Courageous Voices 26 June 2014Alexandra Culloden

conversationsmatter.com.au

Conversations Matter when discussing suicide in LGBTI communities

Why do Conversations Matter?

Suicide in LGBTI community• Most current statistics come from

studies conducted in the last decade• LGBTI people have significantly

poorer mental health and higher rates of suicide ideation than the general Australian population

• There is currently no population based research on LGBTI completed suicides in Australia

Suicide in LGBTI communityPrivate Lives I (2006):

– 49% of LGBTI men had experienced a major depressive episode– 45% of LGBTI women had experienced a major depressive episode– 16% of all respondents had suicidal ideation in the two weeks prior to the

survey Suicide Prevention Australia (2009):

– 28% LGBTI women have self harmed or attempted suicide compared to 8.3% of heterosexual women

– 20.8% of LGBTI men compared to 5.4% of heterosexual men have self harmedNicholas & Howard (1998)

– bisexual young people had a higher rate of self-harm than their exclusively gay and lesbian-identified peers

Discussing suicideOften there is confusion about what is meant by “discussing” or “talking” about suicide and confusion about the evidence• One-on-one conversations• Large group presentations• Media reporting about suicide deaths• Media reporting about the issue of suicide

Need to ensure that we are not ‘too afraid’ to talk about suicide but also that we understand the risks

What Conversations Matter when working with LGBTI communities?

conversationsmatter.com.au

“I think sometimes people feel shame around suicide,

both people who might have ideas of suicide and those

people who might be affected”

“I think if we were able to have more open conversations about it people might be more willing to ask for help earlier,

or do something about it”

Developing community guidelines for discussing suicide- Conversations MatterFunded by the NSW Ministry of Health under the NSW Suicide Prevention Strategy 2010-2015 Aim:

To develop resources (community guidelines) to guide safe and effective discussion of suicide

What needs to be covered?

• Why? - focus of discussion • Prevention, intervention or postvention

• How? –format of the discussion• One-on-one, small group, wide scale

• Where?- setting• Community, online, family, schools, workplaces

• Who? –target groups for discussions• People who identify as LGBTI, people living in rural and remote areas,

Aboriginal and Torres Strait Islander people, CALD communities, men, young people (under 25 years), older people (over 65 years), people with a mental illness, carers, people bereaved by suicide

Developing world first resources…where to begin?

ApproachLiterature Review• Review of research evidence• Review and analysis of existing

resources and approaches

Consultations• Service providers and key

informants across four settings• Consultations with community

Core PrinciplesThree review panels (experts, target groups, settings) reviewed a series of ‘principles’ to guide conversations focussed on: prevention, intervention and postvention

Online resources• Community resources for discussing suicide (tailored resources for Aboriginal communities)• Professional resources to support community discussion of suicide

LITERATURE REVIEW

ONLINE RESOURCES• New name and branding for the resources;• Community resources for discussing suicide;• Professional resources to support community discussion of suicide.

CONSULTATIONS

CORE PRINCIPLES Three review panels (experts, target groups, settings) review a series of ‘principles’ to guide prevention-focused, intervention focused, and postvention focused conversations.

• 120 local, national and international approaches were reviewed

• Only 4.2% were specifically targeting people who identify as LGBTI

• Partnered with ACON to hold focus group with 10 participants

• 29% of the 87 remaining focus group participants identified as LGBTI

LGBTI consultations• 10 participants attended session run in partnership with ACON• Key findings:

• All participants agreed that conversations about suicide were important• Conversations were viewed to be occurring more often with young people

than older groups• Stigma and shame were common barriers to having conversations• Campaigns such as ‘RUOK?’ were viewed as good starting points but concerns

were raised as to what happens when someone says “no”• Need for greater awareness and education about risk factors and warning

signs • Risk factors: isolation, lack of support (incl services), experiences of

discrimination, alcohol and other drugs, suicide bereavement

Launching Conversations Matter

Launched by the NSW Minister for Mental Health, the Hon. Kevin Humphries MP on the 14th November 2013

Community resourcesConversations Matter:• When holding group discussions about suicide• When someone is thinking about suicide• When communities are affected by suicide• To those bereaved by suicide• When telling a child about suicide

Each available as a fact sheet, audio podcast and online presentation

When holding group discussion about suicide

When someone is thinking about suicide

When communities are affected by suicide

To those bereaved by suicide

When telling a child about suicide

www.conversationsmatter.com.auwww.himh.org.au

Follow us on Twitter and Facebook @HInstMHalexandra.culloden@hnehealth.nsw.gov.au

02 4924 6900