The Living is for Everyone (LIFE) Framework has been developed under the National Suicide Prevention Strategy (NSPS) to address the high rates of suicidal behaviour among identified population groups. This Framework guides and informs the implementation of the NSPS.

The NSPS commenced in 1999 and builds on the former National Youth Suicide Prevention Strategy (NYSPS). A key outcome of the NSPS is to support national suicide prevention activities across the life span and the Australian Government provides funding for the development of national and community based models of suicide prevention.

The focus of the NSPS includes people of all age groups and those identified as being at high risk, such as young men, rural residents, the elderly, people with substance use problems, prisoners, rural communities, people with mental illnesses, and Aboriginal and Torres Strait Islander peoples. As well as planning initiatives which impact across the lifespan there is an emphasis on promoting initiatives that aim to address risk and protective factors for suicide.

The Living is for Everyone: a Framework for the Prevention of Suicide and Self Harm in Australia (LIFE Framework) aims to foster strategic partnerships and to position suicide prevention effort across all sectors. It was developed by the National Advisory Council on Youth Suicide Prevention, guided by consultation with key groups and evidence that suicide prevention requires a multi-faceted approach involving collaboration between all levels of government and the community.

The LIFE Framework promotes 6 Action Areas for suicide prevention activity:

1. Promoting well-being, resilience and community capacity across Australia
2. Enhancing protective factors and reducing risk factors for suicide and self harm across the Australian Community
3. Services and support within the community for groups at increased risk
4. Services for individuals at high risk
5. Partnerships with Aboriginal and Torres Strait Islander peoples
6. Progressing the evidence base for suicide prevention and good practice.

Currently the LIFE Framework consists of three companion documents:

• LIFE: Areas for action outlines the framework and identifies its major goals, principles and strategic performance indicators. Six action areas are presented which are linked to strategies for promoting mental health and preventing mental illness. Performance indicators for measuring progress toward achieving outcomes for each of the action areas are also provided.
  
• LIFE: Learnings about suicide sets the context for suicide prevention activity, and provides a profile of the incidence of suicide and the current knowledge of risk and protective factors across different age, population and identified at risk groups.
  
• LIFE: Building partnerships describes the many programs, organisations, and governments with an interest in, or potential overlap with suicide prevention.

A new stage of the NSPS is underway with organisations around the country applying for Community Based Funding. The Life Promotion Program and Waltja have applied collaboratively to work in three remote communities to help strengthen capacity through activities that build on resilience as well as developing resources focusing on suicide and mental health. The LPP Steering committee provided an avenue for discussions around this funding, priority areas for Central Australia and opportunities to collaborate rather than compete with each other.

For more info visit www.health.gov.au/internet/wcms/publishing.nsf/Content/mental-suicide-overview or www.livingisforeveryone.com

Some statistics on suicide in Australia
In Australia, in 2004, there were 2098 reported deaths by suicide. This is greater than the number of deaths caused by traffic accidents. But much of the pain of suicide is beyond the reported statistics.

For many reasons, not all deaths that are suicides are recorded as such. It is estimated that actual the figures for suicides are 5% to 25% greater than what has been reported. This puts the figure for 2004 between 2,203 and 2,622 deaths. This is 6 to 7 deaths a day.

Further, just as not all car accidents result in death, not all suicidal behaviour results in a fatality.
It is estimated that suicidal behaviour is 40 to 100 times greater than the number of suicides. This means that in 2004 alone, between 83,920 and 209,800 Australian lives were at risk from suicidal behaviour. This is between 230 and 575 lives a risk per day.

It is estimated that, in 2004, there were approximately 1,206,678 Australians who lived with thoughts of taking their own life. These people might be living with these thoughts every day.

For each of those people struggling with thoughts or actions relating to suicide, others were connected to their lives. This means that many more people have been affected by the pain of suicide - there is a huge net of stress, trauma, pain and grief pulling on many people’s lives.

For the most part, this net is not spoken about, so it remains invisible or hidden. And when something remains hidden, it is difficult to find a way to get free from it.
Below are some of the ways the Life Promotion Program in Central Australia is working to provide support to those whose lives are affected by suicide.

An Interagency Response.

Working to provide a supportive response …

Loss is difficult ... And responding to loss is difficult too ...

When the police notify the Life Promotion Program about a death by suicide we call members of the Suicide Interagency Response Group. These people come from a variety of services in Alice Springs including government departments, Aboriginal organisations, family services and youth agencies.

The Response Group meets within 24 hours of receiving the news from the police or other agency to provide accurate details to supporting agency workers, to share an understanding of all those who might be affected by this death and to ensure that those affected are given the option of formal support or at least are being cared for by friends and family. This service is based on the understanding that after a suicide, family and close friends can also be at risk of suicide and that their experience of grief can be particularly difficult due to the stigma associated with suicide and the complexity of emotions often experienced by those left behind.

This process can be complicated because we don’t always know the extent of who is affected by the death, and even when we do know some of them, we don’t always know the best way to offer them support. But we believe that support is very important, so we do the best that we can. And we will keep working on this process, trying to make it better.

If you have experienced a loss, we hope you are able to find someone you trust who can support you while you process this difficult trauma and pain.

If it is difficult to find someone to support you, feel free to give us a call and we will try to help you find a counsellor or a group who is right for you. Please also refer to our Resources and Links page for information on help websites and contacts.

For more information phone Laurencia on 8950 4608 or Kristy on 8950 4609.

Delivery of Applied Suicide Intervention Skills Training (ASIST)

First Aid through ASIST: Appropriate intervention during the crisis of suicide

First Aid training has become a familiar concept in Western society, because we know that, when an emergency happens, skilled professionals aren’t always the first ones on the scene. But if there is some level of emergency-handling skills distributed throughout the general public, when an emergency happens, the people whose lives are at risk are more likely to get the assistance that they need. This can save lives.

ASIST is just like First Aid and its focus is specifically on suicide. ASIST is also a way of training people to have the skills they need to stay alive while the net is dragging their lives, and hopefully get free of it all together. There is a great need for this kind of training.

The ASIST program aims to:

• Reduce attitudinal barriers which hinder the ability to be direct and comfortable with suicidal situations
• Dispel myths about suicide
• Identify the indicators and assess suicidal risk
• Provide people with skills to intervene when someone is at risk of suicide
• Build collaborative resource networks for suicidal people

ASIST is a Canadian gatekeeper program developed and managed by Living Works. In Australia the training program is facilitated by Lifeline in Melbourne with trainers based throughout the country.

The Northern Territory delivers more ASIST workshops per population than any other State or Territory in Australia.

This is possibly due to a number of reasons:

• Anglicare NT have played a major role in supporting the ASIST network of trainers over many years
• There is a great demand for this training by workers and local organisations who are requiring the confidence and skills to work with people at risk of suicide.
• The NT has the highest rate of suicide, an equally high rate of suicidal behaviour and the issues in the NT are challenged by geography, isolation and the difficulties faced by people living in remote communities and town camps.
• There are few options of support around suicide and mental health, especially in remote communities and therefore the “gatekeepers” who might be the night patrol workers or the youth workers require the skills to support people until further professional support can be found.

Course information
ASIST is offered as a 2-day interactive workshop and is delivered by local trainers. The course is suitable for workers, volunteers and family who wish to learn more about how to reduce the immediate risk of a suicide and increase the support for a person at risk. Also, Train the Trainer courses are delivered across Australia for people who wish to become ASIST trainers. This course is a 5-day intensive and requires a commitment from workers and organisations that new trainers will use their skills to deliver workshops.

For information about training in Alice Springs or Tennant Creek contact LPP on (08) 8950 4608 or 8950 4609 or Lifeline Alice Springs on (08) 8953 1250. You can also visit Living Works at
www.livingworks.org.au/pages/asist.php or phone on (03) 9894 1833.

Current Suicide Prevention Research
One of the ways to engage in suicide prevention is to share knowledge and understanding. The Life Promotion Program does this in a number of different ways by:

• Networking locally with other agencies
• Giving presentations at workshops and conferences about the Life Promotion Program on a local, state and national level
• Attending seminars and conferences to network with others, share ideas and keep abreast of latest information
• Reading research
• Collaboration with local service providers to deliver suicide prevention and mental health activities and programs
• Working with local schools and within other settings for young people to raise awareness about the issue of suicide and mental health.
• World Suicide Prevention Day on September 10 provides an opportunity to raise awareness about the problem of suicide in Central Australia, how it impacts on family, what strategies are in place to address this issue and what people can do if they or someone they know is at risk of suicide. It is also an important healing ceremony for local communities.

Suicide is like a huge net of stress, trauma, pain and grief pulling on many people’s lives in our country. This net is interwoven in complex ways, made up of personal, biological and psychological factors, and also influenced by economic, social, cultural and familial circumstances.

“No single suicide theory seems to account for all the empirical results. However, many of the social and economic indicators associated with high suicide rates may point to some kind of reduced social integration (eg, due to significant social or economic changes), social inequalities, and different social meanings of, or opportunities for, suicide.” (Caroline Maskill and Ian Hodges. “Explaining Patterns of Suicide: A selective review of studies examining social, economic, cultural and other population-level influences.” Social Explanations for Suicide in New Zealand: Report 1. (Wellington, New Zealand Ministry of Health. 2005): ix

Being caught in the net of suicide is being caught in something complex. For a lot of the time and for a lot of reasons, this net is difficult to speak about. And when something is not often spoken about, it remains unidentified, which makes it harder to address.

But there are many people who are exploring how this net works so that we can discover how best to reduce the influence it has and how people might be able to get free from it as well.

To try and effectively address the net of suicide, the people involved in the Life Promotion Program try to get hold of this information, through reading, research, talking to people on the phone, meeting with people and going to conferences.

We hope that the more we can understand this information, the more effectively we can work.

Life Promotion Program Steering Committee
The Life Promotion Program has sought the support and guidance of representatives from key Government Departments and non-Government organisations through its Steering Committee since 1999. Steering committee representation acknowledges that the problem of suicide and self-harm is a shared responsibility of Government, non-Government organisations and community members.

Objectives of the Steering Committee

To act as an Interagency Committee to carry out the following:

a) To provide guidance to the Life Promotion Program on sustainable and appropriate suicide prevention strategies

b) To provide information on current suicide prevention programs.

c) To assist in advocating for adequate resourcing for programs and services that support the objectives of the Life Promotion Program

d) To assist in strengthening the systems and services that support people at risk of suicide and their families

e) To assist in identifying gaps in service provision related to suicide prevention in Central Australia

f) To advocate for good practices by communities, individuals, agencies and other parties in suicide prevention strategies

g) To support the activities of the Life Promotion Program including the Suicide Response Group function

h) To attend and contribute to Life Promotion Program Steering Group meetings on a quarterly basis and to ensure that relevant information is relayed back to the organisation being represented.

Santa Teresa (Ltyentye Arpurte) Life Promotion Program
Life Promotion is visiting the Ltyentye Arpurte community every fortnight to begin to talk about the issue of suicide and suicidal behavior with people who live and work in this community. We are working from a community development framework that aims to engage local people in identifying solutions to issues that affect them.

Ltyentye Arpurte has been identified for a number of reasons. Five deaths by suicide have occurred here and in Amoonguna (a community with close family links to Ltyentye Arpurte) in the last two years. Many more attempts have occurred, some that do not get reported to the health clinic or to remote mental health. Also, it seems timely to be focusing on mental health in this community as there are other programs and services addressing this particular health issue.

Following a tragic death in May 2006 LPP was part of a community meeting in Ltyentye Arpurte, held to discuss structures that might be put in place to better support people at risk. Some of the ideas that were actioned after this tragedy were to notify power and water to remove the steps that allow easy access to power lines. Reducing the means is one way to reduce suicide rates in the same way that some alcohol and drug strategies work. We know that this does not remove the problems for people at risk of suicide, but it makes it more difficult to access a way out, especially when drinking is also involved.

LPP will be inviting representatives from other communities (such as East Arnhem) to talk to people in Ltyentye Arpurte about ways that have worked to reduce the rates of suicide and suicide attempts.

We continue to talk to elders in the community to gain a better understanding of the problem, to encourage the issue to be talked up in the community and to receive guidance about the work we are doing.

Cultural Consultants
We would like to hear from interested Eastern Arrente people who wish to work with the
Life Promotion Program on a casual basis as cultural consultants, interpreters and artists. We require people who can assist us to work appropriately in Ltyentye Apurte community (Santa Teresa) who can assist with introductions to family and with communication about sensitive issues so that we can engage in two-way learning about suicide and mental health.

For more information about the Ltyentye Arpurte LPP Project contact Laurencia on 8950 4608 or Kristy on 8950 4609.

Data collection on completed suicides and hospital-admitted suicide attempts

In order to work strategically in the areas of greatest need, the Life Promotion Program has begun a research project collecting data on suicide attempts from all relevant sources. We know there are a significant number of suicide attempts, especially in remote communities, however the evidence is largely anecdotal. The hospital, police, correctional centres, mental health services, remote clinics and other non- government organisations collect data on suicide attempts.

Life Promotion and CAMHS (the Central Australia Mental Health Service) are currently in the process of developing a protocol for the collection of data on suicide attempts. If we have evidence-based data to show that there are a significant number of suicide attempts rather than anecdotal information, then it might prove persuasive enough to allocate some resourcing the delivery of evidence-based community development programs.

Collecting this data will provide a means of better understanding the significance of the problem and will identify if there are any emerging patterns based on regions, age groups or gender.