Suicide is preventable yet the latest Australian Bureau of Statistics (ABS) data shows 2864 lives were lost to suicide in 2014, which equates to almost eight a day - an increase of almost 13.5 per cent in a year.

Australia’s health practitioners have a vital role to play in preventing suicide.

Dr Fiona Shand, a clinical psychologist and Senior Research Fellow at the Black Dog Institute, says it’s imperative nurses, midwives and allied health practitioners tap into suicide prevention training.

“We’re seeing an increase in death by suicide unfortunately and also potentially an increase in the number of people who are presenting for self-harm,” she says.

“Suicide is the leading cause of death amongst young people in Australia and also certainly one of the leading causes of death for middle-aged men, so I just think that it’s one of those issues that we can’t afford to ignore.”

Dr Shand, who has worked in suicide prevention for the past four years, says upskilling in the areas of screening for depression and suicide, responding to suicide attempts, and being able to discuss suicide with patients is a key part of prevention.

Evidence shows screening for depression and suicide, and treating depression and distress, are some of the best ways to circumvent a suicide attempt.

Dr Shand says while particular groups of people are considered to be at risk of suicide, such as those presenting with a psychiatric diagnosis including depression, anxiety or bipolar disorder, it’s also important to identify other patients or clients who may be at risk.

“There isn’t any one particular profile of a person who might experience suicidal thoughts, it depends on what’s happening in the person’s life, and suicide risk changes over the course of a person’s lifetime so it’s always important to screen,” she says.

Most importantly, it’s crucial health practitioners are able to have the conversation about suicide with patients. Dr Shand says it doesn’t have to be a complicated process.

“Even just asking a couple of questions and finding out whether the patient has ever had a suicide attempt or if the person is having those kind of thoughts can be the start of putting some positive things in place,” she says.

“Saying it in a way that says - ‘when someone is going through a tough time like you are, it’s not unusual to have these kinds of thoughts and I’m wondering if you’re having them’.

“It’s really just giving the person permission to talk about it. Certainly in our interviews with people who have had a suicide attempt, they said they want to be asked and they want to be asked on the suicide attempt on a regular basis, so they don’t have to be the ones to raise the subject.

“I think when people are feeling so terribly distressed, they often do feel very alone and they imagine that there’s no-one they can talk to, so just having someone ask the question can be a huge relief for them.

“And if it’s a health professional, someone who is a step removed from their family or close circle of friends, then they may often feel more comfortable discussing it with them rather than someone who is closer.”

The biggest predictor of a suicide attempt is an individual who has experienced a previous attempt or an episode of self-harm.

If health practitioners know how to respond well to that first episode, they can save lives, Dr Shand says.

“One of the things we know is that the way people are treated when they present after a suicide attempt is incredibly important.

“If people are treated poorly, where there’s a lack of respect, then they are less likely to want to seek help the next time around.

“If people are treated with kindness and respect when they present in these very distressed states, then that’s really important.”

Training programs

There are a range of training programs that aim to equip health practitioners with knowledge and skills in suicide prevention.

The Australian Psychological Society (APS) provides two online continuing professional development (CPD) courses for psychologists, nurses, midwives and other allied heath practitioners.

David Stokes, acting head of the APS Institute, says the courses ensure health practitioners are well prepared to work in suicide prevention.

“These programs are absolutely crucial,” he says.

“We’ve got a couple of very salient examples of unprepared professionals who didn’t follow good practice when working with suicidal clients.

“Anybody who is working in a professional role in the mental health area would find these very relevant and appropriate.

“They were originally designed for our members but we have made them available to non-members as well.”

The Suicide Prevention Professional Development Training has four modules that cover - understanding suicide and suicidal behaviour, risk assessment and crisis intervention, working with populations at risk of suicide or serious self-harm, as well as referrals and self-care for health professionals.

The other course, The Kimberley Way: Indigenous Suicide Prevention Training, is for health professionals working in the area of Indigenous suicide prevention, with a focus on the Kimberley region in northern Western Australia. It covers foundational knowledge and effective clinical intervention.

“The Indigenous population has a different approach to these issues and they have cultural sensitivities that we need to both be aware of and respect,” Mr Stokes said.

The Black Dog Institute also offers continuing professional education workshops for psychologists and allied health practitioners.

It has a one-day Advanced Training in Suicide Prevention workshop that aims to improve health professionals’ skills and confidence in taking a detailed suicide history and developing a collaborative management plan to increase the safety of people considering suicide.

“It is about working with people who are particularly at risk and dealing with some of the more complex presentations such as co-morbid depression and alcohol dependence,” Dr Shand says.

“Health professionals can expect to learn some strategies to help people to deal with those more complex situations where the person has already had a suicide attempt, so we know that they’ve got elevated risk, or that they’re experiencing depression and alcohol use and perhaps also things like complex family situations or unemployment.”


# Help is available from Lifeline on 13 11 14, beyondblue on 1300 22 4636 or the SANE Australia Helpline on 1800 18 7263.