Numbers tell stories, but those stories don't always come with neat endings.
That's true of last week's release of ABS statistics on suicide in 2014, which showed a 10-year-plus high with 2864 deaths and an increase of 13.5 percent from the previous year.
The story that emerges is that things have become worse in terms of Australians dying by suicide -- which is already the leading cause of death for those between 15 and 44. And that there are thousands of families, friends and work colleagues who at some moment received that horrifying text message or Facebook status post that someone who they love has died by suicide.
Many ask themselves in that moment the same question that the nation has been asking itself this week after learning of these sorrowful stats -- why? And, particularly, why this increase in deaths by suicide now?
We live in a time when Australia -- its national political ping-pong aside -- is envied around the planet for its relative peace and prosperity. While poverty and disadvantage are very real, especially for indigenous Australians, many of us eat better than the kings of less than 150 years ago. Therefore, what accounts for the contrast between our comparative wealth and our crappy well-being? How is it possible that there are now some eight deaths by suicide -- one every three hours -- each day?
From the perspective of Lifeline, which fields some 2600 calls per day from help-seekers, with about half of those from people in crisis, the answer is that we don't know. Nor, I would respectfully suggest, does the mental health fraternity; their discipline is necessarily focused on medical factors (e.g. what's wrong with you?) rather than social or contextual factors (what's happening for you?).
But there are things that are known and it's imperative that as a community we act on what Lifeline believes is a national emergency in order to literally save more lives. It's especially timely as the Federal Government currently authors a suicide prevention flank as part of the 5th National Mental Health Plan.
We know that isolation and loneliness are very significant risk factors in suicidality. Disconnection drives despair, particularly for those who may already be struggling under the weight of a mental illness, depression or anxiety. It's been suggested that in a digital world -- where we physically spend upward of 24 hours per week on-line and countless energy in comparing our regular lives to the curated lives of others -- some people become unstuck from the healing glue that binds family and friends together for mutual good.
We know that protective factors -- which are defined as "skills, strengths or resources to help people deal more effectively with stressful events" -- are vital to suicide prevention. It's frankly the case that as a society we're not doing enough on that front, where the ultimate aim should be keeping people from ever needing to call for help. Indeed, federal expenditure for suicide prevention is half the level of federal expenditure for road safety, even though deaths by suicide are double the road toll. That needs to change in the Budget.
Initially, let's look at the "gatekeepers" in our community who personally interact with people who may be vulnerable: Police, GPs, personnel in emergency wards, teachers and so forth. Based on what those groups tell us, it's fair to say that only a very small percentage of these good folk have received dedicated training to spot the signs of suicide, to respond appropriately and to refer accordingly. They're asking for it.
Indeed, we've become good at asking "R U OK?" and now we need to get more skilled at having the conversation when the answer is "No, actually, I'm not." Much more effort is needed to build the attitudes, knowledge, capabilities and behaviours in the community to be suicide-safer.
However, let's not pretend the solution to the stark reality of failure is training alone. Whether it's governments, academe, mental health NGOs and others, we need to have the guts to innovate when it comes to saving lives. The bigger task for all of us is determining and addressing suicide's social basis; the immediate task for Lifeline -- based on listening to nearly a record million contacts in 2015 -- is seeking to improve and innovate what it does to help people.
We need to get better at using today's technology to deal with today's issues. For example, 40 percent of our help-seekers are men, but 75 percent of those who die by suicide are men. Therefore, subject to sustainable funding, we want to extend our on-line chat crisis support to 24 hours per day (to match our telephone hotline) and then expand to text/SMS (where evidence and feedback suggests some men may feel more comfortable).
Also, just as the telephone became ubiquitous in people's homes in the '60s and gave rise to organisations such as Lifeline, wearable fitness devices are now booming. It's within our reach to use them not only for physical fitness but for emotional fitness too, such as with help-seekers who may wish to voluntarily receive consistent support and behavioural prompts through their wristband. (In the '60s, the idea of saving lives over the phone would have seemed novel too.)
Or, with the increased capacity to use beacon technology to proactively send specific messages to mobiles in a specific setting (say a less safe train station or other "hot spot" known for suicidal behaviours), we can reach out rather than wait for contact. Evidence suggests that strong and direct prompts can make a real difference for people in the disjointed state of suicidal thinking.
In a public policy context of many competing claims for share of purse, we also need to look at ways to fund suicide prevention beside government grants and charitable donations. For example, it may be possible to develop a social benefit bond based on a service to support people who have made an initial suicide attempt, a very vulnerable group for whom there is very little once they've left hospital.
Without being cold, there are direct costs to government of suicide and further costs to society as a whole. Reducing the number of suicides reduces those costs and that differential potentially enables investor dividends, and sustainable funding not fully reliant on tax dollars or donor altruism.
Moreover, an economic perspective -- such as acknowledging the cost of insurance claims for those hospitalised for their injuries from self-harm or attempted suicide -- leads one to different cost mitigation methods. For example, insurance companies could be interested in being involved in respite and recovery centres for identified suicidal people (who don't necessarily have a mental illness diagnosis such as the majority of those who die by suicide).
Much more is possible. Not least of which is calling the contributors to indigenous suicide, which is twice as high, by their real names: past and present discrimination, and a lack of indigenous-led services.
Perhaps before everything else, though, we need to change our own story about suicide. Social research conducted for Lifeline shows it's a stigmatised topic for many Australians, involving blame and shame, and therefore often kept in the dark. That often stops people who are feeling suicidal from coming forward and getting help. A new compassionate community story that's open and honest about suicide -- a condition that we are seeing happen to too many normal people -- will save lives.
If you need help in a crisis, call Lifeline on 131114 or the Suicide Call Back Service on 1300659467. Further information and general support are available from beyond blue on 1300224636.