YOUTH SUICIDE

EXECUTIVE SUMMARY

Reducing suicide is one of the NSW Mental Health Targets and is identified in ‘Mental Health in South Western Sydney’, the strategic plan for improving mental health, which was produced in 1997.

In 1996, South Western Sydney Area Health Service applied for and received funding to develop a strategic plan for youth suicide prevention. Although it is recognised that young people are in many ways particularly disadvantaged in our community and that the strategic plan has a youth focus, many of the strategies which have been recommended in this plan are relevant to all those at risk of suicide.

Suicide is the leading cause of death among 15 to 19 year old males in Australia today. In addition to the personal tragedy of youth suicide and the disruption to and impact on the quality of the lives of parents, siblings, friends, teachers and others, youth suicide also represents a loss of human potential. Suicide involves the premature loss of life and its economic cost is of considerable magnitude. The loss of life expectancy and the associated loss of economic productivity, while perhaps the major impacts, are not the only costs. The direct health and legal costs of suicide must be considered. In addition, suicide attempts impose medical costs as well as substantially impaired quality of life, and cause lost economic productivity because of residual chronic disabilities (Weinstein and Saturno 1989).

Within Australia, a number of researchers (e.g. Goldney and Spence,1987; Grant and Lapsley, 1992) have noted the impact of health and welfare problems associated with suicidal behaviours is creating significant cost burdens on already restricted health and welfare services. Hassan (1987) has estimated that the cost of youth suicide to the Australian economy is over $100 million per year, while King (1988) has suggested that the cost could be as high as $200 million. It is therefore apparent that youth suicide is a significant public health problem within Australia (Fredrico and Davis, 1996).

Suicide is a complex issue, with the risk factors for suicide and suicidal behaviour depending on the interaction and summation of individual disposition, demographic and socio-cultural factors and precipitating factors. Mental illness, social disadvantage and childhood adversity as well as substance abuse and previous suicide attempts are all key risk factors which contribute to an increased risk of suicide.

Because of the multifactoral nature of suicide, its prevention needs to take a collaborative and co-operative approach. It is appropriate for health to be the lead agency in developing youth suicide prevention strategies, recognising that all parts of the health service need to work collaboratively with other government departments and non government agencies to develop strategies to deal with this issue. Each stakeholder in the field of youth suicide brings with them a range of skills and knowledge which are acknowledged in the development of this plan. The challenge is to further develop these in a collaborative way which will lead to better health outcomes for young people in South West Sydney.

The strategies for youth suicide prevention in this plan have been reached via a number of processes:

• The undertaking of a literature review to determine ‘best practice’ in suicide prevention;

• The gathering of data collected by hospitals and community health services in South Western Sydney;

• Site visits to the Emergency Department of each public hospital in South Western Sydney;

• Opinions were canvassed through focus groups with young people and service providers;

• A Youth Suicide and Self Harm Prevention Initiatives Survey provided information on those agencies working with young people who are suicidal or at risk of suicide;

• A half day Youth Suicide Prevention Forum provided an opportunity for participants to recommend local and area wide strategies;

• The draft plan has been circulated for comment to all those who have been involved in the planning process.

The plan includes the following objectives for which strategies have been developed:

To ensure a co-ordinated approach to service delivery for suicidal young people in South Western Sydney;

• To provide appropriate care to suicidal young people with a mental illness;

• To redress areas of disadvantage by the provision of appropriate interventions to families and young people under stress;

• To improve the life opportunities for those who have had adverse childhood experiences;

• Reduce the number of suicide attempts by those who have had a previous attempt;

• To redress the high proportion of young men who attempt suicide;

• To increase the skill level in health professionals in dealing with suicidal young people;

• To increase public awareness of suicide risk factors;

• To ensure adequate collection of suicide data in South Western Sydney.

The reference group for the planning process, the Youth Suicide Prevention Steering Committee, has provided valuable expertise in the development of this plan. The establishment of an area wide intersectoral committee on suicide prevention as well as the employment of a half time Suicide Prevention Co-ordinator, initially for two years to oversee the plan’s implementation, will ensure that the momentum which has been gained during the development of this plan will continue.

Recently, South Western Sydney Area Health Service has secured resources for a number of strategies which will deal with some of the issues affecting suicide, including early identification of depression in young people and a number of other mental health promotion projects. However, full implementation of this plan will be dependent on the allocation of financial resources to South Western Sydney under the principles of equity and fairness presented in the NSW Government’s Health Economic Statement.

The implementation of this plan will go some way towards improving life opportunities for young people at risk, intervention for suicide attempters and support for survivors of suicide in our community.

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