Based on extensive community consultation and community requests, Standby CPR was delivered to Geraldton in the mid-west region of Western Australia from February 2015 until late March 2015 in response to the widespread concerns about the higher than average incidence of suicide and its effects on the local community. Standby CPR was supported by the Australian Government, in partnership with WA Country Health Service Midwest, Mental Health Services and a number of local community organisations and local Standby CPR Advisory Group members including Geraldton Mental Health Services, Yellow Ribbon, STAY, local Government and representatives from the local Aboriginal community.
Feedback received from areas such as education, health services and community-based organisations suggested Standby CPR had been very productive and beneficial in the town. The CPR team also received many comments from training participants indicating that knowledge gained at the various workshops regarding trauma, grief and loss, caring for themselves and others following:
• enhanced feeling of safety from an understanding of their own grief and trauma reactions;
• increased confidence in being able to approach and help people following suicide and other trauma/loss;
• increased confidence that people will have assisted access to qualified and known Pathways to Care via the After Suicide Community Response Plan; and
• greater sense that the load is shared throughout the community and the response does not have to fall to only one resource. (United Synergies 2015).
A report produced by United Synergies outlines several key elements that confirm the effectiveness of the CPR.
• the confirmed widespread support and acknowledgement of need for coordinated postvention response in the community and to strengthen community understanding of postvention readiness;
• general willingness of service providers to refer on, to share information and to work collaboratively; and
• in response to indications of cumulative stress amongst service providers, the CPR team included much discussion and information about self-care when supporting or training with agencies.
The report states that, as the program became more embedded in the community, more information was gained about the circumstances and reactions to suicide events within the community. The use of social media and other interactions raised some concerns about creating a risk of contagion amongst some of the young people. Some community members reported that suicide attempts had occurred and community anxieties were high. Other factors initially impacting on community cohesiveness and the program outcomes include some community perceptions about lack of dedicated postvention and prevention services, with a few more well-known services and individuals ‘carrying most of the load’.
Both workshops had exceedingly high attendances and the workshop evaluation findings suggested that an overwhelming majority had learnt much from the scenario presentations and appreciated the input from the emergency responders and felt that it drew people together.
Key learnings and recommendations
The feedback from the local stakeholders and participants confirmed the importance of:
• a suitable recognised and well regarded community organisation to foster early acceptance of the program and its facilitators;
• establishing a commitment from a lead agency early in the commencement of the program;
• clear understanding of CPR team roles and responsibilities prior to commencement of the program;
• early engagement of key stakeholders – e.g. Police, Ambulance and key community members for building credibility and access within the community;
• establishing a committee that is representative of the community, with genuine commitment from the partner agency, to ensure sustainable outcomes for the program to be accepted and embedded in the community;
• further training about crisis intervention practice to allow staff and others to be able to offer basic crisis intervention if required; and
• further support and interest from the West Australian Mental Health Commission.
Importantly the National Standby CPR identified the need for, and committed to follow-up support for, the Committee to be able to identify agenda items to complement the Postvention Plan. This will provide a ready guide to be passed to any nominated lead agency to ensure a consistent approach when implementing the plan and to provide a basis for ongoing committee activity. The trauma kit will also be provided by the National StandBy Response Service for any future postvention needs.
A study by Visser et al (2014) of the StandBy Response Service indicates that it is a program that is readily adaptable to different settings. Currently in Australia, this service operates in metropolitan, rural, and remote settings. Given the same principles apply to the CPR, it is reasonable to suggest it is also equally effective.