Suicide and suicide attempts contribute to high rates of morbidity and mortality across the globe. Problems linked to mental health and challenges affecting people in their lives could contribute to suicidal thoughts. Although the rates of suicide among certain age groups or populations are higher, suicide reports across the lifespan are common globally. Factors like trauma, mental health disorders, physical illness, drug abuse, feelings of hopelessness among other issues can increase a person’s likelihood of attempting suicide. Implementation of protective factors like the development of suicide prevention programs could improve the care offered to individuals at risk of committing suicide. Understanding the causes of suicide among different populations, risk factors, protective approaches that can be used, and prevention programs, while at the same time involving nurses and other healthcare practitioners involved in mental health promotion can significantly reduce the rates of suicide in Australia.
Part A
Definition, Causes, and Population Groups at Risk of Suicide
Numerous factors exist that increase people’s likelihood of committing suicide. Suicide can be defined as the act of causing harm to oneself deliberately with the intent of ending one’s life (Australian Government, 2015). In 2016, 2862 individuals committed suicide in Australia (Kinchin & Doran, 2018). Some of the common causes or risk factors linked to suicide in Australia include having a family history of suicide or child mistreatment, previous suicide attempts, mental health issues like clinical depression and unwillingness to seek help because of the stigma associated with mental health diseases and having a history of drug or alcohol abuse. Additional risk factors that apply to the general population include bearing feelings of hopelessness, impulsive behavior, chronic illness, feeling isolated from others or antisocial behavior, physical illness, family discord, living apart from family or parents, and having unsupportive parents or family members. An individual might also be influenced by factors such as local reports on high suicide rates and cultural or religious beliefs that support suicide as a problem resolution technique (Kinchin & Doran, 2018). According to research conducted by the Australian government, the populations that face the highest risk of attempting and committing suicide include men, youths, the elderly, people who were born overseas or culturally and linguistically diverse populations (CALD), indigenous populations, and those living in rural or remote areas within the country, and prisoners (Australian Government, 2014). Some of the impacts of suicide that have been seen in the Australian population include increased risk of a suicide-related death in the same family or community due to grief or challenges that families might face after the death of their loved one, injury to individuals who might have been at the site of the incident, and post-traumatic stress. Research shows that for every suicide-related death, six people are affected severely by extreme depression and grief that could go on for many years (Kinchin & Doran, 2018). Suicide has a ripple effect as the impact felt at an individual or family level is compounded at the societal level as the loss of the person affects the productivity and optimal function of the community or a workplace. Other impacts include financial costs linked with loss of productivity and the guilt and blame felt by the bereaving family (Parliament of Australia, 2010). Suicide has great effects on the lives of the individuals left behind.
Population Group 1
Youths are the main population group linked to high suicide rates in Australia. In Australia, suicide is the number one cause of death among individuals aged between 15 and 24 years. Data obtained from the Australian National Coronial Information System (NCIS) showed that between 2001 and 2014, 4460 individuals between 15 and 24 years committed suicide (Kinchin & Doran, 2018). The risks of suicidal behavior among the youths in Australia have been linked to antisocial behavior, having unsupportive parents, being socially marginalized by friends and or colleagues, and being depression. Other factors linked to high suicidal rates in this group include alcohol and drug abuse, physical and sexual abuse, peer pressure and poor peer relationships that promote unhealthy behavior and living far away from their parents or guardians. It has been estimated that 15 to 61% of the suicide-related deaths in Australia are linked to substance abuse (Australian Government, 2014). Youths are the main population associated with substance abuse, suggesting that most of the suicides related to substance abuse affect youths. Suicide among youths has also been driven by family disputes that might contribute to feelings of hopelessness or isolation, suicidal behavior in the family, and having friends who have suicidal behavior or those who committed suicide (Kinchin & Doran, 2018; Milner, et al., 2015). Youths bereaving the loss of their friends or family members, who were close to them, have a high likelihood of committing suicide. The high rates of suicide among youths were commonly influenced by personal and societal factors.
Population Group 2
The second group facing a high suicide rate in Australia is the elderly population. This group is characterized by individuals aged sixty-five years and above. Among the elderly, the high rates of suicide were linked to factors like psychiatric illness such as dementia, isolation and depression, presence of chronic health conditions, physical and functional impairment and its impact on their ability to perform their daily chores, and stress-related to bereaving their friends and family members who might die before them (Australian Government, 2014). Social isolation or being isolated from other family members and living alone have also been linked to high suicide rates among the elderly. A study conducted in Australia showed that 32% of admitted older patients had attempted suicide through self-poisoning (Hopwood, 2017). Addressing the problems affecting the elderly can reduce their suicide rates.
Protective Factors
While not all suicide cases can be prevented, protective factors can be implemented to reduce the rates of suicide in a community or country. Some of the protective factors that can be applied in Australia to decrease the high suicide rate include offering effective care to patients with mental health conditions, providing support and clinical interventions to individuals seeking help and those exhibiting suicidal behaviors, and promoting connectedness in families. Other protective factors include limiting access to tools or means that people can commit suicide, school education programs, coordinated aftercare for high-risk individuals, training people on conflict resolution and problem-solving, and offering general practitioners training on dealing with patients exhibiting suicidal behaviors (Krysinska, et al., 2015; Page, Atkinson, Heffernan, McDonnell, & Hickie, 2017). These protective factors can significantly reduce the rates of suicide in Australia and increase people’s awareness about the risk factors associated with suicide.
Importance of Suicide Prevention Programs
Suicide prevention programs are important in reducing the rates of suicides in Australia. Suicide prevention programs can be useful in identifying the underlying factors contributing to suicide among different population groups and promote healthcare practitioners’ understanding of their patients. This strategy could improve the care offered to individuals exhibiting suicidal behaviors. Other benefits linked to suicide prevention programs include early referral of individuals at risk of suicide to psychiatrists or other specialists, development of self-esteem, and social competency among youths who might be affected by social factors like peer influence, and behavioral change. Suicide prevention programs can also help individuals at risk of suicidal thoughts understand the things that trigger those thoughts or behaviors and avoid them, offer a link to rehabilitation facilities for individuals who are addicted to drugs or alcohol, and teach people coping strategies for stress (Milner, et al., 2015). Suicide prevention programs can be effective in reducing rates of suicide in Australia and globally.
Part B
Program 1
Mindframe is of one the suicide prevention programs that have been introduced in Australia to reduce the rates of suicide-related morbidity and mortality in the country. The Mindframe suicide prevention program encourages the responsible and accurate reporting of sensitive information related to mental health and suicide in the country. This program supports safe reporting, portrayal, and delivery of mental health illness, alcohol and other drugs, and suicide-related news in the media. Mindframe is focused on providing effective leadership within this sector, building the capacity of the media and its sensitivity towards issues related to suicide, innovating and disseminating information on suicide safely, and increasing suicide-related research to promote the use of evidence-based interventions. Mindframe is funded by the Australian government’s department of health and is classified under the National Suicide Prevention Program (NSPP). Mindframe aims to build collaborative relationships with the different Australian news media through the creation and dissemination of evidence-based resources that cold promote a safe and accurate portrayal of suicide and mental health illnesses. The program also supports tertiary educators and students in fields like journalism and public relations as a way of preparing them to address suicide and mental health illnesses in their profession effectively. It also supports other sectors that work with the media such as law enforcers, courts, and primary health networks to promote effective communication and management of suicide-related news. Some of the target sectors for Mindframe include media organizations like radio, online news broadcasted in the metropolitan and rural regions, and media professionals, health organizations that address mental health illnesses, universities, and the Australian film industry that encompass scriptwriters, story developers, and filmmakers (Fletcher, 2020). The key stakeholders in the program believe that high-risk individuals have a higher likelihood of seeking help when offered the correct and clear information about mental health illnesses and suicide. They view help-seeking pathways as extending beyond dialing the number for a support line or texting the emergency service due to the emergence of online community forums and access to downloadable resources. Ensuring that the downloadable information included in online resources and the information posted on online communities is correct, is an effective way of ensuring that people have access to the type of services that they need. The program also contains specific help-seeking cards to ensure that individuals in need can easily access call services that focus on their problems among other services (Mindframe, 2020). By promoting the spread of correct information this organization promotes the elimination of the stigma linked to mental health illnesses and suicide.
Program 2
Another suicide prevention program that has been implemented in Australia is the LifeSpan Newcastle program. LifeSpan is an evidence-based program for integrated mechanisms for suicide prevention in the country. The Black Dog Institute developed this suicide prevention program. The program utilizes nine key strategies in reducing the rates of suicide in the country. This program focuses on the community and works by supporting people to live their lives to the fullest. It brings together healthcare and community services within a region to promote collaboration in implementing multiple strategies that can reduce the risks of suicide. The three key components of this program include its focus on targeted populations at an individual level, simultaneous implementation of the nine strategies that form its foundation, and promoting effective governance by integrating NGOs with local health districts, police, and community groups to promote collaboration in strategy implementation. The nine strategies utilized by this program include improving emergency care and follow-ups for suicidal incidents, utilization of evidence-based treatment for suicidal individuals, equipping primary care centers to identify and support high-risk individuals, improving frontline workers’ competency and confidence in managing suicidal individuals, and promoting help-seeking behaviors among students in schools. The rest of the nine strategies include training community workers on management of high-risk individuals, recognition, and response to suicidality, engaging the community in the move towards change, encouraging broadcasting of safe and purposeful information on the media, and improving the safety of high-risk individuals and reducing their access to weapons or other means of suicide. Some of the approaches used to identify the effectiveness of this program include assessing the rate of suicide over time. Different groups including community services, local governments, education systems, emergency services, and healthcare workers have been established to plan and deliver the nine strategies locally. The privacy ensured through the helplines accessed via the LifeSpan Newcastle program is expected to increase the number of people using these services (LifeSpan Newcastle, 2020). This program promotes access to useful services and helplines for people with suicidal tendencies.
Role of the Nurse in Suicide Prevention
Nurses play a critical role in suicide prevention. Nurses work in different healthcare facilities and marginalized communities, where they deliver healthcare services to individuals suffering from mental health illnesses that could increase their likelihood of committing suicide. Aside from that, nurses also care for individuals who have attempted committing suicide and failed by working towards restoring their physical health in case of injuries, utilizing their interpersonal relationship skills to identify the factors that led to the suicidal attempt, and working alongside psychiatry or psychologist in helping a patient deal with issues affecting their lives. Other roles played by nurses in preventing suicidal cases include conducting follow-ups on patients at risk of committing suicide, researches evidence-based literature on care for suicidal patients, develops a maintains a therapeutic relationship with the patient by avoiding being judgmental and supporting patients in dealing with their health problems. This approach reduces patients’ predisposition to suicidal thoughts and actions. Nurses also maintain the safety of high-risk patients by eliminating any weapon or item within the vicinity of high-risk individuals to ensure that they do not attempt to kill themselves. They collect accurate information from high-risk patients including details like their risk factors, mental status, history of physical or psychological trauma, triggers, patients’ perception of their health, and history of self-inflicted pain (Vandewalle, et al., 2019; Nicholas, Pirkis, Jorm, Spittal, & Reavley, 2019). Such data helps them to identify correctly individuals who have a high risk of committing suicide and developing suicide-prevention care plans for them.
Role of the Nurse in Program 1 and 2 and Mental Health Promotion
Nurses are also included as key stakeholders involved in implementing suicide prevention programs in Australia. In the suicide prevention programs, nurses work along with other healthcare professionals in disseminating correct information regarding suicide and suicidal behaviors in Australia to ensure that the stakeholders who do not have a background in medicine or healthcare provision have access to the right information, which is provided by the nurses. The nurses also communicate information about mental health illnesses, alcohol and drug abuse to the other stakeholders and to the different media platforms that report health-related news. Nurse work alongside other healthcare providers in supporting sectors that work with the media like the suicide prevention and mental health sector and primary health networks in facilitating better understanding about the sensitivity of information related to mental health, alcohol and substance abuse, and suicide-related news. This ensures that information communicated highlights important factors while at the same time reducing the likelihood of confusing or promoting the development of stigma towards affected individuals. Nurses also provide updated information that is evidence-based regarding communication about suicide, drugs and alcohol, and mental health illnesses. They are also involved in conducting training on suicide-related risk factors and behaviors base on national guidelines, writing reports that are updated on the Mindframe website, and assisting help-seeking individuals. The program provides the public with a help-seeking helpline for 24/7 hours that is supported by healthcare professionals including nurses who can offer help-seekers suitable advice. Nurses working with the LifeSpan Newcastle program also implement the nine evidence-based strategies in their care provision and direct contact with high-risk individuals requiring help (LifeSpan Newcastle, 2020; Mindframe, 2020). They also participate in research that focuses on improving early detection of suicidality and evidence-based strategies for managing individuals with a high risk of being suicidal.
In terms of mental health promotion, nurses in Australia are usually at the forefront of promoting programs that address mental health issues and suicide. Mental health nurses work in psychiatric hospitals where they play crucial roles such as preventing suicidal attempts and promoting patients’ recovery from suicidal behaviors. Nurses are also involved in recommending and developing policies aimed at increasing the use of protocol-based interventions that promote patient safety, while at the same time improving patient’s access to the healthcare services that they need. Nurses use suicide prevention protocols to assess different individual’s risks of committing suicide, assign different levels of risk to patients, eliminate suicide means, enforce seclusion when needed, and promoting effective observation of patients. By assigning patients different risk levels, nurses promote easy identification of high-risk patients (Vandewalle, et al., 2019). Nurses also participate in activities related to educating the public about mental health issues and their connection to suicidal behaviors, a practice that increases people’s awareness about mental health and suicide, promotes the use of mental health services, and reduces mental health stigma (Hennessy, 2017). These approaches promote increased awareness of mental ill-health and reduce suicidal behaviors.
Conclusion
Suicide is a major health problem in Australia. Some of the risk factors for suicide in the country included having a history of suicide within the family, observation of high rates of suicide in the local news, depression, mental health problems, alcohol, and drug use, among other factors. High population risks within the country included youths and the elderly. Some of the risks of suicide between these two populations differed. For instance, among the elderly, the presence of chronic age-related illnesses contributed to suicide while among the youths suicide rates were mostly associated with peer influence and family-related problems. Application of protective factors and preventive approaches such as caring for mental health patients well, eliminating weapons or tools that can be used to commit suicide from the vicinity, offering rehabilitation services to alcohol and drug addicts, and promoting connectedness within a family can significantly reduce the rates of suicide in Australia. Continued utilization of the two programs identified, which are used to prevent suicides in Australia and working with healthcare professionals like nurses in mental health promotion could reduce the rates of suicide in the country.
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