrong door’ approach. There was
focussed on improving assessment skills, referrals and a consensus with participants that the health system was
recognising the signs of suicidality for GPs and first currently disjointed, with services assuming suicide is
responders alike. To aid GPs in this process, the community catered for by other agencies, therefore highlighting the
were receptive to trialling the ‘StepCare’ platform allowing need for clear stepped care and service delineation.National Suicide Prevention Trial: Yorke Peninsula Community Consultation Report 9
Discussion
Upon the completion of the community forums and
the closure of the online survey, data was analysed and The key gaps identified within
compared to highlight consistent themes in the needs suicide prevention for the
and gaps identified within the local area. Generally, the key Yorke Peninsula community were:
issues and trends were highlighted and reflected in both
methods, and no obvious disparities were found in the
Yorke Peninsula data. Workforce development
and upskilling
Education and upskilling was reiterated throughout the
consultation process. The survey highlighted a generalised
poor understanding of suicide and mental health, lack
of adequately trained health care providers and lack of
information for families and carers to support them in a Follow up care
crisis. This was reiterated during the forums, albeit with and discharge planning following
a targeted focus on service providers rather than the a suicide attempt
community.
Workforce collaboration was identified in both
methodologies. Seventy-eight percent of survey Youth education
respondents perceived no workforce collaboration and resilience building
taking place in the region, while forum participants
believed the current system to be disjointed with services
assuming suicide is cared for by other agencies, therefore,
highlighting the need for clear stepped care and service
delineation.
Referral Pathways
On reviewing the predominant needs and gaps identified and early intervention
through the forums and survey, an underlying need for
upskilling and service coordination was evident. Overall,
the findings from the community forums aligned with the
online survey findings from the Country North region as
a whole with the key gaps highlighted being follow up
care, stigma around suicide, suicide prevention, training
opportunities and workforce collaboration.
Upskilling and suicide
prevention training for
frontline workers, allied
health professionals and
GPs was a key priority.National Suicide Prevention Trial: Yorke Peninsula Community Consultation Report 10
Key recommendations
The themes and priorities identified through the model and the nine evidence-based strategies. These
consultation process were used to form recommendations strategies are based on the latest evidence drawn from
to improve suicide prevention within each community and large scale suicide prevention programs overseas that have
the region as a whole. The interventions and/ or programs shown positive results. The LifeSpan wheel and strategies
recommended were, in turn, aligned with the LifeSpan are shown below.
Work
forc
king e in
-ma for
ision ma
tio
ec na
nd nd
rive de
d
a- ve
at Improving emergency
lo
p
D
and follow-up care
m
en
for suicidal crisis
t
Using
Improving safety evidence-based
and reducing access treatment for
to means of suicide suicidality
Live
ownership and adaptation
d exp
Equipping
Encouraging safe primary care
erience inclusion at every l
and purposeful Building a to identify and
media reporting
community safety support people
in distress
net that helps
prevent suicide
Local
Engaging
Improving the
the community
competency and
evel
and providing
confidence of frontline
opportunities
workers to deal with
to be part of
suicidal crisis
the change
Training the
Promoting
community to
help-seeking, mental
recognise and
health and resilience
respond to
in schools n
suicidality
Co sio
m lu
mu inc
d
nit
ye an
ce
ng an
age
me overn
g
nt ural
CultNational Suicide Prevention Trial: Yorke Peninsula Community Consultation Report 11
The recommendations for Yorke Peninsula were:
Improving emergency and follow-up care for suicidal crisis
• Promote and expand aftercare services in the region to provide follow-up care for those who have made a suicide attempt.
This includes providing continuity of care, coordination, across services and strong follow-up.
• Implement best practice care guidelines within the emergency departments and deliver training to emergency department
personnel and hospital staff.
• Employ specialised mental health trained nurse practitioners to be based in emergency departments.
• Provide locally developed resource packs to patients, family and careers who have been in contact with crisis care.
• Develop a plan of how more support can be provided for young people under the age of 16.
• Create a ‘no wrong door’ approach.
Using evidence-based treatment for suicidality
• Improve information sharing between services, families and carers.
• Deliver Advanced Training in Suicide Prevention (ATSP) to clinicians including doctors, psychologists and psychiatrists.
• Encourage the use of Telehealth and e-Mental Health tools.
Equipping primary care to identify and support people in distress
• Provide further training opportunities for GPs and practice staff.
• Equip practices with a ‘stepped care’ model allowing GPs to easily identify patients in need of support and tailor a treatment plan
that is right for them.
• Encourage the development of local multidisciplinary networks.
• Create linkages and collaborations between services to ensure streamlined referrals and aftercare support.
• Implement improved consent tools to enable better sharing of information between health services, as well as other support
networks (e.g. family and friends).
Improving the competency and confidence of frontline workers to deal with suicidal crisis
• Provide targeted education and training for accident and emergency staff to refresh or upskill and build their capacity to support
the community.
• Build awareness across first responders of local referral pathways.
• Develop a common, appropriate language across agencies and sectors.
• Encourage participation of frontline workers in multidisciplinary events such as Expert Insight forums.National Suicide Prevention Trial: Yorke Peninsula Community Consultation Report 12
Promoting help-seeking, mental health and resilience in schools
• Encourage the delivery of evidence-based programs, promoting help-seeking behaviours and building resilience.
• Provide suicide prevention training to all education staff.
• Provide Advanced Training in Suicide Prevention (ATSP) to school counsellors.
• Review school referral pathways to ensure at-risk students are being connected to appropriate care.
• Ensure information about local support services and programs is visible throughout local schools.
Training the community to recognise and respond to suicidality
• Implement Question Persuade Refer (QPR) strategies, targeting community members and health professionals alike.
• Provide training opportunities for the community to help recognise and respond to suicidality.
• Develop a local resource that provides people and agencies with a greater level of knowledge and information about who to
contact when people are in crisis.
• Develop an online portal of services and agencies that is easily accessible.
• Work with local employers to include information about local support services in their employee induction process.
• Engage with local government to provide community support through venues, events and staff resources.
Engaging the community and providing opportunities to be part of the change
• Develop a high profile creative advertising campaign targeting suicide prevention with the inclusions of language, stigma reduction
and help-seeking education.
• Establish suicide prevention representatives within organisations to promote help-seeking and suicide prevention awareness.
• Ensure information about support services and programs are accessible and visible in the local community 24/7.
• Develop posters on local service options that are visible and accessible across the community.
• Proactively communicate and engage with the local community using safe, targeted and consistent messaging to build awareness
of how to help someone who is facing a suicide crisis and provide clear actions that people can take to make a difference in their
community.
Encouraging safe and purposeful media reporting
• Facilitate Mindframe training for media and key spokespeople, including mayors, politicians, and others.
• Encourage proactive use of media to ensure promotion of support and resources.
Improving safety and reducing access to means of suicide
• Remain vigilant about emerging trends in means of suicide.
• Facilitate real-time electronic data collection by agencies to report and measure the level of suicidal crisis in the community.You can also read
