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Consultation On Improving Mental Health Services

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Consultation On Improving Mental Health Services

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Consultation On Improving Mental Health Services

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Question:
Discuss about the Consultation on Improving Mental Health Services.
 
 
Answer:

Introduction
The report is on the incidence of the high rate of suicide among old age group in Australia. It discusses the factors that contribute to suicide tendency among the adult population and gives a brief explanation regarding the high rate of suicide. It describes one strategy that has been adopted by the Australian government to address this issue and reduce the incidence of suicide among elderly. The cause may be multi-factorial such as depression, loneliness and withdrawal from society among the older population. This report tries to analyze and identify situations that lead to suicide in people above 75 years in Australia.
The Australian suicide statistics of 2016 reveals highest suicide rate among people above 75 years of age group. It has become a huge health concern for the country. In 2014, suicide accounted for 2% of all death caused in the country that year. It was also found that rate of suicide was more among males than in females. The number of males and females dying due to suicide in Australia was 75% and 25 % respectively in the year 2014. The rate was also found to be higher among Aboriginal and Torres Strait Islander people with suicide being the fifth leading cause of death among them. Suicide is found in all age group, but the peak age group for suicide is 75+ in Australia (Mindframe, 2016).
 
Contributing factors leading to suicide in Australia
Seeing the statistics on suicide rate among Australian population, there is a need to identify what factors lead to suicide in older people. The suicidal tendency may be due to a variety of information problems in an individual’s life like childhood adversity, the experience of traumatic events in life, the problem in the relationship, employment and use of alcohol and drugs by a person. All these problems have an adverse impact on a person, and they may suffer from depression and loneliness (Holmes et al., 2012). There are social isolation and lack of social support in these individuals. The contributing factors in old age suicide may include the following:

Lack of physical independency due to aging
Economic dependency on others due to retirement from work due to age or physical condition.
Mental health problems like dementia and Alzheimer’s in old people.
Depression, hopelessness and grief due to illness and declining health.
Alcoholism (Cleary et al., 2014).

As the proportion of older Australian is increasing, at the same time incidence of mental illness and dementia is also increasing. These disorders may vary regarding duration and stability in an individual. It interferes with older people’s cognitive, social and emotional abilities. Good mental health is dependent on psychological, biological and socio-cultural factors (Simelane, 2015).  Certain situations in older people like losing the ability to live independently, the experience of bereavement due to loss of life partner, drop or complete lack of income may lead to mental illness (Usher et al., 2013). Accumulation of all these factors leads to loneliness, increases physiological distress and tendency to commit suicide among older people. According to World Health Organization (WHO), accumulation of several risk factors from systemic, societal, community, relationship and physical issues increases individual vulnerability to suicidal behaviour (Hawton, K., i Comabella, C. C., Haw, C., & Saunders, K. (2013).. Another reason leading to suicide is that society’s or family member’s attitude towards older people is not good, and they may regard them as invaluable due to their lack of contribution to the economy. Moreover, some people feel them more as a burden due to many kinds of frailty and diseases they may have due aging. When society disregards them and does not consider them as a valuable member of the society, this factor also demoralized older peoples and had an impact on suicidal mobility (Handley et al., 2014).
 
 
There is also a strong correlation between major depression and suicide. Older people lack activity in life, an increase in frailty due to aging, diagnosis of some diseases causes that community. People going through this phase experience avoidant and escape behaviours. It ultimately leads to aggression, irritation, violence and finally suicide (Sachs-Ericsson et al., 2014). Loneliness due to relationship breakdown, loss of life partner, the absence of family members due to personal commitments is the reason for suicidal behaviours in older adults (Singh, 2015). Alcoholism and drug use is also a factor leading to suicide in the elderly population  because alcohol triggers impulsive and violence behaviour and aggregates feeling of hopelessness, grief, and depression. It impairs people judgment level and problems solving skills (Morin et al., 2013). Lack of A coordinated has involved association with suicidal behaviour. Alcohol abuse in older peoples is warning signs of suicide.
Indigenous heritage also has strong relation link with suicide in Australia. Compared to non-indigenous populations, the rate of suicide is far higher in Aboriginal and Torres Strait Islander people of Australia (Ridani et al., 2015). The suicide rate is high due to the marginalization of the indigenous population, more incidence of chronic disease among them and lack of access to proper health care facility. Increases rate of chronic disease in the indigenous population is the reason why more people are depressed and have suicidal tendencies. On analysis of the cause of suicide in Australia, it is seen that majority of suicide about mental by social environment followed by sudden changes in an about life. These changes have an enormous impact on them, and it impairs their capability to regulate desires and aspirations. Suicide cause may also be related to weakened social purpose and activity in life. Apart from this morbidity associated with chronic illness drive people to commit suicide (Cheung et al., 2014).
 
Strategy for suicide prevention in Australia
Preventing suicide and suicidal behaviour is a key priority for Australian Government. The incidence of suicide has a great impact on the lives of family members who are left behind. As suicide is a complex phenomenon, there is no single cause and no single solution for suicide. But suicide is preventable, and the Australian government has worked to reduce the rate of suicide in Australia. They have adopted several strategies and policies to address the issue. One such strategy adopted by the Australian Government to prevent suicide is the Western Australian Suicide Prevention Strategy (Mental health, 2016).  It outlines the government and committees commitment to reduce suicide and prevent self-harm. It was developed after analysis of 20 years data on the incidence of suicide in Australia. This strategy is aligned with National Prevention Strategy called the Living is for Everyone (LIFE). In fact, Australia was the first country to develop a national strategic approach to suicide prevention. The LIFE framework has provided governance structure and guided Western Australia in their initiative for future (Robinson & Pirkis, 2014).
The six area of activity according to Life framework are as follows:

Improving understanding of suicide prevention- It involved researching on suicide and prevention to understand the warnings signs and risk factors for suicide, developing knowledge regarding community resilience for prevention of suicide and identifying the most effective intervention for the Aboriginal community (Song et al., 2014).
Developing individual resilience and capacity for self-help- The Australian government achieved this through the promotion of programs to support life skills that enhance individual resilience level. They also adopted and promoted mental health and well-being program for older people. They fostered an environment where expression of anxiety and grief was not met with stigmatization (Wright, 2013).
Improving community strength in relation to suicide prevention- In this area, they worked to raise awareness regarding characteristics required of resilient community. They developed skill of families and social groups to respond quickly to indicators of suicidal behaviour in people and encouraged older adults too talk more frequently about mental health problems and seek help. The Australian government also worked to support local agencies and groups regarding reducing individual risk and strengthened protective factors to respond to the situation (Cwik  et al., 2014).
Coordinated approach to suicide prevention- It involve coordinating suicide prevention activities across local and state government and between non-government and private sectors. They developed tools for information sharing and implemented a response model for those communities which has increased the incidence of suicide. As illness is also a contributing factor for suicide, it developed a mechanism to improve health service (Robinson & Pirkis, 2014).
Targeted suicide prevention- It involved specific action plans for isolated aboriginal community of Australia and development of an innovative plan for these population as they do not have access to health service (Silburn et al., 2014).
Improving standards and quality in suicide prevention- Under this activity, the government developed and promoted standards for suicide prevention and implemented systematic evaluation models. For this purpose they gave adequate skills and training to worker in suicide prevention (Krysinska et al., 2015).

 
Conclusion
The report covered the major health concern of Australia that is the incidence of high suicide rate among the older age group of Australia. This report provided informations regarding prevalence of suicide in Australian citizens and analyzed the factors that lead risk of suicide and suicidal behaviour. The identification of cause related to suicide gave idea about level of intervention required to improved situation. Finally, analysis of one strategy taken by the Australian Government helped in getting an idea about what the government has so far done to prevent the risk of suicide in the community.
 
Reference
Cheung, Y. T. D., Spittal, M. J., Williamson, M. K., Tung, S. J., & Pirkis, J. (2014). Predictors of suicides occurring within suicide clusters in Australia, 2004–2008. Social Science & Medicine, 118, 135-142.
Cleary, M., Jackson, D., & Hungerford, C. L. (2014). Mental health nursing in Australia: resilience as a means of sustaining the specialty. Issues in mental health nursing, 35(1), 33-40.
Cwik, M. F., Barlow, A., Goklish, N., Larzelere-Hinton, F., Tingey, L., Craig, M., … & Walkup, J. (2014). Selected Research Paper of the Week.American Journal of Public Health, 104, e19-e23.
Handley, T. E., Hiles, S. A., Inder, K. J., Kay-Lambkin, F. J., Kelly, B. J., Lewin, T. J., … & Attia, J. R. (2014). Predictors of suicidal ideation in older people: A decision tree analysis. The American Journal of Geriatric Psychiatry, 22(11), 1325-1335.
Hawton, K., i Comabella, C. C., Haw, C., & Saunders, K. (2013). Risk factors for suicide in individuals with depression: a systematic review.Journal of affective disorders, 147(1), 17-28.
Holmes, A., Christelis, N., & Arnold, C. (2012). Depression and chronic pain.Medical Journal of Australia, 10, 17.
Krysinska, K., Batterham, P. J., Tye, M., Shand, F., Calear, A. L., Cockayne, N., & Christensen, H. (2015). Best strategies for reducing the suicide rate in Australia. Australian and New Zealand journal of psychiatry, 0004867415620024.
Mental health. (2016). Mentalhealth.wa.gov.au. Retrieved 12 August 2016, from https://www.mentalhealth.wa.gov.au/Libraries/pdf_docs/WA_Suicide_Prevention_Strategy.sflb.ashx
Mindframe. (2016). Mindframe-media.info. Retrieved 11 August 2016, from https://www.mindframe-media.info/for-media/reporting-suicide/facts-and-stats
Morin, J., Wiktorsson, S., Marlow, T., Olesen, P. J., Skoog, I., & Waern, M. (2013). Alcohol use disorder in elderly suicide attempters: a comparison study. The American Journal of Geriatric Psychiatry, 21(2), 196-203.
Ridani, R., Shand, F. L., Christensen, H., McKay, K., Tighe, J., Burns, J., & Hunter, E. (2015). Suicide prevention in Australian Aboriginal communities: a review of past and present programs. Suicide and life-threatening behavior,45(1), 111-140.
Robinson, J., & Pirkis, J. (2014). Research priorities in suicide prevention: an examination of Australian-based research 2007–11. Australian health review, 38(1), 18-24.
Robinson, J., & Pirkis, J. (2014). Research priorities in suicide prevention: an examination of Australian-based research 2007–11. Australian health review, 38(1), 18-24.
Sachs-Ericsson, N., Hames, J. L., Joiner, T. E., Corsentino, E., Rushing, N. C., Palmer, E., … & Steffens, D. C. (2014). Differences between suicide attempters and nonattempters in depressed older patients: depression severity, white-matter lesions, and cognitive functioning. The American Journal of Geriatric Psychiatry, 22(1), 75-85.
Silburn, S., Robinson, G., Leckning, B., Henry, D., Cox, A., & Kickett, D. (2014). Preventing suicide among aboriginal Australians. Working Together. Canberra: Government of Australia.
Simelane, G. L. (2015). Lived experiences of student nurses caring for intellectually disabled people in a public psychiatric institution (Doctoral dissertation).
Singh, S. D. (2015). Loneliness, depression and sociability in old age. The International Journal of Indian Psychology, Volume 2, Issue 2, No. 2, 73.
Song, I. H., Kwon, S. W., Kim, J. S., You, J. W., Park, J. H., Kim, L., … & An, S. (2014). Cross-National Comparison of Public Awareness Campaigns for Suicide Prevention: Analysis of Campaign Strsategies and Contents of New Zealand, USA, Ireland, Scotland, Australia, and Korea. The Journal of the Korea Contents Association, 14(7), 253-270.
Usher, K., Park, T., Foster, K., & Buettner, P. (2013). A randomized controlled trial undertaken to test a nurse‐led weight management and exercise intervention designed for people with serious mental illness who take second generation antipsychotics. Journal of advanced nursing, 69(7), 1539-1548.
Wright, P. (2013). Submission to the Consultation on Improving Mental Health Services in Country Australia.

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