Government-funded suicide prevention in Australia

Australia’s National Suicide Prevention Office (NSPO) commissioned the University of Melbourne’s Centre for Mental Health to conduct a scan of the government-led suicide prevention system in Australia to inform the development of a framework for a new national suicide prevention strategy.

What’s the issue?

Suicide is recognised as a significant public health concern in Australia, and it was one of the first countries to develop a national suicide prevention policy. Although the policy has been present since the 1990s, Australia’s rate of suicide has not decreased.1

Australia’s National Suicide Prevention Office (NSPO) was tasked to develop a framework for a new national suicide prevention strategy.2 The new strategy is structured around focus areas and enablers. The focus areas are the critical domains where action is required by governments and service providers to significantly reduce suicide and suicidality. The enablers are foundational areas of system reform required to drive the effective implementation of the strategy as well as strengthen suicide prevention efforts more broadly.

Examination of existing strategy and policy informs development of the new national suicide prevention strategy.

What was done?

The NSPO commissioned the University of Melbourne’s Centre for Mental Health (now named the Centre for Mental Health and Community Wellbeing) to conduct a scan of the government-led suicide prevention system in Australia to inform development of the strategy.

The key research questions of the scan included:

  • What are governments in Australia (federal and state or territory) doing to prevent suicide?
  • To what extent is government-led suicide prevention activity in Australia aligned with the focus areas in the NSPO framework for the new strategy?
  • To what extent does government-led suicide prevention activity in Australia leverage the system enablers described in the NSPO framework for the new strategy?

The scan was conducted from August 2022 to January 2023 and focused on two key methods:

  1. A desktop review of government policy and agreement documents.
  2. A scan of government-led/or directly funded programs and services.

The researchers examined:

  • Publicly available ‘policy documents’ (for examples government agreements, strategies and plans) by referring to documents mentioned in the National Suicide Prevention Adviser’s Final Advice3
  • Key programs and services in the national service system.

Only programs or services labelled, funded or designed explicitly with the objective of suicide prevention were included.

Researchers then developed a coding template to summarise themes, similarities, and differences. This template was applied to the data set found from the scan. Qualitative information was also analysed under a template.

What was found?

Many federal and state and territory strategies, plans and frameworks exist in Australia. Some focus solely on suicide prevention and others combine suicide prevention with mental health.

Most strategies consider priority populations, and some mental health and suicide prevention strategies exist purely for First Nations peoples, LGBTIQ+ people, current and ex-serving Australian Defence Force (ADF) members, and child-specific strategies.

Data analysis against the research questions found the following:

Research question 1: What are governments in Australia doing to prevent suicide?

There are a range of activities aimed at preventing suicide. These include strategies, plans, frameworks, agreements, programs, services, digital resources, digital services and systems, and research and evaluation activity.

Research question 2: To what extent is government-led suicide prevention activity in Australia aligned with the focus areas in the NSPO framework for the new Strategy?

The second research question found five key focus areas:

Focus area 1: Strengthening protective factors and wellbeing

Most documents in the scan supported the principle of a comprehensive, coordinated policy and system response. All the policy documents included multi-component approaches to suicide prevention. They also focused on strengthening protective factors against suicide and encouraged early intervention approaches.

Focus area 2: Mitigating the impact of known drivers of distress

All the policy documents in the review included information on social determinants and their role in suicide prevention and encouraged a whole-of-government approach to addressing them.

Focus area 3: Empowering earlier intervention during life transitions

Documents included in the review acknowledged the importance of early intervention during life transitions to differing extents.

Focus area 4: Providing accessible, comprehensive, and compassionate care

All the policy documents highlighted the need for accessible and ‘person-centred’ care. Compassionate care was not mentioned

Focus area 5: Supporting long-term wellbeing

The policy documents recognised the need for coordinated psychosocial support and integration of care for individuals experiencing a suicidal crisis, as well as care for their families and carers.

Research question 3: To what extent does government-led suicide prevention activity in Australia leverage the system enablers described in the NSPO framework for the new Strategy?

The review found that progress in including enablers mentioned in the NSPO framework within government-led suicide prevention activity in Australia is limited.

This finding applies across all four system enablers including:

  • Governance and collaboration across governments and portfolios
    • Most policy documents reference a commitment to a whole-of-government approach, however details on the approach and operationalisation of this were limited.
  • Embedding lived experience decision making and leadership
    • Most of the policy documents (over 80%) and one-third of joint regional plans specifically referenced people with lived experience and the process of co-design.
  • Data and evaluation
    • A number of evaluation issues and data collection and management systems were identified. Problems include concerns about the availability and quality of routinely collected data, inconsistent monitoring and evaluation, and limited evidence for effective interventions.
  • Workforce and community capability
    • Over three-quarters of the policy documents refer to ‘suicide prevention workforce’.
    • Over one-third of documents include ‘peer/lived experience workforce’ in paid, voluntary or advocacy positions in suicide prevention or a broader mental health context.

Why are the findings important?

A cross-sector, collaborative approach to suicide prevention that addresses the enablers listed in the NSPO’s final advice is essential to decrease suicide rates in Australia.

At present, government-led and funded suicide prevention approaches in Australia are mostly selective. There is less emphasis on universal approaches, wellbeing promotion, strengthening protective factors and mitigating the impact of known drivers of distress. Many suicide prevention efforts focused on social determinants do not have substantial evidence of effectiveness to encourage investment from governments, which is one reason why they are not included in strategy and policy documents.

There is limited evidence to demonstrate a whole-of-government or whole-of-system approach is operating in Australia.

The review results highlight that opportunity exists to improve Australia’s government-led suicide prevention activity including improving cross-portfolio and cross-jurisdiction collaboration and coordination.

Notes

1

Australian Bureau of Statistics (2023). Causes of Death, Australia. Retrieved from Causes of Death, Australia, 2022 | Australian Bureau of Statistics (abs.gov.au)

2

Australian Government National Mental Health Commission National Suicide Prevention Office (2024). National Suicide Prevention Office. Retrieved from https://www.mentalhealthcommission.gov.au/nspo

3

Australian Government National Mental Health Commission National Suicide Prevention Adviser (2020). Connected and Compassionate: Implementing a national whole of governments approach to suicide prevention (Final Advice).

Study information

Authors

  • Bridget Bassilios
  • Dianne Currier
  • Karolina Krysinska
  • David Dunt
  • Anna Machlin
  • Danielle Newton
  • Michelle Williamson
  • Jane Pirkis

Study originally published

26 August 2024

Read the full paper

Translated on Life in Mind

19 September 2024

Citation

Bassilios, B., Currier, D., Krysinska, K. et al. Government funded suicide prevention in Australia – an environmental scan. BMC Public Health 24, 2315 (2024). https://doi.org/10.1186/s12889-024-19483-w