HNN301 Statistical Aspect of Suicide and Prevention Programs in Australia Assessment Task 2 Answer

INTRODUCTION

Suicide has a complex, and multiple factors contributing to the occurrence require a timely and defined interventional program for prevention. As defined by the World Health Organisation, Suicide is in a deliberate act of killing oneself. Suicide has devastating effects on the families, caregivers and friends, and community of the individual. In Australia, Suicide is a national concern as there is 3046 registered suicide in the year 2018. The majority of death cases by Suicide were among the people within the age bracket of 15 years to 44 years of age from 2016 to 2018. In Australia, that data related to Suicide is managed and collected by the Australian Bureau of Statistics, responsible for collecting, monitoring, and recording all the occurrences associated with the cause of death, including suicides and reviewing after every 12 and 24 months of the initial recording. This essay describes the context of Suicide concerning specific risk populations within Australia. Various statistical aspect of Suicide is discussed under the headings of risk factors and protective factors. Mental health promotion programs and suicide prevention programs currently in Australia or also explained in the essay. The essay also emphasizes the role of nurses in suicide prevention and the promotion of mental health.

CURRENT DATA RELATED TO SUICIDE IN AUSTRALIA

Suppose death within Australia is seen through the statistical event. In that case, they may appear to have rare significance as the standardized rate of death due to Suicide is 12 deaths per one lakh of population in 2018 ("Causes of Death - Australian Bureau of Statistics", 2019). However, due to its long-lasting impact on society and the community, Suicide has become a national consideration. Suicide was one of the leading causes of premature death from injury in 2015, where approximately 6% of the Australian fatality burden was from Suicide. In Australia, there has been a 13% increase in the rate of Suicide compared to 2015-2018. The rate of Suicide in men was increased to 18% from 2015 to the year 2018. There are certain risk factors associated with the suicidal tendency within the population distribution in Australia ("Suicide and hospitalised self-harm in Australia: trends and analysis, Table of contents - Australian Institute of Health and Welfare", 2014).

RISK GROUPS

Through the Australian population's statistical analysis, few at-risk groups in Australia are inevitably more predisposed to commit Suicide. Identifying these population groups helps in better targeted interventional programs, further orienting the at-risk population.

INDIGENOUS POPULATION

Between 2000 to the year 2010, there have been 998 deaths by Suicide through suicides in Australia. Although the rate of Suicide has decreased in the country, the concern has been raised due to the contrast comparison of the difference between the suicide rate of the indigenous and non-indigenous population. The rate of Suicide is twice in contrast. In the age group below 15 years, the rate of Suicide among the younger individuals was recorded seven times higher in indigenous people than their non-indigenous counterparts in Australia. Whereas on the other hand, in the age group from 15 years to 24 years, the Suicide rate was recorded four times higher (AIHW, 2019).

Some significant risk factors expose the indigenous population to disadvantages predisposing the individual towards suicidal tendencies. The indigenous population has different languages, political autonomy, and cultures, which place them towards multiple social weaknesses, further affecting their employment and health outcomes.  As a result of the colonization, they face social discrimination and racism (Pollock, Naicker, Loro, Mulay & Colman, 2018). A higher prevalence of health disparity is also a risk factor for suicidal tendencies. Trauma as a result of abuse, long-standing racism, and institutionalization causes health issues prevalent among indigenous.

On the other hand, certain protective factors for the indigenous population include the attachment and bonding of the family with the individual. As a result of being a close-knitted community indigenous population, youth enjoy connectedness to friends, family, community, and social institutions. These protective factors are necessary to create a sense of well-being within the individual having suicidal tendencies. Certain cultural beliefs and religious practices among the indigenous population that discourages Suicide is an apt example of a protective factor.

AGE-WISE DISTRIBUTION

A higher prevalence of suicidal rates in the younger population is a concern in Australia and globally. Almost 1 lakh youths die every year due to Suicide ("World Health Organisation- Preventing suicide: A global imperative", 2014. In the age group 15 years to 19 years the Suicide is one of the top five reasons for mortality worldwide. In Australia, from the age group of 15-19-year Suicide is the most significant cause of death, whereas in the age group of 22 years to 24 years, the end related to Suicide is the second largest cause of premature death. 

In the elderly population, the higher rate of Suicide is associated with the web of risk factors, including chronic illnesses, mental disorders like depression, functional impairment, and physical limitations. Several stressful events like the death of loved ones also predispose elderly people towards Suicide ("Suicide and intentional self-harm - Australian Institute of Health and Welfare", 2020). 

The increased rate of Suicide among the youth generation is it concerned because chronic diseases affecting the physical and mental balance of the human being begin only 45 years of age, indicating the presence of multiple risk factors that need to be addressed. These risk factors include alcohol and drug abuse, sexual abuse, exposure to bullying in school, losing a close friend, and child abuse. The youth population's protective factors are academic achievements, sense of extra circular achievements like being in the science team or captain of the sports team: school safety, and cultural indulgence in school activities.

MENTAL ILLNESS

suicide and mental illness have a long-term effect on causing relationships that have been established in multiple studies. In 50% of cases of attempt to suicide cases, there was a presence of mental illness in history. In contrast, a significant rate of 83% of suicide cases had a positive history of mental illness. Some mental disorders like bipolar, depression, schizophrenia, and anxiety are presented with positive suicidal behavior. There are risk factors, including the feeling of non-productive ways, discrimination from others, hopelessness from within, increase vulnerabilities, and sensitivities. Among the mental illnesses, protective factors can be achieved through coping skills and spirituality. Religious customs restricting Suicide acts as a prominent protective factor and develops a positive attitude and finding the right reason for living (Breton et al., 2015).

SEX DISTRIBUTION

Worldwide as well as in Australia- Suicide is the leading cause of premature death among males. In the recent statistics released by the Australian Bureau of statistics that three-quarters of death among men are due to Suicide ("Suicide and intentional self-harm - Australian Institute of Health and Welfare", 2020). Suicide is the second largest cause of premature death among men all across the globe, whereas, in Australia, it is the highest reason for early death.

 In the year 2019, there have been 33% of total suicides among men. Compared to the male and female ratio, the number of suicide rates is much higher in males than to their female counterparts. The age-standardised suicide rate has been as high as three times in males as compared to the females in the year 2018. In men risk factors are like traditional role and pressure of earning, unemployment, economical failures, financial burden and poverty whereas self-confidence, connectedness to the family, and developing a purpose and sense of life along with creating happiness or some of the protective factors (Tureck et al., 2016).

MENTAL HEALTH PROMOTION PROGRAM FOR SUICIDE PREVENTION

ALIVE AND KICKING GOALS

The program was first started in Western Australia Kimberly due to its highest rate of indigenous youth suicide among the population. The Alive and Kicking Goal is a community-led program which provides mental health promotion and suicide prevention through one-on-one mentoring and counselling. The program is specially designed for preventing suicides among the indigenous youths through peer education. The program acknowledges the interest as well as individual goals. The program work under the Main Outreach Services with the help of psychosocial counselling and peer education. The program comes under the framework of suicide awareness and prevention. 

The program focuses on enhancing the factors like self-confidence, self-esteem and competencies development which act as the protective factors against Suicide. The program is the strength-based project where the individual is motivated through peer programs ("Alive and Kicking Goals! Suicide Prevention Project - Programs - Promote and practice - Australian Indigenous HealthInfoNet", 2020). All activities led through the programmes are meanwhile encouraged to develop positivity and constructive behaviour within the indigenous youth who are fighting with the stigma associated with the community. The program also works on the amount of the disclosure of depression and suicidal tendencies. Being a community-driven, community-based and community development program the Alive and Kicking Goals has achieved several positive landmarks in the past. With an increasing number of suicides among the indigenous population in Western Australia this programme was developed for creating an understanding of risk and protective factors for the indigenous youth population from the contributing viewpoint towards Suicide. In the respective program, the participant indulges in developing the coping strategy and help-seeking behaviour from their peers within the community ("Alive and Kicking Goals! Suicide Prevention Project - Programs - Promote and practice - Australian Indigenous HealthInfoNet", 2020).

The objective of the programme is basically to decrease the youth suicide in the indigenous population through workshops, psychosocial indulgence and peer-led engagement of the youth. The programme aims to enhance the protective factors for Suicide whereas addressing the risk factors among the youth population. The program also targets to provide a safe efficient environment to the individual having suicidal tendency. Various questionnaire and survey studies have shown a positive impact of program where thorough evaluation process found effectiveness at the community as well as population level. The evaluation and monitoring are done in terms of success in implementation and appropriateness to the community within a given specific geographical area. In a survey conducted from the year 2010 to the year 2012 program was found successful in decreasing the suicidal tendency among the indigenous youth through their peer lead indulgence and motivation Tighe & McKay, 2012). 

HEADSPACE

It is an acute mental health programme run with the collaboration of school society and the Australian government. A headspace is an evidence-based approach which supports secondary schools in Australia affected by the higher rate of suicides. The school support programme is initiated and funded by the Department of health and ageing, Government of Australia. The headspace program is committed to work as a part of collaborated effort between the school system and Department of health and ageing to reduce the suicide rate among the school students. Not only the risk factors headspace program also addresses the negative impact of Suicide on communities and families of the individuals (Rickwood, et al., 2014). 

Headspace program is based on the suggestions that school plays a vital role in implementing several crucial steps necessary for preventing suicides within the youth population. Headspace program also addresses the grief and trauma created by the Suicide around the school community. It also aims at reducing the recovery period and the chances of further suicides within the school premises. The headspace program works in the collaboration with the Department of health, government, youth agencies, health agencies and educational systems. The interdisciplinary coordination facilitates the coordinated approach within the school system affected by the Suicide. Headspace school support system works along with the existing management protocols for ensuring the best for the possible outcomes.

Headspace program is based on international and local studies indicating population-based preventive approaches and programmes to build resilience among the adult population which found to be more effective in monitoring system rather than simply focusing on interventional-based approaches (Rickwood, et al., 2014).

NURSE ROLE AND RESPONSIBILITY

Whether it's in implementation or assessment of the mental health promotion and suicide prevention program nurses play a crucial role. The role of the nurses can be placed both as the individual interventional level as well as policy level. At the systematic policy level, the nurses are responsible for maintaining and monitoring the safe environment, development of protocols, a framework for policies and ensuring ethical practises. The leadership among nurses are also responsible for conducting training for implementation of the program within the risk groups.   On the other hand, at the individual level monitoring the risk and protective factor present in the individual case along with providing specific interventions and supervising at-risk population. After the implementation of the mental health programme nurses also plays vital role in the evaluation and the assessment of the outcome of the intervention in respect to achievements as per the desired goals (Davidson, Accardi, Sanchez, Zisook & Hoffman, 2020).

As a nurse is capable of the hand on approach while dealing with the patient, it allows easy monitoring of suicidal behaviours and their potential signs. Being the first point of healthcare contact nurses also plays a vital role in the assessment of these complex sets of suicidal behaviours probably indicating a future tendency of uneventful action (Betz et al., 2018. Meanwhile, nurses are also capable of differentiating pathological mental illnesses their sign and symptoms with risk behaviours of Suicide. Nurses placed at primary health care and home setting also plays a vital role in identifying the social determinants, risk factors and protective factors in the Suicide and whole environmental processes that predisposes the individual towards the tendency. Nurses are responsible for keeping watch on the various factors for identifying the tendency hence providing the required intervention right at the time (Valente S. (2011).

CONCLUSION

Suicide not only impact at the level of the family, society and the community but several indicators for the population also. Suicide is a complex condition which might have multiple factors in the background. In developed countries like Australia suicide is one of the biggest concerns of Premature death. Appropriate introduction of prevention and mental health promotion programs can create a safe efficient environment for communication and indulgence of the individual with suicidal tendency. Recognition of present protective factors and risk factors in the individual are essential in addressing the core issues associated with the Suicide. Being the first point of contact with these at-risk population nurses should identify their role and responsibility along with the policy framework to enhance the efficacy of these mental health programmes. Knowledge of the skill sets required for assessing and monitoring the suicidal health behaviours among nurses help them design the desired care plans for these suicidal tendencies.