SUICIDE in RURAL & REMOTE AREAS of AUSTRALIA - Living is for ...

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Suicide in rural and remote areas of Australia 77 Community Connections Program Developed in 2007, the Community Connections Project, auspiced by The Older Men’s Network (TOMNET), addressed several suicide risk factors that impacted older men in rural areas, such as social isolation, mental illness, and reluctance to seek help. The main aim of the project was to develop and implement more effective and innovative suicide prevention strategies in the regional and remote locations surrounding Toowoomba in South-West Queensland (Macgowan et al, 2009). Importantly this program was framed within the perceptions and experiences of older men in this region (Ferrier at al, 2009). The program’s outcomes were externally evaluated with questionnaires and focus groups with different people including clients, volunteers, key stakeholders and rural men’s groups; client assessment data was also compared (Ferrier at al, 2009). The evaluation found that more than 50 at-risk older men had received individual outreach peer support and they had predominantly been highly satisfi ed with the volunteer peer support program. Men’s help-seeking behaviour improved and they felt better able to self-express; however, their feelings of isolation improved only slightly (Ferrier at al, 2009). This was supported by some direct evidence and much indirect evidence, such as increasing social inclusion, creating supportive environments for self expression and help seeking behaviour. The evaluation allowed the Community Connections Project to be improved and it remains an active program within the region. The Sustainable Farm Families (SFF) project Even if help is available, people in rural communities may not seek it due to their attitudes towards their physical and mental health (Welch, 2000). Consequently, the Sustainable Farm Families (SFF) project, which commenced in 2003, focused on changing farmers’ attitudes to health in regional and remote areas of Victoria (Brumbly et al, 2009). The SFF project particularly focused on occupational injuries, which may include a number of unrecognised or “hidden” suicides (Brumbly et al, 2009). Using an inter-sectoral collaboration, involving health services, universities, agricultural agencies, training organisations and farming communities, the project sample consisted of 321 families within broadacre- and dairy-farms. Health information and education was delivered to men and women from these families, aged 18-75 years, using a workshop format over three years. In year one, participants completed a structured two-day workshop; in years two and three, they completed a one-day workshop. The topics covered were linked to relevant health issues predominant in farming and rural populations but also included stress and stress management. The results from this project showed that health issues, such as high-risk alcohol consumption, mental health problems and sub-standard levels of occupational health and safety, were often underreported by family members. Following the workshops, participants began to put into practice their new knowledge about farm safety and family GriffithBook FINAL 20/09.indd 77 15/11/12 4:28 PM
78 Suicide in rural and remote areas of Australia connectedness. An evaluation of the SFF program showed that 30% of participants specifi cally acted to improve their health while 54% were concerned with improving their health in terms of farm safety (Brumbly et al, 2009). In addition, 24% focused on improving their health and wellbeing by taking holidays or spending more time with their family. During the course of the project, SFF was considered to have: empowered farmers’ knowledge and skills; collected physical assessment data; strengthened community action and planning; used inter-sectoral collaboration; provided an evidencebase to improve the health of farming families; and, increased knowledge–sharing between other health professionals. Additionally, it demonstrated the importance of engaging farmers with health professionals in relevant ways (Brumbly et al, 2009). While suicide was not evaluated as an outcome, the workshops may have indirectly contributed to suicide prevention by encouraging awareness about physical activity, stress, anxiety and depression. More specifi cally, they address the following LIFE Areas for Action: Action Area 2 - Building individual resilience and the capacity for self-help; Action Area 4 - Taking a coordinated approach to suicide prevention; and, Action Area 5 - Providing targeted suicide prevention activities (Living Is for Everyone Framework, 2007). The Shoalhaven Aboriginal Suicide Prevention Program (SASPP) The SASPP is one of the few evaluated programs that focused on suicide. The project used a pre-/ post-workshop evaluation (Capp et al, 2001) as well as a 2-year follow-up evaluation (Deane et al, 2006). Conducted in 1999 in a few Indigenous communities along the south-east coast of NSW, the SASPP primarily used community gate-keeper training. Eight free, one-day workshops were held which aimed to strengthen the capacity of the local Aboriginal community to identify individuals atrisk of suicide, mobilise local networks and, where necessary, facilitate help-seeking. The structure and content of the workshops was developed following community consultation; 11 discussion groups were helped which included 110 participants (97 of whom were Indigenous). The workshops also sought to identify factors associated with suicide in the local area, barriers to help-seeking, and how suicide prevention information could be disseminated within the Indigenous community. Fifty-seven people attended the workshops (84% of whom were Indigenous); 44 (92%) of the 48 Indigenous participants were included in the evaluation. While a signifi cant increase in the participants’ knowledge about suicide was indicated in the pre-/postevaluation results, there was no increase in the participants’ intention to help someone displaying suicidal behaviours (Capp et al, 2001). However, this may refl ect a sample bias, as the participants GriffithBook FINAL 20/09.indd 78 15/11/12 4:28 PM
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Australia’s rural localities face
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2 Suicide in rural and remote areas
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Introduction The burden of suicide
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10 Suicide in rural and remote area
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