Summary of current evidence/best practice: The evidence suggests that multilevel interventions are the strategy of choice for suicide prevention.47,48
Figure 7-1 provides a geographic overview of project activities at a state/territory and national level. The state level profiles reflect the number of projects that are active in each state. Projects that have a multi-state component are included in the profile of each individual state/territory in which they operate.
Four key observations are evident from Figure 7-1:
- Activities are directed across all LIFE Action Areas across all states and territories
- A mix of universal, selective and indicated approaches have been used in each state/territory
- The majority of state/territory level project activities had a local geographical reach
- National level projects also showed activities across all LIFE Action Areas and a mix of universal, selective and indicated approaches were evident.
While it is clear that NSPP-funded activities address multiple target groups in each jurisdiction, as shown in the map at Figure 7-2, a number of gaps are evident at a jurisdictional level. These gaps are summarised in Table 7-1.
The groups that emerged as being most consistently absent as project targets at jurisdictional level are LGBTI, CALD, refugees and people affected by natural disasters.
It should be noted that these gaps are based on an analysis of data from the Project Survey, as the survey accounts for project activity across the life of the Evaluation. There are some inconsistencies between the gaps identified above and those emerging from analysis of the MDS data. As outlined in Section 6.6, the MDS analysis indicated that there were no group or individual activities for the following target groups:
- People who have self-harmed (ACT)
- Rural and remote communities (ACT)
- LGBTI populations (SA, WA, NT)
- CALD communities (SA, WA, NT, ACT)
- Refugee communities (SA, WA, NT, ACT)
- Older people (ACT)
- People living with an alcohol or other drug problem (ACT)
- People affected by workforce redundancies (ACT)
- People affected by natural disasters (SA, WA, ACT)
- People at risk (no previous attempts of suicide or self-harm) (ACT, NT)
- People engaged with the justice system (Qld, NT, ACT).
As outlined in Section 5.3, multiple approaches were often evident within projects and a mix of individual and group level activities were provided. Overall, NSPP-funded projects are engaged in activities that are consistent with current best practice, in that they are providing a range of multilevel interventions.
Two caveats apply to this finding. First, the extent to which the particular mix of projects can be considered appropriate needs to be interpreted with caution. While the jurisdictional level analyses provides some indication of the LIFE Action Areas and target groups covered, this activity is based on the number of projects that were active in each jurisdiction.
Second, the gaps in target group coverage need to be interpreted with caution. This is because gaps at state or territory level may be addressed by:
- National NSPP-funded projects.
- Whole-of-community projects. For example, projects that target hard to reach groups such as farmers or rural men generally may do so through whole-of-community projects rather than through projects that overtly target farmers or rural men. Activities may be delivered though community events such as Country Women’s Associations, banking groups, and agricultural shows who by virtue of familial, community or business connections serve as gatekeepers to this these hard to reach groups
- Non-NSPP-funded activities. For example:
- Gaps evident in relation to mental health and AOD may be covered through specific mental health and AOD funding
- Suicide prevention activities occurring at state/territory level that are not funded by NSPP may be addressing these gaps. This issue is discussed in detail in Chapter 11. Top of page
Key findings
Overall, the NSPP-funded projects provide a range of activities across the LIFE Action Areas, using a mix of approaches and targeting a broad range of groups known to be at higher risk, as advocated in the LIFE Framework. Importantly, this mix not only occurs at state/territory level but also within individual projects.Figure 7-1: National and state/territory project profiles
Larger version of figure 7-1
Larger version of figure 7-1: National and state/territory project profiles (PDF 139 KB) Top of pageText version of figure 7-1
This diagram provides summary information for the nation, and for each state and territory, as follows:National
n = 15 i10.6 age-standardised suicide rate ii
$37,091,816 funding 06/07-12/13 iii
Project approach
11 universal6 selective
1 indicated
Project reach
15 nationalLife action areas
8 LAA 110 LAA 2
12 LAA 3
11 LAA 4
8 LAA 5
9 LAA 6 Top of page
Northern Territory
n = 3 i19.3 age-standardised suicide rate ii
$2,468,715 funding 06/07-12/13 iii
Project approach
1 universal3 selective
1 indicated
Project reach
2 local1 state-wide
Life action areas
2 LAA 13 LAA 2
3 LAA 3
1 LAA 4
1 LAA 5
2 LAA 6 Top of page
Queensland
n = 11 i12.4 age-standardised suicide rate ii
$18,007,776 funding 06/07-12/13 iii
Project approach
3 universal8 selective
5 indicated
Project reach
9 local1 state-wide
1 multi-state (Wa/ Tas)
Life action areas
8 LAA 18 LAA 2
10 LAA 3
9 LAA 4
7 LAA 5
10 LAA 6 Top of page
New South Wales
n = 6 i8.6 age-standardised suicide rate ii
$9,660,962 funding 06/07-12/13 iii
Project approach
1 universal5 selective
6 indicated
Project reach
5 local1 multi-state (ACT)
Life action areas
4 LAA 16 LAA 2
5 LAA 3
4 LAA 4
4 LAA 5
5 LAA 6 Top of page
Australian Capital Territory
n = 1 i9.9 age-standardised suicide rate ii
$2,047,858 funding 06/07-12/13 iii
Project approach
0 universal1 selective
1 indicated
Project reach
1 state-wide1 multi-state (NSW)
Life action areas
0 LAA 11 LAA 2
1 LAA 3
1 LAA 4
0 LAA 5
1 LAA 6 Top of page
Victoria
n = 4 i9.6 age-standardised suicide rate ii
$6,237,574 funding 06/07-12/13 iii
Project approach
3 universal4 selective
1 indicated
Project reach
3 local1 state-wide
Life action areas
2 LAA 13 LAA 2
4 LAA 3
2 LAA 4
1 LAA 5
4 LAA 6 Top of page
Tasmania
n = 4 i14.1 age-standardised suicide rate ii
$7,083,907 funding 06/07-12/13 iii
Project approach
1 universal4 selective
2 indicated
Project reach
1 local2 state-wide
1 multi-state (WA/ Qld)
Life action areas
2 LAA 13 LAA 2
4 LAA 3
2 LAA 4
1 LAA 5
4 LAA 6 Top of page
South Australia
n = 2 i12.0 age-standardised suicide rate ii
$982,097 funding 06/07-12/13 iii
Project approach
0 universal2 selective
0 indicated
Project reach
1 local1 state-wide
Life action areas
1 LAA 12 LAA 2
2 LAA 3
1 LAA 4
2 LAA 5
1 LAA 6 Top of page
Western Australia
n = 6 i13.1 age-standardised suicide rate ii
$13,235,694 funding 06/07-12/13 iii
Project approach
1 universal5 selective
3 indicated
Project reach
5 local1 multi-state (Qld/ Tas)
Life action areas
4 LAA 16 LAA 2
5 LAA 3
4 LAA 4
4 LAA 5
5 LAA 6
i Source: ABS 3303.0 Causes of Death Australia, 2011.
ii Source: NSPP Survey.
iii Source: DoHA Project Data.
Figure 7-2: National and state/territory projects by target group
Larger version of figure 7-2
Larger version of figure 7-2: National and state/territory projects by target group (PDF 180 KB) Top of pageText version of figure 7-2
National | Northern Territory | Queensland | New South Wales | Australian Capital Territory | Victoria | Tasmania | South Australia | Western Australia | |
---|---|---|---|---|---|---|---|---|---|
n i | 15 | 3 | 11 | 6 | 1 | 4 | 4 | 2 | 6 |
Bereaved | 4 | 0 | 5 | 2 | 1 | 3 | 2 | 1 | 3 |
Men | 2 | 2 | 3 | 4 | 0 | 3 | 3 | 1 | 4 |
Children | 1 | 0 | 1 | 1 | 0 | 1 | 2 | 0 | 1 |
Youth | 2 | 1 | 5 | 2 | 0 | 2 | 3 | 0 | 4 |
Indigenous | 1 | 2 | 5 | 3 | 0 | 1 | 2 | 1 | 4 |
Mental illness | 2 | 0 | 4 | 2 | 0 | 1 | 1 | 0 | 0 |
Previous attempt | 2 | 1 | 6 | 3 | 0 | 1 | 1 | 0 | 1 |
Self-harm | 2 | 1 | 4 | 1 | 0 | 1 | 1 | 0 | 1 |
Rural & remote | 3 | 3 | 5 | 4 | 0 | 2 | 2 | 1 | 3 |
LGBTI | 2 | 0 | 2 | 1 | 0 | 0 | 2 | 0 | 1 |
CALD | 4 | 0 | 2 | 0 | 0 | 0 | 2 | 0 | 2 |
Refugee | 1 | 0 | 3 | 0 | 0 | 0 | 3 | 0 | 1 |
Older people | 1 | 0 | 2 | 2 | 0 | 1 | 2 | 0 | 2 |
AOD problem | 0 | 1 | 3 | 1 | 0 | 1 | 1 | 0 | 1 |
Whole community | 9 | 2 | 7 | 2 | 0 | 2 | 2 | 1 | 3 |
Workforce | 7 | 1 | 3 | 3 | 0 | 3 | 3 | 0 | 3 |
Redundancies | 1 | 1 | 1 | 2 | 0 | 2 | 1 | 1 | 1 |
Natural disasters | 0 | 0 | 2 | 1 | 0 | 1 | 2 | 0 | 0 |
People at risk | 2 | 0 | 1 | 1 | 0 | 1 | 2 | 2 | 1 |
Justice system | 0 | 0 | 0 | 1 | 0 | 1 | 2 | 1 | 1 |
Table 7-1: Jurisdictional gaps in the range of groups targeted
Table 7-1 is presented as text in this html version. It is a table in the original PDF document.Target groups not listed in the survey responses as a specific target by any of the projects active in that jurisdiction are:
- Bereaved
- NT
- Men
- ACT
- Children
- ACT
- NT
- SA
- Mental illness
- ACT
- NT
- SA
- WA
- Previous attempt
- ACT
- SA
- Self-harm
- ACT
- SA
- Rural & remote
- ACT
- LGBTI
- ACT
- NT
- SA
- Vic
- CALD Top of page
- ACT
- NSW
- NT
- SA
- Vic
- Refugee
- ACT
- NSW
- NT
- SA
- Vic
- Older people
- ACT
- NT
- SA
- AOD problem
- ACT
- SA
- Nat
- Whole community
- ACT
- Workforce settings
- ACT
- SA
- Redundancies
- ACT
- Natural disasters
- ACT
- NT
- SA
- WA
- Nat Top of page
- People at risk
- ACT
- NT
- Justice system
- ACT
- NT
- Qld
- Nat
47 C van der Feltz-Cornelis, M Sarchiapone, V Postuvan et al, ‘Best Practice Elements of Multilevel Suicide Prevention Strategies’, The Journal of Crisis Intervention and Suicide Prevention, vol 32, no 6, 2011, pp.319-333.
48 J Mann, A Apter, J Bertolote et al, 'Suicide Prevention Strategies – A Systematic Review', Journal of the American Medical Association, vol 294, no 16, 2005, pp.2064-74.