The Strategy recognises the need to build the capacity of communities to take action in response to suicide. This has two dimensions: one is the encouragement of leadership, action and responsibility for suicide prevention on the part of communities; the other involves the development, implementation and improvement of preventive services and interventions for communities and their members. The focus of the first dimension is engagement of communities to jointly develop the awareness of suicide and the need for action, to assess strategies that are appropriate for the community and to plan for action. It is critical for agencies and organisations to understand communities, to respect local cultures, strengths and histories and to recognise differences in social relationships and possibilities for action in rural, urban and remote settings. The second dimension involves the development of appropriate resources, the implementation of initiatives to enhance community safety, to strengthen preventive mental health and wellbeing services and the implementation of early intervention programs for families and young people.
Outcome 1.1 Communities have the capacity to initiate, plan, lead and sustain strategies to promote community awareness and to develop and implement community suicide prevention plans.
- Issue: Communities differ widely in their composition and their capacity and readiness for action. The concept of community cannot be imposed on people; community action does not guarantee participation of intended groups in prevention and there is a need for locally developed strategies to engage community members in discussion about suicide prevention. External support should aim to assist communities to take charge, plan and act. This can take the form of a facilitated process initiated after expressions of interest.
Outcome 1.2 Materials and resources are available that are appropriate for the needs of Aboriginal and Torres Strait Islander peoples in diverse community settings.
- Issue: There are very wide linguistic, cultural, socio-economic and historical differences between communities and groups. Resources should be developed for specific needs rather than a one-size-fits-all strategy to produce Aboriginal and Torres Strait Islander-specific materials for engagement, training and practice. Substantial local input and capacity is integral to the generation of high quality, meaningful resources supported by appropriate professional expertise.
Outcome 1.3 There is access to community-based programs to improve suicide awareness among “gatekeepers” and “natural helpers” in communities affected by self-harm and suicide.
- Issue: Gatekeepers are service providers and officials who influence access of clients and community members to care; natural helpers are members of families or communities who are in a position to recognise difficulties in individuals and to assist them to seek help. There is strong demand for improved access to training for gatekeepers and Aboriginal and Torres Strait Islander natural helpers. Training should be adapted for Aboriginal and Torres Strait Islander peoples. There should be evaluation of its effectiveness in suicide prevention, either alone or in combination with other approaches, or as part of a targeted community implementation program. It should be implemented in a planned way that is appropriate for specific settings; for example, in discrete remote communities and more dispersed urban environments, where targeting and implementation of training may require different strategies. There should be strategies to ensure that turnover of personnel does not dissipate the effectiveness of training over time.
Outcome 1.4 High levels of suicide and self-harm in communities are identified and monitored to facilitate a planned response. (see 5.3).
- Issue: There are wide gaps in the capacity of primary health care and mental health services to identify and assess self-harm and maintain appropriate approaches to intervention and follow-up, including follow-up after discharge from hospital treatment. There needs to be improved consistency of assessment and data collection and the ability to compile data on self-harm from multiple sources to help identify potential cumulative risks of suicide.
Outcome 1.5 Communities are assisted to plan and implement a comprehensive response to suicide and self-harm that includes both short–term and long-term early intervention and prevention activity.
- Issue: Suicide signifies multiple sources of difficulty and potential for future or ongoing risk. Community responses should include early intervention and treatments across the lifespan for families, children and youth, delivered in multiple settings, both widely available and appropriately targeted according to risk.
Outcome 1.6 Mental health services and community organisations are able to provide appropriate postvention responses to support individuals and families affected by suicide.
- Issue: Services are not always available or appropriate, and communities and families may resist external intervention or be uncomfortable with “mental health” approaches. Sources of support within the community—church members, elders, family members and Aboriginal and Torres Strait Islander practitioners or traditional healers—may need to be engaged to develop and provide appropriate postvention support in partnership with specialised mental health services. However, appropriate and confidential external support is often needed by many people.
|Outcome 1.1 Communities have the capacity to initiate, lead and sustain strategies to promote community awareness and to develop and implement community suicide prevention plans||i. Identify communities and regions (by expression of interest) to workshop models for community action |
ii. Develop information and resource guides for coordinating community action to prevent suicide
iii. Review and disseminate information on best practice models for community suicide prevention
iv. Develop specific strategies regarding access to methods and means of suicide in the community
|Outcome 1.2 Materials and resources are available that are appropriate for the needs of Aboriginal and Torres Strait Islander peoples in diverse community settings||i. Identify resource gaps and needs |
ii. Review and extend Aboriginal and Torres Strait Islander language training programs for mental health and social and emotional wellbeing
iii. Produce resource materials in diverse formats for use by Aboriginal and Torres Strait Islander peoples in different community contexts, including those with Aboriginal and Torres Strait Islander languages
|Outcome 1.3 There is access to community-based programs to improve suicide awareness and prevention skills among “gatekeepers” and “natural helpers” in communities affected by self-harm and suicide||i. Examine the option of trials for the expansion of culturally adapted gatekeeper programs in remote community and urban settings|
ii. Develop, implement and evaluate training for Aboriginal and Torres Strait Islander natural helpers
iii. Provide cultural awareness and suicide prevention training for providers in mainstream services
|Outcome 1.4 High levels of suicide and self-harm in communities are identified and monitored to facilitate a planned response||i. Standardised methods for assessment and recording of suicidal behaviour and self-harm are reviewed for adoption by primary health care and specialist mental health services|
ii. Primary health care and community services implement protocols for mental health assessment and recording data on self-harm
|Outcome 1.5 Communities are assisted to plan and implement both short-term and long-term early intervention and prevention activity||i. Identify appropriate early intervention programs that have been adapted for Aboriginal and Torres Strait Islander families|
ii. Build partnerships with schools, community councils and other agencies to deliver early intervention and prevention programs for parents, children and at-risk youth
|Outcome 1.6 Mental health services and community organisations are able to provide appropriate postvention responses to support individuals and families affected by suicide||i. Develop protocols for communication between specialist mental health services and Aboriginal and Torres Strait Islander families regarding intervention needs and support following bereavement |
ii. Build capacity of community members and community-based personnel to lead postvention responses to bereavement
iii. Develop innovative strategies for bereavement support including practical assistance with housing, finances, work and children’s needs, psychological support and counselling
iv. Develop culturally appropriate best practice therapeutic options for responding to traumatic bereavement and complicated grief among Aboriginal and Torres Strait Islander peoples
v. Support development of partnerships between communities and NGOs to support emergency response in diverse settings
vi. Emergency response should be consistent with best practice (based on systematic review of research on suicide bereavement first responses and emergencies such as Victorian bushfires and Queensland floods)