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Chapter 1 Introduction

1.1                   Suicide is one of the most common causes of death for young people in Australia, accounting in 2005 for approximately 20 percent of all deaths of those aged between 15 and 24 years of age.[1] This figure is considerably lower than the peak youth suicide rate in 1997, where suicide accounted for 21 percent of deaths in the ages 15 to 19 and 34 percent of deaths in the ages 20 to 24.[2] Suicide is the second most common cause of death in young people, after transport accidents which, in some years, account for up to 44% of youth deaths.[3]

1.2                   The rate of suicide for young males is even higher than the general youth rate, and much higher than the rate of suicide in older males – accounting for almost one quarter of all deaths in males between the ages of 15 and 24. Similarly, suicide is much more common in young females than in older females.[4]

1.3                   Although the rate of youth suicide remains distressingly high, it appears that measures to reduce youth suicide rates may have had significant impact, as evidenced by the decline in suicide rates since 1997. Therefore, in November 2009 the House of Representatives Standing Committee on Health and Ageing of the 42^nd Parliament (the former Committee) resolved to conduct an inquiry to examine the potential for effective intervention programs to further reduce rates of youth suicide.

Conduct of the Inquiry

42^nd Parliament

1.4                   Although the former Committee was aware that the Senate Community Affairs Reference Committee had already initiated a comprehensive inquiry into suicide in Australia, it felt that a House of Representatives inquiry, if appropriately focussed, could complement that work. Therefore, in February 2010, while in Perth, the former Committee sought an initial briefing to assist in refining the scope of its inquiry. Organisations represented at the briefing included Youth Focus, Fremantle Headspace, Telethon Institute for Child Health and OZHELP (WA). During the briefing participants described the work that they undertake to prevent youth suicide, and identified priority issues for further consideration. As a result of the briefing the former Committee refined its terms of reference to focus the inquiry on ‘the need for and success of early intervention programs aimed at preventing youth suicide’.

1.5                   The former Committee also decided that a series of roundtable forums would be the best way to progress the inquiry, as this would afford opportunities for interested individuals to discuss the issues in an interactive way. To this end the former Committee convened two public roundtable forums, in Melbourne on 20 April 2010 and in Sydney on 30 June 2010, with a diverse range of professionals working in the field of youth suicide prevention. While the former Committee was in Melbourne, Members also took the opportunity to visit a Headspace site and to meet with staff and youth representatives. The former Committee also expressed a desire to meet with and hear from young people directly. A confidential discussion session with a number of young people was convened as part of the Sydney roundtable. Although there was no formal request for written submissions, 12 submissions and 21 exhibits were received. The inquiry lapsed on 19 July 2010, the date on which the House of Representatives was dissolved ahead of the August 2010 federal election.

43^rd Parliament

1.6                   The 43^rd Parliament was opened on 28 September 2010 and the current House of Representatives Standing Committee on Health and Ageing was established under House of Representatives standing order 215 on the following day. On Tuesday 16 November 2010, the current Standing Committee on Health and Ageing (the Committee) resolved to re-adopt the Inquiry into the need for and success of early intervention programs aimed at preventing youth suicide from the previous Parliament. In resolving to do so however, the Committee recognised that the former Committee had been unable to report on the inquiry in the 42^nd Parliament.

1.7                   Therefore, the Committee decided to publish a discussion paper drawing together the evidence that had already been presented, highlighting emerging themes and inviting comment from those who had participated in the inquiry to date.[5] The themes presented in the discussion paper were broadly categorised as:

• collaboration;
  
  
• mental health literacy; and
  
  
• ‘gatekeeper’ training.

1.8                   The discussion paper also outlined a number of policy proposals that had emerged during 2010 to address youth mental health issues and reduce rates of youth suicide. These policy proposals were:

• the need for more frontline services including psychological and psychiatric services;
  
  
• additional support for communities affected by suicide;
  
  
• targeting those who are at greatest risk of suicide;
  
  
• promoting mental health and well-being among young people;
  
  
• additional youth ‘headspace’ sites; and
  
  
• additional Early Psychosis Prevention and Intervention Centres.

1.9                   The discussion paper was published on the Committee’s webpage in December 2010. It was also distributed to those organisations that had engaged with the inquiry in the 42^nd Parliament, with an invitation to submit further comment. The Committee received an additional 15 submissions (including supplementary submissions) and 28 exhibits. A list of submissions is at Appendix A. Exhibits are listed at Appendix B.

1.10               In early 2011, the Committee held two further roundtable forums in Perth on 31 January 2011 and in Canberra on 11 February 2011. The schedule of public briefings and roundtables is at Appendix C.

Senate Committee Inquiry and Report

1.11               In addition to publication of the Committee’s discussion paper, the Senate Community Affairs References Committee tabled its report, The Hidden Toll: Suicide in Australia, in June 2010. The report makes 42 recommendations addressing ways to improve responses to suicide in Australia.[6] In summary the recommendations call for:

• an assessment of the social and economic costs of suicide;
  
  
• continued and expanded support for the activities of the National Committee for Standardisation of Reporting on Suicides, the standardisation of suicide reporting and improved data collection and reporting;
  
  
• enhanced suicide awareness and prevention training for front-line workers (e.g. people working in primary care, law enforcement and emergency workers);
  
  
• affordable access to crisis and counselling services, including telephone and on-line services;
  
  
• mechanisms to improve the ‘connectedness of services’ and continuity of care;
  
  
• long-term awareness campaigns using a range of media, including campaigns targeted at high risk groups;
  
  
• more programs and increased program funding for at risk groups; and
  
  
• additional Early Psychosis Prevention and Intervention Centres.

1.12               In November 2010, the Government responded to the Senate report’s recommendations, noting:

Of the 42 recommendations the Government has already actioned six, has set in place initiatives to meet a further twenty, and will progress or consider the remaining recommendations in consultation with relevant stakeholders.[7]

1.13               The Committee notes the recommendations made by the Senate Committee and the Government responses. The Committee views its own report on youth suicide as a complement to that comprehensive report and its recommendations.

Structure of the Report

1.14               Chapter 2 presents an overview of suicide statistics, with a focus on suicide statistics for the 14-25 years age-group. It reviews what is known about risk and protective factors youth suicide and identifies groups of young people who are at increased risk.

1.15               Chapter 3 examines the various theoretical approaches used to reduce the suicide rates among young people, with a focus on prevention and early intervention. The Chapter provides a review of Australian Government youth suicide prevention strategies and the role of research and evaluation in developing a robust evidence-base to inform future best-practice strategies for youth suicide prevention.

1.16               Chapter 4 expands on guiding principles that were outlined in the Committee’s discussion paper, examining them in the context of developing a coordinated, collaborative and inclusive approach to preventing youth suicide.