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Indigenous Australia Analysis

Governments fail to keep suicide prevention service alive

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Deaths of Indigenous Australians from suicide were at an all time high in WA in 2019 (Screenshot via YouTube)

WA's First Nations suicide toll will likely rise with the fall of outreach service NSPTRP, which needs proper government funding to survive, writes Gerry Georgatos.

*CONTENT WARNING: This article discusses suicide

IN 2018, 169 First Nations individuals suicided. Up from the preceding year’s 165 and 162 the year prior, nearly every year this century, the First Nations suicide toll has increased.

At the turn of the century, there were on average just below 100 suicides in the last years of the 1990s. From 2001 to 2010, there were 996 suicides of First Nations individuals, an average of almost 100 suicides each year. The annual suicide toll in the half-decade to end 2018 increased by more than 50%. 

By the end of 2019, the First Nations suicide toll that year had staggeringly increased to 196. I had been warning from near the beginning of the year of an increasing suicide toll. In the first eight days of 2019, five First Nations girls – two, aged 12 years; two, aged 14 years and one, aged 15 years – died by suicide.

By the end of February, First Nations suicide was higher than in any comparative period. I had been screaming it would reach thereabouts 200 by the year’s end — which would translate to one in 17 First Nations deaths as a suicide. To put that into context, one in 50 Australian deaths is suicide and one in 40 migrant-born deaths in Australia is suicide. From a disaggregated racialised lens, it is my assessment that Australia's one-in-17 First Nations suicide count is the world’s highest rate of suicide.

In 2019, suicide accounted for 5.7% of all First Nations deaths — three times as high as the comparable proportion for non-Indigenous Australian deaths at 1.9%.

The suicide toll was record-high for First Nations people in 2019 and will be again for 2020, and I forward estimate it will be the case again for 2021 — except for Western Australia.

In January 2019, after the tragic loss of the five girls, I self-funded and established the National Suicide Prevention & Trauma Recovery Project (NSPTRP). Of the 15,000 individuals we have supported in the two years since, 70% have been First Nations individuals and of those First Nations individuals we supported, 70% live (or lived) in Western Australia.

We focused majorly on Western Australia. I argued to governments at the time that we could reduce the First Nations suicide toll by half if there was an adequate investment in substantive outreach capabilities and concomitant resources. 

In the decade leading up to my establishing the NSPTRP, I had raised nearly $100 million in funding (from governments and various benevolence) for 19 projects to assist our vulnerable sisters and brothers. Of the funds, 70% raised established long overdue projects and services for vulnerable First Nations individuals.

Among them, was a post-prison training-to-employment program: Ngalla Maya. In the last few years, more than 300 people since leaving prison have completed various training. More than 250 of them are presently employed.

We have facilitated education programs that have seen hundreds graduate at the tertiary level and set up a national suicide post-intervention service to assist with loss and grief, of which – for two and half years – I was the inaugural coordinator of responders.

I secured funding for Australia’s most successful eviction prevention and tenancy stabilisation service, and this service – with a near 100% eviction prevention record – has kept a roof over the heads of more than 2,000 of Perth’s First Nations children. 

But despite raising near $100 million in funding, I was not able to win hearts and souls to fund a 100%-based outreach suicide prevention service. So, I spent from my savings and worked pro bono for the last two years. I claimed we would reduce the Western Australian First Nations suicide toll in 2019 by more than 20% — and we did. 

In 2018, the First Nations suicide toll was 39. There were 381 suicides of West Australians in 2018, of whom 39 were First Nations. In 2019, the West Australian suicide toll increased tragically to 418 but the First Nations suicide toll decreased to 31. It is our claim that this is no coincidence, but a correlation. Our outreach, its intense psychosocial support, the relentless throughcare — that was the differential. 

If we were resourced adequately, we could have achieved the same results right across the nation and for the first time this century, significantly reduce the national First Nations suicide toll compared to preceding years. It is the story most Australians are crying out to hear. But the political will is not there and in my view, what political will does exist is a mix of stupidity and chicanery. 

So, while we reduced the First Nations suicide toll in Western Australia, the toll went up everywhere else. Of First Nations suicides in 2019, 30% were of females compared to 24% of suicides of non-Indigenous females. The annual suicide rate increase of First Nations males across Australia is dramatic.

According to the Australian Institute of Health and Welfare (AIHW), the 2018-2019 rate of intentional self-harm hospitalisations for non-Indigenous Australians was 109 hospitalisations per 100,000 population. First Nations hospitalisations for intentional self-harm were three times that rate — at 341 hospitalisations per 100,000 population.

This is where relentless psychosocial outreach can make the difference — actually being there for people. 

Also, according to AIHW, the 2018-2019 rate of intentional self-harm for First Nations youth and children aged 15 to 19 was staggering at 668 hospitalisations per 100,000 population (the leading cause of death – by suicide – for this age group). Comparatively, the non-Indigenous rate for 15 to 19 years of age was less than half — 332 hospitalisations per 100,000 population. Disaggregated to First Nations females aged 15 to 19, it was harrowingly highest — 1,045 hospitalisations for intentional self-harm per 100,000 population.

What should be unimaginable, is the percentage of Australian children who suicide, aged 10 to 14. First Nations peoples account for 3.3% of the Australian population while First Nations children – less than 18 years of age – account for nearly 5.9% of Australia’s population aged less than 18 years.

But, for First Nations children aged 14 years and less suicide is the second leading cause of death — and they are up to eight times more likely to die by suicide than non-Indigenous children.

The nation should weep. This more than indicts and damns our nation. It is intergenerational criminality of the most hideous reprehension. The original sin of racism continues to haunt unabated, abominably. 

Long have I called for and argued – and evidenced – relentless outreach, for intense psychosocial supports, for throughcare and aftercare. I continue to call for these, because through this "people-supporting-people-in-person" approach, we can reduce the suicide toll — not only for First Nations, for all Australians. It breaks my heart that one government after another instead – to be seen to be doing something – funds research, which delivers more of the same “recommendations”.

Wherever the NSPTRP has dished out its intense psychosocial support, relentless outreach and throughcare we have delivered.

During Western Australia’s 2020 March to May COVID-19 lockdowns and ban on travel – not only interstate but also regionally in Western Australia – Banksia Hill Detention Centre (BHDC) saw a number of provider services pull out of this kids' prison.

The NSPTRP was asked if we’d provide in-reach services to Banksia for eight weeks. We did. We were the only external service during this period going in, daily. We worked substantively with female detainees, aged 11 to 18.

In the eight weeks, we reduced the prison population of the girls from 18 to 7 – by more than half – and worked with 31 female detainees in terms of turnover during the eight weeks. The majority had self-harmed, lived horror lives — their families never had a chance from the beginning of life. We won the trust of the Children’s Court and we invested pro bono outreach for as long as we could, post-release. 

The self-funded NSPTRP is winding down but leaves a compelling narrative. We are three remaining core psychosocial workers, with 12 other volunteer workers and two sister services (which I secure funding for) that assist when we tap them on the shoulder.

We are a patchwork effort of can-doers but after two years plus we are winding down and out as we are unfunded beyond my savings. I can no longer afford to self-fund this service. I also live with Parkinson’s disease, diagnosed two years ago and worsening. I do not regret the sacrifices of the last two years, as we have saved lives, changed and improved lives and shown the way.

The youngest suicide I have responded to, where I have worked long-haul to support the family, was that of a nine-year-old child. The youngest attempted suicide I have responded to was of a six-year-old. Our governments must fund the capacity for as many of the affected as possible to improve their life circumstances.

There are many whom we have kept alive by someone being there for them, by improving their lives, by validating their trauma and subsequently disabling their trauma. We were and are there for them. There is no legacy more important than the one that improves the lot of others to the point of saving lives.

I remember everyone lost to suicide but foremost I remember those lost to suicide that we could have helped if we had been resourced to do so.

If you would like to speak to someone about suicide you can call Lifeline on 13 11 14.

Gerry Georgatos, the son of CALD migrants, is a suicide prevention and poverty researcher with an experiential focus. He has a Master in Human Rights Education and a Master in Social Justice Advocacy & Civil Rights Arbitration. He is the national coordinator of the National Suicide Prevention & Trauma Recovery Project (NSPTRP). You can follow Gerry on Twitter @GerryGeorgatos.

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