What guides local action in suicide prevention?

The Fifth National Mental Health and Suicide Prevention Plan recognises suicide as a significant health and social policy issue, and makes commitments to a national, systems-based approach to reducing suicide rates. 

The Plan positions Primary Health Networks (PHNs) and Local Hospital Networks (LHNs) at the centre of enabling and supporting community-led suicide prevention action, with commitments to:

  • Engage local communities to develop suicide prevention action plans

  • Map providers across the service system and strengthen referral pathways

  • Build community knowledge of available services and how to access them.

Acknowledging the complex nature of suicide prevention policy and practice, many PHNs and LHNs have looked for guidance from best practice models of taking evidence-informed action to prevent suicide in their communities. Arguably the most prominent model being used in Australia is Black Dog Institute’s LifeSpan Framework. 

“LifeSpan aims to build a safety net for the community by connecting and coordinating new and existing interventions and programs, and building the capacity of the community to better support people facing a suicide crisis

LifeSpan adopts a community-led approach and combines nine strategies that have strong evidence for suicide prevention, incorporating a range of sectors and initiatives that are predicted to lessen the impact of suicide and suicide attempts, with strategies focusing on primary care, means restriction, responsible media reporting, emergency and follow-up care in a suicidal crisis and several others. 

The Department of Health has invested heavily in the LifeSpan model through the National Suicide Prevention Trial, with 12 ‘trial sites’ across the country provided with additional funding to implement LifeSpan under the leadership of their respective PHN. 

What was the project?

Brisbane North PHN was one of the 12 sites involved in the National Suicide Prevention Trial. While the PHN commenced the trial back in 2017 with a reasonable understanding of key issues experienced by people with lived experience of suicide and their families and carers, there was less information and insight available into how people typically accessed support across the ‘care pathway’ and how the service environment aligned with the LifeSpan framework. 

In response, Brisbane North PHN engaged Beacon Strategies in partnership with Wesley Mission Queensland to deliver a Suicide Prevention Care Pathways Project for the Brisbane North region. 

The project aimed to better understand how people could access the right support, in the right place, at the right time when they or someone they care for is at risk of suicide, following a suicide attempt or is bereaved by suicide. 

The Care Pathway was guided by a shared governance mechanism with Brisbane North PHN, Metro North HHS, subject matter expertise and representation from lived experience (consumer and carer), Aboriginal and Torres Strait Islander peoples and LGBTIQ+ communities, and was informed through stakeholder engagement activities held right across the region, including separate consultation workshops with:

  • Metro North HHS clinical staff and management

  • community-based service providers and primary care practitioners

  • people with lived experience of suicide

  • Aboriginal and Torres Strait Islander people, LGBTIQ+ communities, and people who identify as both Aboriginal and Torres Strait Islander and LGBTI Brotherboys and Sistergirls.

The Suicide Prevention Care Pathway, which can be viewed on the MyMentalHealth portal here, assists people to better understand and navigate the broad range of suicide prevention services available. These services and supports are categorised across different streams based on a person's needs at a point in time, including:

  • Suicidal crisis

  • Safety planning

  • Self-guided support

  • Community-based support

  • LGBTI+ services

  • Aboriginal and Torres Strait Islander services

  • Support after suicide.

The Pathway follows a consistent format to provide people with information about the different types of suicide prevention support available, including:

  • When a type of support might be appropriate

  • Where and how to access it

  • What can be expected.

So what did we learn?

The development of the Suicide Prevention Care Pathway responded to a range of local issues that were identified for many people who have experience in accessing suicide-related support for themselves or a loved one. These issues included:

  • Members of the community and service providers are often not aware of what services are available

  • There is limited understanding of what the different types of services available aim to do (and what they don’t do)

  • People don’t move between services in a coordinated way, particularly between the hospital and community settings

  • There is a general over-reliance on emergency services and hospital emergency departments

  • Hospitals have limited ability to respond to the factors that might be causing a person to experience a suicidal crisis

  • People who identify as Aboriginal and Torres Strait Islander or LGBTI+ often don’t receive support that is culturally appropriate

As well as generating a huge amount of valuable information about the pathways that do and don’t exist for people needing support in a suicidal crisis, the consultation we held across the region received overwhelmingly positive feedback from stakeholders and community members in connecting people, sharing ideas and knowledge, and building awareness and momentum for collaborative action to improve outcomes at a regional level.

In fact, one person even said ‘this was the best training I’ve been to in years!’, which we felt indicates the strong appetite for more and better quality engagement and development activities across the broad suicide prevention sector—particularly for those people and organisations in the ‘pathway’ who may not appreciate the important role they plan.  

Where to next?

The development of the Suicide Prevention Care Pathway ‘product’ represents an important milestone for the region, but only the first step. Brisbane North PHN and Metro North HHS are continuing, with support from Black Dog Institute, to work across the nine strategies of the LifeSpan framework to provide the right support, in the right place, at the right time. 

In particular, the Suicide Prevention Care Pathway provides a huge opportunity to bring the local sector together and guide engagement and development activities into the future that build the capacity and capability of the ‘system’ to better respond to people at risk of suicide.

In addition to the care pathway products, some of the recommendations we identified for the Brisbane North region, which we feel would have relevance and applicability to many other regions in Australia, included:

  • Avoid duplicating information already available on other websites. Raise awareness of existing resources, particularly platforms such as Head to Health and Life in Mind 

  • Consider strategic partnerships to promote awareness of support services, including information about what people can expect when accessing a service

  • Use clinical tools such as HealthPathways as a source of information for GPs and hospital-based staff to support consistent clinical pathways for community-based treatment

  • Develop local relationships that aim to improve support following discharge from hospital

  • Channel communication about suicide prevention to priority population groups through trusted and embedded community organisations and leaders

  • Invest more in community-based, suicide prevention-specific organisations to provide clinical, psychosocial and practical supports to people at risk of suicide

  • Resource gatekeeper organisations to provide service navigation and coordination via service hub or ‘safe space’ model

  • Promote the uptake of safety planning to better support people in times of suicidal crisis. 

If you’re interested in learning more about the Suicide Prevention Care Pathways project, please get in touch with our project team via email to info@beaconstrategies.net 

As a mission-based health and social services consultancy, Beacon Strategies is committed to partnering with PHNs to better plan, design, implement, evaluate and communicate their work in delivering health outcomes for local communities. Click the button below to access other insights from our recently completed PHN work or head to www.beaconstrategies.net/phns