Transcript Slide 1

Krysinska, K., Martin, G. and Sheehan, N.
The University of Queensland
“The Mental Health of a Nation is judged by the care with which those most
in need are assisted to regain control of their own lives”
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Pitjantjatjara child ACH 1975
CAMHS Ngarrindjerri Riverland position 1996 to date
Elcho Island visit (Terry Yumbulal) (NYSPS Liaison),
1996
Auseinet position 1997-2006
Masters & Grad Cert program 1998 to date (Sharon
Cruse)
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Yunggorendi First Nation Centre, Flinders Uni and
Nunkuwarrin Yunti
2nd Year Medical student patient 1998
Spirituality and Suicide Conference, Brisbane 2004
Mount Isa child 2008
Mornington Island service planning, 2009
From Nanna, Christmas 1955
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Our literature review was based on 9 Key
Principles consistent with existing Australian and
International declarations, frameworks, policy,
plans and strategies
Our recommendations derive from the best
available evidence (both national and
international) in promotion of social and emotional
wellbeing, and prevention of suicide through early
intervention in social, family, personal and
biological determinants along the trajectory to
suicide.
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Direct Involvement of Community Members and
Development of Local Workforce
Ensuring Program Sustainability and Organization
Capacity
Evidence‐ or Theory‐Base for Programs
Appropriate Program Evaluation
“Researching Ourselves Back to Life”
Community Empowerment
Recognition of Human Rights, Transgenerational
Trauma, Loss and Grief
Development of Individual, Family and Community
Social and Emotional, and Spiritual Wellbeing
Acknowledgement and Recognition of Aboriginal and
Torres Strait Islander Diversity and Importance of the
Local Context
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Mackay 2008
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Children’s Commission Report 2008
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2 cases
“Suicide Prevention for Indigenous Australians: A
Social and Emotional Wellbeing Approach”
pdf from
<www.SuicidePreventionStudies.com.au>
Nearly
1 million
people
in 2007
(a) Males
60
50
50
40
40
30
30
20
20
10
10
0
0
(b) Females
No. of years pre-strategy
54
51
48
45
42
39
36
33
30
27
24
21
18
15
12
9
6
3
0
3
6
9
12
15
18
21
54
51
48
45
42
39
36
33
30
27
24
21
18
15
12
9
6
3
0
3
6
9
12
15
18
21
Rate per 100,000
.
60
No. of years pre-strategy
No. of years post-strategy
All ages
15-24 years
No. of years post-strategy
(a) Males
60
50
50
40
40
30
30
20
20
10
10
0
0
(b) Females
No. of years pre-strategy
54
51
48
45
42
39
36
33
30
27
24
21
18
15
12
9
6
3
0
3
6
9
12
15
18
21
54
51
48
45
42
39
36
33
30
27
24
21
18
15
12
9
6
3
0
3
6
9
12
15
18
21
Rate per 100,000
.
60
No. of years pre-strategy
No. of years post-strategy
All ages
15-24 years
No. of years post-strategy
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“National suicide prevention strategies have
been proposed despite knowledge deficits about
the effectiveness of some common key
components
the most promising interventions are physician
education, means restriction, and gatekeeper
education. Many universal or targeted
educational interventions are multifaceted, and
it is not known which components produce the
desired outcome”
National Strategies are successful if they provide…
 communication program to the whole population
 education for relevant groups (‘gatekeepers’)
 reduced access to means (bridges, firearms, etc)
 a strategy on drugs and alcohol
 a critical mass of clinical services with relevant
and sufficient highly trained professionals
 improved services managing suicidal people, as
well as improved linkages with the community
 proper evaluation with a formative approach
 a strategy for Indigenous peoples
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The estimated resident number of Indigenous
Australians (June 2006) is 517,200 including
463,900 Aboriginal Australians, 33,100 Torres
Strait Islander Australians and 20,200 people
identifying as both Aboriginal and Torres Strait
Islander, altogether comprising 2.5% of the
total population (ABS&AIHW, 2008).
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Best available data indicate that overall
mortality rates among Indigenous males and
females are almost three times higher than for
non‐Indigenous Australians, and there is a
17‐year gap between life expectancy at birth for
Indigenous and non‐Indigenous males and
females (59 v 77 yrs and 65 v 82 yrs
respectively) (ABS&AIHW, 2008).
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Among Indigenous Australian males, overall
suicide rates are almost three times higher than
suicide rates for non‐Indigenous Australian
males, with biggest differences in younger ages
(ABS&AIHW, 2008).
Suicide rates among Indigenous Australian
females aged 10‐24 are five times the rate of
other Australian females, although in age
groups 45‐54 and over, suicide rates are similar
or lower compared to rates for non‐Indigenous
Australian females.
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The situation of Indigenous Australians looks
grim even by comparison to other Indigenous
populations (Freemantle et al., 2007), and not
much has changed since 1995 when Ring
observed that “expectations for life for Indian
populations in Canada and the United States,
and for the Maoris in New Zealand are at least
10 years more than for Australian Aborigines,
an enormous difference” (Ring, 1995; p. 228).
Male
Suicide
Accidental
Poison.
Assault
Female
Total
Rank % All deaths
OR
(X60-X84)
Indig Aust
74
29
103
5
4.2
Non-indig
1,588
444
2,032
14
1.5
2.8
(X40-X49)
Indig Aust
24
13
37
14
1.5
Non-indig
408
156
564
39
0.4
3.75
(X85-Y09)
Indig Aust
22
15
37
14
1.5
Non-indig
100
62
162
51
0.1
15
129/12,006
1.1%
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Interpret with caution
183 (1.94%) respondents identifying as Aboriginal or
Torres Strait Islander compared to 2.29% in the
population (Χ2=0.63, p=0.426).
4 week prevalence 2.4% (1.1% NI)
 Females 4.2%, (n=4)
 Males 0% (none)
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Lifetime prevalence 15.7% (n=29) (8.1% NI)
 Higher for women (17.8%, n=19)
 Males 13% (n=10)
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Sufficient Indigenous professional capacity to
sustain development and implementation of
programs toward Social and Emotional Wellbeing
at the local level;
Coordinated local training in Mental Health First
Aid, ASIST, Drop the Rock and other relevant
programs where evaluation shows them to be
effective;
Provision of relevant crisis management at the
local level for suicidal people.
Sufficient local awareness of mental health systems
and how these are accessed.
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Suicide Awareness for Aboriginal Communities manual and
workshop
King, Appleby, & Brown, 1995
Yarrabah Men’s Health Group
Mitchell, 2005; Patterson, 2000
Family Wellbeing Empowerment Program
Mitchell, 2005; Tsey et al. 2004a, 2004b, 2005, 2007
Healing Our Way self-help resource
Mitchell, 2005
Indigenous community suicide intervention forums
Indigenous Psychological Services
Toughin’ it out. Survival skills for dealing with suicidal thoughts
pamphlet
Bridge, Hanssens, & Santhanam, 2007
Health Interactive Technology Network (HITnet)
Hunter, Travers, Gibson, & Campion, 2007
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Applied Suicide Intervention Skills Training (ASIST)
LivingWorks
Increasing the Capacity of Local Counsellors “Drop the Rock”
Royal Flying Doctor Service of Australia (Qld)
Learning from the experts: Building bridges to implement
successful life promotion and suicide prevention expertise across
Aboriginal communities
Centre for Rural and Remote Mental Health Queensland et al.
Something Better
Queensland Police-Citizens Youth Welfare Association
Napranum Life Promotion
Queensland Police-Citizens Youth Welfare Association
Issues
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Lack of co-ordinated service response
to self-harming behaviour
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Lack of follow-up services
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Inappropriateness of psychological
testing tools
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Interdisciplinary training (eg Wesley
Mission Lifeforce program)
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Issue of stigmatisation of 'Mental
Health’
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Appropriate referrals
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Better data on suicide and deliberate
self harm patterns
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Better data required on help-seeking
behaviours
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Lack of accommodation for young
people exhibiting high risk behaviour