Uncovering and Identifying the Missing Voices in Suicide Bereavement
The field of suicide postvention remains relatively immature in terms of the current knowledge base. This manuscript examines the existing knowledge regarding suicide bereavement and describes the limitations of the suicide bereavement knowledge base using a critical review of the literature specifically relating to suicide bereavement published in the previous 10 years. Six limitations are identified in the literature: concern about samples used in research, sampling only people who have been help-seeking, women being overrepresented in studies, additional design issues including limitations by research ethics boards, definitional problems in who is suicide bereaved, and determining the size of the population bereaved by suicides. This is followed by a discussion of the need to define the suicide bereaved population, as well as understand the effect of suicide bereavement. The paper closes with suggestions for future directions that are required in the field of suicide bereavement in order to best understand and help those people left behind in the wake of suicide deaths.
Women and suicide: beyond the gender paradox
Traditionally, suicide research has focused on male mortality, with little attention paid to the female experience of suicide. This means there has been a lack of research examining how female suicide rates and behaviours have changed over time and between countries. Through an exploration of the World Health Organisation Statistical Information System (WHOSIS) data, this paper aims to analyse changes in the trends of female suicide across the period 1950 to 2009 in 106 countries. Observed changes in female suicidal behaviours are discussed in the context of 12 geographical and cultural areas of the world: Africa, Anglo-Saxon countries, the Western Pacific, the Baltic States, Central and Eastern Europe, Eastern Mediterranean countries, Scandinavia, South America, South East Asia, Southern Europe and Western Europe. By seeking understanding as to how suicidal behaviours are gendered within specific cultures and societies and by unpacking the Gender Paradox using Cultural Scripts Theory, this paper explores some possible culturally relevant explanations for female suicide rates and behaviours worthy of future research attention. Analysing the data and its limitations, and acknowledging its place within social and cultural constructs, allows for better understanding of the fatal female suicidal behaviour.
Life, death and the experience of suicide and accidental death bereavement for Australia's rural farming families
Rural farming families constitute a heterogeneous slice of Australia's population, frequently existing in unique psychological, social and geographical contexts, and subject to numerous heightened mortality risks including suicide and accidental death. Despite efforts to measure and understand such deaths, there is a dearth of knowledge on how such incidents affect those remaining. This thesis aimed to understand how Australian farming families live and die and how they experience suicide and/or accidental death, the following questions were posed: (1) Who are Australia's farming families? How do they live? How do they die? (2) How do farming family members experience loss following suicide and accidental death? (3) How does the farming family context influence this bereavement?
A mixed-methods systematic review of suicide prevention interventions involving multisectoral collaborations
Background: Governments and third-sector organizations (TSOs) require support to reduce suicide mortality through funding of suicide prevention services and innovative research. One way is for researchers to engage individuals and services in multisectoral collaborations, to collaboratively design, develop and test suicide prevention services and programmes. However, despite widespread support, to date, it remains unclear as to the extent to which stakeholders are being included in the research process, or if they are, how these partnerships occur in practice. To address this gap, the authors conducted a systematic review with the aim of identifying evidence of multisectoral collaborations within the field of suicide prevention, the types of stakeholders involved and their level of involvement.
Methods: The authors conducted a strategic PRISMA-compliant search of five electronic databases to retrieve literature published between January 2008 and July 2021. Hand-searching of reference lists of key systematic reviews was also completed. Of the 7937 papers retrieved, 16 papers finally met the inclusion criteria. Because of data heterogeneity, no meta-analysis was performed; however, the methodological quality of the included studies was assessed.
Results: Only one paper included engagement of stakeholders across the research cycle (co-ideation, co-design, co-implementation and co-evaluation). Most stakeholders were represented by citizens or communities, with only a small number of TSOs involved in multisectoral collaborations. Stakeholder level of involvement focused on the co design or co-evaluation stage.
Conclusion: This review revealed a lack of evidence of multisectoral collaborations being established between researchers and stakeholders in the flied of suicide prevention research, even while such practice is being espoused in government policies and funding guidelines. Of the evidence that is available, there is a lack of quality studies documenting the collaborative research process. Also, results showed that the inclusion of co-researchers from communities or organizations is defined as co-creation, but further analysis revealed that collaboration was not consistent across the duration of projects. Researchers and practitioners should consider issues of power and equity in multisectoral collaborations and encourage increased engagement with TSOs, to rigorously research and evaluate suicide prevention services
Those who walk away
Last year marked the 40th anniversary of the film version of Joan Lindsay's book 'Picnic at Hanging Rock'. First published in 1967, the book is an Australian-based story set in 1900, in which four students and a teacher from a private girls' school go missing after climbing Hanging Rock. The narrative of the book plays with the danger of the Australian bush, at a time when it was still perceived to be wild and untamed, ready to consume those who did not understand its risks. However, Lindsay also played with its deep magic, which lingers still, where Aboriginal spiritualities and mysticism converge. The mystery of the women's disappearance is never solved, even as one of the girls is eventually found with no memory of the event. Indeed, the only hint of solution Lindsay has ever given is a final chapter, not published in the original novel, where the young women follow a snake into a hole in space. Even here though, no resolution occurs for those left behind. We do not know where the girls are or if they will ever be able to return, and if so, in what state. Here, the readers, and the community, are betwixt and between the details of the absence and the wonderings about the where and the why of the unresolved loss.
Informed consent in a vulnerable population group: supporting individuals aging with intellectual disability to participate in developing their own health and support programs
Objective: The aim of the present study was to explore the use of complementary consent methodologies to support a potentially vulnerable group of people, namely those aging with intellectual disability, to provide personal input. It was premised on the view that processes to determine capacity for consent, appropriately modified to account for individual capabilities and current circumstances, could facilitate meaningful participation in the development of personal health care plans of people previously excluded from contributing. Methods: The present descriptive case study research was undertaken in New South Wales, Australia. A seven-step process for determining capacity for consent was developed, and 10 participants aged between 54 and 73 years with lifelong intellectual disability and health comorbidities were involved. A variety of assistive communication tools was used to support individuals to demonstrate their capacity for giving informed consent. Results: After being provided with tailored support mechanisms, seven participants were considered to meet all seven components for determining capacity for consent. Three participants were deemed not to have capacity to give consent regardless of the type of support provided. Conclusions: Three critical factors for facilitating personal involvement in decision making for individuals with an intellectual disability were identified: (1) defining consent specifically for the target outcome; (2) outlining the criteria needed for consent to be obtained; and (3) using appropriately modified alternative communication mechanisms as necessary.
Sticks and stones: How words and language impact upon social inclusion
Language framed as derogatory names and symbols can have implications for people and their life experiences. Within a Saussurian-inspired frame, and looking at ideas of stigma and social inclusion, this paper examines the use of language as a weapon within a social context of (changing) intent and meaning. Three examples of language use in mainstream society are analysed: 'retarded' which evolved from scientific diagnosis to insult; 'gay' as a derogatory adjective within popular culture; and, the way language around suicide is used to both trivialise and stigmatise those who are suicidal, as well as those who are bereaved.
Suicide in Rural and Remote Areas of Australia
Australia's rural localities face an increasing burden of death due to suicide (Hirsch, 2006). Those groups most vulnerable to suicide appear to be males, youth, farmers and Indigenous people. Data from the Queensland Suicide Register showed that, between 2005 and 2007, male suicide rates in remote areas (36.32 per 100,000) were significantly higher than male suicide rates in non-remote areas (18.25 per 100,000). Further research has also shown that the relative rate of male suicide in rural Queensland was 1.99 compared to rates in metropolitan locations (Kõlves et al, 2009). While the gap is widest between metropolitan and remote suicide rates and the rates highest among rural males, regional suicide rates are still higher and metropolitan rates and the rural female suicide rate is higher than the urban female suicide rate. The present report aimed to present a holistic examination of suicide in regional and remote Australia. It predominantly focused on the Queensland experience and has investigated a wide range of psychological, environmental and cultural factors, within this bound geographical context.
Suicide prevention for men
The ways in which suicide prevention initiatives can target different stages of the suicidal process have been described by Mann et al. (2005). These authors argue that suicidal ideation may stem from stressful life events and/or psychiatric disorders. These factors can be influenced through education and awareness programs, screening of individuals at risk, and various treatments. However, it must be noted that while the impacts of environmental factors, such as stressful life events, can sometimes be reduced, the events themselves may be unavoidable. Aspects of suicide prevention can focus on building resilience as a way to combat the impacts of these inevitable events. Once suicidal ideation is present, it can be detected by screening individuals at risk. Before ideation leads to a suicidal act, it can be targeted through treating issues such as underlying disorders and impulsivity, hopelessness and/or pessimism. Other suicide prevention initiatives may also limit access to suicide means and exposure to negative or harmful examples in the media. Australia was the one of the first countries to reflect upon the national and global evidence which recognised the devastating consequences of suicidal behaviours (Jenkins and Kovess, 2002; Department of Health and Ageing, 2008). Since the early 1990s, the Department of Health and Ageing has led the national approach for suicide prevention. The National Youth Suicide Prevention Strategy 1995-1999 was further expanded into the National Suicide Prevention Strategy (NSPS); a strategic plan to prevent suicide across the whole lifespan. In 2000, the Living Is For Everyone: A Framework for Prevention of Suicide and Self-harm in Australia (LIFE Framework) was launched. This was later evaluated and further development led to the release of the Living is For Everyone (LIFE) Framework (2007).
Suicide in Indigenous Populations of Queensland
Indigenous populations have been recognised to have elevated rates of suicide in many countries around the world, including Australia. However, to date, comprehensive understanding of the complexities of suicides among persons of Aboriginal and/or Torres Strait Islander origin (in the report referred to as Indigenous populations or Indigenous Australians) has been limited due to scarce epidemiological evidence about its prevalence and specific factors that distinguish Indigenous suicides from those among non-Indigenous populations. This report aims to fill in this gap by providing an analysis of the incidence of suicide among the Indigenous population in Queensland, thereby increasing the understanding and awareness of the distinctive aspects of Indigenous suicide.