More of the same isn’t working, but you won’t hear this from governments or myriad suicide prevention associations.
One hundred and twenty years ago an American Baptist minister named Harry March Warren opened Save-A-Life-League, the world’s first suicide prevention organisation.
Warren espoused rather bizarre views about men, family, religion and sex, yet he also recognised a link between precarious financial situations and self-death, which he saw as an inability to cope with undesirable circumstances, especially for single mothers in a society devoid of social supports or welfare.
By supporting those lacking housing, food and clothing, Save-A-Life prevented suicides.
Warren’s 1906 initiative inspired William Booth (founder of the Salvation Army) to establish the Anti-Suicide Bureau in Britain. Suicide prevention organisations then spread across Europe “giving sympathetic and sensible advice to despairing persons tempted to end their existence” as one paper described it.
Despair is the key word.
These pioneering preventionists understood that not all suicides were related to mental ill-health. They understood “situational” suicide; that poverty, debt, hopelessness, helplessness, violence, substance abuse, loneliness, social isolation, racism, as well as physical and psychological pain, led many to self-death.
Suicide and attempted suicide were illegal in England until 1961 (and is still a criminal act in about 20 countries); the Bureau therefore kept some from the horrific ordeal of British prisons.
In the following century, circumstance and situation were relegated as suicide prevention became subsumed, funded and “managed” by health systems.
Suicide is now inextricably associated with mental illness, with a well-funded prevention industry dictating policies and programs. Suicide prevention is funded by health departments, not housing, employment or social services.
The preventionists operate with an underlying perfidy, not deliberately dishonesty or deceitful, yet seemingly unwilling to acknowledge that suicide cannot always be prevented, and certainly not if “managed” primarily by health systems.
When prevention doesn’t save a life, when people are discharged into a void, when murders occur, psychiatrists, hospitals and the “health system” are held responsible, directly or by implication.
In response, governments promise to prioritise suicide prevention with more: more funding, more acute beds, more psychiatrists, more awareness campaigns, more strategies and suicide maps, more research funding.
More of the same isn’t working, but you won’t hear this from governments or myriad suicide prevention associations.
“Mental health will be a second-term priority for the government,” Prime Minister Julia Gillard pledged during the 2010 election campaign, committing an additional $277 million to help Australians at risk of suicide.
Almost a decade later Ms Gillard, as chair of Beyond Blue, boldly told a national suicide prevention conference that “the time is right, for the sake of society and the economy, to tackle suicide and make the seemingly impossible, possible”.
“Never before have public sentiment, political will, and our sectors been so aligned. This is our moment,” she said.
Ms Gillard wasn’t the only leader to assert that their government, through increased funding, would reduce suicide. Kevin Rudd convened a national advisory council, which collapsed in 2010 after chair John Mendoza resigned, rightly criticising the Rudd government’s lack of vision and commitment.
When Mendoza quit, Australian of the Year Professor Patrick McGorry said Australia’s mental health system “is absolutely on its knees”.
In 2017, the Malcolm Turnbull government, ignoring past (and failed) proclamations, said it was dedicated “to improving our national suicide prevention efforts” by funding 12 national suicide prevention trials, and increasing funding to prevention organisations.
Prime Minister Scott Morrison boasted he would “tackle the issue” by creating a National Mental Health Commission. Morrison said his government “is working towards a zero suicide goal”, again declaring suicide prevention a priority for the Coalition government.
At the time of Morrison’s “zero suicide” pronouncement, the most recent data (2017) confirmed 3128 suicides in that year; by 2023 the number of suicides rose to 3214.
The perfidy is exacerbated by the myth that suicide and mental illness can be “fixed”.
They approach suicide prevention with funding as the barrier, not the biomedical approach that prioritises medication, psychiatry and hospital beds over resources going to housing, day-to-day living supports, or changing laws that criminalise substance abuse and incarcerate those who self-medicate just to cope.
We can initiate and maintain ways to alleviate and intervene at crisis times, but this requires a restructure of how governments and bureaucracies administer appropriations, and Australia is not mature enough for this discussion.
The demands for a low-taxing economy stifles this type of policy discourse; that we trade higher taxes for functioning health, welfare, housing and social services systems.
Hampered by structural reform inertia, and unable to do more than commission reports and consult with stakeholders, governments and suicide prevention agencies continue to fund what they know, and what they know will be acceptable to a sector unwilling to acknowledge the limited effectiveness of current suicide prevention strategies.
The National Suicide Prevention Strategy 2025-2035 acknowledges the inability of health-led interventions; “Despite our advances, as a community we have not been able to reduce the stubborn prevalence of suicide among Australians.”
The statistics are grim: every year more than 3000 people die by suicide. That’s nearly nine people a day. Suicide is the leading cause of death for people aged 15 to 44, and the second leading cause of years of life lost.
The Strategy assures us that “our understanding of suicide has increased greatly”.
This may be, but the ability to implement effective interventions remains bogged in a mire of bureaucracy, competing loud voices, funding silos, and a refusal to remove media restrictions on reporting suicide so we can talk about it honestly and openly.
We’ve created a vicious circle: more strategies, more consultations, more recommendations, more money (because that’s the response), then repeat.
Suicide prevention strategies shouldn’t be obsessed with statistics, as if measuring slight fluctuations indicates “success” or otherwise. Strategies should be honest, however confronting this may be.
Suicide is not an aberration, an alien concept or phenomenon. It’s not “a national shame” as Scott Morrison so inappropriately called it. Suicide exists in every country, religion, culture and ethnicity. Suicide has been known since the beginning of recorded human history.
Suicide prevention is about the living, an understandable response to grief, tragedy, enduring loss and pain. We struggle with why? and what could I have done to prevent it? We seek answers, explanations. We appropriate blame. We turn our anger towards those we feel should have foreseen this, prevented it, intervened. If only we had more crisis helplines, more awareness campaigns, more funded psychological appointments, more apps and websites.
Australian governments have been unable – or unwilling – to address the risk factors.
They won’t reform drug laws to help, rather than criminalise users and those who self-medicate in the absence of appropriate healthcare.
Too many are living without basic needs, such as safe and secure housing, food security; they’re exposed to violence, racism and discrimination.
Governments cannot make a life hopeful and promising, but they can fund services and supports for those who find themselves in desperate circumstances.
They can build services that don’t discharge people from hospital to homelessness, they can fund day-to-day living supports, social workers, peer workers and others who provide critical, non-medical, supports.
We should not give up on identifying and intervening. We must continue to devise and implement programs and supports that reduce suicidality, and fund and promote online and medically effective methods that alleviate and defer suicidal actions.
Harry Marsh Warren, for all his antiquated religious views, identified the relationship between one’s circumstances and the risk of suicide.
Let’s be honest and stop talking about “zero suicide” and suicide prevention as an outcome that can be achieved if only governments invest more money and have more strategies and plans.
Simon Tatz was director of communications for Mental Health Australia, director of policy for Mental Health Victoria and co-author of The Sealed Box of Suicide: The Contexts of Self-Death.
