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By suicide, we mean, the act of harming oneself, intending to die. Speaking specifically about Australia, the preliminary data for 2018 shows a total of 3,046 deaths occurred by suicide and an average of 8.3 deaths by suicide each day (Mindframe,2019). In Australians aged 15-29, suicide is the leading cause of death, causing over 2800 deaths (Australian Bureau of Statistics, 2015) and 26,000 hospitalizations annually (J. Harrison & G. Henley, 2014). Due to the alarming numbers and increasing trends around suicidality, the Australian Healthcare Department has come up with various projects to spread awareness as well as deal with suicide, such as the National Suicide Prevention Programme (NSPP).
Healthcare professionals in the primary healthcare set up are some of the people who play a pivotal role in early suicide intervention and prevention. The concept of mental health is also gaining a lot of popularity and issues regarding mental health are being addressed by general physicians, primary healthcare as well as community services, though for severe cases it is advisable to see a mental healthcare professional – psychologist or psychiatrist. It has been observed that the primary healthcare workers have been contacted by people who are either at risk for or have attempted suicide. This is mostly because either the vulnerable individuals are physically unwell as well or simply do not know who to approach for help. Whatever the reason be, primary healthcare has been commendable in their response to suicide prevention, intervention, identifying the ones at risk, referring them to specialists when needed and providing other forms of support and services.
There are protocols in place to be followed in cases involving suicide. The protocols vary according to the risk of suicide – a patient can be at low risk, medium risk or high risk. A person at low risk can mostly manage themselves, with the help of adequate social support and information, resources and consultations with health workers. Persons assessed for medium risk can directly seek help from primary healthcare workers where assessments, follow-ups and strategic techniques to intervene and prevent suicide will be carried out to avoid the escalation of the problem. For people at high risk, continuous monitoring and referral to a mental health specialist are ideal.
Though suicide continues to be a growing public health concern in Australia, there still exist, many gaps in the understanding of how to prevent suicide (G. Zalsman et al., 2016). There is little information available on what approaches work for the diverse needs of the population (Struszczyk et al., 2019).
The guidelines and protocols are reasonable and practical. However, there is always a scope of improvement. These usually involve the quality of patient care. One such limitation is the ability to show empathy. Empathy is a key component for patient care, as it makes the patient feel safe and cared for (McKay et al., 2017). A systematic review involving healthcare experiences of people who have attempted suicide shows that the knowledge, ability to listen, be emphatic as well as sympathise of the medical workers needs to improve (Taylor et al., 2009). Hence, changes in the attitudes of the staff and training them to be more sensitive and non-judgemental is required.
Another limitation is the difficulty healthcare workers face by providing aftercare to meet the various needs of individuals at risk for suicide (C. Haw & K. Hawton, 2008). Providing basic training to all the workers who are even remotely associated with mental health-related work is extremely necessary. Another concern is the individuals who are not comfortable or likely to seek help from conventional medical settings (Milner et al., 2017). Provisions need to be made to reach out to such individuals as well. Primary healthcare workers need to keep themselves updated on the current trends and remediations involving suicide.
Though there are policies for suicide intervention and prevention, suicide continues to be a major concern in the country. The standard protocols for assessing, providing treatment and referrals may be in place, it seems as if it is not enough. There are deficits in knowledge, patient care requires improvement and strategies involving follow-ups need to be looked into. Also, there is a lack of catering to the needs and conditions of diverse communities. Strategies such as focusing on vulnerable groups – adolescents and the elderly – need to be explored further. The present policies need to be reviewed to get a better understanding of what more can be done to reduce suicidality so that this problem can be tackled efficiently and more lives are not lost to it.
Hill, N. T. M., Shand, F., Torok, M., Halliday, L., & Reavley, N. J. (2019). Development of best practice guidelines for suicide-related crisis response and aftercare in the emergency department or other acute settings: a Delphi expert consensus study. BMC Psychiatry, 19(1), 1–10. https://doi.org/10.1186/s12888-018-1995-1
Page, A., Taylor, R., Gunnell, D., Carter, G., Morrell, S., & Martin, G. (2011). Effectiveness of Australian youth suicide prevention initiatives. British Journal of Psychiatry, 199(5), 423–429. https://doi.org/10.1192/bjp.bp.111.093856
Schlichthorst, M., Reifels, L., Krysinska, K., Ftanou, M., Machlin, A., Robinson, J., & Pirkis, J. (2020). Trends in suicide-related research in Australia. International Journal of Mental Health Systems, 14(1), 2. https://doi.org/10.1186/s13033-019-0335-2
Life in Mind Australia. (2019). National Suicide Data. https://lifeinmind.org.au/about-suicide/suicide-data
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