As Suicide Rates Hit a Ten-Year High, is There Anything Australia Can Do?

We've just come out of NAIDOC week—a celebration of Aboriginal and Torres Strait Islander history and culture. It's also a week that's brought renewed calls for a Royal Commission into Aboriginal and Torres Strait Islander suicide with some researchers are labeling it an epidemic. In Western Australia, Indigenous suicide rates have hit some of the world's highest levels.

Petition Royal Commission into — Aboriginal Health (@NACCHOAustralia)June 28, 2016

This year's federal election saw every major political party commit significant funding specifically to suicide prevention programs. The Liberals offered up 12 suicide prevention trial sites, the Greens promised "whatever it takes" to implement a plan devised by the National Coalition for Suicide Prevention, and Labor promised not only $84 million in funding, but also to halve the suicide rate in 10 years. Suicide prevention has never had such bipartisan support.

But as someone who works in the mental health sector, I know everyone is asking "how can Labor halve the suicide rate?" Or, if you're already embittered by the political process, "is this just another empty election promise?"

Right now in Australia, suicide is the leading cause of death for people aged 15-44 years old. It's twice the road toll, claiming seven lives every day on average. And while successive governments have pledged support for mental health services—$1.5 billion in additional funding over the past seven years—the suicide stats show no sign of waning.

From 2004 to 2014, the suicide rate actually jumped from 10.4 to 12 people per 100,000. Knowing these dire figures, I wanted to know where Labor got the idea that they could halve the suicide rate. Could such a significant drop in suicides even be possible?

Labor pledges to cut suicide rate by half — Bill Shorten (@billshortenmp)October 8, 2015

Turns out the target was not born in a Parliament House backroom; rather it was put to the major parties by the National Coalition for Suicide Prevention, with support from the Black Dog Institute, beyondblue, and Lifeline. And it's with this broad backing that the 50 percent in 10 years figure gained political weight across the spectrum.

The target is based on strategies modelled by the European Alliance Against Depression in Europe, which saw a 24 percent decrease in suicides in just two years. As their site explains, the model involves a "four-level approach"—from educating GPs and teachers, to guaranteeing "patients, high-risk groups and relatives … direct access to professional help in a suicidal crisis." The model is now being used in over 17 countries across Europe.

Over 10 years, Scotland's Choose Life program has also seen significant outcomes, with a 17 percent reduction in the suicide rate. And while this didn't quite meet their initial reduction goal of 20 percent, the results are still inspiring. However, they are significantly lower than Australia's 50 percent target.

So is Australia's ambitious goal just setting us up to fail? Well, the research—which is lacking—shows us that "if all evidence-based prevention strategies were integrated" we'd see a 20-25 percent drop in suicide. This is well below the 50 percent being promised, which begs the question, why set a goal you can't attain?

There is one theory that if we want to tackle complex social problems like high suicide rates individual organisations, government departments, and campaigners will have to abandon their own agendas in favour of the common good—it's called "Collective Impact."

The Greens explain the concept pretty simply, "While we have targets for reducing road deaths and other preventable health issues, we have no national targets for reducing suicide. Targets help to drive policy and program action and capture the attention of decision-makers." The target is used as a uniting force, and a driver for change, rather than a measure of success.

Using a target like this is a political and social manoeuvre. Such an impressive goal warrants attention from government, policy makers, and the public. It unites us in a way that might not be achievable under a less profound goal.

Professor Helen Christensen, Director and Chief Researcher at The Black Dog Institute says there is "some disagreement as to whether we should go for such a high rate." She says the 50 percent reduction "could happen in particular communities" but that the goal is ultimately "aspirational."

While I understand that there is an "ends justify the means" argument here—that we might achieve more shooting for an impressive goal than settling for a pragmatic one—I'm concerned that forming policy on targets that aren't attainable will lead us inevitably to looking like we're failing. If the suggested strategies are put into place and we don't reach the target, the strategies themselves could look unsuccessful, changing the face of our evaluation, and potentially putting funding for suicide prevention programs at risk.

Honor Eastly is a mental health advocate, writer and professional feeler of feelings. Follow her on Twitter.

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