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The Weekend Neos Kosmos : 3 September 2016
22 THE WEEKEND NEOS KOSMOS | SATURDAY 3 SEPTEMBER 2016 DIGITAL.NEOSKOSMOS.COM Australia’s suicide prevention space is immature and inauthentic GERRY GEORGATOS The suicide prevention space is still raw and immature. There is a lot of work to be achieved in understanding the extensiveness of the space and its multifactorial issues. There is quite a bit of ground to travel in order to unveil the various ways forward. It's a space vulnerable to exploiters, carpet-baggers and snake oil merchants. To protect the space we need to explore the space, every bit of it. There are various traumas and contexts that remain effectively unexplored but which lead to suicide. There is much that we know works, much that works which is not applied and much that remains unexplored, and as a result the suicide prevention space is an inauthentic one polluted with far too many with little idea of what they are doing and who are over-involved or dangerously leading sections or layers of this life and death space. Far too many are in the space with limited knowledge and hence do more damage than good, indeed, perpetuate trauma, compounding trauma. Many have jumped into the space out of wellmeaning or from tragic lived experiences to at least be the shoulder that those with suiciderelated traumas rest on. Despite the great good, the solace that some provide, many fuel the anger, displace anger and hence traumas escalate. Then there are the specialist practitioners – some who consider themselves 'suicidologists' – and who argue their particular prevention, intervention or postvention program, therapy and counselling as the be-all and end-all when in fact the issues and traumas culminating in suicide are various, different, multifactorial (even if many are intertwining). There are also the researchers, many driven by a profit-motive – funding – and accolades, many who are surface-level researchers and remain doggedly in the generalised instead of serious disaggregation not just demographically but more importantly to various contexts and therefore to elevated risk groups. Far too many are setting up in the suicide prevention space prematurely to tap into opportunity to scratch out a quid, but at what price? Soaked in the blood of others? Soaked in the grief of those mourning? The space does need many more people, and interconnectivity, and the space does need the mavericks who will crash through the cor- rals of ignorance but what this life and death space does not need is snake oil merchants and carpet-baggers, or, if I can put this more civilly, the space should vet the ill- and uninformed. Many are speaking out as 'experts' without ever having studied or experienced in person the various traumas that lead to suicide and the anguish of the suicide-related trauma of affected families. Some have soaked up a little knowledge and are running wild as workshop facilitators in prevention, intervention and postvention. Of concern are the carpet-baggers, not just the ones at the coalface extracting a pricey quid at the coalface but also those who should know better, the 'highly' titled-up educated classes who scrummage government and philanthropic funding. This funding should be dedicated to those authentic within the suicide prevention space. Without data disaggregation we make invisible the elevated risk groups and we leave unidentified the specific risk factors. When we leave behind people, we are discriminating. We must leave no-one behind. Australia-wide, suicide takes more lives than all violence, including domestic homicides and military deaths and the road toll combined. The suicide toll should be the nation's most pressing issue, the issue of our time, but alas it has not translated as a national priority. I am deeply immersed in the suicide prevention space, as a researcher (on its extensiveness, the elevated risk groups and the ways forward), and daily absorb the grief and loss of the suicide-related trauma of affected families. There is a humanitarian crisis in this affluent nation – a catastrophic systematic crisis – taking more than five per cent of Aboriginal and Torres Strait Islander deaths – suicide. It's a staggering, harrowing statistic. In fact, it's even higher. In my estimations, because of underreporting issues, suicide is at 10 per cent of deaths. The contributing factors are many and intertwined, however, they are underwritten by acute poverty, disadvantage and marginalisation the likes of which should make no sense in one of the world's wealthiest nations. But they are not limited to socioeconomic factors alone – from within the cesspool of this situational trauma, this narrative of victimhood, there has become manifest a constancy of traumas – mul- tiple, composite and aggressive complex traumas. They need to be addressed in addition to the socioeconomic disadvantages. Friend and well-known former journalist Jeff McMullen recently emailed: "The losses are staggering and yet the election campaign continues to focus largely on the material comfort of people who are among the most comfortable in the world. Does your calculation of five per cent of the Indigenous population dying through suicide engage politicians when you tell them this? I find the numbers so catastrophic that it is hard to believe a nation can be so numb to this." That the nation has not engaged with the tragedy of suicide has contributed to the carpet-baggers exploiting the suicide prevention space. When the nation seriously engages with the suicide crisis, the suicide prevention space will benefit – the nation's engagement will be a protective factor, a contributing factor to developing authenticity. We need more than just generalised counselling but this last resort is the first resort. Resilience selling is part of this generalised counselling where we beg the victim to adjust their behaviours – but how far and for how long without hope on the horizon? Self-destructive behaviours that can culminate in suicidal behaviours and distress families and communities are a leading cause of familial breakdowns and of community distresses. Once again, the point is that the factors that can culminate in suicide are the most preventable of the various destructive behaviours that impact on families and communities. These need to be prioritised in national conversations. There are many ways forward. A national inquiry or royal commission into Aboriginal and Torres Strait Islander suicides – and in fact into all suicides – is long overdue. We cannot live in the silences and dangerously internalise this tragedy. I have travelled to hundreds of homeland communities and the people who are losing their loved ones are crying out to be heard, they are screaming. It is a myth and predominately a wider community perception that there is a silence, shame, taboo – it's the listening that is not happening. This humanitarian crisis needs to translate to a national priority. There is no greater legacy than to improve the lot of others, to the point of changing lives and saving lives. The royal commission should be a must-do. Despite all the good work by many and the saving of lives, the suicide toll, particularly for the most elevated risk groups, is on the increase. Without the deep examination that a royal commission will provide, the suicide prevention space will remain inauthentic, hostage to carpet-baggers and the ignorant and the toll will increase and a wilderness of grieving families and communities. The ‘memory of wounds’ remains, but needs to be contextualised with an understanding that meanings dawn from an onus on outstripping negative risk factors with protective factors. But this cannot be achieved with one-stop shop counselling but by identifying the various trauma and identifying the perpetration, the impacts and the subsequent coherent tailor made education will rapidly unfold. It is never enough to deal with the symptoms; the cause must be validated without languishing within it so as to avoid drowning in negatives and misery and instead to move towards the positive self. Identifying trauma in any given population, whether demographical or topical such as LGBTIQ, former inmates, foster children, the homeless, the chronically impoverished, newly-arrived migrants, culturally and linguistically diverse migrants and Aboriginal and Torres Strait Islanders or from within composites, we start with behavioural observations and proceed with the opportunity for the individual to tell their story. People need people, 24/7. Our capacity to listen is an imperative and must be achieved without judgment for often redemption is needed, forgiveness in addition to sympathy and empathy. These skills do not come easy to everyone but they are vital in the suicide prevention space, in trauma counselling, in restorative therapies, in navigating people to a positive self. We must be careful. Trauma expert, Emeritus Professor Judy Atkinson states: "We must act in a manner that does not re-traumatise those with whom we are working." Suicidal behaviour is often the culmination of a set of experiences, events and of an underlay of feelings – how one feels about themselves contextually in light of experiences and events.
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