With the development of the National Youth Suicide Prevention Strategy (NYSPS), Australia became one of the first nations to take a nationally coordinated approach to suicide prevention. Operating between 1995 and 1999, the NYSPS was replaced in 2000 by the National Suicide Prevention Strategy (NSPS). The NSPS not only expanded the focus on suicide prevention activities across the life span but also included consideration of specific at-risk groups.8
The goal of the NSPS is to reduce deaths by suicide and suicidal behaviour by:
- Adopting a whole-of-community approach to suicide prevention in order to extend and enhance public understanding of suicide and its causes
- Increasing support and care available to people, families and communities affected by suicide or suicidal behaviour by funding and evaluating initiatives which enhance or inform the establishment of better support systems.
- Build individual resilience and the capacity for self-help
- Improve community strength, resilience and capacity in suicide prevention
- Provide targeted suicide prevention activities
- Implement standards and quality in suicide prevention
- Take a coordinated approach to suicide prevention
- Improve the evidence base and understanding of suicide prevention.9
- LIFE Framework: sets an overarching evidence-based strategic policy framework for suicide prevention activities
- NSPS Action Framework: provides a work plan for national leadership in suicide prevention and policy
- National Suicide Prevention Program: the Australian Government funding program dedicated to suicide prevention activities
- Mechanisms to promote alignment with and enhance state and territory suicide prevention activities: includes progressing elements of relevant frameworks, such as the Fourth National Mental Health Plan 2009-14.
3.3.1 The LIFE FrameworkOriginally developed in 2000 and updated in 2007, the LIFE Framework provides the operational framework for the NSPS.10 It outlines the vision, purpose, principles, action areas and proposed outcomes for suicide prevention in Australia. In September 2011, the LIFE Framework was adopted in all jurisdictions as Australia’s overarching suicide prevention framework.
The LIFE Framework is based on the premise that in order to reduce suicide rates, activities should occur across eight overlapping domains of care and support, as described below:
- Universal interventions target whole populations, with the aim of reducing risk factors and enhancing protective factors across the entire population. Typically such approaches include (but are not restricted to) reducing access to means of suicide, improving media reporting of suicide and providing community education about suicide prevention.
- Selective interventions target subgroups whose members are not yet manifesting suicidal behaviours, but exhibit proximal or distal risk factors that predispose them to do so in the future. These may include gatekeeper training or programs that involve screening those thought to be at elevated risk.
- Indicated interventions are designed for people who are identified through screening programs or by clinical presentation as already beginning to exhibit suicidal thoughts or behaviours, and may include psychological or pharmacological treatment of underlying mental disorders.
- Symptom identification involves knowing and being alert to signs of imminent risk, adverse circumstances and potential tipping points by providing support and care when vulnerability and exposure to risks are high.
- Finding and accessing early care and support when treatment and specialised care is needed. This is the first point of professional contact that provides targeted and integrated care, support and monitoring.
- Standard treatment when specialised care is needed to manage suicidal behaviours and comprehensively treat and manage any underlying conditions, improve wellbeing and assist recovery.
- Longer-term treatment and support which entails continuing integrated care to consolidate recovery, reduce the risk of adverse health effects and prepare for a positive future.
- Ongoing care and support involving professionals, workplaces, community organisations, friends and family to support people to adapt, cope and build strength and resilience within an environment of self-help.
Table 3-2: LIFE Action Area Outcomes
LIFE Action Area
LIFE Action Area Outcome
|Improving the evidence base and understanding of suicide prevention.||1.1. Understanding of imminent risk and how best to intervene.|
1.2. Understanding of whole-of-community risk and protective factors, and how best to build resilience in communities and individuals.
1.3. Application and continued development of the evidence base for suicide prevention among high-risk populations.
1.4. Improved access to suicide prevention resources and information.
|Building individual resilience and the capacity for self-help.||2.1. Improved individual resilience and wellbeing.|
2.2. An environment that encourages and supports help-seeking.
|Improving community strength, resilience and capacity in suicide prevention.||3.1. Improved community strength and resilience.|
3.2. Increased community awareness of what is needed to prevent suicide.
3.3. Improved capability to respond at potential tipping points and points of imminent risk.
|Taking a coordinated approach to suicide prevention.||4.1. Local services linking effectively so that people experience a seamless service.|
4.2. Program and policy coordination and cooperation through partnerships between governments, peak and professional bodies and non-government organisations.
4.3. Regionally integrated approaches.
|Providing targeted suicide prevention activities.||5.1. Improved access to a range of support and care for people feeling suicidal.|
5.2. Systemic, long-term, structural interventions in areas of greatest need.
5.3. Reduced incidence of suicide and suicidal behaviour in the groups at highest risk.
5.4. Improved understanding, skills and capacity of front-line workers, families and carers.
|Implementing standards and quality in suicide prevention.||6.1. Improved practice, national standards and shared learning.|
6.2. Improved capabilities and promotion of sound practice in evaluation.
6.3. Systemic improvements in the quality, quantity, access and response to information about suicide prevention programs and services.
3.3.2 Groups at higher risk of suicideCertain groups are identified in the LIFE Framework11 as being at higher risk of suicide (acknowledging that this is not an exhaustive list):
- Men aged 20-54 and over 75
- Men in Aboriginal and Torres Strait Islander communities
- People with a mental illness
- People with substance use problems
- People in contact with the justice system
- People who attempt suicide
- People in rural and remote communities
- Gay and lesbian communities
- People bereaved by suicide.
3.3.3 The NSPS Action FrameworkThe NSPS Action Framework is developed by the ASPAC in collaboration with DoHA, and has two primary purposes:
- To help ASPAC plan and manage the provision of confidential advice to the Australian Government on strategic direction and priorities in relation to suicide prevention and self-harm
- To help DoHA plan and manage the implementation of the National Suicide Prevention Program.
3.3.4 National Suicide Prevention ProgramThe third component of the NSPS is the NSPP, which is the Australian Government funding program dedicated to suicide prevention activities. The NSPP funds local community-based projects as well as national projects that take a broad population health approach to suicide prevention, including research. Drawing upon the priorities set out in the LIFE Framework, the NSPP funds universal, selective and indicated suicide prevention activities. The first competitive grants round for the NSPP started in 2006.
Funding under the NSPP is provided to support suicide prevention activities that will contribute to outcomes specified in the LIFE Framework. The central goal of the LIFE Framework is to reduce suicide attempts, the loss of life through suicide and the impact of suicidal behaviour in Australia. Suicide prevention activities, programs and interventions aim to build:
- Stronger individuals, families and communities
- Individual and group resilience to traumatic events
- Community capacity to identify need and respond
- The capacity for communities and individuals to respond quickly and appropriately
- A coordinated response, providing smooth transitions to and between care.
3.3.5 Mechanisms to promote alignment with and enhance state and territory suicide prevention activitiesThe fourth component of the NSPS aims to enhance alignment (thereby promoting synergies and reducing duplication) between the NSPS and state/territory suicide prevention activities by progressing the relevant actions of related national frameworks, such as the Fourth National Mental Health Plan 2009-14.
8 Department of Health and Ageing, LIFE: Research and Evidence in Suicide Prevention, DoHA, Canberra, 2007.
9 Department of Health and Ageing, National Suicide Prevention Strategy, DoHA, Canberra, 2012, accessed 11 November 2012.
10 Department of Health and Ageing, Living is For Everyone (LIFE) Framework, DoHA, Canberra, 2007.
11 DOHA, LIFE Framework, p.32.