Tuesday 20th November 2007
COMMUNITY DEVELOPMENT COMMITTEE INQUIRY INTO SUICIDE PREVENTION STRATEGIES
Mr FINCH (Rosevears - Motion) - Mr President, I move -
That the report of the Joint Standing Committee on Community Development on strategies for the prevention of suicide be considered and noted.
This is the most comprehensive and up-to-date investigation ever taken into the problem of suicide in Tasmania. The committee has worked hard on the subject for many months - years - considering 20 submissions and listening to 47 witnesses. I think that it is fair to say that we wrestled with a very complex and serious problem. Suicide in Tasmania ranks alongside road accidents as a major cause of death. Unfortunately there are no easy answers. While commendable work continues around the State to help reduce suicide, I mention here particularly the work by the Tasmanian Suicide Prevention Steering Committee, there is a need for greater focus and coordination. The report therefore calls for an invigoration and overhaul of current strategic efforts to prevent suicide in Tasmania.
Terms of reference for the inquiry were to examine the effectiveness of current national and local strategies in addressing the issue of suicide, in particular the role of governments, non-government organisations, communities, the media and businesses. We were to look at strategies for men and also data collection and research.
The report contains 21 conclusions from which the committee has derived its recommendations. Among the conclusions were the following: one, suicide prevention is a difficult task and no single approach exists, which makes defining effectiveness problematic; two, funding arrangements are overly complex and probably as a consequence no witness could provide the committee with an appropriate figure of total suicide prevention funding in Tasmania; three, non-government organisations providing suicide prevention services face some unnecessary impediments to their work; four, substantive data on suicide in Tasmania is difficult to find and there is some degree of reluctance to make certain information public. The amount of research and data collection on suicide is less than ideal.
I might point out at this stage that the Coroners Office has a very difficult time. If they release information they are accused of releasing too much information; if they do not, it is not enough. I suppose they are damned if they do and they are damned if they do not.
The committee's report makes a total of 16 recommendations. A theme strongly apparent in evidence presented to the committee was the complexity of suicide. While the committee acknowledges its report cannot possibly provide all the answers, the report nevertheless provides a valuable foundation from which new strategic directions can be built.
In summary the committee has recommended that the State Government urgently put in place a suicide prevention strategy for Tasmania; a framework of suicide prevention strategic performance indicators for Tasmania should be developed; the ad hoc distribution and allocation of funding for suicide prevention must be addressed; an independent non-government body should be established in Tasmania to oversee the progress of suicide prevention and to conduct research and data analysis; non-government organisations should be assisted to encourage and allow them to expand their suicide prevention services and activities; Tasmanian suicide research and data collection should be increased without overshadowing actual prevention activities; and further, some funding should be specifically allocated for this purpose.
This report did not find any easy answers to the problem of suicide in Tasmania because there are not any. However, the report does offer what I believe is a solid foundation on which to build a revitalised, well-coordinated and adequately funded suicide prevention strategy for Tasmania.
Mr WILKINSON (Nelson) - Mr President, I suppose the most alarming statement that I heard in relation to this whole report was a young child who had left one school and was in his first year in a new school. That young child was walking home one day after cleaning out his locker. Because he was new and there was already a peer group at the school he was bullied. The bullies continued to bully him on his way home after he had cleaned out his locker and his books all fell to the ground. One of the children in his class at the school - and in every class there is a person or a number of people who the rest of the class look up to - helped that boy collect his books and finished up walking home with him and later befriended him.
That does not seem, on the face of it, much at all. You might say that it happens in a lot of schoolyards or on the way home from time to time but that same student finished up, on leaving school, getting the prize for dux of the school. He referred to the incident in a speech that he made when given the dux prize. In the speech, he stated that that person who helped him had saved his life because he was going home and had intended to endeavour to commit suicide because of being bullied. He did not want his parents to have to go back to the school and unlock the locker and take all his belongings out after he attempted suicide.
It was that small thing that changed that person's life. I think that impressed upon me the fact that suicide is an issue not only amongst 24 to 45-year-old males who, when we came into the inquiry, we were told were the people who are really at risk. One of the experts in the area confirmed that and they are, but it is not only restricted to those people. It is the case for young children as well.
I think that also impressed upon us that there has to be an education program in the community not only for those who finish school and go to work to be able to see those with a suicide ideology and wish, but also there has to be education within the schools for people to understand that if there are children at risk there should be points of contact to have with certain members of the peer group and also certain teachers at school to assist those who are going through difficult times.
It did impress upon me the fact that it is not only an issue related to certain people, it is an issue related to a broad spectrum of the Tasmanian and Australian community and one which we should be educated on in an endeavour to do what we can to save those who wish to end it.
An interesting statistics as well is that in 2004-05, I think it was, or it might have 2005-06, 73 people committed suicide which was exactly the same as the number of road deaths. When one looks at the focus that the Tasmanian community has on road deaths, we should have the same focus on those at risk because the numbers are the same. Prior to the year that I mentioned, the number of people who committed suicide was over and above those that met their death on the roads.
It is an important issue, an issue I think which we should all be aware of and which we should also be doing all we can to say to the Government, this area needs some focus. It needs some focus with some certainty because when we spoke with the witnesses we heard that there were people who were doing terrific work out there in the community who were Australian experts in the field but were only getting piecemeal funding.
The funding was for 12 months, six months to do a program and these people therefore would carry out that work in the expert fashion that they were accustomed to, but then they had to take their eyes off the ball, to some degree, and think of the next funding round and what they would have to put in their funding application in order to get the money to be able to do the work. One of the people - and I will not mention his name - the honourable member for Rosevears had a great deal of conversation with and also probably was partly the reason for him getting the funding just recently to allow him to continue, but for a period of time he was unable to do the job that he was renowned for in Australia. Not only was he an expert within Tasmania but he would be going interstate to do the same work, especially with indigenous people interstate. Only recently has it been recognised and he is able again to roll his sleeves up and get into the work in which he is an expert.
Mr Finch - Through you, Mr President - that funding finishes in June. Did you mention that?
Mr WILKINSON - That is right.
Mr Finch - It finishes in June so then he is back on the treadmill.
Mr WILKINSON - Yes, he is on the merry-go-round once more. My belief is there should be some certainty of funding. That funding should be for a period of time, three years maybe or whatever the appropriate time is -
Ms Forrest - Do you think that has proven to be effective? If it's a new program that hadn't been identified as being effective or helpful you are going to stand perhaps for a shorter time frame but when it's a known project, surely five or 10 years is not unreasonable.
Mr WILKINSON - I agree with you and especially when you look at what happens if they go to the hospitals. We did get some evidence which I thought was again fairly alarming, evidence which spoke about what happens if you go to the hospital as a result of a suicide danger. I refer members of this Chamber to page 34 of the report where it is stated:
'Dr Ashley (Director of Psychological Medicine, Royal Hobart Hospital) said that sometimes the hospital could be overrun'.
And he noted:
'Often after hours there is nothing else available, so it all collapses at the Royal ? The questions I ask when I see patients include: are they psychotic or non-psychotic; do they have a medical condition; are they certifiable or not; can they give consent; are they treatable or is it just a matter of containment? The assumption for most of us is the worst-case scenario, requiring low risk and maximum impact.'
He then went on:
'Dr Ashley said there were times when "unwell" people were discharged before the weekends. He was asked if this was done to free up beds, and he replied, "Yes".'
There are issues out there. It is a new area and I know the honourable member for Rosevears and I were lucky enough to go to two SPA conferences - Suicide Prevent Association conferences. Again the expert there said that they were just putting their toes into the water, they were learning things. It was a new area of expertise as far as they were concerned and the question is what do you do. They said, 'I really don't know what to do. All I know is we have to do something' but that is a couple of years ago now. Because of the work that is being done Australia-wide we are starting to become more aware of what is happening and why it is happening and how, hopefully, we are able to prevent it.
In Australia we have one of the foremost experts in the world, Professor Diego De Leo, who is world renowned. I believe it would be worthwhile for the Government to look at a scholarship for a person to be able to train under him in Queensland for a period of a year, which he believed would be the appropriate time, and then to return to Tasmania and take the knowledge that they have obtained in Queensland under a world-renowned expert into Tasmania and work with other experts and people who are interested in this area because it is a matter of concern.
As I said, in 2004-05 the number of deaths from suicide were the same as the number of deaths on the road. Look what we are doing about deaths on the road. Let us look at this issue as a whole and I would also urge the Government to let us look more urgently at what is happening in relation to suicide prevention. Let us take advice from the experts and endeavour to reduce what would otherwise be a preventable toll - 73, we would hope that could be reduced markedly. I say that knowing that there are already a number of people doing some remarkable work and I think we have to take our hats off to them. But there is still plenty more that can be done and I think we, as a parliament, can do all we can to give those people the support that they need.
Ms RITCHIE (Pembroke) - Mr President, suicide, to be or not to be, is described as the intentional taking of one's own life. In thinking about suicide I often think of the quote that came from the American poet, John Whittier:
'For all sad words of tongue and pen, The saddest of these, "It might have been"'.
That always comes to mind for me when I think about suicide and the very sad loss, the waste of a human life that is associated with this devastating social problem.
Mr Wilkinson - And the effect that it has on family and friends.
Ms RITCHIE - And that ripple effect. Each year many Tasmanians attempt or are successful in carrying out the act of suicide. This does not even begin to take into account those people who have just had thoughts about it, just considered it. It is a devastating and tragic form of self-inflicted violence that has of course the immediate effect of the tragic death of the person or persons involved and then the ongoing effect for the families, friends and the community that is left behind.
Suicide touches the lives of many people and is in every case a tragedy. Many of us know someone who has attempted or completed a suicide and from a personal perspective over the past few years, my family has lost two people as the result of suicide. I can tell you from first-hand experience that it is not easy to fathom the death of a person before their time. You try to understand why and ask yourself millions of times if there was something that you could have done. Perhaps you missed something, you were not vigilant. Those things are always there. I know the loss of a loved one never goes away, no matter what the cause of the death, so I do not try to pretend that my losses are any more significant than anyone else's but I think that it is just slightly different emotionally trying to come to terms with suicide.
We all agree that every year every suicide is one too many. The honourable member for Nelson did point out that we had in 2005-06 some 73 deaths attributable to suicide. And we have had the analogy of motor vehicle accidents that we have seen and the figures are interesting when you look at them. Back in 1978 we saw some 49 deaths by suicide and it is interesting the way that they have ebbed and flowed over time. If you jump to 1992 there were 97, then back down again to 61 in 1997 and then back up again. So there does not seem to be any rhyme or reason to the figures.
Mr Wilkinson - Eighty per cent of those are males.
Ms RITCHIE - That is right, 80 per cent of those are males. I was just going to get to that. If we look at regions, and this is all laid out in the report, you will see that from 1978 to 2004, 50.3 per cent of suicides occurred in the south, 28.8 in the north and 20.9 in the north-west. There is the information there about the age groups and the breakdowns there and the one that we are all alarmed about, which is the male statistic. It is reported that males accounted for 80 per cent of the suicides in Tasmania during this period.
Methods of suicide are also outlined and they changed a little bit over time. From 1978 to 1994 the principal methods of suicide were gunshot 44 per cent, followed by hanging and asphyxiation 16 per cent, carbon monoxide poisoning 16 per cent, poisoning 13 per cent and other methods 11 per cent. The trends have changed slightly because from 1995 to 2007 the principal method of suicide was hanging and asphyxiation was 33 per cent, followed by carbon monoxide poisoning 26 per cent, gunshot 18 per cent, poisoning 12 per cent and other methods 11 per cent, so you have seen a bit of a reversal in some of the methods, Mr President, which is all laid out there for members to read in the report. As I said, it does have a terrible ripple effect. It can have devastating impacts on family members, friends and colleagues.
We really do need to look at addressing the over-representation of males, as I said, and it should be noted that these types of figures are not unique to Tasmania. According to the World Health Organisation, suicide is the thirteenth leading cause of death. Among those aged 15 to 44 years, self-inflicted injuries are the fourth-leading causes of illness and disability. Suicide rates are higher among men than women and on average it appears that there are about three male suicides for every female case, with the exception of older men for whom the figures tend to be even higher.
As members can probably appreciate, the committee did need to conduct reasonably wide-ranging inquiries and consultation. I was fortunate enough to go to a fantastic conference, with other honourable members, at Glenelg and I was really grateful for the experience that I was able to glean from that conference. I think it has been important for the committee to draw on the experiences and perspectives of other people to enable us to take both an evidence-based and pragmatic approach in prioritising actions that the committee would recommend to be undertaken.
Mr President, suicide has long been one of those complex and almost impenetrable phenomena that has attracted the attention of so many people from philosophers, theologians, physicians, psychologists - you name it - poets, everybody has thought about this over the centuries and it has been considered that for a suicidal person, generally death is not the attraction but really an escape from some unbearable psychological anguish.
Whatever the reasons might be, suicide is a serious public health problem that does demand our attention. The reality is, however, that prevention and control are not tasks that are easily undertaken. Nonetheless it is the committee's view that Tasmania does need a suicide prevention strategy of its own that will require significant amounts of work, appropriate funding and effective monitoring, notwithstanding that we know that this will not be a one-fits-all or a one-fix-all solution.
While I acknowledge that the Government has an interest in this issue and that some guidance has been gleaned from the Federal Government's 1999 National Suicide Prevention Strategy, the committee did feel quite strongly a specific strategy for Tasmania would be appropriate in order to take into account our own local issues and requirements.
All that being said, I also want to acknowledge that there is some very good work being done here in Tasmania in regard to suicide and in particular by the Tasmanian Suicide Prevention Steering Committee. We know that some of the risk factors for suicide include issues such as alcohol and drug use, history of physical or sexual abuse, psychiatric problems such as depression and other mental health issues, stressful circumstances such as poverty, loss of loved ones, arguments with friends and families, family violence and breakdowns, work-related problems and social isolation.
These are just some of the contributing risk factors which can tap into a person's feelings about suicide. I think that we are all aware of the well documented links between suicide and mental health issues such as depression and anxiety. The prevention of suicide, whilst acknowledging the difficulty of the challenge, does involve a whole series of activities ranging right back, I believe, to the parenting skills that we apply when bringing up our children and youth through to the effective treatment of mental disorders to the effective control of the risk factors, and I previously outlined some of those. To this extent, I believe that we all have a role to play in suicide prevention. There is already increased public awareness about depression and mental health but it remains essential that we continue to build on this so that we can recognise danger signs and to better enable family, friends, teachers, GPs, work colleagues and many others in our community to help them to identify those people at risk.
Best international practice would seem to suggest that suicide prevention programs should be developed on the basis of improving the mental health of the general population in combination with developing strategies for known high-risk groups. This needs to be coupled with continual and improved data collection in order to assist policy makers to set appropriate targets which can be measured, monitored and reviewed into the future.
In concluding I would like to put on the record my thanks to all those people who took the time to give evidence, write submissions or otherwise provide information to the committee, and to the committee staff who are always there to help and who are a fantastic support to our committee members. The world over, no-one has all the answers in regard to the question of suicide. But I do think that the report generated by our committee has provided some really valuable information for going forward in our efforts to reduce the rate of suicide in our State. Phil Donoghue, the American talk show host, once said that suicide is a permanent solution to a temporary problem. How right he is. While we can never pretend that we can magically fix or prevent all suicides from happening, we cannot shy away from the fact that it is a serious problem. We cannot ignore it, nor can we be complacent about the growing incidence of self-harm. The prevention of suicide and reducing the rate of suicide is therefore a very important public health issue and part of our responsibility to create a healthy, prosperous and social inclusive place to live.
I hope honourable members take the time to have a look at the report if they have not yet been able to do so and I commend the report to the Council.
Mr PRESIDENT - That was a commendable and courageous address and also commendable and appreciated was the gesture of the honourable member for Huon.
Mrs JAMIESON (Mersey) - Mr President, I too would like to commend the committee on this very emotive topic. It is not an easy one at any time for us to deal with it at all, but it is still something that we do have to be aware of. We know what is happening out there in the community and we must ask ourselves why do we always have to intellectualise things. Why are we always philosophising about things, too, particularly in our sophisticated Western World? Why are we having the problems when so many other countries who are less fortunate than ourselves do not seem to have the same problem? But if we are going to keep on questioning and so we should, we must have a way of resolving the issues too and that seems to be part of the problem. We have been doing a lot of talking about strategies and all the rest of it for at least 10 to 15 years now, but we never quite get anything resolved. We have a plethora of services out there that are attempting to redress the issues but they only get little parcels of moneys that are never expanded to keep them a viable organisation.
We have many issues confronting us in our Western World and suicide certainly has been one of them. There have been many national, international and State forums, select committees, strategies and reviews, et cetera held over the years but they all become overwhelming. They end up in the too-hard basket and we end up with little, itsy-bitsy pieces of work being done and sometimes just another arm of bureaucracy which has to be funded to support our policies and strategies. The net result is that people still commit suicide.
We do recognise the fact that suicide has been occurring since time immemorial, but sadly, recently the profile of the people committing suicide seems to have changed. We have suicide in our drug circle, HIV, homosexual youth and other groups who feel very disenfranchised and this has become almost an acceptable norm. These issues have to be dealt with within our communities. Community education and raising awareness of the suicide issue can also make younger people much more aware, particularly people who are impulsive and/or immature who think oh, this is normal, I will have a go at it.
We also do not seem to have done too much work as a society on where people are getting their information - the Web for example. When the honourable member for Rosevears winds up, I would be interested to know whether the web site involvement has been mentioned. I could not find it in the report. Until we know the reasons and correlate the actual data, not just the limited data but the actual data - for some reason or other people seem to be reluctant to make available all the facts and figures in our so-called civilised and compassionate society - we are going to always struggle with understanding why people plan to end their lives.
We all need a reason for getting up in the morning and if for whatever reason life is just not worth living then people do start thinking in this negative way. Accidental and experimental high-risk actions can end in death. Somehow or other that is almost more acceptable because, oh, it was a young person enjoying themselves and it was an accident. But for unexplained deaths it leaves us feeling sometimes bitter. Sometimes it leaves us questioning and feeling that we may have been responsible, that we contributed to the person thinking this way, and/or that we should have actually been aware that there was a possibility of them committing suicide and did nothing about it.
As the report in the executive summary states - and I will just quote from that -
'Suicide is a very complex problem. There is no single explanation for why it occurs and why a person may decide to end their life, and this was reflected in the evidence presented to the Committee.
The main question the Committee has been faced with is whether suicide prevention programmes and projects are more important to prevention than research and data collection in order to better understand the problem. If more is known about suicide, strategies can properly be formulated to achieve a reduction in suicides, but on the other hand, research and data collection does not amount to actual prevention activity.'
I would have to agree; we must know the background for these things so we can be more proactive and direct our energies towards that. The committee was unable to ascertain, for example, how much funding from government and non-government sources is available for suicide prevention in Tasmania and what proportion of this money is actually spent on data and research. It is a very complex issue all round. It becomes a bit of a chicken and egg situation. Which does come first? Do we put prevention in, education, money; which way do we actually go?
It comes back to knowing what is driving and what is happening in an individual's mind and life. We need resource-intensive efforts made by the community and governments to address societal changes such as family breakdowns, angst, hopelessness, isolation and disconnectedness; the need to turn to the dark side of the Internet, as I mentioned earlier, to find solace. As policy makers we must ask ourselves: have we gone too far with the non-touch technique? These days we have these policies where you are not allowed to comfort people because it might be an unwanted touch, for example.
From my own experience, I ended up at the police station because I had guided a woman at work by the elbow and she took this as a form of harassment, as an unwanted gesture. I had to sit through 25 minutes of interviews, videoing, actual fingerprinting and recording and then the police went over to Orana and questioned the rest of the staff who fortunately, of course, realised what had happened and were able to explain that I was not doing anything that was aggressive. But it wasted police time on a so-called harassment charge.
The women's movement in the 1960s and 1970s, for example, has left many non-assertive men in particular without their old comfort zone of being the breadwinner, the dominant one. In other words, society rapidly became an unbalanced entity and out of kilter. I certainly agree we need more focus on male wellbeing but there must be a balance in that focus and it must be meaningful, it must be well-resourced and most importantly it must be ongoing. Just throwing money at a problem on a temporary basis is not the answer, otherwise you have people's expectations lifted but then they are dashed and we leave them with a bigger black hole and a potential suicide.
Suicide is not just a problem in Tasmania. Suicide data is still not available in many countries around the world and at present there is data from only 90 countries in the world's 192 nations which are available through the World Health Organisation and this data is available for 15 to 19-year-olds and is one of the largest databases in the world.
The mortality statistics are commonly broken down by gender and age. However, some countries do not report deaths broken down for the 15 to 19 age group. So we are left with another little bit of a gap as well. The reliability of suicide statistics is often questioned and because suicides are under-reported for cultural reasons maybe, religious reasons, as well owing to classifications and ascertainment of procedures. Suicide can be masked by many other diagnostic categories such as cause of death for example. Unfortunately young people's deaths due to suicide are often misclassified or masked by other mortality diagnoses and this makes the global picture much more difficult to work out what the actual figures are.
But again, it has also been noted that suicide rates for younger people in the 15 to 19 age group is much higher in males than in females, and young males' overall suicide rate is 2.6 times higher than that of females. Exceptions were found apparently in a number of non-European countries such as Sri Lanka, El Salvador, Cuba, Ecuador and China where the suicide rates for female 15 to 19 year olds actually exceeded those of the males in the same age group.
Clearly we have some work to be done out there in the community. Overseas studies have also shown that suicide is one of the leading causes of death amongst younger people in both sexes. We have to ask ourselves just how are we going to address this particular issue. There was some information which I found on the Internet regarding suicide rates and I will refer to that. It was headed 'Suicide Trends in 1964-1997, Youth and Beyond' and the objective was to examine the Australian suicide rates across all ages and compare Australian rates with that of Western countries.
Suicide rates for males 15 to 24 and 25 to 34 rose from 1964 to 1979. Comparable rates for females showed no significant change. However, suicide rates for several of the older age and sex groups declined over that period. Comparison with suicide rates of other Western nations showed that while Australian youth suicide rates were relatively high, this is not the case with the older groups. Australian suicide rates are higher than those in the European nations of origin of our major migrant groups but similar to those of other Western nations also colonised by the Europeans would you believe, such as Canadians, the USA and New Zealand people.
Their conclusions were that priorities for suicide prevention in Australia are correctly concentrated on youth but the targeted age range should be extended to include men aged 25 to 34. A comprehensive policy should also not neglect the needs of other age groups and so further studies need to be done.
I will finish my contribution with a couple of comments on the fact that clearly data collection is most important to guide strategies for reducing suicide and if the chairman would not mind making comment if he has the chance, on reference to the web site and report the influences on youth but also whether or not there has been any meaningful reference to voluntary euthanasia for example. Because again, we have people in another group who are looking for ways to end their lives.
One of the other things that we need to be concerned about also is the years of potential life lost, particularly when we are talking about the younger age group of people who have not had a chance to live a full life and for what reason. As other honourable members have mentioned, there is a plethora of services out there that are trying to assist people in overcoming what is happening within our community. We have White Wreath, which is a national service, we have got CORES, which is the Community Response to Eliminating Suicide, and I realise that they gave evidence to the committee. It is a group response to eliminating suicide. That was a group in Sheffield and they have been working there since 2003 because of the needs that were seen in that local community. Then we have Parakeleo which the Church of Christ from Victoria and Tasmania have set up as a service for counselling - and it is just a retreat - but of course there are some people who do not want to associate with what they would perceive to be a Christian-based service. We have had the Applied Suicide Intervention Skills Training program - ASIST - that was put out by Lifeline last year. I personally wrote to all the doctors and the TFGA, the dairy industry and all the other rural areas encouraging them to go along to the service and be part of those projects.
Then we have Suicide Prevention Focus that was held through YAFS - Youth and Family Services project. That went for three years. Again, funding was stopped and so it did not continue. It leaves people very frustrated when that happens. We have had the National Suicide Prevention - and they go on and on. We have Lifeline, with Survivors of Suicide kits, and endless information. One has to ask, 'In a place the size of Tasmania, why have we got so many small groups?' Church groups are all setting up awareness programs and trying to deal with the situation - Lifelink, the Good Samaritans, Youth Suicide, tool kits for helping someone at risk of suicide - which was put out by Lifeline. Lifeline ran another program called 'Enough is Enough. The Silence is Killing Us'. It was a very interesting program but, again, it was a short-term one.
We have another one on the Internet - 'Dads in Distress' - and people can anonymously go onto the Internet and get information. There is so much information out there, but honing in on the individual in their time of need is also a bit of a challenge. We also have the current community forums on suicide prevention happening in Tasmania at the moment.
Where do we end up with all of this? I can only say I commend the committee for becoming involved in this and giving some very clear indications as to how we could work forward on the matter of trying to recognise the issue of suicide, but also recognising that you will not stop suicide completely because there will always be somebody who will find that life is just not worth living, for whatever reason.
Recognition of Visitor
Mr PRESIDENT (Statement) - I draw honourable members' attention to the presence in the President's Reserve of the honourable John Cowdell, former President of the Legislative Council in Western Australia. I am pleased to say that he is a regular visitor to Tasmania. Maybe on this occasion he has come to check on how the Deputy Clerk has settled in since he graduated to this Chamber. We can assure Mr Cowdell that we are very happy to have Nigel and he is doing very well. We extend another very warm welcome to the Honourable John Cowdell.
Members - Hear, hear.
Mr HALL (Rowallan) - Mr President, I would like to acknowledge the heartfelt contributions of members who have spoken before me. Not having been a member of the committee, I would still like to make a few short comments in regard to their report. I must firstly say, tongue-in-cheek, that it is nice to see that committee get a report out -
Mr HALL - compared to another more proactive joint House committee. We seem to knock one out every two or three months. Congratulations.
Mrs Rattray-Wagner - Is that the reason for your contribution?
Mr HALL - No, it is not. I think the main body of the report - the conclusions and recommendations - have been well covered by other members, so I do not intend to re-encapsulate those. I want to make a brief comment on a matter which, from my quick reading, was perhaps only very briefly touched on in this report. The report acknowledged that unfortunately Tasmania had a rate of some 39 per cent above the national average, and as in some other jurisdictions men are over-represented. The committee noted that aspect when they commented that more services, especially for men, are needed.
'Males are overrepresented in suicide statistics in Tasmania. This fact seems well recognised as a major problem that needs addressing. A reluctance of men to communicate and seek help for personal problems makes it difficult for service providers to have the opportunity to offer assistance.'
Therefore, Mr President, I thought it very pertinent and relevant to read into Hansard a recent article from the Tasmanian Country newspaper dated 9 November 2007. The interview was conducted with a longstanding friend of mine, Dr Robert Simpson of Oatlands. Ras, as he is commonly known, services a large area of central Tasmania, and is widely acknowledged as being one of the most capable and experienced GPs in the State. He has also seen life from a myriad angles, and he often goes off to far-flung destinations in the world to do work with Medécins Sans Frontières. That is all voluntary work, of course. As well as that, I know that he extends his knowledge and advice to many other people around Tasmania, often at his own personal cost, I might add. The article is headed, 'Heartbreak Takes an Awful Toll' and the statistics paint a heart-wrenching picture. It reads:
'Men in rural areas have four times the suicide rate, four times the heart disease death rate, three times the vehicle crashes and 30 per cent less Medicare expenditure than their urban counterparts.
"There are all these terrible factors and the trouble is that men in particular are proud, stoic and definitely stubborn," says Oatlands general practitioner Robert Simpson.
"What we are seeing with the drought is a far greater level of depression.
"Unfortunately it is not the farmers who are feeling the biggest impact but the families, wives and partners. They are the people who are coming into the doctors' surgeries voicing the greatest concern about what is happening out there."
But Dr Simpson, with 30 years in the profession, is seeing a change for the better.
"Over the past few years I have had farmers, perhaps one, two or three of them, coming in and discussing with me their concern about one of their mates because of the impact of the drought," he said.
"Sometimes there are other stresses, but drought is the one thing that is really putting a lot of pressure on farmers, particularly those who don't have economies of scale.
"These people ask how they should go about doing something to help their friends or neighbours who are in trouble, some of whom are more resilient than others.
"There is a lot of sensitivity in handling these situations, including confidentiality, pride and the reluctance of these stoic men to seek any sort of help," Dr Simpson said.
"The most basic and sensible approach is usually to identify somebody who is a good networker - a respected friend or neighbour - to go and have a chat and help share the burden of the problems and direct them to, maybe, counselling or other services.
"I never used to see this but more and more now I am getting farmers coming and asking what they can do for their neighbour who they fear is in such a depressed state.
"The catastrophic end point of depression which, of course, is suicide. I guess that when people think of these situations they tend to think of the worst possible outcome - and that is what it is.
"Identifying these people and approaching them with a great deal of sensitivity and judgment is critical," he said.
"The response is pretty good. The reason is that we are very careful who we identify as the person who is going to make the initial contact and the subtle way in which stresses are confronted and broached.
"If you can break down those barriers with sensitivity sometimes it just sort of opens the flood gates.
"It doesn't matter who it is, perhaps a counsellor or GP, as long as you provide links to these people who need help and are happy to embrace whatever is available out there." '
Ms Forrest - Often the GPs do not have the necessary time to give these people, though. That is the problem. They have back-to-back appointments in our rural communities, as you well know.
Mr HALL - Yes, exactly.
Ms Forrest - These people need longer appointments, and that time. It just is not available.
Mr HALL - Yes. Yes, I think the member for Murchison, by interjection, Mr President, brings up a very valid point. I think most of us who have large rural electorates know the pressure that a lot of these practices are under and particularly the GPs just do not have time. I know a couple of GPs in Deloraine who have some very difficult cases to deal with at the moment and they feel as though they are not quite doing what they ought to be doing because they simply do not have the time or resources. It is a very difficult situation and, as we know, to send them to an urban practice is not an option as a lot of those urban practices have closed their books. All that further exacerbates the problem.
Ms Forrest - If you have a man who does not really want to go to a doctor about being a bit depressed and you cannot get an appointment easily, they are just going to give up, aren't they.
Mr HALL - Yes, that is right. Dr Simpson went on to say that in the past couple of years 20 per cent of people on the land had left.
'"Season after season it is being relentless with people selling off," he said.
"At the moment one positive is that lamb prices are holding up." '
He might have said that two or three weeks ago but that has changed in that time, I must say.
'"There is a lot of new money from the big end of town, timber plantation developers are paying money for land that is probably not sustainable in the longer term.
"If people are getting out the only positive thing I can say is that many of the prices they are getting are reasonable.
"It is sad to see those old traditional farmers who have been on the land for generations leaving and the new money coming from the big end of town coming in and mopping up."'
That is not a really happy story, but it is one which is occurring all too frequently in many parts of rural Tasmania, and indeed Australia. The whole issue of increasing anxiety, severe depression and ultimately the prospect of suicide in rural areas is exacerbated by the fact that farmers mostly work in isolated circumstances and they have little or no control over many aspects of their business. That fact was noted in the committee's report when Professor Graham said in evidence that the approach would need to be different according to a person's circumstances. Again, if you are 25 and married, have employment and are on an income of $80 000 a year, for example, that might require a different strategy from one applicable if you were living up on the north-west on a farm isolated from the community and only seeing your mates once every fortnight.
We all choose our lot in life but I am just trying to highlight the fact that a farmer, for example, despite good management practices and the best intentions in the world can see that world undone by factors and circumstances totally beyond his or her control - drought and commodity prices just to name a couple. In stark comparison the city-based bureaucrat on, say, $90 000 to $100 000 a year with guaranteed superannuation entitlements -
Sitting suspended and then resumed
Mr HALL (Rowallan) - Mr President, I would like to congratulate the Community Development Committee again on finally getting a report out; they have done well.
Mr Wilkinson - Posthaste, thank you very much.
Mr HALL - We will see a flow of reports no doubt from that committee coming on board.
Mr President, before the luncheon suspension I also made mention of something that was missed in the committee's report and that was the rates of rural suicide. I was particularly speaking
about the experiences of a GP friend of mine, Dr Rob Simpson, at Oatlands who talked about a lot of those issues. Just to encapsulate, men in rural areas have four times the suicide rate, four
times the heart disease rate and three times the number of vehicle crashes and yet they use 30 per cent less Medicare expenditure than their urban counterparts.
As I moved on, Mr President, I mentioned some of the issues that rural people have under drought conditions and circumstances where it is difficult to obtain medical services, particularly in
small country towns. The honourable member for Murchison, by interjection, picked that particular issue up. I was also doing a stark comparison with a city-based bureaucrat on say, $90 000 to $
100 000 with guaranteed superannuation entitlements, holiday pay, sick leave, ready access to all services, who is on a somewhat different planet, I would suggest, Mr President. I certainly do
not want to denigrate those in more fortunate stations in life because that is the way the world is. But I am just pointing out that as a member of parliament with a large rural electorate and
as a farmer with decades of experience in that sector I am only too aware of the huge pressures being faced in many sectors of our rural economy, particularly when 500-plus people turned up to a
BeyondBlue forum earlier this year at Longford. I think that tells a story.
My own very recent information from TFGA has verified that this situation is being further exacerbated by the prevailing conditions in many areas. I was particularly critical of the State
Government for not extending the exceptional circumstance areas for drought relief to some other badly effected areas. It certainly would assist in a psychological sense to some out there, even
though there are a myriad of hurdles they have to jump over to qualify, but at least it does give some hope.
Mrs Rattray-Wagner - It's recognition too of the issues that they are facing, I believe - absolute recognition.
Mr HALL - Yes. I think the lines on the map were a little too hastily drawn and there was not enough recognition.
Therefore, Mr President, I would urge the minister and his department to watch this situation closely and make some adjustments. As I think the honourable chairman said, finding effective
solutions and recommendations on a subject like this is always going to be a tough call and the honourable member for Mersey went through many of those. The acknowledgment and community
discussion about the debilitating and often tragic consequences of depression have been recently highlighted by many high-profile people in the Australian community and I think that is a good
and positive thing to happen. The more media attention, recognition and resources that can be applied, the better.
Anybody who has had to deal with close family or friends who have had severe depression and/or suicidal tendencies will well recognise what a traumatic and difficult experience that can be.
Mr President, I have to say, unfortunately, my own Vietnam veteran community is well over-represented in suicide statistics and unfortunately there have been a few who I knew well and served
with. So, as a consequence, I completely understand the emotion and the anguish relayed to us by the honourable member for Pembroke when she gave her contribution.
Mr President, I commend the committee on its report and hope that the conclusions and recommendations translate to positive outcomes and actions.
Ms FORREST (Murchison) - Mr President, I too would like to commend the committee on the report. Although I was not a member of the committee, it is still an issue that is fairly close to my
heart. Coming from a background in health, even though I did not work within mental health, we were often exposed to mental issues and the issue of suicide on a not too uncommon occasion, Mr
President. It is a very challenging and complex topic. It is a very challenging topic to even talk about. A lot of people think if they do not talk about it maybe it will not happen. That
was the approach taken many years ago by a lot of people, that if you do not talk about it, it will not happen. So, just put up the blinkers, shut down and then it will all go away and that is
probably when it probably did not go away. That is when people felt they were unsupported and might have made that choice. Whether it is seen as a choice or not, it is sometimes an outcome of
the situation that person finds themselves in at that particular time.
It is something that I think over the years perhaps has not been given the attention it could have been or should have been. It is such a difficult and sensitive topic to talk about and it does
challenge individuals. It also makes you think about where you have been in your life and what situation might have put you in a place where you felt life was not worth living. As a young
child, in about grade 5 or 6, I thought that was a reasonable option. I was too scared of it hurting me though so I thought I would not go that far. Probably a bit of bullying had caused it at
the time. The member for Nelson's story about the child who was bullied - I am not sure how old that child was, but if he had a locker he was probably at high school - was related to me
previously and I was almost in tears when he told me on that occasion and again today. It is such a challenging issue and I certainly commend the committee for looking into it.
Whilst I was not part of it, I acknowledge and commend the people who gave evidence to the committee, the people who bared their souls in that committee, because it must have been confronting at
times for the members of the committee as well as for those people involved. It also would have affected the experts in the field who gave evidence to this committee. They are trying to deal
with the situation, make a difference, identify those people who are at risk but becoming increasingly frustrated when they have programs working, doing good stuff and find that they have to
dedicate almost one person to the position of completing grant applications and submissions for funding. What a waste of resources. We have people who potentially could be on the ground
helping people, but who are instead filling out grant applications to try to get the next round of funding secured so that service can continue.
Whilst I have not read the report from cover to cover I certainly have scanned it. I have read the executive summary and the Chairman's foreword, and will make a few comments on that, but I do
recognise the depth of emotion that is contained within these pages.
I noticed in the chairman's foreword that the report opened up a number of other areas for question and hopefully it provides some other answers or direction. The report states that it carries
a strong message that more must be done and greater attention needs to be given to this issue of suicide generally. Also there are comments that the general community would perhaps prefer to
avoid it because it is too hard in the minds of many to look at what it means and how we can be prevent this. Until you are touched personally, I think it is a bit easier to step away from the
issue of suicide. There are people who have not had a personal encounter with a close family member or friend who has either attempted suicide or succeeded.
I for one had a very dear friend suicide a few years ago. I was well aware of his mental illnesses. His wife and I felt we were being proactive in getting treatment for his illness.
Unfortunately we were not able to secure the help he needed at times in a timely manner but being inside the profession made it a little easier; I hate to think how the other people outside cope. Unfortunately this young man - I do not think he was even 30 at the time - with a five-month-old baby whom he loved and adored and a gorgeous wife found life too hard to bear. He felt he was
doing her a service; in his suicide note that was one of the things he said. I think, what a tragic waste of life. When his wife rang me I was at work and I still remember the day. I remember
I was delivering a baby on that day. I remember the baby's name I delivered on that day. When she rang me she was hysterical and I thought it was one of my kids being hysterical at the time
because I could not understand what she was saying. When I finally could understand what she was saying I knew what the story was. When I knew who it was, I did not know what had happened but
I knew that the outcome must have been that he had suicided.
I asked myself, could I have done more? I have a fair degree of knowledge in this area. I knew he was not well. I knew that his condition was unstable. We were fairly certain he had made
another attempt previously. We were not really sure, his wife and I. But there it was. You do ask yourself the question, could I have done more? I do not think we probably could but you
still ask yourself the question, Mr President.
Mr PRESIDENT - And everybody else does, too.
Ms FORREST - Yes, that is right.
Some of my children have had school friends suicide over recent years, not necessarily when at school but soon after they have left school, in their late teens. Again what a tragic waste of
life. Unfortunately, we are just seeing it way too often. Sometimes it seems to come as a bolt from the blue and no-one seems to know that these kids are not okay. One particular family in
Burnie with, I think, four children, have had two sons suicide within a couple of years of each other, both by hanging. How does a family cope with that? How do the parents cope with that?
When it is the parents who find one of their sons hanging in the garage when they go home, how do they cope? I do not know. It is pretty tough. I only saw the parents the other day, just
briefly, and they are getting on, but it is tough.
This is a very timely report. It would be a timely report whenever it came in, I think, and I commend the committee for their work.
One of the issues that I did look at within the report was the breakdown of the areas where suicides are occurring. From the data collected - and it has been commented upon a number of times in
the report - perhaps the inadequacy of the data collection makes it a bit hard to pinpoint where the problems may be more specifically. About 50 per cent were in the south and 50 per cent in
the north of the State, which pretty much matches the population. I believe there are cases where people from the north and north-west of the State have been in the psychiatric intensive unit
and discharged in the south and who have suicided soon after discharge, so the figures may be slightly skewed.
That cannot be identified within the available data and I think that is an area that should be looked at more thoroughly. These recommendations are contained within the report, to some degree,
about the need to improve the data collection so this sort of information can be gleaned. More people are coming from rural communities so we need to ascertain whether there is a greater lack
of support in the rural areas for these people, or is it right across the State. I think the data collection is an important part of that.
The report says, and I am just quoting from the executive summary:
'The main question the Committee has been faced with is whether suicide prevention programs and projects are more important to prevention than research and data collection in order to better
understand the problem. If more is known about suicide, strategies can be properly formulated to achieve a reduction in suicides, but on the other hand, research and data collection does not
amount to that prevention activity.'
It has been acknowledged and I think we need both. When we have cases of completely out-of-the-blue suicide completions we really need to look at why these things happen. For people with
existing mental illnesses and that sort of thing it may be a little easier to see why a certain path is taken but with the ones that seem to be out of the blue we probably need more research
into those areas.
I noticed, in looking at the issue of funding - it has been covered by other members so I will not go into great detail - Wendy Quinn claimed in the report that some of the funding had been
given by the State Government for suicide prevention projects but she did make the comment, on pages 31 to 32 of the report that -
'Our State government funding, our suicide-prevention-specific funding, has been relatively limited but that is not to say that there isn't a range of funding going into general health and
community services and population health-based approaches that does not support the whole agenda.'
She identified that there may be global funding but there is nothing that is specifically targeted. If we look at road safety, for example, and we were told the correlation between the numbers
of people dying on our roads and the number of people dying through suicide being the same in the last year, we have such targeted road safety programs within the whole picture of vehicle safety
and all the road safety measures, maybe we do need to re-target some of our funds directly into this area.
There was an interesting comment, too, and when I read it I thought this man is quite right. Professor Diego de Leo said that 90 per cent of psychiatrists are in private practice. That
certainly seems to be the case. It seems to be very difficult to attract psychiatrists, particularly skilled psychiatrists with a range of experience, into the public sector. In the public
sector you tend to need that specific and wide-ranging experience because in the public sector you get absolutely everything.
I would like to quote him from the report:
'The public hospital clients are quite a different clientele from that of private hospitals, to be very frank. The most disadvantaged people go into the hospital: dirty, bad-smelling, of low
education or whatever, but psychiatrists want to have blonde young girls, intelligent, witty, funny and making a lot of money with easy patients. In the public hospital you have a tough job;
you have very hard patients, very tough, sometimes very violent patients, but not because they are mad and bad, but because they are scared … The problem is the management of public mental
health. The big numbers of suicide in this psychiatric sphere comes from the public psychiatric sphere.'
This just brought home to me that on the north-west coast we have Spencer Clinic, which is the public psychiatric facility, and we have Rivendell Clinic at the North West Private Hospital which
is now run by Healthe Care. When Healthscope managed the private hospital they had no psychiatric services at all. In recent years they developed what we call 'soft psych', which is the easy
psychiatric patients for want of a better phrase as this professor was saying. These patients are low-risk patients. If they are a suicide risk they are not allowed in basically. They are
only cared for within the public system when they are a known suicide risk. So it is easy money for a private hospital. And this has been expanded by Healthscope and then by Healthe Care and
it is a lovely setting up on the hill and it is very therapeutic, but you do not get the really tough patients that we see in the public system. Professor De Leo is saying that very thing that
I have seen in practice. It is a real problem. We need to resource the public mental health services because that is where the really hard work is, the real challenges are, where people are
really scared and where the majority of suicide risk comes from. The soft psych wards do not provide that level of care.
Perhaps we need to provide greater incentives for psychiatrists to provide a public mental health service. The member for Rowallan mentioned, as others did, the issue of the over-representation
of men in the suicide statistics. There is a bit of discussion in the report about that. Particularly in our rural communities, men have traditionally just gotten on with the job and have
often been reluctant to seek help or to admit that they have a problem. But it is becoming more okay in our rural communities now for men to admit that they are feeling a bit depressed, that
they are struggling, particularly in hard financial times and times of drought and other challenges.
We have seen some really great initiatives around the State including in our rural areas. I mentioned the CORES program that I think was originally established in Kentish and was taken up by
the Circular Head councils. That has done some really great work in suicide prevention. In our rural electorates there is now the opportunity for the staff representing us to undertake the
mental health first-aid course. I think that it was offered to all of our staff and my staff took it up because I personally, and I assume others do to, get a lot of constituents through the
door and a number of them with quite significant mental health problems. One constituent that I have been dealing with for most of my time in Parliament has been suicidal at times and relies on
the support from my office to get him through some bad patches at times. The mental health first-aid course that my PA, Julie, undertook has certainly helped her to manage people like this when
they come in and to know where to get help and how to recognise that perhaps the person has a problem that needs more specialised attention than she or I can give.
As I say, there are some good things out there but obviously more needs to be done. So I certainly support the call for dedicated funding and for a statewide suicide prevention strategy. I
think that is really important. The issue of improved data collection is also important, because if we really want to know the extent of this issue we need to have good data. I was reading
from a comment made from Professor Des Graham who heads up Mental Health Services. He was saying that the data collection is limited and poor, although there are opportunities for improvement
that are being pursued. In the report at page 67 he states:
'We have some data collection through Mental Health Services but it is limited. We have some data collection through the coroners, but the coroners' information is clearly those people who have
taken their lives .... data collection and information management systems with mental health programs, for example, require significant development and we are, as a business unit of the
Department of Health and Human Services, having internal conversations with our infrastructure and our information people about how we collect the data better … Overall there is poor data
Professor Graham has identified that we know how many people have succeeded in their suicide attempt but we really have no idea about how many people out there are attempting suicide. If we do
not know about those people how can we really design a service to meet their needs? I fully acknowledge those comments and would have to concur with them.
That moves into the issue of under-reporting of suicide and Professor Graham was also quoted in the report as saying:
'In terms of the number of people who attempt suicide or suicides which are under-reported - and we know that suicide is under-reported - there is really limited data collection in these areas.'
Linda Trompf said accidents and suicides can potentially count together. She says in the report:
'In the ACT - and I am sure it is the same in Tasmania and other jurisdictions - a suicide is only confirmed as a suicide once you have had the coronial inquiry. They are the only ones that are
counted, which would seem to me we are missing a lot. There would be a lot happening that we are not counting, but it is also difficult to know how you count those. Who is going to go back and
ask whether the guy who ran off the road and hit a tree was an accident or a suicide?'
The data collection is a really important part of this process as is the research and the dedicated funding toward a suicide prevention strategy. All those things are needed to understand the
extent of the problem, to identify the people who are at risk and hopefully see, in the near future, a reduction in the number of lives we lose to this terrible tragedy.
Mr PARKINSON (Wellington - Leader of the Government in the Council) - The Government is committed to tackling the issue of suicide and the Government does commend the committee for its report.
It is now widely accepted that suicide prevention activity extends beyond clinical intervention. It is a broad continuum of activity that consists of health and wellbeing promotion, suicide
prevention, early intervention and bereavement support work with individuals, families, communities and social groups. Tasmania's approach to suicide prevention is proactive and supportive of
whole-of-government and whole-of-community responsibility. An intrinsic element of this is the Tasmanian Suicide Prevention Steering Committee. The Tasmanian Suicide Prevention Steering
Committee report for 2004-06 was released in December 2006. The next report is due to be released in December 2008. A core activity in 2007 for the Tasmanian Suicide Prevention Steering
Committee is implementing a statewide consultation on suicide prevention which will result in a statewide action plan for suicide prevention. I can indicate to the committee that the
recommendations of the committee will be forwarded to the Tasmanian Suicide Prevention Steering Committee.
Mr FINCH (Rosevears) - Madam Deputy President, thanks very much to the members for their contributions to this noting of the report of the Community Development Committee. As we have heard,
members of the Community Development Committee, who have spent much time and effort on this report, have greatly clarified some of those issues associated with Tasmania's unacceptable suicide
rate. The committee members are consistent in their views and opinions and that I believe is the reason for the clarity of the observations and the recommendations that we have made.
I would like to mention again one of the aspects of suicide that is often overlooked although it has been mentioned here by a couple of members, the work of Tasmanian coroners in investigating
and recording each death. They are one of the keys to a better understanding of the numerous reasons why people do take their own lives. The collection of coronial data does need to be
consistent, we believe, across all States and Territories and data should be specially collected that is significant to a better understanding of suicidal behavior. This collaboration is
urgent and will facilitate focused research in the future.
Of course, too, Madam Deputy President, the front-line work of our police force has not gone unrecognised in our report. Those people generally deal with the aftermath of the completed suicide
first and we know that there is training there and perhaps that focus could come again on that situation because it must be a tough assignment for those members of our Tasmania police force to
generally be the ones who have to deal with the situations and to then have to deal with the families and the people who are affected by these events.
We can all imagine some of the reasons for suicide. The member for Pembroke detailed a list and of course sometimes people can be helped through those situations that they do confront. Suicide
can be averted. I think that was the feeling that we had. Life is about highs and lows but it is when people are in those lows that they feel that there is no alternative, no other way out.
The word 'resilience' seems to be used now in educating young people in these situations. Children are being focused on the word 'resilience' and having an understanding of what resilience is and I think part of that is having an understanding that we do go through those times when we are not as in control as we would like to be or situations seem to be unmanageable. We need to have understanding and support from our peers who have been through a better educative process to be able to support people who are going through times of trouble.
We do need to know more about the motivation for suicide so that more help can be given. State Government departments have an understanding but could even have a better understanding of the
complex needs of individuals who are suicidal. There ought to be more fluid communications across sectors in regard to client care and early intervention strategies embedded as part of the client's care plan.
Martin Harris of the University of Tasmania's Rural Health Department, who was one of our contributors and is on the Tasmanian Suicide Prevention Steering Committee, made some additional points
to me that I would like to quote. He says:
'The role of the TSPSC needs to be carefully considered … it brings interested parties to the table and has the potential to inform, research, activity and governance. Currently its aims are
" aspirational" and more support is required to allow it to work more comprehensively across sectors. At the moment, it is "based" in mental health services, but it probably needs a wider base,
or one which is reflective of a broader partnership between the major government departments …The TSPSC … has played an important role in the development of suicide prevention activities in the
State, but it has the potential (if resourced properly) to do much more and to be pro-active in directing attention to areas of priority. This would be consistent with the "whole of population" approach that is required.'
I appreciate very much Mr Harris giving me some feedback on our report because he noted, too, that service providers, both government and NGOs, need ongoing education and training to ensure that
service provision is best practice. This will require an ongoing commitment from training providers and resourcing for research and best practice models.
Funding of course is essential for research. It is essential for suicide prevention, for suicide intervention and post-vention and whilst I acknowledge the ongoing commitment of the Australian
Government's funding through the NSPS, the flow of funds into Tasmania does not meet the needs of our community.
Mrs Jamieson - It's not ongoing either. It's given for 18 months or something like that.
Mr FINCH - That is right, we have talked about that, the waste of time and energy in seeking ongoing funding for projects that are generally proving their worth and are generally playing a role but you cannot assess them over a short time.
Ms Forrest - It ties up a person actually applying for the grants and putting in submissions all the time and that person could be out there potentially providing a better service on the ground.
Mr FINCH - And because this situation is complex you need longer time spans than the short time spans that that funding generally is attached to. You need 10 years -
Ms Forrest - People can be depressed for a long time. They don't always get depressed for a week and then they're over it for good.
Mrs Jamieson - That's true of all preventative programs anyway, you just don't get results for 10 years sometimes.
Ms Forrest - Not in an election cycle certainly.
Mr FINCH - Tasmania has the second-highest suicide rate after the Northern Territory and we have particular needs that require investigation and attention. It is really inappropriate for us to
think that research from the USA or the UK can be transposed with any accuracy for the needs of the Tasmanian population. We just need that local information.
They were some of the comments from Martin Harris who is an expert in rural health who I know contributes strongly in a sense and it would be comforting, I am sure, to the member for Rowallan to know that somebody is specialising here in Tasmania in rural health, is cognisant of the issues of which he spoke about, men particularly, and the pressures that are with people on the land, and I am sure that he would look to expand and continue his work strongly.
The member for Rowallan also mentioned the work of BeyondBlue. I must say that I am not as cognisant about their program as I would like to be. We hear of their work of course. I am appreciative of the fact that young people in Tasmania in our community are starting to embrace the concept of BeyondBlue. I think particularly young rural people have an understanding of the impact that it is having on their lives and their families' lives and they are taking an interest particularly in the area of fundraising. So young people, through organising events - and ostensibly I suppose they are having fun with those events, good fellowship and good social activities - also have that other side of confronting a serious issue for our community.
Mrs Jamieson - They can make contact through the Internet as well.
Mr FINCH - Yes. You did ask about the IT opportunities for people who do have suicide issues but we did not focus on that as part of our references and we did not have strong evidence from submissions to us in relation to that but I would imagine that if people were to deal with the BeyondBlue web site - and I think also of Lifeline and Lifelink Samaritans -
Mrs Jamieson - Even Whitelion.
Mr FINCH - Yes. Those sorts of organisations with their web sites would then be able to transport you quickly to the advice that you would be seeking. Voluntary euthanasia was not an issue in the representations that we had.
The member for Nelson mentioned the idea from Professor Diego de Leo. I know that sounds very much like a stage name and he looks a bit like an actor, too.
Ms Forrest - He was very right in his comments, though, the ones I read out.
Mr FINCH - He made some excellent contributions, particularly when we went to the Suicide Prevention Association conferences, particularly in Sydney. He was a very, very strong contributor and you could just sense the respect that he garnered from the gatherings whenever he moved into any group or made a presentation. He is a very, very impressive man. I know he did talk with the member for Nelson in respect of this opportunity where if we were able to fund a scholarship for a young person to further their studies in mental health here in Tasmania or if they need to study on the mainland, he would happily take them under his wing, and I can tell you that if somebody was interested in that area of endeavour he would be a wonderful, wonderful mentor.
Ms Forrest - So is he looking at up-skilling medical staff or a community worker or social worker or a mental health nurse or anyone?
Mr FINCH - It is more somebody who was moving through that academic side.
Ms Forrest - The medical side of it.
Mr FINCH - Yes, with a specific interest in mental health.
Ms Forrest - Or someone who is doing the psychiatric registrar thing and would go under his wing for a year.
Mr FINCH - Yes. I know it sparked the interest of the member for Nelson and hopefully that can maybe get legs and we can explore that opportunity more because it is a wonderful opportunity with
Professor Diego de Leo.
I will conclude by thanking the members of the committee.
Mrs Jamieson - Through you, Madam Deputy President - before you finish was there any reference to youth years lost through suicide and the compilation of the number of youths who have died, the
potential loss of youth not going into adult life?
Mr FINCH - No. You do not mean the cohort group? You are not thinking of that?
Mrs Jamieson - You have 10 people who have suicided between the ages of, say, 18 and 21, then they have the potential for living for the next -
Mr FINCH - No, we made no reference to that. There is a reference in the report to a cohort group that travelled through that used to be 13 to 20 and then -
Mrs Jamieson - I saw that. I could not see the other one that -
Mr FINCH - No. Certainly thank you to members of the committee and others who travelled and to the member for Pembroke who joined us for the SPA conference in Adelaide after the member for
Murchison and I travelled to Sydney for the first SPA conference there. It was very instructive and there was plenty of information, plenty of food for thought. I suppose if there were easy answers to problems such as suicide well maybe our committee would not have worked over such a long period. It was quite a time, as the member for Rowallan took great delight in highlighting a couple of times.
Mr Wilkinson - It is worthwhile mentioning though - through you, Madam Deputy President - the assistance we received from Nathan. The assistance we received from Nathan was terrific in relation
to pulling it together. That is worth mentioning, I think.
Mr FINCH - Oh yes. Are you only saying that because he is in the Chamber at the moment?
Mr Wilkinson - No.
Mr FINCH - I struggled to get the information from my chair down to the Clerk; the evidence that we had was vast and when travelling through this body of evidence, it is very hard to retain it all and to get the clarity into the conclusions and recommendations. We certainly did appreciate it when Nathan came on board. Without having the experience of being there for that evidence he was able to just pare that down for us and give us a real focus in those conclusions and recommendations. So we certainly do thank Nathan very much and, of course, Charles Casimaty who is part of our Secretariat and his assistant, Sandra Slade. Also Kira - I am not aware of her last name.
Mr Wilkinson - Aldridge.
Mr FINCH - Thank you. We do thank her as well.
I believe this committee has wrestled over many months and years with one of our communities' most complex and seemingly intractable problems but I know that the member for Nelson, who shared
the reference to the suicide committee, and I hope that our hard work will not be in vain.