#JamesDonaldson on #MentalHealth – Recruiting More #MentalHealthWorkers Won’t Stop #Suicides. Preventing #ChildAbuse And Neglect Will

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Two major reports on #mentalhealth and #suicide released this week suggest two very different solutions to preventing suicides.

One, from the House of Representatives Select Committee on #MentalHealth and #SuicidePrevention, recommends putting more resources into the #mentalhealth workforce. This includes recruiting and training more #healthprofessionals.

This might sound commendable, but I argue the evidence shows this is unlikely to work.

The other report, from the Australian Institute of Health and Welfare (AIHW) released today, provides the latest data on #suicide and self-harm. This report makes no recommendations about preventing #suicide. However, it identifies #childabuse and neglect as a major modifiable risk factor for #suicide right across the lifespan.

This approach to preventing #suicide, involving removing the underlying causes, has more evidence to back it. Yet this was barely mentioned in the select committee report.

Read more: We asked 9,000 Australians about their #mentalhealth needs post-#COVID — this is what they want

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

More health workers unlikely to reduce #suicide

In my own submission to the select committee report, I argued increasing treatment resources is unlikely to reduce rates of #suicide.

Over the past 15 years or so, Australia has substantially increased spending on #mentalhealthservices and expanded the #mentalhealth workforce considerably.

However, the #suicide rate has been trending upward over this period. The AIHW report noted that between 2003 and 2019, the loss of life due to #suicide increased by 13%.

It could be argued #suicide would have risen even more over this period without the increase in services or the increase in services has not been sufficient to meet demand.

However, an examination of long-term #suicide trends in Australia over three decades show no evidence various implemented service innovations and #mentalhealth policies have had any impact.

Doctor or nurse putting hand on patient's shoulder
More #mentalhealth #doctors and #nurses won’t necessarily fix the problem. Shutterstock

While it might be expected treating #mentalhealthproblems with talk therapy or medication would reduce #suicide deaths, there is very little evidence from randomised trials to support a reduction in #suicide as a result of treatment.

A major limitation of any attempt to reduce #suicide is that suicidal feelings often arise relatively quickly in response to overwhelming events. These include relationship breakdown, loss of a job, financial crisis or trouble with the law.

Suicidal actions can also be impulsive. This may be particularly the case for #males and is more likely when the person has been using #alcohol. In such circumstances, if a #mentalhealthprofessional was present, they may be able to support the person and prevent a #suicide.

However, in practice, it is unlikely a professional will be present when a crisis occurs. This is why it is important everyone in the community has basic #suicide prevention skills, as they may be in the best position to provide support on the spot.

Read more: How to ask someone you’re worried about if they’re thinking of #suicide

Could preventing #childabuse and neglect work?

The AIHW estimates #child abuse and neglect account for around a third of the burden of #suicide and self-harm in #females and around a quarter in #males. “Burden” refers to the combined effects of #suicide and self-harm on years of life lost and disability.

However, this is only a theoretical calculation based on what would occur if #childabuse and neglect could be eliminated. The AIHW report does not suggest how Australia could go about reducing, let alone eliminating, this risk factor.

Read more: Complex trauma: how abuse and neglect can have life-long effects

Reducing #childabuse and neglect sounds like a difficult task and any benefits for #suicideprevention would take decades to see.

However, there is evidence it is possible to reduce this and other #childhoodadversities that increase risk for #suicide.

The Centre for Research Excellence in #ChildhoodAdversity and #MentalHealth, with which I am affiliated, has reviewed the international evidence.

We found high-quality evidence for a number of interventions to reduce these adversities or lessen their impact on #children.

Therapist holding up emojis to toddler
We should be aiming for more early intervention in at-risk #children. Shutterstock

To find out which interventions would best suit Australia’s needs, we convened a panel of experts and sought their consensus on national priorities.

The experts’ recommendations included:

  • training programs to improve the quality of parenting
  • home visiting programs where a #nurse visits at-risk families with young #children
  • #school programs to prevent bullying
  • psychological therapies for #children exposed to trauma.

These programs can work in various ways to protect #children. These include improving the capacity of #parents to care for themselves and their #children, reducing adverse events such as bullying, and reducing the impact of adversities once they have occurred.

Read more: Treating a child’s #mentalillness sometimes means getting the whole family involved

Where to next for #suicideprevention?

On the surface, training more #mentalhealthprofessionals and providing more services seems a plausible approach to preventing #suicide that is relatively easy to implement. However, the evidence does not support this actually works.

There is no one approach of achieving a lasting reduction in #suicide in Australia. The causes of #suicide are complex and require a multi-pronged solution.

However, reducing #childhoodadversities is part of the solution that has been neglected. Australia needs to give it greater priority.

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