Child Deaths: Suicide

1
Child Deaths Suicide Risk Taking

• 187 (23) children young people died from
  suicide risk taking between 1996 and 2000
• 72 were aged between 16-17 years
• 71 were males
• Indigenous deaths over represented
• 38.5 living in intact biological families at
  time of death

2
Characteristics of deaths

• Higher rates of deaths among children and young
  people characterised by
• - Leaving school early
• - Drug alcohol use at least once per week
• - Trouble with police
• - Prior suicidal behaviour (44-59)
• - Stressful life events

3
Characteristics of deaths

• Precipitants include
• Relationship breakdown/argument
• Alcohol intoxication (risk taking deaths)
• Methods include
• Hanging
• Drug overdose especially heroin overdose

4
Groupings of deaths

• Enduring difficulties (66.3, N 124)
• Mental health problems
• Family dysfunction
• School problems
• Diagnosed problems (32) intense distress (22)
• Pivotal life events (13.9, N 26)
• Interpersonal issues, illness, sexual assault
  etc.
• Adolescent experimentation (15, N 28)
• Substance use, dangerous driving

5
Prevention of suicide risk-taking deaths of
children young people

• Cooperation collaboration across a wide range
  of groups, communities, agencies and individuals
• Suicide prevention initiatives currently
  implemented across all levels of government
• - Living Is for Everybody (LIFE)
• - We can all make a difference NSW Suicide
  Prevention Strategy

6
NSW Suicide Prevention Strategy

• In 1998 NSW Health collaborated with 16
  Government Departments key community groups to
  develop the strategy.
• Important indicators included in the strategy
  have been progressed under five strategic
  directions.

7
Five Key Strategic Directions

• We can all make a difference
• - Increasing communities ability to prevent
  suicide
• Connect and care
• - Supporting groups at higher risk
• Suicide, an emergency
• - Enhancing the effectiveness of services in
  suicide prevention
• Care and support
• - Providing support for people affected by
  suicide
• We need to know more
• - Improving information on suicide prevention

8

• School-Link
• - Collaboration between education and health
• - Focus on depression and related disorders in
  adolescents
• - School-Link Training Program for school TAFE
  counsellors and mental health workers
• - Promotion, prevention and early intervention
  programs in schools
• - Pathways to care

9
Getting in Early

• Framework and a rationale for effective
  prevention and early intervention strategies for
  young people
• Focus on first onset psychosis and depression and
  related disorders
• Five broad strategies
• developing and coordinating comprehensive
  programs
• engaging young people and their families
• educating the community
• prevention programs
• monitoring quality and effectiveness

10

• Policy Development
• NSW Health Policy Circular 98/31
• Comprehensive Suicide Risk Assessment Guidelines
• Suicide Risk Assessment Guidelines for Young
  People
• Discharge and Follow-up Policy
• Postvention Guidelines
• Audit of reduction of Access to Means of suicide
  and deliberate self-harm in mental health
  in-patient units

11

• Education Training
• General Suicide Risk Assessment Management
  Training
• Introduction to Clinical Aspects of Suicide
  Prevention for Young People Training Manual
• Getting It Straight Working with People at Risk
  of Suicide
• Suicide Prevention for Older People Training
  Manual
• Bereavement Care Training Program for NSW Health

12

• Information for the general public
• Care Support Pack for Families and Friends
  Bereaved by Suicide
• Supporting Children After Suicide Information
  for parents and other care givers
• Family Help Kit
• Development of Healthy Kids A parents' guide
  (TMHC)
• Dumping Depression postcards booklets
• An Intergalactic Guide to Relationships

13

• Other Initiatives
• NSW Suicide Data Report We need to know more
• NSW Mental Health Sentinel Events Review
  Committee
• NSW Rural and Regional Youth Suicide Prevention
  Project
• NSW Elderly Suicide Prevention Network
• Collaboration with Lifeline
• Mental Health for Emergency Departments - A
  Reference Guide
• Management of people with a co-existing mental
  health substance use disorder

14

• Mental Health Outcomes and Assessment Training
  Program - Child and Adolescent component
  (MHOAT-CA)
• Child and Adolescent Mental Health Services
  Network (CAMHSNET)
• Child and Adolescent Psychological Telemedicine
  Outreach Service (CAPTOS)

15

• Children and young people with parent affected by
  mental illness
• NSW Parenting Program for Mental Health
• Integrated Perinatal and infant Care
• NSW Early Psychosis Program
• NSW Caring for Carers Mental Health Program
• Young Carers Project
• Living on the Edge project

16
Review of the NSW Suicide Prevention Strategy

• Review conducted over 12 month period
• Consultation, review and updating of content
• Whole of Government Suicide Prevention Forum
• - Mental Health Week 2003
• planning future strategic suicide prevention
  goals
• Audit of Area Health Services suicide prevention
  activities

17
NSW per capita spending on Child and Adolescent
Services
96-97 97-98 98-99
99-00 00-01 01-02
Provisional NSMHS (2001/02)
18
Prevention of suicide risk-taking deaths of
children young people

• We can all make a difference
• - Increasing communities ability to prevent
  suicide
• Family dysfunction
• Not seeking assistance for difficulties
• Inability to manage stressful situations
• Narrow male stereotypes
• Inaction of friends/family members when seeking
  help
• Stress associated with the HSC

19
Prevention of suicide risk-taking deaths of
children young people

• 2. Connect and care
• - Supporting groups at higher risk
• Peer relationship difficulties
• Learning behavioural problems
• Engaging in risk taking behaviours
• Predominantly male deaths
• Indigenous over representation
• Victims of abuse and neglect
• No record of contact with human service agencies

20
Prevention of suicide risk-taking deaths of
children young people

• 3. Suicide, an emergency
• - Enhancing the effectiveness of services in
  suicide prevention
• Underestimation of suicide risk by health
  professionals
• Discharge from EDs without sufficient
  observation, assessment or management plans in
  place
• Non-compliance with medication

21
Prevention of suicide risk-taking deaths of
children young people

• 4. Care and support
• - Providing support for people affected by
  suicide
• Friends family members affected by suicide
  death
• Media images portraying suicidal behaviour

22
Prevention of suicide risk-taking deaths of
children young people

• 5. We need to know more
• - Improving information on suicide prevention
• Suicide surveillance systems data sources
• 6. Other avenues for prevention
• Illegal access to quantities of methadone
  creating vulnerability to overdose