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Those Who Are Hardest To Love Are The Ones Who Need It Most

What we've been doing so far has not really been working that well.

30/08/2016 5:24 AM AEST | Updated 30/08/2016 11:02 AM AEST
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R U OK?

This has never happened before. An Australian Government has been elected by its citizens with a mandate to reduce suicide among fellow Australians.

Indeed, the last Federal election saw real and creditable policy responses by both major Parties to our current national suicide emergency, where 2864 deaths in 2014 are the worst we've experienced in 10 years.

They may not be used to praise, but our political leaders deserve some for seeing the situation for what it is and trying to fix it. In particular, starting from the Prime Minister and the Minister for Health, they've recognised that suicide can actually be prevented with the right approach.

As National Mental Health Commissioner and 'lived experience' advocate Jackie Crowe reminds us, more than a hundred thousand Australians survive a suicidal crisis every year and we should focus on life and recovery rather than death. We need to understand and multiply what kept these people alive.

To that end, the re-elected Turnbull Government has committed record funding to suicide prevention of $192 million, which is the doubling of funding that Lifeline was calling for. Notably and disappointingly, the only specific area lacking new and explicit commitment is indigenous suicide reduction.

Lifeline itself has been granted $2.5 million to introduce an innovative SMS-based crisis support and suicide prevention service where people in need can use their smartphones -- which are not even 10 years old as a technology -- to reach out when they need help.

As the Government, its service providers like Primary Health Networks at the regional level, professionals and the NGO community now step up the life-saving response, there is much to be very mindful of so that we can succeed.

Let's start by admitting that what we've been doing so far has not really been working that well. The sorrowful stats show it; the profound pain in thousands of families proves it. Therefore, we should not simply use new funds to expand on old programs and approaches.

This will be a huge challenge in an era where public sector operators -- such as the PHNs charged with most of the suicide reduction roll-out -- are regimented into risk resistance and where the framing of suicide is largely 'medicalised.

As a community, starting from our political leaders, we need to instruct those public servants to innovate and that includes seeing suicide as a social issue as much as a health issue.

Importantly and thankfully, some PHN leaders charged with getting the local job done are getting this. Based on his extensive review of available evidence, one recently said to me: "The work we do is actually less important than what we bring to the work. If we're truly committed to care and kindness for our clients, then we will get outside our comfort zones and really help them."

As per the recommendations of the National Mental Health Commission, innovation means much more attention on the single group of people that we know to be most at risk -- people who have made an initial suicide attempt and have been unadmitted from the health system. From my own time on the phones at Lifeline, I can attest to the calls we daily receive from often very lonely people in crisis basically saying: "I've left hospital after a suicide attempt and have no idea what to do."

Innovation such as post-attempt, follow-up support that is jointly run by hospitals and charities are one opportunity; special centres -- or 'LifeHouses' as modelled by the Australian Institute for Suicide Reduction and Prevention (AISRAP) -- are another. Compassion and connection are the key here -- matched with quality health care and clinical treatment.

Let's also harness the trends in our society to prevent suicide death. Digital technology defines our lives; it can also drive our life-saving. Through a survey released in August, our colleagues at R U OK have recently determined that the average Australian spends an average of 46 hours of their weekly downtime looking at their TVs and digital devices, compared to an average of six hours engaging with family and friends. Or, as a character in author Don Delillo's new novel Zero K says: "Every touch of a button brings the neural rush of finding something I never knew and never needed to know..."

It's seemingly constant contact without human 'heart-ware'. About a decade old, this digital daze of distraction from ourselves and disconnection from others must surely be driving up social and health costs. But, it's also our opportunity to disrupt the digital into the mindful and meaningful (says this self-confessed social media junkie).

Certainly, the ever-expanding spectrum of self-help apps and online peer-to-peer support groups for mental wellness is one aspect of taking back the Internet for our own good. Through our colleagues at Reach Out, Australia was the first in the world to offer e-mental health solutions.

But it's only a start.

The Government's current attempt to build a 'digital gateway' to mental health services is now underway. In complement with face-to-face help-seeking, new e-mental health software such as 'Project Synergy' has the further potential to give people, including those with suicidality, ways to hold their own health information (even in wearable tech), share that information with providers like Lifeline, and thereby be empowered in their own wellness.

Subject to privacy assurance, there is also promise in using data analytics on social media postings to better understand suicide as a phenomenon. If we can use them to sell car insurance and orange juice, why not apply algorithms for life? This is already occurring in the US, and the NSW Government has especially started a good conversation with the Australian chapters of the huge international social media operators about what's possible here.

We need to understand the prevalent context in which we want to see positive change. The internationally renowned pollster Mark Textor recently told a room of Lifeline leaders and volunteers and other suicide prevention stakeholders that "we're increasingly living in a society where people are splitting off into their own bubbles and shouting at each other across cultural, political, geographic and economic differences." Textor is concerned that this leads to "the loss of civic middle ground where, historically, Aussies have looked after each other exceptionally well."

Combined with an economy in shake-out mode (and where Sydney is seemingly closer to Singapore than to Singleton), there appears to be a deep sense of loneliness being felt by many in the community. This is, in part, shown by Lifeline's near 1 million interactions in 2015/16. Some 55 percent of our callers live alone; one in four of our callers living with someone else also report loneliness. And, if we know nothing else from 53 years of life-saving work, it is that loneliness can really wear away a person's capacity to cope -- while connection to other people is precisely the personal warehouse of preparedness for life's challenges.

So, as we go down this new national track of life-saving work, it's crucial that as individuals we compassionately act on our personal tracks too. On September 8th, which is R U OK Day, or on September 10th, which is World Suicide Prevention Day, we can make that list of the three people we know who are socially isolated, and then reach out to them for a conversation or a coffee or even encouragement to call Lifeline. Know that it's okay to ask them not only if they are okay, but if they're suicidal -- many are liberated by the very opportunity to talk.

Frankly, those who are the hardest to love are probably the ones who need it the most. Our simple choice to be kind and show kindness -- or what New York Times columnist David Brookes calls "the revolution of small connections" -- can save someone's life.

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You can take Lifeline's online loneliness survey here.

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