Crisis services play an important role as part of a comprehensive approach to suicide prevention

The Report Implementing Integrated Suicide Prevention In Aboriginal And Torres Strait Islander Communities A Guide For Primary Health Networks (Dudgeon et al. 2019) confirms the need for crisis intervention to ensure communities have the capacity to respond to crises with appropriate postvention interventions to improve the type of caring for people who have survived as well as those affected by suicide attempts. Providing a full range of crisis services can reduce suicides when coupled with mental health follow-up care. Crisis services and systems can be effective and cost saving alternatives to emergency room services and hospitalizations, providing safe transitions to care and support for people experiencing a crisis. Effective suicide prevention requires a full continuum of services designed to provide the right care at the right time for different population groups in a setting where people feel most relaxed.

Crisis services can be provided in many different settings and can include:

  • Crisis helplines and hotlines that help callers who are in a suicidal crisis (e.g. Lifeline)
  • Mobile crisis teams (e.g. Thirrili, national),
  • Walk-in crisis clinics,
  • Hospital-based psychiatric emergency services (National)
  • Outreach clinics (e.g. HOPE, Vic;)
  • Peer-based crisis services (e.g the Safe Haven, Vic).

Peer-based crisis services are crisis alternatives located in a house or community setting with the aim of diverting hospitalisation. They are generally staffed and operated by peers who have professional training in providing crisis support to build mutual, trusting relationships within a safe environment for people to overcome crisis.

Postvention and critical responses to suicide or traumatic crisis are an important part of a systems approach to suicide prevention in Indigenous communities, including reducing the risk of suicide clusters.

The Fifth Mental Health Plan has adopted the European Alliance Against Depression (EAAD) model which has 4 levels of intervention, one of which involves providing high-risk groups young people in adolescent crisis and persons after suicide attempt (and their relatives) with “Emergency Cards” guaranteeing direct access to professional help in a suicidal crisis.

Other initiatives recommended include establishing:

  • Regional self-help groups and supporting them with expert advice.
  • Partnerships with patient associations and intensifying support for existing groups.

HOPE – Hospital Outreach Post-suicidal Engagement

The HOPE Initiative will provide tailored, holistic support to people post a suicide attempt with the aim of supporting the person and their carers and families to identify and build the protective factors that reduce the risk of suicide attempt/completed suicide.

Contact: Program Coordinator for HOPE is Eileesh Diviney (DHHS), Senior Policy Officer Dept. of Health and Human Services
Email: Eileesh.Diviney@dhhs.vic.gov.au

HOPE – Hospital Outreach Post-suicidal Engagement – initiative provides practical support for people across Victoria who have thought about suicide or made an attempt on their life, and need an intensive response in the months following. HOPE is part of the state government’s Victorian Suicide Prevention Framework 2016-25, a co-ordinated strategy to halve the state’s suicide rate by 2025.

HOPE was trialed at hospitals including Peninsula Health (Frankston Hospital), Alfred Health (The Alfred), St Vincent’s Health (St Vincent’s Hospital), Barwon Health (Geelong Hospital), Eastern Health (Maroondah Hospital) and Albury Wodonga Health (Wangaratta Hospital). The program has assessed and supported more than 500 people since 2018. The government funding will enable the program to be rolled out in an additional six hospitals and health services including Ballarat Health Services.

New sites were selected based on suicide and intentional self-injury data analysis; population demographics; and community profiles so that rural communities are able to have the same level of access and quality treatment and positive outcomes as the larger communities. HOPE is auspiced with PHNS to provide advise on where to best target the funding and resources to meet the different needs of different communities. Funding has been provided to appoint an Aboriginal Suicide Prevention Coordinator in Albury-Wandonga.

The initiative which links with local communities aims to:

  • Help people for up to three months after they leave hospital following a suicide attempt.
  • Support carers and families to identify factors and build strategies to reduce the risk of suicide.
  • Establish really good partnerships with all our services including Aboriginal Community Controlled Health Services.
  • Leverage off earlier service pathways and assertive outreach work undertaken as a part of the HOPE project in Benalla.
  • Build capacity within the community to contribute to suicide prevention planning and to achieve better coordination of support services. ·
  • Enhance greater understanding and respect of Aboriginal culture and the holistic view of health and wellbeing, while harnessing the skills and strengths of local Aboriginal people and community.

The success of HOPE in the communities requires building the capacity of local Aboriginal and Torres Strait Islander people to contribute to the HOPE project and suicide prevention planning through:

  • Building safety in the community through suicide prevention education
  • Building confidence in the mental health service pathway through identifying current barriers to service.
  • Working with service providers to address identified barriers to accessing services and work towards developing cultural competency

Standby: Support after Suicide (National)

Losing someone to suicide can be overwhelming and confusing and can present a wide range of emotions. StandBy provides local support to people affected by suicide.

Contact: Standby Operations Manager, Geoff Timm
Phone: 04022 54831 Email: standbynational@unitedsynergies.com.au

Established in 2002, StandBy is a program of United Synergies which is designed to meet the need for a co-ordinated community response to suicide. This suicide postvention program is dedicated to assisting people and communities impacted by suicide. StandBy provides support services all around Australia to anyone who has been impacted by suicide at any stage in their life.  StandBy’s support can be accessed by a wide range of people and groups who have been affected, either directly or indirectly by suicide, including families and friends, witnesses and community groups. Services are available round-the-clock and include telephone or face-to-face support at a time and place which is best suited to the client. This support is free and is provided by local caring staff, committed to the well-being of the person or group impacted. Depending on need, StandBy will arrange follow-on support from existing local services and groups, or simply provide information and links to other available services. Follow-up contact may continue for up to one year to ensure that clients receive sufficient help to enable them to recover from their trauma. StandBy works with the community to deliver workshops and education programs to encourage and enable increased knowledge and awareness of suicide and suicide bereavement.

StandBy operates nationally by partnering with local organisations, engaging their expertise within the community to deliver the most effective and culturally suitable support for each circumstance. Locally tailored community workshops and education programs are provided to increase awareness of suicide and suicide bereavement to assist people within a community to provide support to others within their community. To summarize, in addition to community education, StandBy provides a national community-based suicide bereavement service which provides a co-ordinated community response to suicide.  This is done by providing a central point of co-ordination which connects people to the support they need through referrals to services, groups and organisations within their local area.

StandBy aims to

  • Enable communities to provide a co-ordinated response to suicide
  • Promote respect, equality and the inclusion of all members of the community
  • Value the experiences and courage of people bereaved or impacted by suicide and the willingness of local communities to support them
  • Work with communities and individuals towards a shared vision of hope and unity
  • Operate nationally by partnering with local organisations and engaging their expertise within the community to deliver the most effective and culturally suitable support
  • Deliver tailored community workshops and education programs to increase suicide awareness
  • Enable community members to support each other through traumas associated with bereavement by suicide
  • Enhance its services and provide the best possible outcomes for clients

StandBy has a Support Information Pack1 which consists of a variety of information sheets, each dealing with a possible aspect of suicide bereavement or issues which may be faced by people impacted by suicide. Below are links to some information sheets that are available.

  1. What Happens Now?
    This sheet explains people you and your family may be involved within the coming days.
  2. Grief after Suicide
    This sheet explains the grieving experiences which those bereaved by suicide may encounter.
  1. Supporting Children and Young People
    Here, tips to help children and young people understand and better cope with the suicide of a family member or friend are provided.
  1. Having Trouble Sleeping?
    Explanations of why sleep deprivation may occur during suicide bereavement and tips on how to best cope are given.
  1. Unwelcome Intrusive Thoughts – (Flashbacks)
    Techniques to assist the management of unwelcome intrusive thoughts are detailed.
  1. Services for National Support
    A list of contacts.

In 2018, an independent evaluation of the StandBy program was conducted by the Science of Knowing2. This evaluation measured the well-being of 545 people who had been bereaved by suicide. The evaluation compared StandBy clients whose loss was within the last 12 months to a control group who were not StandBy clients and whose loss was also within the last 12 months. Findings were that StandBy clients were significantly less likely to be at risk of suicidality, to experience the grief reaction of a loss of social support, to experience feelings of social and overall loneliness, to report experiencing mental health concerns or to report experiencing a loss of social connections. Furthermore, support from StandBy was assessed as more effective than the support of a general healthcare service. When comparing StandBy clients with a control group who received other types of support, such as a support group, GP or psychologist, the same trends were found. Those receiving support from StandBy had a significantly lower risk of suicidality, mental health concerns and social isolation following the loss of a loved one.

Additionally:

  • Over two-thirds of people who accessed StandBy reported that the program staff had helped them make some sense of their loss
  • Four out of five people reported that they did not have to wait long to access support services referred to them by StandBy
  • Nine out of ten people supported by StandBy reported that they believe StandBy is an important form of support for people bereaved by suicide

Promising program, assessment pending

  1. Standby: support after suicide. Resources. Standby Resources
  2. Gehrmann M, Dixon S, Visser V, et al. StandBy National Client Outcomes Project: summary of project results. 2018. Standby Natioanl Client Outcomes Project Final Report

Thirrili National Indigenous Critical Response Service

Thirrili Ltd is a not for profit organisation which aims to contribute to the broader social wellbeing of Aboriginal and Torres Strait Islander people. Thirrili offers a range of programs which are designed to address fully the systemic and long standing causal issues for which solutions have eluded us for too long. We stand ready to partner with governments, academia and the broader service system to tackle these issues.

Contact: Adele Cox Founding Director and Chief Executive of Thirrili Ltd and Project Director NICRS
Phone: (03) 8578 1410

National Indigenous Critical Response Service (NICRS)
The National Indigenous Critical Response Service supports individuals, families, and communities affected by suicide or other significant trauma.

A Critical Response Support Advocate can be contacted 24/7 by calling 1800 805 801

The telephone service is usually answered by one of our Critical Response Support Advocates. If for some reason the call is diverted to message bank, callers are asked to leave a message with their best contact number and the Support Advocate will call them back as soon as possible.

If you or someone you know is suicidal

If you are looking for help, please call one of the following national helplines:

  • Lifeline Counselling Service: 13 11 14
  • Suicide Call Back Service: 1300 659 467 (cost of a local call)