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.