Aboriginal Youth Suicide in Central Australia: Developing a consistent data system & referral pathway
Over the last decade suicide has become a significant contributor towards Aboriginal premature mortality in Australia(Commonwealth of Australia, 2010; Department of Health and Ageing, 2007; Elliott-Farrelly, 2004), despite beingvirtually unheard of prior to the 1960’s (Elliott-Farrelly, 2004; Hunter & Milroy, 2006). It was estimated that between the years 2005-2009 the suicide death rate for Indigenous peoples was 2.5 times the rate of non-Aboriginal peoples (Australian Bureau of Statistics, unpublished, as cited in Steering Committee for the Review of Government Service Provision, 2011). Additionally, the rate of standardised non-fatal hospitalisations for intentional self-harm in 2008-2009 was higher for Aboriginal peoples than non-Aboriginal (3.5 per 1000 and 1.4 per 1000, respectively) and more prevalent in remote areas (4.1 per 1000) than in major cities (3.5 per 1000). Of recent concern has been the high and increasing rates of suicide and suicide attempts among young Aboriginal peoples (Australian Government Department of Health and Ageing, 2010; Krysinska, Martin, & Sheehan, 2009).
In the Northern Territory (NT) suicide is occurring at an earlier age among Aboriginal peoples compared to non-Aboriginal peoples (Pridmore & Fujiyama, 2009). The rate of suicides in 2001-2006 for Aboriginal children under the age of 15 years in the NT was 5 times the overall Australian rate. There have also been an increasing number of anecdotal reports of child and youth suicides and suicide attempts across the Central Australian region as well as a recent spark of media coverage on the issue (Australian Broadcasting Commission, 2010; Henderson, 2011; Kerin, 2011; The Australian, 2011). Consequently, a Senate “Inquiry into Youth Suicides in the Northern Territory”
was convened in November 2011.
The inquiry report “Gone Too Soon” (Legislative Assembly of the Northern Territory, 2012) outlined that there is successful work being undertaken in the area of suicide prevention, however, generally Aboriginal suicide and suicide attempts among young people remains under or un-reported and poorly understood. Specifically, it was outlined that no standardised framework currently exists in Central Australia to collect information on suicide attempts or to inform appropriate coordination mechanisms between agencies.
The aim of this project was to develop a systematic data collection system for suicide and suicide attempts and suggest appropriate referral pathways between agencies in Central Australia.
• Gain multiple perspectives from relevant stakeholders about suicide and attempted suicide
data collection processes and referral processes in Central Australia.
• Develop an appropriate data collection system to be implemented by agencies in Central
Australia (this will include incidence of suicides and suicide attempts).
• Recommend appropriate service coordination pathways and mechanisms between agencies
in Central Australia.
Aboriginal young people are one of the most disadvantaged and vulnerable groups in Australia (Lee et al., 2008). In the southern region of Central Australia, Aboriginal youth aged 10-24 years account for 44% of all Aboriginal peoples living in Aboriginal communities (Fietz, 2006). Suicide not only impacts the individual, but also affects friends, family, communities and the broader society (Commonwealth of Australia, 2010). The economic cost of suicide is considerable and “a moral or human obligation exists to assist those at risk of suicide and those who have been bereaved by suicide” (Commonwealth of Australia, 2010, p. 13). It is therefore a priority that research and appropriate responses to address Aboriginal youth suicide are developed and implemented. There is currently no coordinated data collection system available to collate information on suicide attempts across Central Australia. A standardised database will provide a more accurate picture of the extent and scope of the issue across the region. Additionally, it will lead to an enhanced understanding of the characteristics of suicide and attempted suicide, including: risk/resilience factors, perceived determinants and geographical incidences of Aboriginal youth suicide and suicide attempts. The data will establish where to target appropriate responses and develop a plan for what resources are required. The data could also identify the source of referral of suicide risk and highlight the efforts of non-health professionals and family in remote communities. Such evidence could promote the need for whole of community training and support. It may also provide evidence of successful programs currently operating and will contribute to their further support and distribution.
It has been identified by local stakeholders that service coordination pathways and mechanisms for agencies to respond to a suicide or suicide attempt are inadequate. Furthermore, where referral is possible, there are significant barriers to the uptake of services by individuals, families and communities. This research will provide recommendations for a systematic coordination pathway for relevant stakeholders in Central Australia to enable a more efficient and effective referral process and will provide recommendations for appropriate supports to enable effective referral. This will reduce duplication of service provision and enable improved service pathways for individuals in the system. The model may also provide a framework for others developing coordination pathways in other areas or fields. In addition, this study will explore the need for professional development, including improving the skills to identify cases and providing appropriate support and follow up for individuals.
The outcomes of this study will form the basis for future research in other aspects of Aboriginal youth suicide in Central Australia. In addition the study will contribute to research in the general area of Aboriginal suicide and will build towards collective knowledge in the community. Outcomes are intended to be practical, relevant and useful to ultimately reduce the impact and incidence of suicide in the region.