What+progress+has+been+made+in+youth+suicide+prevention+and+what+needs+to+be+the+focus+in+the+future?


 * Name: ** Meagan Lay
 * Student Number: ** 06333222
 * Tutor: ** Michelle Newcomb


 * __ Topic: __**

** Mental Health: ** What has been done in the prevention of suicide and self-harm amongst Australia's youth, and what needs to be done in the future?


 * __ Artefact: __**



Image link: http://fineartamerica.com/featured/teen-depression-gail-allen.html

This piece of artwork is a painting done by Gail Allen titled “Teen Depression”. It was created as an entry for The Artist’s Challenge (http://www.theartistchallenge.com) under the theme of “A Belief that Possesses the Mind”. The artwork depicts a girl’s face with enlarged eyes (a child’s innocent eyes), overlapped with a teenage girl trapped behind bars having lost the sparkle and glow of a child (Easel Tides: Gail M. Allen’s Painting Journal, 2010).


 * __ Public Health Issue: __**

There were over 2000 deaths from intentional self-harm registered in 2009, ranking suicide as the 14th leading cause of all deaths in Australia (Australian Bureau of Statistics, 2009). Among youths aged 15-24 years, however, suicide as a cause of death is second only to transport accidents (Australian Bureau of Statistics, 2008). Other acts of intentional self-harm including cutting, poisoning and attempted suicide are also prevalent is this age group, with over 8000 hospitalisations in 2005-06 (Australian Bureau of Statistics, 2008). The suicides of teenagers and young adults are particularly tragic due to the huge loss of potential life years, and the immense grief it causes for surviving family and friends. This essay will examine the types of youth suicide prevention activities that have been implemented in the past, and analyse their effectiveness using an evidenced based approach. Based on this analysis, it will then be discussed what future public health action needs to focus on, in order to successful combat this largely preventable problem facing Australian youth.


 * __ Literature Review: __**

In Australia, youth suicide rates peaked in 1997, with the rate of 31.0 per 100,000 for males and 7.2 per 100,000 for females between the ages of 15 and 24 years (Australian Bureau of Statistics, 2008). Although suicide rates have decreased significantly since then, (14.3 per 100,000 for males and 4.2 per 100,000 for females between the ages of 15 and 24 years), it still accounts for 20 percent of deaths in this age group making it the second main cause of death after traffic accidents (Australian Bureau of Statistics, 2008). In comparison, suicide only accounts for 1 percent of deaths among people aged 25 years and over (Australian Bureau of Statistics, 2008). Research also shows that between 7 percent and 14 percent of adolescents will engage in self-harm (Hawton & James, 2005), and while self-harm may not involve suicidal intent, people who engage in self-harm behaviours are at an increased risk of suicide in the future (Hawton, Harriss, & Zahl, 2006; Hawton & James, 2005; Zahl & Hawton, 2004).

The incidence of suicide changes across varying demographic groups. Statistics based on gender show, that although males are four times more likely to die by suicide (Australian Bureau of Statistics, 2008), females are over twice as much more likely to engage in self-harm (Australian Bureau of Statistics, 2008). Suicide rates are also higher among Indigenous youth (Hunter & Milroy, 2006; Pridmore & Fujiyama, 2009), youth residing in rural and remote areas and youth who identify as gay, lesbian, bisexual, transgender or intersex (De Leo et al., 2009 ; Eisenberg & Resnick, 2006; Page, Morrell, Taylor, Dudley, & Carter, 2007).

The development of youth-focused suicide prevention activities became prominent with the establishment of the of the Federal Government’s National Youth Suicide Prevention Strategy (NYSPS) in 1995 (Australian Institute of Family Studies, 2000). Since then, there have been many different types of prevention activities set up both on a population and individual level. As young people spend a significant proportion of their time at some form of educational institution, this has been an effective setting for mental health initiatives (Askell-Williams et al., 2005; Slee PT et al., 2009). Research has shown that school-based education programs produce outcomes of improved knowledge and awareness of mental health issues (Aseltine & DeMartino, 2004; Thompson, Eggert, & Herting, 2000), however it is unclear if these programs reduce risk factors of suicide or actual suicide rates (Sawyer et al. 2010). Certain programs have also focused specifically on anti-bullying education. These programs have been shown to reduce bullying behaviours, which are risk factors for suicidal thoughts, depression and anxiety (Rigby & Slee, 2008). In the past some school-based program had included sections relating directly to suicide awareness and prevention; however this is controversial as there is research to suggest that do so may normalise suicidal behaviour and inadvertently increase suicide risk among certain individuals (Bridge, Goldstein, & Brent, 2006).

Another area in which suicide prevention activities have been focused on is the media. Australian youth today are surrounded by countless forms of media including television, magazines, internet, films and social networking sites. Research has shown that the way suicide events and mental illness is portrayed in the media can significantly alter the impact it has on the people exposed to it (Pirkis, 2010). The inappropriate coverage of suicide may sensationalise and glorify the issue, possibly encouraging a more tolerant stance of suicide as a way of coping with stress or crisis (Niederkrotenthaler et al., 2009). An example is the increasing number of pro-suicide websites which explain various methods of suicide and encourage young people to partake in the behaviour. However, shutting down these sites is particularly difficult due to the “freedom of expression” nature of internet media (Mishara & Weisstub, 2007). In the face of technological advances, various aspects of internet media have become seen as an innovative and effective way through which to engage and support the youth of today. Despite this nonetheless, there is now also a need to better manage what may be dangerous information, and ensure those at high risk of suicide behaviours can access accurate and helpful information (Harris, McLean, & Sheffield, 2009).

Youth suicide prevention activities have also been developed to work on a more individual level. “Gatekeeper” training is an example of a program which does this. It refers to education and training programs which help people who have regular contact with potentially suicidal individuals or groups (e.g. general practitioners, teachers, emergency services, nurses and social workers), to recognise the risk factors and warning signs, as well as appropriate ways to respond. There has been some evidence to suggest that these programs can have positive outcomes with reductions in suicide rates following implementation (Knox, Litts, Talcott, Feig, & Caine, 2003), however there is also evidence showing that the increased awareness may be mostly temporary, with limited long-term behaviour change (Knox et al., 2003; Stuart, Waalen, & Haelstromm, 2003). In spite of this, these programs still have an important role, as they build the confidence of front-line workers involved in treating suicide incidents or suicide risk factors (Isaac et al., 2009; Knox et al., 2003). Other activities focusing on at risk individuals include mentoring and peer support programs. These have been shown to effectively improve self-esteem, connectedness, personal relationships, communication skills and conflict management (Boras & Zuckerman, 2008; Karcher, 2008).


 * __ Cultural and Social Analysis: __**

The Australian Federal Government’s National Youth Suicide Prevention Strategy (NYSPS) developed in 1995, was one of the first strategies implemented to meet the call from the World Health Organisation (1990) for member states to develop national strategies targeting suicide and other severe dysfunctional conditions (Australian Institute of Family Studies, 2000). The NYSPS’s main objectives were to reduce the incidence and prevalence of suicidal ideation and behaviours (including self-harm), decrease the suicide rates for young Australians and increase protective factors (such as resilience and social connectedness) for young people (Australian Institute of Family Studies, 2000). An evaluation conducted in 2000, showed that many of the programs and activities initiated through the NYSPS, have achieved positive outcomes in reducing risk factors for suicide behaviours and increasing the protective factors amongst Australian youth (Australian Institute of Family Studies, 2000).

In 2000, the NYSPS was expanded to the Living is for Everyone Framework (LIFE), and it now addresses suicide prevention across the entire lifespan (Department of Health and Ageing, 2008). In the decade following the high incidence suicide rate among Australian youth in 1997, suicide rate in this age group have decreased significantly Australian Bureau of Statistics, 2008), and therefore young people were no longer identified as priority high risk group for action. However, with the growing acknowledgment of mental health illness as a major cause of disability and mortality (World Health Organisation, 2011), it may be time to review the state of youth suicide risk and prevention. This is supported but evidence that suicide and self-harm are often associated with other mental health conditions including depression, anxiety personality disorders (Hawton & James, 2005).

There has been inquiry into the accuracy of suicide-related statistics in recent times, and experts have suggested that suicide rates may actually be between 11% and 16% higher than what has been officially reported (De Leo et al., 2010). This may be due to requests from family in an effort to avoid stigma or discrimination in the event of a suicide incident (De Leo et al., 2010). There has also been evidence demonstrating that although the suicide rates have decreased, the number of hospitalisations for intentional self-harm has increased by more than 40 percent, particularly among young women (Eldridge, 2008). Also, young people of both genders make up approximately a third of total self-harm hospitalisations (Eldridge, 2008). This statistic however, may also underestimate the actual number of self-harm incidents, as many injuries that are not life-threatening may not even receive medical treatment (Hawton & James, 2005).

These statistics demonstrate that there is a possible need to readdress youth suicide prevention. As previously mentioned, youth suicide is second only to road traffic accidents, as a cause of death among Australian youth (Australian Bureau of Statistics, 2008). In order to effectively address the prevention of youth suicide, initiatives need to address the unique needs of young people and the factors that play a role in their wellbeing. There is strong evidence demonstrating that those who have previously attempted suicide have a much higher risk of committing suicide in the future (Hawton & James, 2005). This means making youth suicide prevention a priority of public health promotion, may also help in preventing suicide incidents in older age groups.


 * __ Artefact Analysis & Learning Reflections: __**

This artefact effectively portrays the feelings of youth depression. The markings appear like tears and form bars over the image of the young girl. I think this is an accurate representation of what a young person is experiencing, when they feel the need to turn to self-harm and suicide. The artefact clearly demonstrates the feelings of overwhelming sadness, and the feeling of being trapped in a situation, with no way out. These are the feelings which are commonly associated with suicide attempts. I think this artefact is a good representation of the case of suicide prevention among youth, as although the girl behind the bars appears trapped, the overlapping face has large child-like eyes which seem to portray a glimmer of hope. It appears as if the face is imploring for someone to help and show them how to make things better. I think it also sends the message that children may be growing up to fast in today’s society of technology and information overload, and mental health issues such as youth depression, self-harm and suicide are the consequences.

Through analysis of the available research on the history of youth suicide prevention, I have found that it is an topic which needs to be re-examined, and new initiatives need to be developed to better meet the unique needs of today’s youth. Society has change a lot since the last peak of youth suicide rates in 1997 (Australian Bureau of Statistics, 2008), and there are new issues affecting the mental health of Australia’s youth. The issues of increasing self-harm among youth, and the possible under-reporting of suicide and self-harm rates, should both be examined and appropriately addressed. This assessment piece has shown me how public health issues which may have been successfully addressed in the past may become an area of need again in the future, even if the circumstances influencing the issue are different. It has affected my thinking process by reminding me to keep an open mind as there can be many factors influencing a public health issue. It has also reminded me of the importance of mental health and the important role it plays in the overall health and wellbeing of a person.


 * __ Links: __**

ASIST (Applied Suicide Intervention Skills Training) LivingWorks []

Mindframe - A resource on the portrayal of suicide and mental illness []

MindMatters – Leading mental health and wellbeing []

QSPACE []

ReachOut.com [|http://www.reachout.com.au]


 * __ Reflection Task: __**

=Depression and mental health= I found this particularly interesting as i also did the topic of youth mental health. Mine was on the topic of youth suicide prevention which is strongly linked with depression. I also thought it was an interesting artefact choice which is a very good portrayal of overwhelming depression. It is so sad that children and teenagers are suffering like this and that it increases their risk of having continued mental health issues in the future as adults. Really great literature review as well. Good job! ||
 * Wiki: 'Children Waiting For The Day They Feel Good' - The Salience of Depression in Adolescence and Young Adulthood**
 * [[image:http://c1.wikicdn.com/i/user_none_lg.jpg width="48" height="48" caption="meagan.lay" link="http://www.wikispaces.com/user/view/meagan.lay"]] || [|meagan.lay]
 * [[image:http://c1.wikicdn.com/i/user_none_lg.jpg width="48" height="48" caption="meagan.lay" link="http://www.wikispaces.com/user/view/meagan.lay"]] || [|meagan.lay]

=Interesting topic and artefact= I think your artefact shows a very interesting take on the impact of technology on Gen Y. It seems that at all hours of the day everyone is constantly connected to the internet by either laptops or smart phones or ipads! I think your're right in that not all the consequences are positive ones. The increased inactivity due to technology use has become a significant problem, and i think the effects are even more noticeable in Gen Z who have spent their entire lives with easily accessible internet. Really great work and art piece! ||
 * Wiki: Lost in Translation- Technological Takeover of Generation Y**
 * [[image:http://c1.wikicdn.com/i/user_none_lg.jpg width="48" height="48" caption="meagan.lay" link="http://www.wikispaces.com/user/view/meagan.lay"]] || [|meagan.lay]
 * [[image:http://c1.wikicdn.com/i/user_none_lg.jpg width="48" height="48" caption="meagan.lay" link="http://www.wikispaces.com/user/view/meagan.lay"]] || [|meagan.lay]


 * __Reference List: __**

Allen, G. (2010, August 28). Easel Tides: Gail M. Allen’s Painting Journal [Web log post]. Retrieved from []

Allen, G. (2010). Gail M. Allen Fine Art America. Retrieved from []

Askell-Williams, H., Lawson, M.J., Murray-Harvey, R., Slee, P. (2005). //An investigation of the implementation of a mindmatters teaching module in secondary school classrooms final report.// Adelaide: School of Education, Flinders University. Retrieved from []

Aseltine, R. H., Jr., & DeMartino, R. (2004). An outcome evaluation of the SOS Suicide Prevention Program. //American Journal of Public Health, 94//(3), 446-451. Retrieved from []

Australian Bureau of Statistics. (2008). //Australian Social Trends//. Retrieved from [|www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Chapter5002008]

Australian Bureau of Statistics. (2009). //Causes of Death, Australia//. Retrieved from []

Australian Institute of Family Studies. (2000). //Valuing young lives evaluation of the national youth suicide prevention strategy.// Retrieved from []

Boras, S., & Zuckerman, Z. I. (2008). Influence of the Monitored Youth Mentoring Program for adolescents with behavioural problems and behavioural disorders. //Coll Antropol, 32//(3), 793-806. Retrieved from []

Bridge, J. A., Goldstein, T. R., & Brent, D. A. (2006). Adolescent suicide and suicidal behavior. //Journal of Child Psychology and Psychiatry, 47//(3-4), 372-394. Retrieved from []

De Leo, D. (2009). Cross-cultural research widens suicide prevention horizons. //Crisis, 30//(2), 59-62. Retrieved from []

De Leo, D., Dudley, M. J., Aebersold, C. J., Mendoza, J. A., Barnes, M. A., Harrison, J. E., et al. (2010). Achieving standardised reporting of suicide in Australia: rationale and program for change. //Medical Journal of Australia, 192//(8), 452-456. Retrieved from []

Department of Health and Ageing. (2008). //Living Is For Everyone (LIFE) Framework//. Retrieved from []

Eisenberg, M. E., & Resnick, M. D. (2006). Suicidality among gay, lesbian and bisexual youth: the role of protective factors. //Journal of Adolescent Health, 39//(5), 662-668. Retrieved from []

Eldridge, D. (2008). //Injury among young Australians.// Retrieved from []

Farrelly, T., & Francis, K. (2009). Definitions of suicide and self-harm behavior in an Australian aboriginal community. //Suicide Life Threat Behav, 39//(2), 182-189.

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Harris, K. M., McLean, J. P., & Sheffield, J. (2009). Examining suicide-risk individuals who go online for suicide-related purposes. //Archives of Suicide Research, 13//(3), 264-276. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Hawton, K., Harriss, L., & Zahl, D. (2006). Deaths from all causes in a long-term follow-up study of 11,583 deliberate self-harm patients. //Psychological Medicine, 36//(3), 397-405. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Hawton, K., & James, A. (2005). Suicide and deliberate self harm in young people. //British Medical Journal, 330//(7496), 891-894. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Hunter, E., & Milroy, H. (2006). Aboriginal and Torres Strait Islander suicide in context. <span class="citationsource" style="font-family: 'Arial','sans-serif'; font-size: 16px;">//Archives of suicide research// <span style="font-family: 'Arial','sans-serif'; font-size: 16px;">//, 10//(2), 141-157. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Isaac, M., Elias, B., Katz, L. Y., Belik, S. L., Deane, F. P., Enns, M. W., et al. (2009). Gatekeeper training as a preventative intervention for suicide: a systematic review. //Canadian Journal of Psychiatry, 54//(4), 260-268. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Karcher, M. J. (2008). The study of mentoring in the learning environment (SMILE): a randomized evaluation of the effectiveness of school-based mentoring. //Prevention Science, 9//(2), 99-113. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Knox, K. L., Litts, D. A., Talcott, G. W., Feig, J. C., & Caine, E. D. (2003). Risk of suicide and related adverse outcomes after exposure to a suicide prevention programme in the US Air Force: cohort study. //Bmj, 327//(7428), 1376. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Mishara, B. L., & Weisstub, D. N. (2007). Ethical, legal, and practical issues in the control and regulation of suicide promotion and assistance over the Internet. //Suicide and Life Threatening Behavior, 37//(1), 58-65. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Niederkrotenthaler, T., Till, B., Kapusta, N. D., Voracek, M., Dervic, K., & Sonneck, G. (2009). Copycat effects after media reports on suicide: a population-based ecologic study. //Social Science and Medicine, 69//(7), 1085- 1090. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Page, A., Morrell, S., Taylor, R., Dudley, M., & Carter, G. (2007). Further increases in rural suicide in young Australian adults: secular trends, 1979-2003. //Soc Sci Med, 65//(3), 442-453. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Pirkis, J. (2010). //Suicide and the news and information media. A Critical Review//. Newcastle: Hunter Institute of Mental Health. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Pridmore, S., & Fujiyama, H. (2009). Suicide in the Northern Territory, 2001-2006. //Aust N Z J Psychiatry, 43//(12), 1126-1130. Retrieved from [|http://web.ebscohost.com.ezp01.library.qut.edu.au/ehost/detail?sid=e8da1f44-f6f2-4072-b3a3-91f98f2ffe38%40sessionmgr115&vid=1&hid=112&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=c8h&AN=2010503943]

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Rigby, K., & Slee, P. (2008). Interventions to reduce bullying. //International Journal of Adolescent Medicine and Health, 20//(2), 165-183. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Sawyer, M. G., Pfeiffer, S., Spence, S. H., Bond, L., Graetz, B., Kay, D., et al (2010). School-based prevention of depression: a randomised controlled study of the beyondblue schools research initiative. //Journal of Child Psychology and Psychiatry, 51//(2), 199-209. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Slee PT, L. M., Russell A, Askell-Williams H, Dix KL, Owens L, Skrzypiec G, Spears B. (2009). //Kidsmatter primary evaluation final report//. Adelaide: Centre for Analysis of Educational Futures, Flinders University of South Australia. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Stuart, C., Waalen, J. K., & Haelstromm, E. (2003). Many helping hearts: an evaluation of peer gatekeeper training in suicide risk assessment. //Death Studies, 27//(4), 321-333. Doi: 10.1080/07481180302906

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Thompson, E. A., Eggert, L. L., & Herting, J. R. (2000). Mediating effects of an indicated prevention program for reducing youth depression and suicide risk behaviors. //Suicide Life Threat Behaviour, 30//(3), 252-271. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">Zahl, D. L., & Hawton, K. (2004). Repetition of deliberate self-harm and subsequent suicide risk: long-term follow-up study of 11,583 patients. //British Journal of Psychiatry, 185//, 70-75. Retrieved from []

<span style="font-family: 'Arial','sans-serif'; font-size: 16px;">World Health Organisation. (2011). Mental Health. Retrieved from [] <span style="display: block; height: 1px; left: -40px; overflow: hidden; position: absolute; top: -25px; width: 1px;">