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

Suicide in rural and remote areas of Australia 81
Discussion
In this chapter, we conducted a literature review
of the suicide prevention initiatives for rural
communities in Australia. This included a search of
appropriate databases for any relevant publications,
as well as a search of relevant web-sites for suicide
prevention programs and services implemented in
rural areas. The main aim of the literature review was
to identify existing suicide prevention initiatives (i.e.,
programs, services, and initiatives). The identifi ed
initiatives were classifi ed into three groups:
1. Suicide prevention initiatives for rural population
in general
2. Suicide prevention initiatives for farmers
3. Suicide prevention initiatives for Indigenous
population
For all of these groups – the rural population as a
whole and the two sub-populations (farmers and
Indigenous population) – recommendations were
provided and discussed.
Overall, we found that:
• More activities are based in the provision of
recommendations than active interventions for
suicide prevention for rural populations;
• The majority of programs address the issue
of suicide prevention indirectly (e.g. via
strengthening community networks);
• Indirect suicide prevention approaches in
rural areas often address variables on a
collective level, such as community attitudes
towards help-seeking or farmers’ attitudes
towards health;
• There are very few programs where an
evaluation of outcomes is available. Further,
most evaluations were not conducted in
parallel with a ‘control group’, which makes
it diffi cult to account for other possible
environmental or individual factors that brought
about the noted changes.
• Due to these factors, it was diffi cult to assess
whether interventions in rural areas actually
made a difference in terms of a reduction
in suicide.
Aside from this, another important consideration
for the future of any suicide prevention program
is whether it can be naturally sustained within
a community after project completion. This is
especially vital in rural areas given their already
scarce resources. Indeed, sustainability can be
considered an indirect measure of a program’s
effectiveness; the more positive community changes
following the implementation of a program, the more
likely these changes will enhance resilience to and
reduce the risk of self-harm and suicidal behaviours
in that community. However, it must be noted that
sustainability and effectiveness are not necessarily
positively-related concepts. This means that ongoing
evaluation should remain a vital component of any
effective suicide prevention program in Australia
(LIFE, 2007). Additionally, it is equally important
to monitor any negative or harmful effects that may
occur as determining suicide prevention approaches
that may reduce suicide rates.
• Only few programs report about any results of
their activities; and,
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