Community Toolkit Reflections

My name's Nicholas Proctor. I work for Adelaide University. I'm a professor of nursing at Adelaide University, and for about 30 years been deeply interested in suicide prevention at population levels, but also in clinical work. And I lead a program of work around safety planning, trauma-informed practice in suicide prevention, and supervise students as well. My perspective on the suicide prevention strategy is that it takes the population-based understandings of suicide and suicide-related distress and brings us closer to things that we can do at the point of contact, point of care, or at system-level performance. So it takes things in the wider world we know about for people who are disproportionately impacted by suicide, but gives us guidance to be able to take that forward so that the lives of people who are experiencing suicidal distress, their families, their carers, but also people working in services, have something to work with. And at the core of the things that they do and will be doing, I believe, is bringing compassion and person-centered approaches. When we come together, it reduces ambiguity. It makes pathways for a solution a lot easier.

It creates trust. I believe we're more alike than unalike if we really put our minds to it. We're more alike than unalike in what we want to see happen in suicide prevention. Sometimes what I notice about strategy is it can be this big government document with tables and language that perhaps the people reading it are not familiar with, don't see that language in that format every day. But this strategy at its core is built for people in local and regional communities as well as larger communities. And the reason I say that is that throughout the strategy, there are possibilities for compassion, actionable ideas, person-centered approaches that have reach, relevance, and meaning for the people on the ground. So reach into the strategy. Find your way into it. Don't be intimidated by the strategy. Local communities know the heart of what's going on.

They can tell us things that outsiders perhaps will take time to discover or may not even discover at all. Within communities, there are informal relationships, informal partnerships, and knowledges that can be, if you like, levers to be able to create change or maintain support or create innovation at the local level. So when local communities have that and are recognized for that, it sends a message of validation to local communities. What you know and what you do, and how you can apply what you know and what you do at the local level is valued byus. So please go forward and make that a reality for you.

My name is Pino Migliorino. I am honoured to be on the National Suicide Prevention Office's advisory board, and I have been since its inception, which has been brilliant.

My own history around this issue has been one of bringing a perspective from ethnic communities and more diverse communities, undertaking research with people with lived experience in the development of the advice which predated the office, and making sure that the issues which are considered in the strategy and in the frameworks around it are robust enough to be able to include and reflect cultural and linguistically diversity, which is so important in Australia. The approach to groups which are disproportionately impacted by suicide is really important, and I think the way that the strategy is framed is really important. So in the first instance, it looks at are there aspects of disadvantage in terms of social determinants, and do they have an impact? And I think it's in that framework that the ability to look at then the experiences of migrant communities, refugee communities. While migration is not a determinant itself, aspects of migration fit very neatly and comfortably within the social determinants. So issues like discrimination and that sense of social inclusion are impacted if indeed you are not accepted into a community or feel that you're alienated from the community. If you've come from overseas and have qualifications which aren't recognized, the impact on employment and economic development does get impacted, and therefore, there are some quite specific factors relevant to migration which feed into the social determinants. And then at the individual level, I think that's where it's also really important.

What are the individual circumstances? While those things can group people into potentially predictable areas of stressors, the individual in their own context becomes really important, and it's in this that the ability to see the individual, from my perspective, in their cultural reality, whether it's bicultural, multicultural, or those cultural precepts or values that impact on their lives and how they interact with suicidality itself. I think the main thing that I've really, really enjoyed about the strategy, it does not frame itself around mental health. It frames itself around what are the individual conditions that people experience and what are the prevailing areas around their experiences which could make them more vulnerable to suicidality. The way that the strategy allows communities to come together is by providing a framework which is so broad that it doesn't in itself have a negative impact on people. 

So if the framework was only mental health, then we would come up against quite strong cultural values around that as well, sensitivities, taboos, which would make it very, very hard to do so. But if you start bringing people together around similar life experiences, situations which could make them more vulnerable, then you are going to be able to frame it in such a way that becomes preventative, as opposed to then only dealing with something which is highly critical. One of the big issues around ethnic communities is that in many areas of health, mental health, physical health, the point at which people are actually diagnosed tends to be quite late, and what we need to do is to accept that this is a framing which can actually allow people to address issues far earlier on, so we don't move into a  needs state of services or supports.

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I'm Jordan Frith. I'm a Lived Experience Partnership Group member with the NSPO. I have a lot of fun, really rewarding lived experience roles that I do, and I've been engaged in national advocacy for about eight years. And my specific role with the Lived Experience Partnership Group is to provide support and advice from a lived experience perspective, especially as someone based in Queensland and speaking for that community.

The model that's embedded within the National Suicide Prevention Strategy is comprised of three main domains. We have the prevention domain, so how do we actually prevent people from experiencing distress to begin with? We have the support domain, which is how we actually provide effective, supportive, compassionate services to people who are experiencing distress, as well as their families and supporters and communities that surround them.

And then we have critical enablers, and these are the things that are necessary to achieve everything else that we want to achieve within the strategy. What I think is really unique about the entire model is it takes the conversation around suicide prevention away from that pointy end of crisis and actually starts thinking about prevention from a public health perspective. So how are people supported within their communities?

How are they supported within their workplaces? How are they living high-quality lives? How are their communities living high-quality lives so that they're not reaching that more pointy end? But when people are in distress, how are we actually making sure that the system is wrapping around them and responding to the people around them, so that the support that they receive is effective and caring? When we think about suicide in communities, we're very rarely thinking about it through a health lens, and we're very rarely thinking about it through an interventions lens.

We're thinking about it in terms of issues around access to employment, support with parenting and childcare. We're thinking about it in terms of transport. We're thinking about it in terms of who gets access to resources and who doesn't, who experiences violence and who doesn't. My message for people who are wanting to make a difference and are willing to come to the table and collaborate around suicide prevention is have brave conversations. Don't be afraid to discuss what's not working. Once we have a better understanding of that, we'll be able to have the language to develop solutions, and the solutions are there. They're in our communities, and deeply listening to those communities is essential. And the other thing I'd say is don't give up. It's a really difficult job, and the benefits of this work are often not seen for years, or you take one step forward, you take two steps back. But hold your nerve, and if we keep having the conversation, eventually we'll start seeing better experiences for people.

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I'm Elizabeth Peyton, and I'm the project lead for Everymind's Mindframe program, which supports people to communicate about issues like suicide, mental health concerns, and alcohol and other drugs. We support people who want to talk about an issue like suicide. Primarily, we do support the media who are talking to the most people and the most often about these issues. But we also support people who might be supporting the media as well. So that might be giving an interview or sharing information with them, or it's for people who might be doing their own types of public communication. That might be through social media channels, through podcasts, or other types of public-facing community events. So our program is based on a whole heap of evidence that looks at the impact that public communication about suicide has in the community. So some ways of talking about suicide publicly can actually be quite harmful. For instance, it can increase suicidal behavior in the community, increase suicide deaths or attempts. But we also have some evidence emerging that shows that other ways of talking about suicide can be preventive or positive, whether that's reducing stigma or reducing suicide rates as well. There's some important things to remember when we're talking about suicide. If we're talking about suicide deaths, we should always frame those as a tragedy. We know how we talk about those deaths can really impact people who've been bereaved by suicide, as well as those in distress. So we want to make sure we're using language that doesn't glamorize a suicide death, for example, making it seem like a solution to the problems that person was experiencing. We also want to make sure we're taking care about how we talk about that person. We don't want to use language that makes it seem like they're a criminal, that they're selfish, or that they're stupid, for example.

So that type of language we have to take care with. When we're talking about suicide death, we also need to make sure we're not sharing details about suicide methods, or if a person has died in a public location, not giving details about those either. When we do share those details in our communication, we know that it can increase attempts or deaths using those methods or those sites. If we want to prevent suicide, we can't just talk about suicide deaths, though. We also need to hear other types of stories, stories of survival, which can be really important for people in distress to hear. So we want to hear stories of how people have gotten through a crisis, what worked for them, what helped them get through, what services they used, the people that they spoke to, the things that helped them survive. Those kinds of stories can also model that behavior to those that are in distress and need a way through. It helps them to know that it's possible to get through that crisis. So when we combine all of these stories, when we've got a real diversity of stories around suicide, those can play a really powerful role in suicide prevention. So we have a whole lot of resources to help people navigate how to communicate about an issue like suicide publicly.

That includes some resources for people with a lived-in living experience of suicide called Our Stories Matter, and lots and lots of different tips for how to go about telling a story. We also have language guides, the words to use or not use, things that can help other people in the community feel that it's safe to talk about what they're experiencing. You can access all of those resources on the Mindframe website at mindframe.org.au. We know from the evidence that how we talk about suicide is incredibly important. It can have positive impacts, but it can also have negative impacts. So having language or communication guidance in this toolkit is a really good foundation for communities to have these important discussions about suicide while they're implementing the National Suicide Prevention Strategy locally.

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