Wednesday, 28 March 2012

‘Prevention’ Approaches to Aboriginal Suicide

(a) The National Youth Suicide Prevention Strategy

There is both activity and innovation in suicide ‘prevention’ strategies inAustralia.5 The National Youth Suicide Prevention Strategy, allocated $31 million between 1995 and 1999—supplemented in the 1999 federal budget—has four goals: to prevent premature death by suicide; to reduce rates of injury and
self-harm; to reduce the incidence of suicidal ideation and behaviour; and to ‘enhance resilience, resourcefulness, respect and interconnectedness for young people, their families and communities’. The focus is on the public health model: even though it incorporates ‘sensitivity to social and cultural context’ by asserting that we need a ‘variety of interventions and the involvement of multiple service sectors and government departments’ is needed. A variety of professional training programs are under way. The Strategy embraces a ‘community development approach’, with two areas pinpointed for action: parenting skills programs and school-based ‘mental health promotion programs’. The Strategy prefers ‘mental health promotion’ to the term ‘primary prevention’.

The Strategy undertook a National Stock take of Youth Suicide Prevention Activities in 1997-98. Of 919 programs in the Stock take, only 75 were ‘identified as belonging to the community development and support approach’. Of those 75, eight (including my study), related to Aborigines and Torres Strait Islanders; one (presumably my study)emanated from a university. It is important to note that New South Wales has in place, in addition to its ‘We Can All Make a Difference: NSW Suicide Prevention Strategy’, the development of suicide prevention programs for Aborigines in 1999.

(b) A specific Aboriginal emphasis
National and state strategies have to embrace specific Aboriginal ‘wings’ in all that they do.

A Strategy Bulletin quotes a Department of Family and Health Services publication listing of risk factors for suicide: among mental health problems, drug and sexual abuse, homelessness and unemployment, appears one other category: ‘Aboriginality’! This may have been a shorthand, but it sits badly to have a national suicide body and a key government agency listing race as an inherent cause of its own self-harm.

What is meant by ‘community development strategies’ is too broad and ill-defined to apply to specific Aboriginal communities. The geography and demography of the Hunter-Reser study—one community which is physically separated from mainstream society and two island communities—cannot apply to the Aborigines in New South Wales. There needs to be a separate Aboriginal strategy, and within that framework, a series of appropriate and region-specific strategies.

What has always bedevilled Aboriginal administration is the search for universal policies and practices, failing always because of the desire to implement simple and uniform solutions to complex problems.

Here is an opportunity to avoid repeating past failures, and to take the region-by-region, community-by-community approach, which is the long and difficult way round.

Key Messages:
• Strategies for alleviation must have separate Aboriginal and non-Aboriginal ‘wings’.
• There are no universal strategies which apply to all Aborigines, even within one state: the only path is the difficult one, region by region, sometimes community by community.

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