Terms of reference
On 10 September 2009 the Senate referred the following matter to the
Senate Community Affairs References Committee (the Committee) for inquiry and
report by the last sitting day in April 2010 (the reporting date was later
extended to 24 June 2010):
The impact of suicide on the Australian community including high
risk groups such as Indigenous youth and rural communities, with particular
(a) the personal, social and financial costs of suicide in Australia;
(b) the accuracy of suicide reporting in Australia, factors that may impede
accurate identification and recording of possible suicides, (and the
consequences of any under-reporting on understanding risk factors and providing
services to those at risk);
(c) the appropriate role and effectiveness of agencies, such as police,
emergency departments, law enforcement and general health services in assisting
people at risk of suicide;
(d) the effectiveness, to date, of public awareness programs and their
relative success in providing information, encouraging help-seeking and
enhancing public discussion of suicide;
(e) the efficacy of suicide prevention training and support for front-line
health and community workers providing services to people at risk;
(f) the role of targeted programs and services that address the particular
circumstances of high-risk groups;
the adequacy of the current program of research into suicide and suicide
prevention, and the manner in which findings are disseminated to practitioners
and incorporated into government policy; and
(h) the effectiveness of the National Suicide Prevention Strategy in
achieving its aims and objectives, and any barriers to its progress.
Conduct of the inquiry
The inquiry was advertised in The Australian newspaper and on the
Committee's website, inviting submissions from interested parties. Due to the
considerable interest in the reference subject matter, the Committee undertook
to continue to receive submissions up to 17 June 2010. The Committee also wrote
to relevant organisations and individuals notifying them of the inquiry and
The Committee received 258 public submissions, which were made available
through the Committee website.
Due to the nature of the reference subject matter the Committee determined that
a number of these would be published with the name of the submitter(s)
withheld, or with material of a sensitive nature (such as information
identifying unrelated third parties) removed. A number of submissions were also
accepted as confidential submissions. A list of individuals and organisations
that made submissions or provided other information authorised for publication
by the Committee is contained in Appendix 1.
A joint submission to the inquiry was funded by Lifeline Australia, Suicide
Prevention Australia (SPA), the Inspire Foundation; OzHelp Foundation; the
Salvation Army; the Mental Health Council of Australia (MHCA), and the Brain and
Mind Research Institute (BMRI) and supported by many other organisations and
individuals. This joint submission (Submission 65, referred to in the
report as the Suicide is Preventable submission) was presented to the Chair and
Deputy Chair of the Committee at Parliament House, Canberra, on 23 November
The Committee held 12 public hearings over the course of the inquiry.
- 1 March 2010, Canberra
- 2 March 2010, Brisbane
- 3 March 2010, Sydney
- 4 March 2010, Melbourne
- 24 March 2010, Canberra
- 25 March 2010, Canberra
- 30 March 2010, Perth
- 31 March 2010, Perth
- 4 May 2010, Adelaide
- 17 May 2010, Darwin
- 18 May 2010, Canberra
- 20 May 2010, Hobart
Witnesses who appeared at these hearings are listed in Appendix 2.
The Committee wishes to thank the many people who gave evidence in
person or in writing regarding their experiences in relation to suicide which
were often personal and distressing. Much of this evidence was received
confidentially and the Committee would like to record its appreciation for the
time and effort made by these persons to assist the inquiry.
The Committee would also like to thank the managers and staff of the Understanding
& Building Resilience in the South West Project and Lifeline Hobart for allowing
the Committee to visit their offices in Perth and Hobart respectively.
The Committee is also grateful to the members and secretariat of the
Australian Suicide Prevention Advisory Council (ASPAC) who made time to meet
with Committee members in Canberra on 28 May 2010.
The Committee recognises that suicide is a subject that needs to be
discussed carefully and sensitively. Inappropriate discussion and reporting of
suicide can be distressing for those bereaved by suicide and can have negative influences
on those at risk of suicide. Nonetheless the Committee also has a responsibility
to clearly and accurately report on this significant issue. While the Committee
has made efforts to use appropriate language in this report, evidence and
quotations from submissions and witnesses have not been edited where
inappropriate language may be used. This may include descriptions regarding methods
of suicide and locations where suicides have taken place.
Suicide and euthanasia
During the course of the inquiry the Committee received a substantial
number submissions linking the terms of reference to the issue of self, voluntary
and assisted euthanasia.
While the issue of euthanasia has several linkages with some of the topics covered
during the inquiry, the Committee has made a decision not to focus on the issue
of euthanasia in this report.
The Committee acknowledges that there are strong views on both sides of
this issue and the decision may be disappointing to those who have made
submissions addressing this topic. However the Committee considers suicide is
the focus of the terms of reference of the inquiry. The evidence received in
relation to euthanasia has been noted by the Committee and will be tabled as
part of the final report of the inquiry.
Structure of the report
The structure of this report broadly follows the terms of reference
(ToR) provided by the Senate. Chapter 1 includes a brief background to the
issue of suicide in Australia. Chapter 2 deals with the personal, social and
financial costs of suicide in Australia ToR (a). Chapter 3 addresses the
suicide reporting issues in ToR (b). Chapter 4 combines ToR (c) and (e) to
examine the appropriate role, effectiveness and training of agencies, frontline
personnel and others in assisting persons at risk of suicide. Chapter 5 covers
ToR (d), public awareness campaigns as well as the many issues concerning
stigma covered during the inquiry. Chapter 6 deals with groups at high risk of
suicide in ToR (f), the programs and services which support them, and the
balance between universal and targeted approaches to suicide prevention.
Chapter 7 addresses ToR (g), the adequacy of current suicide research and the dissemination
of research results to practitioners and policy makers. Chapter 8 focuses on
the National Suicide Prevention Strategy (NSPS), addressing ToR (h). Chapter 9
concludes the Committee's comments and summarises the recommendations made.
Background to suicide and suicide prevention
A suicide occurs when a person dies as a result of a deliberate act
intended to cause the end of his or her life. The World Health Organisation (WHO)
has estimated that around the globe approximately 1 million people die from
suicide every year. In Australia, suicide is a leading cause of death with over
2000 persons dying every year, three quarters of these deaths are men.
Attempted suicide is also an important issue with estimates that in Australia
over 60,000 people a year attempt to take their own lives, the majority being
women. It is recognised that the number of suicides and attempted suicides is
likely to be underreported for a number of reasons including the practical
problems of determining a person's intentions, reporting problems and the stigma
around suicide and self harm.
A completed suicide often has many complex causes and motivations. It
may be an impulsive, irrational act or a carefully planned choice. Biological,
cultural, social, economic and psychological risk and protective factors have
been identified, which reduce or increase the likelihood of suicidal behaviour.
People who attempt to take their own life usually have many risk factors and
few protective factors. Risk and protective factors are often at opposite ends of
the same continuum. For example, while social isolation is a risk factor for
suicide, social connectedness is a protective factor. In Australia links have
been recognised between suicide and geographic location (regional, rural and
remote) and socio-economic disadvantage (low socio-economic status).
However there is not always a clear relationship between a particular risk or
protective factor and suicide. For example mental illness is a frequently cited
risk factor, but not everyone who takes their own life will be mentally ill.
While completed suicide can be considered a low prevalence event, when
it occurs it has devastating and wide spread impacts on those connected to the
person who has died and their community including personal, social and economic
Suicide prevention in Australia
Australia was one of the first countries to develop a dedicated national
strategy to address suicide. The initial focus of suicide prevention was on
youth suicide following international, government and community concerns raised
during the 1980s and 1990s. The National Youth Suicide Prevention Strategy
(NYSPS), introduced in 1995, was administered and coordinated through the
Mental Health Branch of the then Commonwealth Department of Health and Aged
In 2000, the NYSPS was expanded into the NSPS with a broader focus preventing
suicide over the whole life span. The first iteration of the LIFE Framework, Living
Is For Everyone: A Framework for Prevention of Suicide and Self-harm in
Australia was also developed to provide a strategic framework for national
action to prevent suicide and promote mental health and resilience.
In 2006, the Council of Australian Governments (COAG) agreed to a
National Action Plan on Mental Health 2006-2011 which included a commitment
from the Commonwealth Government to double funding for the NSPS (from $62
million to $127 million) to enable the expansion of suicide prevention programs,
particularly those targeting groups at high risk.
These funds have been directed to programs and projects through the National
Suicide Prevention Program (NSPP). A new LIFE Framework suite of resources was
commissioned, developed and made available after consultations in 2006-07.
In 2008 the ASPAC was established to provide national leadership and
strategic advice to Minister for Health and Ageing on suicide prevention
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