The Illawarra Shoalhaven Suicide Prevention Collaborative is working hard to address the unacceptable rates of suicide in the region, but we all need to play our part and look after each other.
Suicide is the leading cause of death for Australians aged 15 to 44 years – more than motor vehicle accidents, assaults and substance use combined. Every day in Australia, eight people die by suicide and another 240 will attempt suicide. Despite a number of services being available to help those at risk, the Illawarra Shoalhaven region has a higher suicide rate than the state average, with 40 to 60 suicides reported each year.
While these figures are alarming, they do little to show the devastating and permanent impact suicide has on individuals and our communities. Most will look at these figures, be shocked for a moment and then go about their day. University of Wollongong clinical psychology graduate Dr Alex Hains isn’t most people. He spends each day working to lower suicide rates in our region and believes if we all work together, we can turn the tide.
Stop, collaborate and listen
In 2015, the Illawarra Shoalhaven Suicide Prevention Collaborative was formed to adopt a more coordinated approach to address the suicide rate.
“At the time we formed, suicide rates weren’t going down,” says Dr Hains, the Regional Manager of the Collaborative. “If anything, they were going up, even though there were lots of really good people doing really good work.”
The Collaborative now has 39 organisations and community groups from various sectors, including health, education, government, media and business. Along with lived experience advocates, these organisations are all contributing significant time and resources to prevent suicide in the region.
“I believe that suicide is preventable and we weren’t doing everything that we know works,” Dr Hains says. “What we’re really focused on now is working more collaboratively to ensure our efforts complement each other and that our activities are based on evidence.”
Dr Hains says that working with many different organisations across different sectors is a challenge, but not without reward.
“They do bring different perspectives, and that’s part of why they’re so important,” he says. “Yes, we have some disagreements. But that’s a good sign that we’re talking about the right things.”
You can't argue with somebody's personal experienceDr Alex Hains
Getting help from those who have been through it
Perhaps the most important perspective in the room doesn’t come from a business or government organisation. It comes from people with a lived experience.
“Their input has proven to be critical to the Collaborative’s success so far,” Dr Hains says. “They provide rich insight into what we need to improve. You can’t argue with somebody’s personal experience.”
Enabling people with a lived experience to play a really central role in improving suicide prevention initiatives has also been therapeutic for those telling their story.
“We’ve heard from those involved that it’s the first time that something that’s always been framed as a flaw or weakness in them is now being seen as an asset,” Dr Hains says.
Telling her story
UOW student Rhiannon Mackie is one of those sharing their experience to help improve the Collaborative’s approach. Rhiannon describes herself as a genuinely happy, outgoing and positive person who has so much to live for. She has a good group of friends, is engaged to be married and has just passed her first semester studying for her Bachelor of Social Work.
Six years ago, it was a different story.
“My mum passed away just before my 18th birthday, I couldn’t sit for my HSC exams because I had an emergency operation and I didn’t have any friends to talk to. I had really bad insomnia, I was hallucinating and my brain was shutting down.”
Rhiannon is telling her story as part of an Illawarra Mercury series on suicide prevention. She wants to increase awareness of mental health care plans and encourage those who do seek help not to give up.
“I repeatedly asked for help and I was heard. It’s sad that it did take an attempt to get the right help for me, but it’s not like that for everyone. You can definitely get help before you reach that point. It’s easy to get a mental health care plan from your doctor and it’s free.”
Rhiannon says while some primary carers need updated mental health and sensitivity training, people shouldn’t be deterred if they don’t find the right fit straight away.
“You might not find your perfect GP the first time. I have been to GPs who would say things like ‘This is stupid, why would you want to do that? You’re so young’.
“When you do get over that hurdle and see someone but feel judged, it’s disheartening, but keep trying. Get a free mental health care plan and find that doctor that works for you, because they are out there.”
What work is getting done
The Collaborative has managed to attract more than three million dollars in new funding to the region for suicide prevention and is now one of four trial sites in NSW for LifeSpan. Run by the Black Dog Institute, LifeSpan is Australia’s largest integrated suicide prevention program and its nine key strategies are expected to reduce suicide deaths by 21 per cent and suicide attempts by 30 per cent.
“We started before LifeSpan came onto the scene as an offering, so we were really well positioned to take on the challenge of implementing such an ambitious initiative,” Dr Hains says. “Lifespan’s systems approach to suicide prevention provides a really clear framework to help engage stakeholders across sectors. It also gives us confidence that there is considerable evidence behind each of our activities.”
The Collaborative has also helped establish a range of new initiatives, including a service that supports people who present to emergency departments after a suicide attempt, a new universal screening program to assist GPs, a school-based initiative for students in Year 9 and an evidence-based community training program that teaches people how to support those around them.
“I’m proud of the way that we’re working together,” Dr Hains says. “It’s a big achievement to just have all of these people in a room together, let alone working on problems that had previously been considered too hard, too difficult or too complicated to resolve.
“They aren’t just turning up to meetings to hear about what’s going on, they’re actively involved in creating solutions.”
Backed by research and practical support
“UOW was one of the first organisations at the table when we talked about setting up the Collaborative, and they continue to be a really key member,” Dr Hains says.
In 2008, UOW and the Illawarra Shoalhaven Local Health District established the Illawarra Health and Medical Research Institute (IHMRI) to advance health and medical research in the region.
“That perspective of research, evaluation and practical support is really important.” Dr Hains says “It ensures what we’re doing is informed by evidence and that we continue to monitor whether we’re having the desired impact.”
In July 2018, UOW launched Mental Illness in Nowra District: Goals and Prevention (MIND the GaP), where researchers and community service providers collaborate to address the mental health needs in the Shoalhaven, particularly among vulnerable and younger people.
At the opening of MIND the GaP at UOW’s Shoalhaven campus, Project Manager Glenn Williams acknowledged the need for an approach that included all members of the community.
“We are reaching out to the Shoalhaven’s diverse group of community members and organisations and invite a collaborative mindset to focus on the task of improving mental health in this region,” he said.
Starting the conversation early
Self-harm behaviour typically begins between 14 and 16 years of age and 70 per cent of mental health issues begin during adolescence, like they did for Rhiannon. This is why Dr Hains says it’s vitally important to provide support to people of this age.
“While the majority of suicide deaths are middle age or older, young people are a really critical access point to make sure they get the help they need,” he says. “This improves the outcomes in the short term and the longer term.”
To address these needs, the Collaborative has begun rolling out the Youth Aware of Mental Health (YAM) program to the majority of high schools in the Illawarra Shoalhaven. Run by accredited trainers external to the school, the program aims to get Year 9 students talking openly about mental health while learning practical skills through role play.
“It’s not just a teacher standing in front of a class,” Dr Hains says. “It’s workshopping relevant dilemmas that the young people themselves come up with. Essentially, it shows them there are multiple ways to deal with a with any kind of dilemma, including ones that lead them towards suicidality.”
While YAM has had overwhelming support from principals, school counselors and parents – who are all encouraged to do training to support these young people – it’s hearing stories of students helping each other that Dr Hains is most proud of.
“Yesterday we heard from a young person whose friend told them they were self-harming. They said that without having done YAM they wouldn’t have known what to do. YAM gave them the confidence to help their friend and tell a trusted adult. That friend is now getting the support they need.”
Rhiannon believes a program like YAM could be the difference between life and death.
“A lot of kids in high school just don’t know about mental health care plans. When I was in school I was clueless. I didn’t know where to turn. I felt alone and it was up to me to find that help.”
Dr Hains says a young person in Year 9 now is far more likely to reach out for the kind of help they need than a young person in Rhiannon’s cohort.
“Generationally, that’s going to have a really positive impact on suicide death and attempts,” he says.
You don't have to solve the problem – just listening can be incredibly helpfulDr Alex Hains
Turning awareness into suicide prevention
Dr Hains believes Australia is at the point where we need to start turning our increased mental health awareness into actions, and everyone has a role to play.
“We want everybody to know how they can help people around them, and we want them to feel confident to do that,” he says. “Only then will we change the culture around suicide and have a significant and sustained impact on deaths and attempts.”
To start this process of change, the Collaborative is encouraging people to complete a one-hour online suicide prevention training course called Question, Persuade, Refer (QPR). The course provides people with the confidence to identify warning signs in others, talk to them about suicidal thoughts and connect them with professional care.
“QPR a really great option to better-equip the community to support each other,” Dr Hains says.
“If one in 10 people know how to support the people around them, then if somebody in the community is struggling it won’t take very long for them to bump into somebody who can help.”
Dr Hains says there is a very dangerous myth in the community that if you ask somebody if they’re thinking of suicide, that you will put the idea in their minds.
“There’s lots of research that has shown it’s not true.
“If you notice somebody around you who isn’t their usual self or seems to be stressed or overwhelmed by something, ask them if they’re okay. Ask them if they’re thinking that maybe life isn’t worth living. Ask if they’re thinking about hurting themselves.
“They’re really lifesaving questions that need to be asked directly and confidently without using awkward euphemisms. Let them know that you’re concerned, listen to them and then check in with them again. You don’t have to solve the problem – just listening can be incredibly helpful.”
I want to help youth access the mental health resources they needRhiannon Mackie
Rediscovering the spark
“There is life after an attempt,” Rhiannon says. “You think it’s going to be crappy and everyone’s going to judge you. But you work on your issues and what you want your future to be like.”
After her own experience, Rhiannon knew she wanted to help others and gained entry into UOW after completing a course at UOW College.
“I can’t advocate UOW College enough. I was never made to feel stupid. I got retaught what I didn’t remember from school.
“When I got the letter to say I made it to UOW, it was incredible. I love it here and the counselling services are fantastic.”
Keen to start supporting others as soon as possible, Rhiannon is a Collaborative member and is volunteering at national youth mental health foundation, headspace.
“I’m a huge advocate for headspace and not just because I volunteer there. It is a genuinely amazing organisation,” she says. “I want to help youth access the mental health resources they need and a social worker does exactly that.”
Getting the help she needed, Rhiannon has discovered new hopes and dreams, and believes others can do it too.
“It doesn’t matter how long it takes, you will find the thing you have a passion for and there will be a spark that will be lit again – and that’s the best thing in the world.”