CBPATSISP

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Prevention

Suicide prevention encompasses Aboriginal and Torres Strait Islander peoples’ holistic view of mental health, physical, cultural and spiritual health, and has an early intervention focus that works to build strong communities through more community-focused and integrated approaches to suicide prevention.
There are a number of programs and services offered across Australia that provide local, culturally appropriate strategies to identify and respond to those most at risk.

Browse Programs & Services

Aboriginal Mental Health First Aid (AMHFA-National)

Aboriginal Mental Health First Aid (AMHFA) is a national program designed to train participants to assist Aboriginal or Torres Strait Islander adults with mental health issues or crises until professional help is available or until the crisis is resolved. The course is offered routinely across Australia.

CONTACT
General Enquiries: 03 9079 0208
Email: mhfa@mhfa.com.au

Aboriginal Mental Health First Aid was informed by strategic guidance from a similar Canadian program, First Nations Mental Health First Aid (CMHFA). Evaluations of CMHFA reported that participants experienced gains in knowledge, self-efficacy, skills and decreased self-stigma. To make the program appropriate for Aboriginal and Torres Strait Islander (hereafter just Aboriginal) communities in Australia, after consultation with expert reference groups, stakeholders and local community members, the CMHFA was adjusted for cultural factors, to produce the AMHFA.

From 2007-2008, 199 Aboriginal Instructors were trained through one of the 17 five-day Instructor Training Courses held around Australia. Since then, over 600 Aboriginal people have become AMHFA Instructors, with 200 Aboriginal people currently active as accredited AMHFA Instructors. Since the launch in 2007, a revised 14-hour AMHFA course has been run approximately 2,700 times across all states and territories to over 50,000 members of the community.

Courses have been informed by a range of Delphi consensus studies drawing on the expertise of Aboriginal people with lived or professional experiences across Australia. Through these consultations, the 14-hour AMHFA Course is now in its third edition. Additional programs have also been developed to supplement the 14-hour course. These are:

  • A four-hour course for accredited AMHFA Instructors who have completed the 14-hour AMHFA Course to refresh their knowledge and skills three years after completing their training
  • A five-hour ‘Talking About Suicide’ course which focuses on teaching skills on how to provide mental health first aid to an Aboriginal person experiencing suicidal thoughts and behaviours
  • A five-hour ‘Talking About Gambling’ course which focuses on teaching skills on how to provide mental health first aid to an Aboriginal person experiencing gambling problems
  • A five-hour ‘Talking About Non-suicidal Self-injury’ course which focuses on teaching the skills of providing mental health first aid to an Aboriginal person engaging in non-suicidal self-injury
  • A Youth AMHFA course which focuses on teaching adults how to provide mental health first aid to an Aboriginal adolescent

The overall vision of those who have developed and implemented the AMHFA is of a community where many people have the skills to support those with mental health problems. To achieve this vision, the objectives are to:

  • Provide high quality, evidence-based mental health first aid courses to train community members to become accredited AMFA instructors
  • Provide refresher courses to accredited AMHFA Instructors
  • Consult regularly with Aboriginal communities regarding course updates
  • Update the courses according to these consultations

Aboriginal Mental Health First Aid focuses on developing knowledge about symptoms and behaviours linked with help-seeking by Aboriginal people experiencing mental illness, as well as increasing individual and community understanding of suicide prevention. Accredited AMHFA Instructors were more likely to run AMHFA courses if they had previous teaching experience and were provided with follow-up support from one of the program trainers. Overall, AMHFA has been shown to be effective in improving trainees’ knowledge of mental illnesses, their treatments and appropriate first aid strategies and increasing their confidence in providing first aid to a person experiencing a mental health problem. Other participant outcomes are decreases in stigmatising attitudes and increases in the amount and type of support which they are able to provide to others1.

An evaluation framework to inform and guide the implementation of the program was established at the commencement of AMHFA in 2007. The evaluation report by Kanowski et al. (2009)1 presented information on its uptake and acceptability for Aboriginal people based on quantitative and qualitative data. Analysis showed that both the Instructor Training Course and the AMHFA course were culturally appropriate, empowering and provided relevant and important information for training to assist Aboriginal people with a mental illness2.

A later evaluation3 confirmed that program attendance led to an improvement in the recognition of mental disorders, confidence in the value of treatment, decreased social distance from people with mental disorders, increased confidence in providing help and an increase in the amount of help provided to others, which was shown to be sustained for up to six months after program completion.

Aboriginal Mental Health First Aid was rated as strong evidence of effectiveness and best practice. It is evident from survey feedback and literature pertaining to AMHFA that the program is a valuable initiative to build community capacity. The program aligns with community consultations and enables people to talk, share with and build social connectedness. Concurrent action to address stigma by creating safe community environments was consistently identified.

A review of psycho-social programs3 to improve social and emotional well-being in Aboriginal people scored 16 interventions for strength of evidence. Aboriginal Mental Health First Aid was ranked first as having the strongest evidence with a 100% score. There was strong support from the Aboriginal respondents with 64% of the respondents finding the program increased knowledge and skills3.

The program is constantly evaluated and improved using the Delphi consensus method with 28 Aboriginal health experts participating across two independent Delphi studies.

This method was identified as a useful consultation tool for Aboriginal people gauging culturally appropriate best practice in mental health services. The AMHFA guidelines and culturally appropriate guidelines for providing mental health first aid to an Aboriginal person who is experiencing problems with alcohol or drug misuse have been updated. Furthermore, a trial of the latest edition of the 14-hour AMHFA Course and the ‘Talking About Suicide’ course is being planned to evaluate its efficacy.

A review of the program evaluations confirm that the AMHFA program is well-organised, comprehensive and provides a sound cultural adaptation of a more general program to assist Aboriginal people experiencing psychological distress. Importantly, this program is in accord with best practice guidelines and has been developed and managed by Aboriginal people.

Aboriginal Mental Health First Aid builds strengths and capacity in Aboriginal communities, especially by providing materials and resources that are appropriate for the needs of Aboriginal people in diverse community settings. It also offers access to community-based programs to improve suicide awareness among “gatekeepers” and “natural helpers” in communities affected by self-harm and suicide through contextualised delivery of programs to people in the community. It also builds strength and resilience in individuals and families through culturally appropriate, life-promoting, resilience-building and sustainable strategies that are tailored specifically for Aboriginal people. The program focuses on developing knowledge about symptoms and behaviours linked with help-seeking by Aboriginal people experiencing mental illness, as well as increasing individual and community understanding of suicide prevention. Aboriginal Mental Health First Aid was rated very highly as strong evidence of effectiveness and best practice.

It is evident from the feedback from the informational survey and the literature that the AMHFA training program is a particularly valuable type of initiative to build community capacity. The program aligns with community consultations regarding the need to enable people to talk and share with one another and build social connectedness.

  1. Mental Health First Aid Australia. Why Mental Health First Aid? 2018 [Available from: https://mhfa.com.au/why-mhfa.
  2. Kanowski LG, Jorm AF, Hart LM. A mental health first aid training program for Australian Aboriginal and Torres Strait Islander peoples: description and initial evaluation. International Journal of Mental Health Systems 2009;3(1):10.
  3. Day A, Francisco A. Social and emotional wellbeing in Indigenous Australians: identifying promising interventions. Australian and New Zealand Journal of Public Health 2013;37(4)

Alive and Kicking Goals (WA)

Alive and Kicking Goals is an Indigenous-led program from the Kimberley which aims to prevent youth suicide through football and peer education, one-on-one mentoring and counselling.

CONTACT
Kevin McKenzie – Phone: 08 9193 5904
Email: kevin@aliveandkicking.org.au

Alive and Kicking Goals (AKG) is a program designed to respond to local needs and interests, and to effectively engage young people. Operating under the Men’s Outreach Services and through peer education, this program is within the framework of suicide awareness and prevention. It takes a strengths-based approach by seeking to enhance protective factors such as capacity, confidence, competence and self-esteem and encourages positive help-seeking behaviours. Further, this program seeks to dismantle stigma by opening discourses around depression and suicidality. This is a community-based, community-developed and community-driven, peer-led, suicide awareness and prevention program which is grounded in continual learning.

In response to high rates of suicide among young people in the Kimberley, AKG was developed to provide a way for the community to work towards more effective prevention and a better understanding of protecting youth from suicide. Participants are shown that dreams are possible through hard work and passion. Services are based in Broome and workshops are conducted in nine other Indigenous communities across the Kimberley region. These are Derby, Fitzroy Crossing, Halls Creek, Looma, Bidyadanga, Beagle Bay, Djarindjin Community, One Arm Point and Lombadina.

A Steering Committee oversees AKG and key personnel are a Project Mentor (PM) and Peer Educators (PEs). The initial model of delivery was developed with the Broome Saints Football Club (BSFC). This club was established in 1960 and has a predominance of Aboriginal members and a very high standing in the community. Initially, weekly meetings were held after Football Practice. At these meetings were the Project Mentor (PM) and the youth sub-committee who were well-respected sportsmen and training to be volunteer youth leaders.  This training included the development of leadership skills along with suicide awareness and prevention. From these weekly meetings, emerged workshops where the young men from the youth sub-committee emerged either as PEs or remained on the Steering Committee. At the end of 2012, there were four full-time PEs; three young men and one young woman and by the conclusion of the pilot, there were 16 PEs1. Under the AKG program, PEs conduct holistic mini workshops which look at both protective and risk factors of Aboriginal suicidality. Participants learn healthy coping strategies and help-seeking behaviours for themselves and to impart to others. A safe space is provided where the young participants can discuss sensitive topics of importance to them.

The overarching goal is to reduce Indigenous youth suicide. It works to achieve this by conducting peer-led workshops which aim to:

  • Engage Indigenous youth
  • Enhance the protective factors for suicide
  • Encourage positive help-seeking behaviours
  • Provide a safe space which enables participants to discuss sensitive topics of importance
  • Dismantle stigma by opening discourses around depression and suicidality

Training PEs

A DVD and associated workshop were developed to train PEs to implement the AKG program. Trainees reported that the content of the DVD were relevant and appropriate within the Kimberley context. Many of the trainee PEs reported that the narrators of the DVD told stories that they could relate to. They could see themselves using ideas from the DVD to make aspects of their workshops more tangible and relevant to participants.

Participants

The DVD and associated workshop was well-received by participants who responded positively to the use of local narrators and content specific to their community. Almost 45% of the pre- and post-workshop survey participants demonstrated a positive change in attitude towards talking about suicide, their feelings, and help-seeking. In the focus group for participants aged 16 years and older, those who had attended the workshop and watched the DVD provided confident and detailed answers about how to deal with a person with suicidal ideation as compared with those who had not attended the workshop.

Program

  • The program is embedded in the community where it is delivered
  • There are two types of workshops: one for those aged 16 years and older, and another for those aged 10-15 years
  • The space where the workshops took place was safe so members were able to discuss sensitive issues of importance
  • In total, 449 people completed at least part of the pre-/post-workshop surveys with 255 (57%) answering all questions of each survey
  • The pre/post-workshop surveys indicated that most of the participants rated the DVD and workshop positively
  • All participants noted positive changes which indicated a positive impact of the DVD on attitudes and knowledge
  • Many participants had been touched by suicide

Resources

  1. Link to thirty-minute documentary about AKG: Part 1
  2. Link to Thirty-minute documentary about AKG: Part 2

Tighe and Mackay1 conducted an evaluation of AKG during the period from November 2010 until 2012. A process and impact evaluation using participatory action research with largely qualitative data was chosen as the most effective and feasible way to evaluate the program. During the collection period, all AKG workshop participants were invited to participate in the evaluation. For the 16+ year group, both pre- and post-workshop surveys were taken, as well as a focus group. Participants aged 10-15 years were invited to attend a focus group at school after the workshop. In addition, principals and teachers were invited to participate in a survey to express their perceptions of the AKG workshops. By utilising a combination of surveys and focus groups with varied participants, a greater contextual understanding was obtained.

Participants

The various evaluation tools showed that the process and impacts of AKG are positive. The process evaluation covered an analysis of the appropriateness of AKG’s content and implementation within a Kimberley context. The impact evaluation looked at participant measured change in attitude and knowledge about suicide after the workshop.

Findings

Two significant findings emerged from the evaluation. First, there was the way in which some participants constructed their responses around the recognition of someone who was feeling down or depressed. There was more a sense of physical presentation of the susceptible person, about how the person looked (face and body) and their physical and emotional isolation from their family and community. Second, some participants were shouldering the responsibility of saving people’s lives when, sometimes, a suicide may not be able to be prevented. People who take on supporting roles need to know that a suicide death is not their fault. They need to know that suicide prevention is a shared effort, not an individual one. When care-givers do not take care of themselves, they put themselves at risk of burn-out, and worse. While well-intentioned, these participants need to take care of their own well-being.

Three critical factors were found which underpinned the effectiveness and success of the program. These were:

  1. Initiative is embedded within the contexts in which it is working.
  2. The program is community-based
  3. The space where meetings took place was safe for participants

Alive and Kicking Goals building strengths and resilience in youth by:

  • The provision of culturally appropriate community activities to engage youth, build cultural strengths, leadership, life skills and social competencies
  • The development of life promotion and resilience-building strategies
  • Improving access to well-being services among Aboriginal and Torres Strait Islander males
  • Using long-term, sustainable prevention strategies that build resilience and promote social and emotional well-being which have been specifically developed for Aboriginal and Torres Strait Islander youth
  • The provision of services that engage Aboriginal and Torres Strait Islander youth and are appropriately linked with culturally competent services
  • Providing counselling and therapeutic support, including services for families who have experienced suicide or traumatic bereavement

In summary, AKG is promising evidence of effectiveness and practice. It is a program designed to respond to local needs and interests and to effectively engage young people. It takes a strength-based approach focusing on enhancing protective factors and working to dismantle stigma, open a discourse around depression and suicidality, and encourage positive help-seeking among young people.

  1. Tighe J, McKay K. Alive and kicking goals!: preliminary findings from a Kimberley suicide prevention program. Advances in Mental
    Health
     2012;10(3):240-45.

Deadly Thinking

Deadly Thinking is one of four programs developed by Rural and Remote Mental Health (RRMH) specifically for Aboriginal and Torres Strait Islander people – Deadly Thinking, Deadly Thinking Youth, Deadly Thinking, Train the Presenter and Creative Livelihoods. Using artwork to stimulate discussion, Deadly Thinking addresses emotional wellbeing (anxiety, depression) and suicidal behaviours and thoughts as well as substance abuse in Aboriginal and Torres Strait Islander people living in remote and rural Australia.

CONTACT
Peta Boorman, Program Manager
PO Box 126, Goodwood, SA 5034
1300 51 59 51
info@rrmh.com.au

Deadly Thinking is a culturally tailored, readily manualised program that comprises three phases: (I) train-the-trainer (TTT); (II) delivery of community workshops to Aboriginal and Torres Strait Islander community members in rural and remote Australia; and (III) ongoing support resources and networks (e.g. Facebook forums). Deadly Thinking is a suicide prevention program that also addresses social and emotional wellbeing for Aboriginal and Torres Strait Islander people and communities. Deadly Thinking uses a strengths-based model to develop skills to be able to yarn with others about topics such as anxiety, depression, suicidal ideation and substance abuse.

The program was developed by Aboriginal and Torres Strait Islander people in 2010 through Rural and Remote Mental Health (RRMH) who also offer mainstream programs for vulnerable groups (farmers and fly-in-fly-out workers) in the agricultural and resource sectors in rural and remote areas. Recurrent funding is grant-based and through enterprise contracts.

According to the Pilot Evaluation Report ‘The workshops were designed for all community members and particularly, Elders, those with leadership roles, ‘natural helpers’ or those with an interest in promoting awareness and discussion about social and emotional wellbeing issues. They aimed to elicit two-way understanding about emotional wellbeing problems and protective factors and to provide a framework for community leaders to facilitate ongoing discussion and information sessions.2

The program can be contextualised to meet the specific language and cultural needs of the community and ensures that existing community networks are included as a reference group. The program delivery is led by a trained Aboriginal and Torres Strait Islander facilitator with lived experience who engages small groups (10 to 20 participants) to participate in activities using art as a medium for generating discussion.

Participants are given materials to use and take with them with Deadly Thinking branding. The materials are designed to promote health literacy. Videos are used to present some of the content which features (amongst other aspects) yarning, staying strong, being proactive and maintaining a connection to country and culture. A focus of the workshops is establishing a culturally safe, confidential environment so that participants are comfortable to tell their own stories and share their personal experiences.

The program usually is delivered over six hours at a cost of around $200 per attendee but may increase depending upon the location of the session and travel costs.

Deadly Thinking Youth

Adapted from the adult Deadly Thinking program, Deadly Thinking Youth is for younger people aged between 12 and 17. While the program content is similar to that of the adult version, it is presented in a way that is sensitive and safe for a younger audience. Trained facilitators incorporate activities, such as artwork, sport, music and filming, into the program to engage young people in the Deadly Thinking material.

The program aims to help young Indigenous people to:

• Learn the importance of yarning with family and friends
• Be more aware and understanding what causes depression, anxiety and suicide
• Understand how life changes can contribute to stress
• Understand their own worries and how to deal with them – topics covered include cyber-safety, bullying and body image
• Develop plans to help deal with challenges to their social and emotional wellbeing and,
• Connect to culture and country as a source of strength.
The program has been designed for flexible, group-based delivery, either as a single one-day workshop, 2–3 half-day workshops or as individual units over a number of days or weeks.3

Deadly Thinking Train-the-Presenter program is a two-day program which allows communities to develop their own team of Aboriginal or Torres Strait Islander presenters.

Creative Livelihoods can be adapted and delivered to your chosen location by our professional and friendly team.

Ongoing support. Online support via Deadly Thinking Facebook group for members and regular social media posts providing information for trainers, organisations and past attendees.

Printed support materials Social and emotional wellbeing booklets, posters and passports. See online at: rrmh.com.au

The objectives of the workshops are to use a holistic approach to address social and emotional wellbeing, increase the community knowledge of mental health issues, particularly suicide prevention using a range of strategies and care pathways to accomplish this goal.

Deadly Thinking has as initial objectives:

• Increasing mental health literacy and knowledge about promoting emotional wellbeing and knowledge of where to go and what to do to access mental health services
• Increasing community participation and community empowerment
• Identifying and building the capacity of local champions and community leaders to facilitate informal learning about mental health within their communities and,
• Increasing community capacity to make informed choices about their mental health and wellbeing.

In addition, the Deadly Thinking workshops identified the following objectives for participants:

• Learn the importance of yarning with family and friends
• Provide some plans and pathways to help deal with social and emotional wellbeing issues for individuals, families and their community
• Raise awareness and improve understanding of depression, anxiety, Ngarlu and suicide
• Understanding change and how it contributes to stress and,
• Identify community members interested in and able to undertake more advanced programs such as the Aboriginal Mental Health First Aid course.

Additionally, Deadly Thinking provides contextualised, evidenced-based information about suicide and substance abuse. Participants learn how to proactively problem solve, seek help and stay strong. The program encourages the development, strengthening and maintenance of social and emotional wellbeing support networks within the community and amongst peers. Participants are also made aware of the need to be able to appropriately refer to other resources or pathways.

Deadly Thinking is a suitable entry program to more advanced programs such as the Aboriginal Mental Health First Aid course.

The evaluation of the Pilot study in five communities across Australia confirmed that the workshops effectively address:

• those things that give rise to stress, anxiety, depression and substance abuse, with particular regard to the Indigenous context
• how to recognise the symptoms in yourself and others
• information about suicide
• the affects of substance misuse
• self-help techniques, help-seeking behaviours and their effectiveness
• how to build social and emotional wellbeing support networks
• problem solving
• how to develop and utilise change management skills
• referral processes/pathways to care (which are accessible by remote Indigenous individuals and communities) and,
• the identification of community members interested in and able to undertake more advanced programs such as the Aboriginal Mental Health First Aid course.

Many participants were aware of the Aboriginal Mental Health First Aid (AMHFA) course, and 25% had completed the training.
In 2015, the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) Summary of Promising Programs conducted a review of the survey with 55 participants with the following results 60% found program worthwhile; 47% found it culturally relevant and between 35 and 39 % identified increased knowledge and empowerment.

Deadly Thinking sessions have been attended by over 420 attendees from 40 locations across Australia in Queensland, South Australia, Western Australia and the Northern Territory in the past ten years. Deadly Thinking has achieved a longevity that many programs have been unable to match. Rural and Remote Mental Health has maintained a commitment to this program as well as other specific programs for Aboriginal and Torres Strait Islander people and youth.

This evaluationalso shows that the program overwhelmingly assists the participants to be able to address their personal health and wellbeing issues. There is strong evidence1 that the program allows the participants to normalise yarning about health and wellbeing thereby removing barriers to early and proactive suicide prevention.

An independent evaluation was completed in 2018, a total of 413 attendees from 40 locations across Australia completed the Deadly Thinking program evaluation1. This evaluation showed that there is the opportunity for the developers of the program to consider a men-only program due to the lower number of male participants. The program is acknowledged by the participants as being culturally relevant however the authors caution that the program may not be changing the target behaviours long term.

In a pilot evaluation, the authors tested the use of well-considered, mainstream measures to evaluate the efficacy of the program in order to provide data that could be compared to mainstream programs but these were found to be too complex for the participants and subsequently modified.

A recent evaluation1 shows that just under three-quarters of the participants are women with around two-thirds of these women identify as being Aboriginal and Torres Strait Islander. The relative absence of men from this program may not provide the community with the proportional necessary skills to address social and emotional wellbeing within the population of men.

In summary, the evaluation found that the overwhelming majority of participants stated that the Deadly Thinking workshop:

• was highly acceptable and helpful (90%)
• produced a positive change in their attitude to mental health (94%) and,
• would help them understand and deal with their own worries (100%).1

A summary of the recommendations from the 2018 evaluation1 include:

1. consideration should be given to providing male-only workshops;
2. more attention should be made to follow-up activities to determine if long-term changes in behaviour, knowledge retention and reduced rates of suicide are occurring; and,
3. development of standardised, culturally appropriate instruments to measure outcomes that are reliable and valid.
4. Pre site visits could be longer and the workshop could include clearer processes for providing feedback, as well as follow up workshops.
5. Recommended as a precursor to AMHFA.

Deadly Thinking has demonstrated its relevance to its target audience and has grown into a well-rounded set of programs for many Aboriginal and Torres Strait Islander people. The program has been developed by Aboriginal and Torres Strait Islander people and has engaged in independent review to ensure a continuous quality improvement process. The program strengthens indigenous governance and helps build capacity within the communities in which the program is run. The program also allows for individuals to further build their understanding of referral processes through the Aboriginal Mental Health First Aid program.
The program is able to be contextualised and adapted to local community needs. Additionally, Aboriginal and Torres Strait Islander facilitators bring a culturally safe environment to the delivery of the course. CBPATSISP has assessed this program as being a promising program.

  1. Evaluation of Deadly Thinking: An emotional health promotion program for remote and rural Aboriginal and Torres Strait Islander communities 2018 Report. Orygen, The National Centre of Excellence in Youth Mental Health. [Available: https://www.rrmh.com.au/wp-content/uploads/2019/02/Deadly-Thinking-Final-Evaluation-Report-2018.pdf accessed 2019 October 15
  2. Pilot of Deadly Thinking Workshops Evaluation Report 2011. Developed and delivered by the Australasian Centre for Rural & Remote Mental Health [Available: https://www.rrmh.com.au/wp-content/uploads/2019/05/Deadly-Thinking-Pilot-Report-2011-reduced.pdf accessed 2019 October 15
  3. Deadly Thinking Program Brochure. Rural and Regional Mental Health. https://www.rrmh.com.au/wp-content/uploads/2019/09/Deadly-Thinking_Program-Brochure.pdf
  4. Snodgrass, W. J., Rayner, V., Rice, S. M., Purcell, R., & Bowers, J. (2020). Evaluation of a culturally sensitive social and emotional well‐being program for Aboriginal and Torres Strait Islanders. Australian Journal of Rural Health, 28(4), 327-337.

GREATS Youth Services (Maningrida, NT)

GREATS Youth Services consists of core programs delivered by Malala Aboriginal Health Service. These are an impressive range of community-determined programs and services for Aboriginal and Torres Strait Islander youth.

CONTACT

Melisango Dube (Mel) Phone: 0438 921 550Email: melisango.dube@malala.com.au

GREATS (Great Recreation, Entertainment, Arts, Training and Sport) Youth Services [GYS] is a core service provider of Malala Aboriginal Health Service and provides a range of services for Aboriginal and Torres Strait Islander (hereon Aboriginal) youth aged from 10-20 years. This provider commenced operation in 2009 and its range of programs and activities have been in response to a serious of suicides, self-harming and petrol sniffing incidents in the community.

Current programs include a range of activities encompassing sport, art, on-country events, culturally-based workshops and sessions on digital technology. Workshops are held from Monday to Saturday and examples are a workshop for young men and another for young women which include life skills, eating a healthy diet, and living a healthy lifestyle. Others include bush camps for at-risk young people where they are exposed to similar skills while removed from the community so that their harmful behaviour may be addressed. In another activity, young men experience woodwork and painting with community Elders. Importantly, school-aged children are not permitted at the Youth Centre during school hours.

A Saturday activity is a barbecue and drop in session with outdoor volleyball. Each day from six to nine pm, there is also a drop-in service at the Youth Centre for up to 75 children and youth.  Other services for youth include a crisis-safe house and a Youth Patrol and Outreach Program. Four times a year, there are school holiday programs and an annual National Youth Week celebration. Workshops targeting substance misuse and suicide interventions are conducted on a needs basis. The community is involved at all stages of program development with a bi-annual consultation with the Maningrida community to inform future programming. Youth workers are involved in on-going suicide prevention training.

These services aim to:

  • Enable youth to remain connected to culture and country
  • Reconnect disengaged and at-risk Indigenous young people to culture and country
  • Introduce youth to Elders and Traditional Land Owners by their inclusion of the latter in specialised workshops and programs
  • Employ staff from across the clan groups and to encourage others to work, train and participate
  • Foster peer support and provide pathways for young people

GREATS Youth Services trains and employs only local young people from across the clan groups as youth workers, sexual health officers, youth diversion officers and peer support workers. In this way, GYS provides a pathway to training and employment opportunities for local Aboriginal youth, along with mentoring roles for young parents in the community.  As well as delivering cross sector case management of Aboriginal youth identified as at-risk, GYS provide the opportunity for their high level of engagement within the community. Concurrently, different agencies are brought together to plan and coordinate this approach.

Malala Aboriginal Health Service conducts regular community assessments across the clan groups to ensure that the services of GYS are responsive to the needs and concerns of the community. There is also an ongoing review of suicide prevention planning.
In a  formal report1,  GREATS Youth Services was assessed as strongly aligned with building strengths and capacity in Aboriginal communities, building strengths and resilience in individuals and families and a targeted suicide prevention service. In addition, there was evidence of the development of governance and infrastructure and the capacity for planning to support the regional and local co-ordination of suicide prevention. Another identified outcome was the existence of comprehensive plans to develop and support the participation of Aboriginal people in the suicide prevention and wellbeing workforce. Another two outcomes were the development of standards for community engagement and cultural awareness in wellbeing services and for early intervention plans for Aboriginal people, families and communities. In summary, GYS was rated very highly as strong evidence of effectiveness and best practice and as an example of community determined, led and governed programs and approaches to addressing the issues facing its young people1.

GREATS Youth Services was assessed as:

  • A program with community leadership and governance responding to the issues of its young people
  • Targeting suicide prevention using a range of interventions2
  • Having the ability to build  the strength and capacity of the  community and the strengths and resilience of individuals and families within that community
  • Providing access to Aboriginal people at risk of suicide or self-harm
  • Development governance, infrastructure and the capacity for planning to support regional and local coordination of suicide prevention
  • Having comprehensive plans to develop and support the participation of Aboriginal people in the suicide prevention and wellbeing workforce
  • Having a high standard of community engagement, cultural awareness, early intervention  and wellbeing services for Aboriginal people1
  1. Walker R, Scrine C. The Aboriginal and Torres Strait Islander Suicide Evaluation Project: summary of promising programs, services and resources in Aboriginal suicide prevention and postvention. Perth, Australia: Telethon Kids Institute, UNiversity of Western Australia, 2015.
  2. Healthcare Management Advisors. Suicide Prevention in Aboriginal and Torres Strait Islander Communities: Learnings from a meta-evaluation of community-led Aboriginal and Torres Strait Islander suicide prevention programs. 2016. https://www.atsispep.sis.uwa.edu.au/resources

Gan'na Healing Program

The Gan’na healing program works through a trauma informed lens to increase the health and wellbeing of Aboriginal and Torres Strait Islander Peoples. It is working across most Central Australian communities.

Phone: Lukas Williams – 0455 558 625
Email:
director.ganna@gmail.com

The program develops grass roots healing programs while at the same time implementing a unique healing model that helps to build pathways to long term change at individual and community levels. Gan’na provides trauma informed workshops; men’s and women’s healing camps, community healing circles, education and custom programs.
Gan’na is currently working with Aboriginal communities in Hermannsberg, Uluru and Santa Tersia. It was the first responder to a suicide in Yuendumu (a town in the Northern Territory). They are now implemeting the SEWB model into that community as well as Mt Theo out station.

To deliver best trauma informed practices to all Indigenous and non-Indigenous peoples, as well as skilling up the Australian workforce, through a unique Indigenous pedagogy, allowing all Australians the opportunity to learn and respond as frontline trauma specialists.
Gan’na’s objective is to deliver programs that see community people heal together using the SEWB wheel which keeps all community members safe.

Case Study – Gan’na delivered a trauma workshop to a football team in Alice Springs who had been impacted by suicide. 5 of the players had taken their own lives. Gan’na delivered the workshop using the SEWB wheel that now hangs in their clubrooms. Two months after the workshop the club won all 4 premierships and have not had any repeat suicides or suicide attempts. The community feedback was that the workshop for the participants was life changing.

The trauma workshop for the football team was internally evaluated.
Yuendumu is currently being evaluated, externally and from what we see is using this in a way that is creating some deep healing so that community can respond to crisis situations.

To be updated in 2021

To be updated in 2021

Kimberley Empowerment Healing and Leadership Program

The Kimberley Empowerment Healing and Leadership Program is a program delivered by the Kimberley Aboriginal Medical Services (KAMS) team across the Kimberley in Western Australia.

CONTACT
KAMS, 12 Napier Street, Broome
Phone: (08) 9194 3200
Email: sewbadmin@kamsc.org.au

The Kimberley Empowerment Healing and Leadership Program was developed following the successful pilot of the Kimberley Empowerment Project initiated in response to the high rates of suicides in the region from 1999 to 2006. This course is delivered over 5 two-day blocks and a healing session over a 5-week period. In partnership with Centacare, this program is also delivered in the West Kimberley Regional Prison five times per year. It is delivered by the Social and Emotional Wellbeing (SEWB) team in the KAMS office.

The KAMS SEWB Team is supported by the Western Australian Country Health Service (WACHS) and the National Indigenous Australians Alliance (NIAA) to promote and support the social and emotional wellbeing of communities, and the capacity of the SEWB workforce, across the Kimberley.

The aims of the program are:

  • Raise self-awareness of the individual’s identity and strengths
  • Empower individuals to take control of their lives
  • Heal – Allow behaviour change so that individuals grow in all aspects of their life

KAMS has received significant government funding for their suicide prevention efforts, reflecting the quality of their programs and services, specifically the KEHLP. The Kimberley site was one of the first suicide prevention trial site in Western Australia.

During 2018 and 2019, 126 participants registered to participate in the KEHLP and 14 courses were delivered across the Kimberley in Broome (6), West Kimberley Regional Prison (5), Kununurra (2) and Bidyadanga (1). Of the registered participants,

  1. 35 were Aboriginal Health Worker students who completed the KEHLP Module 1 only as part of their training
  2. 38 completed the KEHLP
  3. 4 completed the Train the Trainer
  4. 49 did not complete the KEHLP – of these, 19 attended one or more sessions

Participant evaluation/feedback demonstrated that the KEHLP

  1. increased participants’ knowledge of SEWB
  2. improved confidence and knowledge of relevant SEWB concepts
  3. increased positive aspects and decreased negative aspects of their SEWB 

Participants also reported that KEHLP provided them with skills and tools to help them make positive changes to their behaviours. A significant outcome is capacity building where participants stepped into community leadership roles, progressed their careers and started a business.

The Kimberley Aboriginal Medical Services (KAMS) commissioned the Rural Clinical School of Western Australia (RCSWA), University of Western Australia (UWA) to evaluate the effectiveness of the Kimberley Empowerment, Healing and Leadership Program (KEHLP) in improving the Social and Emotional Wellbeing (SEWB) of participants. The evaluation report can be found here.

KAMS is a member of the Aboriginal Health Council of Western Australia and of the National Aboriginal Community Controlled Health Organisation.  KAMS is a partner of the CBPATSISP with strong mutual working relationships. KAMS is governed by a Board of Directors which comprises of representatives from each of KAMS Member Services in the Kimberley region. KAMS was assessed as a strong community organisation that is well respected by the local communities, providing best practice programs and services.

Carlin E, Seear K, Spry E, Ferrari K. Kimberley Empowerment, Healing and Leadership Program Evaluation: Final report to Kimberley Aboriginal Medical Services. Rural Clinical School of Western Australia, University of Western Australia, 2020. https://doi.org/10.26182/f307-zc62

Life for Koori Kids (Redfern, Sydney NSW)

Life for Koori Kids (LFKK) is an Australian not-for-profit voluntary organisation that supports children of Aboriginal heritage in Sydney’s inner city to overcome challenges and realise their potential.

LFKK provides an open network of support for families within the community, whether it be through education and training programmes, sporting activities, medical and dental support or strengthening Aboriginal cultural heritage.

Contact: Ailsa Gillett, OAM
Email:  AilsaGillett4@gmail.com

To be updated in 2021

To be updated in 2021

To be updated in 2021

To be updated in 2021

To be updated in 2021

To be updated in 2021

Maga Brandi Social & Emotional Wellbeing Support (WA)

The Maga Brandi Social and Emotional Wellbeing Support team is operated by Geraldton Aboriginal Medical Services. (GRAMS). The service is available in Geraldton and Mt Magnet in WA.
Geraldton
60 Rifle Range Road, Rangeway WA 6530
(08) 9956 6555
Mt Magnet
56 Attwood Street, Mount Magnet, WA 6638
(08) 9940 3222

The Social and Emotional Wellbeing (SEWB) team provides holistic and culturally appropriate social support services to support families and individuals in crisis. Counselling is available for adults and children for depression, anxiety, trauma, anger management and post-traumatic stress disorder.

The team consists of a social support coordinator, social worker, psychologist, social health worker trainee and a mental health trainee.

The service offers a range of support services from having a good yarn to developing strategies to help address and manage mental health issues including:

1) Domestic and family violence
Domestic and family violence can have a profound impact on the mental health of victims and witnesses. GRAMS can provide support by delivering culturally responsive counselling for children, their families and carers experiencing family violence and survivors of family violence.

2) Drug and alcohol abuse
Individual and group counselling for Adults and Youth. The GRAMS social and emotional wellbeing staff work closely with other agencies in the Mid West to provide the best support. GRAMS can provide brief intervention for Drug and Alcohol issues and can arrange residential rehabilitation and at-home detoxification if required.

3) Trauma and loss
The SEWB program helps Aboriginal and Torres Strait Islander who has suffered from trauma and grief through removal from family, social injustice, loss of culture and colonisation of Indigenous land. GRAMS aim to support the healing for Indigenous people by empowering resilience and strengthening mental health outcomes.

4) Suicide Prevention
Unfortunately, the Yamatji people of the Murchison/Gascoyne region have the highest suicide rate in the world. GRAMS offer services to address psychological distress, self-harm and suicide. We also have regular suicide prevention workshops to provide a culturally safe space for an opportunity to share your experiences.

5) U RITE? Call Centre
If you are feeling helpless, sad, lonely, or not like your normal self, contact our social and emotional wellbeing team for support. If you know someone who requires emotional support, you can refer them to our SEWB program. If you need to yarn about your feelings and talk to someone, you can also call GRAMS on (08) 9956 6555 and press option 2.

 

To be updated

 

To be updated

The executive committee of GRAMS are all Aboriginal peoples. GRAMs is an organisation of Aboriginal people, for Aboriginal people, controlled by Aboriginal. GRAMS recently launched the 2018 Suicide Prevention Project in 2021, an event graced by Minister Stephen Dawson MLC Minister for Mental Health, Aboriginal Affairs, Industrial Relations. The launch included sharing of lived experience of community member who has benefitted from the services provided by GRAMS.

Mowanjum – Connection to Culture (WA)

The Mowanjum Aboriginal Art and Cultural Centre is a creative hub for the Worrorra, Ngarinyin and Wunumbal tribes, who make up the Mowanjum community outside Derby, Western Australia. These three language groups are united by their belief in the Wandjina as a sacred spiritual force and the creators of the land. They are the custodians of Wandjina law and iconography.

CONTACT
Email:
 sales@mowanjumarts.com

Keeping Place and Media Project and the Junba project commenced in 2012 in the community of Mowanjum WA in response to a cluster of youth suicides. The Elders of the Mowanjum community believed that the learnings and activities that connect young people to culture, country and a strong identity would give them strength and be the source of their happiness and health. Community elders and artists expressed their fears for what they believe to be an inevitable loss of culture knowledge if committed efforts are not made to secure it for future generations. The programs respond to a belief that without culture, Mowanjum youth face losing their identity and elders fear the repercussions that loss will have on their children’s health and wellbeing.

Mowanjum Keeping Place and Media Project

The Mowanjum Keeping Place and Media Project records stories of people and places, language and perspectives for families and language groups living in the region. It delivers an interactive and participatory platform that supports the maintenance of culture and law through the promotion of intergenerational teaching and learning – for current and future generations. Multi-media and digital archives are two of the engagement strategies in the program with digital film and photos and sound utilised to capture storylines, songs, and dance and for young people to interview each other. These tools attract young people to the program and are an effective way in which they choose to engage with culture. The use of cameras also assists young people to overcome shyness. Cultural camps and the making of totems are another activity. Creative materials are produced by community members in collaboration with Mowanjum Aboriginal Art and Culture Centre and other partners for exhibitions, festivals, publications and community initiatives. Digital records of this material and its production is then stored for safekeeping, sharing and teaching.

Junba Project

Junba is a form of storytelling through traditional song and dance. The Junba project increases the number and scope of opportunities for young people to engage with Junba by arranging workshops that team youth with community elders and multimedia specialists.

Culturally, Junba is considered essential for good social and emotional wellbeing, and is a means for young people and families to strengthen intergenerational bonds and connection to country. Junba gatherings on country are arranged in the lead up to the annual Mowanjum Festival. During this time elders, parents and young people practice together. As learning is reinforced through practice and the retelling of stories, cameras are provided to young people so that photographs and moving image recordings can be made. Recordings are used in youth media workshops, as well as stored and shared via Storylines.
The programs’ rationale is to keep culture strong through the engagement of Mowanjum’s young people working closely with Elders to achieve intergenerational knowledge translational and sharing. Training in managing the digital collection addresses community unemployment rates and creates culturally relevant jobs and long-term employment for community members. Employment encourages community participation through meaningful work relating to cultural maintenance.
The Projects give young people the opportunity to engage with the latest multimedia equipment within a meaningful, cultural context.

• Provides young people, elders and children a pathway and a future built around a strong cultural identity and sense of belonging to their community. It is developing a repository of cultural knowledge and is developing multimedia skills among the community. The cultural and social fabric of the community has been directly strengthened by the program and the benefits to young people and Elders are recognised by many within the community
• A team of Trainee Digital Collections Officers have been recruited from the community who are also excellent community liaisons and advocates for the project
• Increased teaching and learning of Junba between Elders and young people
• Long term presence of the program in the community, the sustainability of the program and the staff that has resulted in an increased response to the activities and involvement of young people
• Community have come to value the program and recognise the difference it is making to young people and children
• Relationships of trust established between the program staff and elders and young people, including those who have been previously disengaged
• Ensures community ownership and community consultation, engagement and participation of the three language groups in all aspects of the program
• A completely inclusive approach to anyone wanting to be involved in the program
• Fostering a sense of pride, identity and leadership among young people who are then acting as important role models to young children in the community. An important outcome has been the eagerness with which young children are wanting to get involved and are aspiring to do the cultural activities and learnings
• Elders and young people experiencing a number of positive effects from their cultural knowledge exchange
• Ongoing opportunities for community to be actively involved in the recording of material across different mediums
• Promotes the planning, implementation and production of local initiatives that can then be stored and preserved for intergenerational teaching and learning
• Youth are encouraged to actively participate in exhibitions, festivals, bush trips and community initiatives, in diverse creative roles including dancers, artists, photographers and production assistants. Training and production equipment is available for their use on bush trips and in-house at Mowanjum Art Centre

Program evaluation is forthcoming.

These programs were rated very highly as evidence of promising evidence of effectiveness and practice. They are culturally embedded, responsive, based around a clear program logic, supports Indigenous social and emotional wellbeing and self-determination and pathways for young people.

To be updated in 2021

National Suicide Prevention & Trauma Recovery Project

The National Suicide Prevention & Trauma Recovery Project is non-racialised but in its first two years, since establishment in January 2019, two-thirds of people supported by the service have been First Nations.

Phone: 0430 657 309
Email:
info@suicidepreventionnational.com.au

 

The National Suicide Prevention & Trauma Recovery Project (NSPTRP) began in 2019 with a mission to provide outreach. It was set up with 12 outreach responders from across Australia, but predominantly in Western Australia. The NSPTRP supports people through multifactorial issues, including suicide prevention, education and employment pathways, and accessing Centrelink.

The objectives of NSPTRP include the following:

Suicide prevention
Poverty alleviation
Education pathways
Employment pathways
Tenancy stabilisation
Centrelink assistances
Post-prison support
Mentoring
Psychosocial counselling
Outreach
Advocacy and arbitration

The NSPTRP has assisted 19,000 individuals Australia wide, with 12,000 in Western Australia, since its inception in 2019.

In a pilot program at Banksia Hill Juvenile Detention Centre, NSPTRP saw the number of female detainees drop from 18 to seven in eight weeks.

The work of the NSPTRP has been recognised in the following releases:

Outreach program reducing ‘horrific’ suicide rate in First Nation communities (Health Times)

Intensive WA Suicide Program Proves Outreach Can Reduce First Nations Deaths (Sydney Criminal Lawyers)

National Suicide Prevention and Trauma Recovery Project supporting nation’s most vulnerable (National Indigenous Times)

Australia’s invisible Indigenous left behind (Independent Australia)

A universal wage will reduce poverty for First Nations people and for all Australians (Independent Australia)

Governments fail to keep suicide prevention service alive (Independent Australia)

Harmony’s story: Breaking the cycle of youth incarceration in Western Australia (SBS News)

 

Since inception over 2.5 years ago, 19,000 individuals have been supported with 2,100 Centrelink assistances.
From 22 March to 21 May, 2021, the NSPTRP reduced the Banksia Juvenile Detention Centre female prison population from 18 to 7.

There has not been a formal evaluation.

Indigenous ownership
Both First Nations and non-Indigenous led – the Indigenous stream is First Nations led

Community leadership
By First Nations advocates and director

Community consultation and co-design
Worked closely with the Geraldton Regional Aboriginal Medical Services
Partnerships with Ngalla Maya Aboriginal Corporation and Ngalla Maya’s First Nations Homelessness Project

Cultural responsiveness
Director of NSPTRP, Megan Krakouer was a former cultural advisor and educator

Stronger Smarter Yarns for Life

Stronger Smarter Yarns for Life is an early suicide prevention program that develops the skills of Aboriginal and Torres Strait Islander and non-indigenous people to understand the unique issues impacting First Nations People’s mental health and well-being and assists in recognising the signs of distress and to engage in yarning to support vulnerable community members.

CONTACT
Marion Wands, Director, ConNetica
Phone: (07) 5491 5456
mwands@connetica.com.au

In 2016 ConNetica Consulting collaborated with OzHelp and Chris Sarra, 2016 NAIDOC Person of the Year to develop the training program Stronger Smarter Yarns for Life. The program was piloted with and incorporated feedback from local elders and Aboriginal and Torres Strait Islander people in Bundaberg, Sunshine Coast and Canberra prior to completion. This program is delivered across Australia in metropolitan, rural and remote locations and includes a Participant Program and a Train the Trainer Program. ConNetica works with local communities to develop their abilities to provide suicide prevention training programs in line with community directions.

The program incorporates Chris Sara’s strengths-based approach to these yarns and provides learners with an understanding of the impact of intergenerational trauma and the effects of colonisation upon Aboriginal and Torres Strait Islander peoples and communities wellbeing. ConNetica contributed to the program their mental health, suicide prevention and program design expertise.

This is a one-day program early suicide prevention program that is designed to build the skills, knowledge and confidence of Aboriginal and Torres Strait Islander people and non-indigenous people to have early yarns with First Nations’ people who are vulnerable and or experiencing a personal crisis.

The program is evidence-based using the disciplines of population health, health promotion, suicide prevention, social marketing, change management and adult learning principles. All facilitators must be accredited and ongoing mentoring is provided. Programs are always delivered by 2 facilitators, with at least one being an Aboriginal or Torres Strait Islander facilitator. This training provides participants with:

  • an awareness of the prevalence of mental illness and suicide in Australia generally and for Aboriginal and Torres Strait Islander people
  • a strengths-based approach to social support and suicide prevention
  • an understanding of the unique factors contributing to thoughts of suicide for Aboriginal and Torres Strait Islander people
  • the skills and knowledge to identify signs and debunk social myths
  • tailored Indigenous mental health conversation planning tools
  • yarning practices and
  • list of suitable referrals, support options and resources at local and national levels.

The resources can be amended to meet local conditions and history. Base-line and completion evaluations are completed by the participants. Independent Australian National University – Centre for Mental Health Research has completed independent evaluations of the program which show statistically significant increases in suicide prevention knowledge, skills and willingness to have these important yarns.1 The program can be used as a preliminary session for other more detailed programs such as Aboriginal Mental Health First Aid.

The program is designed to introduce participants to early suicide prevention activities by being able to recognise:

  • the effects of colonisation
  • intergenerational trauma
  • distress and substance abuse in Aboriginal and Torres Strait Islander people at the community level.

Those who undertake this program would be working or living within a community. Therefore they would have first-hand knowledge of the community’s history and members. Participants are given an opportunity to develop skills in:

  • recognising when yarning is necessary
  • finding an appropriate moment to start the yarn
  • maintaining respect through a non-judgemental interaction
  • helping the person develop a plan to address their concerns and
  • if needed, be able to refer the person to other supports and resources.

Theories underpinning the program include:

  • stronger smarter philosophy
  • suicidality
  • health promotion
  • population health
  • social marketing and
  • adult learning and community development

While the program is an early suicide prevention program, the skills of yarning can be used to discuss other health-related and everyday personal matters.

The program has been delivered to more than 10 regional Queensland towns, and in Derby in the Kimberley, as well as in Canberra and Melbourne to a cross section of participants including traditional owners, community members, social workers, youth workers, teachers, police and health professionals.2 Participants do not need to have a pre-requisite knowledge of suicide prevention however they are required to have an interest in learning the knowledge and skills that lead to early suicide prevention interventions. The program has been delivered to over 400 people with attendees aged primarily between 21 and 50 years.

Participants are able to develop skills in recognising when yarning or intervention is required and based upon pre-and post-evaluations it appears that their confidence in their skills is greatly enhanced as a result of this program. The process of developing a yarning plan is given specific attention and is central in the program. There is little reference to formal psychological concepts in the learning materials as the language is kept to everyday language that resonates at a local level (such as ‘suss it out’) and focuses on positive action rather than diagnosis.

The program has been evaluated by the Australian Nation University’s Centre for Mental Health Research in July 2019 using both qualitative and quantitative techniques.1 The evaluation included an assessment of acquired knowledge and skills including the capacity for action (willingness) to engage in a yarn to reduce the suicide risk of a person, knowing when a yarn is required, and when to find the right moment to engage in the yarn, help another person express their thoughts and feelings, to adopt a respectful approach, to follow practical steps and take action if needed and, finally, to refer the person for help. They also asked participants how much they learned from the course.

The analysis of data from pre-and post-course evaluations showed the program was regarded as being very helpful to the participants. With the researchers reporting that Stronger Smarter Yarns for Life program achieved “outstanding results”.

Participants commented positively on the ‘simplicity of the resources’ which used lay language to communicate suicide prevention concepts, having ‘greater confidence in discussing sensitive issues with others, and the ‘relevance of the course to their community or professional work’.

The pre-and post-course evaluations showed a statistically significant difference between the two measures used in all of the areas on the self-assessment. The evaluation team concluded that:

“The majority of participants reported a statistically significant increase in their knowledge about the prevention of suicide. They reported improved skills to engage in a yarn to reduce the suicide risk of a person, including knowing when a yarn is required, to find the right moment to engage in the yarn, help another person express their thoughts and feelings, to adopt a respectful approach, to follow practical steps and take action if needed and, finally, to refer the person for help. Moreover, most participants were willing to engage in the yarn, to work out the practical steps learnt and take action if needed, and to refer the person for help.”p.221

While the evaluation team noted that the scope for improvement was limited given the results of the assessment were extremely positive they did suggest further work may need to be done in the program to help build the participant’s confidence in developing referrals to other supports and resources.

Stronger Smarter Yarns for Life demonstrates many of the guiding principles underpinning CBPATSISP which build on those identified in the ATSISPEP report Solutions that Work.3 Specifically, the program was co-developed by an Aboriginal and Torres Strait Islander person with expertise in education and leading experts in suicide prevention and Aboriginal community members with lived experience in consultation with community members. The team recruits and trains local Aboriginal and Torres Strait Islander people to deliver the program in Aboriginal communities. The program ensures that the local community is involved in the preparation and delivery of the program so that it meets local needs. The program is delivered in a culturally safe manner and is able to be adapted to meet local needs. The program uses data to measure its effectiveness and ensures that improvements and enhancements are made. CBPATSISP has rated this program very highly and as strong evidence of effectiveness and best practice.

  1. Martínez, N and Pérez, J. Stronger Smarter Yarns for Life Evaluation Report July 2019. Australian National University’s Centre for Mental Health Research.
  2. Media Release Oct 11 2018, Recognition for Stronger Smarter Yarns for life – Early Suicide Prevention Program
  3. Dudgeon, P., Milroy, J., Calma, T., Luxford, Y., Ring, I., Walker, R., Cox, A., Georgatos, G., & Holland, C. (2016). Solutions That Work: What the Evidence and Our People Tell Us. Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project Report. Perth, WA: University of Western Australia.

Suicide Story

Suicide Story is a three-and-a-half-day suicide prevention program created for use in Aboriginal and Torres Strait Islander (hereon Aboriginal) communities by Aboriginal people who live and work in remote communities. The workshop is structured around nine topics which are covered in an accompanying DVD and target community-based helpers.

CONTACT
Mental Health Association of Australia 
Phone: (08) 8950 4600
Email: info@mhaca.org.au

Suicide Story was developed by the Mental Health Association of Central Australia (MHACA) in partnership with a Suicide Story Aboriginal Advisory Group. The latter consisted of Aboriginal people from remote communities in the central Northern Territory (NT) who ensured the cultural appropriateness of the program. Under the Suicide Story umbrella, workshops are delivered by trained local Aboriginal facilitators. A local and culturally specific approach is used to guide participants through the process of understanding suicide and reducing the associated stigma so that they can effectively identify and respond to the signs of an impending suicide attempt in a family member or friend. This approach respects the unique needs and issues within each community.

Suicide Story was launched in March 2010 and funded by the NT Department of Health and Families and the NT Primary Health Networks to support healthcare workers and Aboriginal people living in remote communities. Suicide Story is a prevention-oriented program and responds to requests from communities using a capacity building approach. Suicide Story was adapted from the MHACA, Life Promotion Program (LPP) which delivered ‘gatekeeper training’ to healthcare workers and Aboriginal people who might encounter people at high risk of suicide. A two-day Applied Suicide Intervention Skills Training (ASIST) workshop was used in the NT in 2001 and was consistently in demand among those working in the community healthcare sector in Alice Springs. However, it was found that this model did not address some of the core issues central to the needs of Aboriginal people, especially those living in remote regions and town camps. Through extensive consultations with Aboriginal people and discussions with related service providers, the LPP team began to further develop this resource and the style of training to tailor to the needs of Aboriginal people. Suicide Story was created.

Utilising a community development and action research approach, Suicide Story is a community suicide awareness and prevention training program which is developed, led and delivered by and for central Australian Aboriginal people. Over the years, the content and delivery of the program have been reworked and adjusted through a continuous cycle of participatory action research and quality improvement processes according to extensive feedback from facilitators and participants.  A Suicide Story Aboriginal Advisory Group has been maintained to ensure ongoing cultural safety and the integrity of storytelling throughout the Program. This has optimised its effectiveness and ability to be applied in multiple communities and to multiple language groups. A key message to participants is that there are no right or wrong answers.

The program incorporates a DVD composed of short films that feature the voices of Aboriginal people, combined with animation, artwork, music, pictures and posters to generate scenarios, conversations and discussions. The DVD focuses on nine topics relevant to suicide, and accompanies nine modules that are completed over the three-and-a-half-day program to address the following questions:

  • Should we talk about suicide?
  • Why is suicide a problem in Aboriginal communities and how big is the problem?
  • What leads people to think about suicide?
  • How do I recognize a person at high risk of suicide?
  • What can families and community members do to help protect their community from suicide?
  • What gets in the way of helping?
  • What are good ways to support people at high risk of suicide?
  • How might people heal after the death of a loved one by suicide?
  • How can we keep the helper safe?

Core elements of the program are:

Listening … sharing … learning
By listening, sharing and learning from the stories of Aboriginal people, a relevant contextual picture of suicide is developed. Suicide Story contains meaningful training material that is respectful of the people, culture, language and context of people’s lives in Central Australia including Alice Springs, Santa Teresa, Yuendumu, Tennant Creek and Gove Peninsula. It includes drawings, animation and film that have been added to enhance this unique, culturally developed training resource.

Local artwork
In 2006, women from the remote community of Santa Teresa painted two banners for World Suicide Prevention Day which portrayed a local understanding of some of the causes of suicidal behaviour and some of the ways to care for people who display suicidal behaviour. This artwork and the associated story remind participants that Suicide Story is about ‘raw and real’ experiences. It is based on the premise that the best way of reducing the rates and pain of suicide for Aboriginal people is to guide them to understand their own experience and to bring to them new learnings in the best possible way.

A culturally sensitive approach
Suicide Story provides a culturally sensitive approach to understanding the issues surrounding suicide. It recognises the importance of learning through sharing stories and sharing knowledge through recognisable symbols, images and language in Aboriginal communities. The program uses a collaborative approach that allows community members to work with service providers in a culturally safe space.

The program’s mission is to target suicide by empowering local facilitators. This can be achieved by increasing the skills, knowledge and confidence of participants to work with at-risk people. In turn, local facilitators can work to improve the health and wellbeing of Aboriginal people in remote communities of Central Australia and restore their hope for the future.

The objectives of Suicide Story are to:

  • Deliver Suicide Story only within communities where Elders have formally requested the program and then, only if the community is considered ready for change
  • Deliver suicide prevention workshops in remote regions of the NT free of charge and to interstate workshops for a service fee
  • Accommodate varying levels of English literacy and different ways of learning among program participants
  • Empower adults in remote Aboriginal communities with the tools to identify the warning signs of suicide
  • Increase participant awareness of the problem of grief and trauma in their communities and to understand how this has been impacted by historical and social factors
  • Debunk the myth (especially among some Elders and smaller communities) that suicide threats, especially by young people, are ‘just kids mucking up’
  • Refer members of the community who seek extra and/or ongoing resources to the relevant provider(s)
  • Overcome the lack of understanding of some communities about the pain some people experience, especially in the smaller communities and homelands where fewer people have experienced suicide first-hand
  • Identify and support networks of appropriate people within traditional communities who would like to undergo training and work in their own regions/communities
  • Work with the community to identify the issues, the requirements and how this can be achieved within the context of service providers and existing programs
  • Encourage service providers to attend workshops to increase their capacity to identify the warning signs of suicide
  • Explore impulsive suicide, suicide as a threat, along with blame and payback in Aboriginal people within a cultural and local context
  • Explore the history of social injustice and legislated change and the consequent losses which pertain to current suicide issues in Aboriginal communities
  • Examine issues around traditional language and skin groups and whether transgressing traditional systems exacerbates suicide rates and impacts the availability of resources for the transgressors.

The DVD helps participants to realise that there are many Aboriginal people who are willing to ‘talk up strong on suicide’ because of family members lost to suicide. From March 2017 to June 2018, Suicide Story delivered workshops to 141 participants. Each year, six workshops are delivered in the NT: two in the Top End and four for Central and Barkly regions. On average, around 20 people attend each workshop.

Suicide Story has been evaluated in 20121, 20142 and 20193. The program received recognition in 2017 by Lifeline with the LiFE Award for Excellence in Suicide Prevention in the Aboriginal and Torres Strait Islander category4. The program was recognised for the strong collaboration of developers with the Suicide Story Aboriginal Advisory Group to develop a curriculum. In the LiFE award evaluation, it was stated that 97% of participants gained skills to identify the warning signs of suicide and 98% stated that the workshop ‘strengthened their fire’ to support suicide prevention in their community4.

In a review of mental health and suicide prevention services, the Northern Territory Mental Health Coalition described Suicide Story as an example of an invaluable prevention resource which required long-term and secure funding5. Reviewers expanded with an explanation of how Suicide Story aimed to reduce the need to remove people at risk of suicide from their community by providing local people with the skills, confidence and ability to deal with attempted suicides or suicide ideation5.

The most recent evaluation3 sought to answer three questions which related to 1) assessing the impact at the individual and community level, 2) how this impact can be strengthened, and 3) the continued benefits after the delivery of the workshop. The findings are that the program is having a positive impact on the resilience of individuals and the community through increased awareness of grief, trauma and suicidal ideation; normalisation of discussions around suicide; and, increased confidence of individuals to proactively intervene. The factors that moderate these actions are (amongst other aspects) local governance, local language, local facilitators and being culturally appropriate to those involved.

In that evaluation3, it is recommended that the program proceed without fundamental changes except for the review and up-dating of the general materials and resources and the development of a youth-focused program with corresponding learning materials. The 2019 evaluation recommends a greater governance role for the program’s advisory group and increased governance by local Aboriginal community-led organisations with a reduced role of the Mental Health Association of Central Australia in the management of the program.

The 2019 evaluation3 does recommend that greater attention be paid to the preliminary groundwork prior to the program and an increased number of follow-up visits post-program. Considering the proven effectiveness of the program, the current evaluation3 recommends that Suicide Story be run more frequently and expanded through increased training and development of local facilitators and support staff. This last recommendation would require increased liaison and awareness-building in the minds of those in the funding and government bodies as to the value and effectiveness of the program which would lead to increased resourcing.

Suicide Story builds strength and capacity in Aboriginal communities and resilience in individuals and families. Specifically, it promotes participant capacity to initiate, plan, lead and sustain strategies to promote the awareness of suicide risk and subsequent prevention plans within a community.

Suicide Story also provides materials and resources which address the needs of Aboriginal peoples in diverse community settings. This program also provides culturally appropriate community activities that engage youth, build cultural strengths, leadership, life skills and social competencies, resulting in life promotion and resilience-building. Suicide Story also builds long-term, sustainable prevention strategies that build resilience and promote social and emotional wellbeing. It is specifically adapted from programs for the general public and made appropriate for Aboriginal families and children. Suicide Story also offers a coordinated approach through multi-sectoral co-ordination across levels and sectors of government and supports regional and local co-ordination of suicide prevention. There are agreements to support collaborative approaches to joint case management to ensure continuity of services and support for higher risk clients. There are also strong partnerships between services, agencies and communities.

Suicide Story demonstrates high standards in suicide prevention. There is a comprehensive plan to develop and support the participation of Aboriginal people in the suicide prevention and wellbeing workforce with a focus on community engagement, cultural awareness in wellbeing services, early intervention and a focus on quality improvement for social and emotional well-being and mental health care.

Suicide Story was rated very highly as strong evidence of effectiveness and best practice. Drawing on a strong theory base of what works in suicide prevention training, the program has been adapted to be culturally responsive. This is a very organised, well-structured and well-designed program with a clear set of deliverables and reflective practices. The program is able to be flexible, dynamic and accommodates different learning styles, languages, traditions, issues and levels of readiness. It is designed using logic and an approach that adheres to culture, a local approach by local people, and a respect for Elders and Aboriginal spiritual and cultural values.

Finally, the program strongly aligns with the guiding principles of the CBPATSISP Evaluation Framework. It emphasises the need to ensure the representation of local communities. The program examines the needs of each community and responds accordingly with an underlying emphasis on the significance of culture, history, and human rights. The program also incorporates an individualised plan for participants to identify the services and stakeholders and the ways in which the Suicide Story team can co-ordinate their work with the existing infrastructure within their community. This allows the program to address more pressing concerns that are specific to a community and advocate for any identified gaps in service.

    1. Lopes J, Lindeman M, Taylor K, et al. Cross cultural education in suicide prevention: Development of a training resource for use in Central Australian Indigenous communities. Advances in Mental Health 2012;10(3):224-34. doi: 10.5172/jamh.2012.10.3.224
    2. Evaluation of suicide prevention activities: Suicide Story Train the Trainer 2014
    3. Guenther, J., & Mack, S. (2019). Evaluation of Suicide Story, Final Report. Batchelor: Batchelor Institute of Indigenous Tertiary Education
    4. Suicide Prevention Australia. 2017 LiFE Award Winners for Excellence in Suicide Prevention Brisbane, Australia 2017
    5. Northern Territory Mental Health Coalition. Mental Health & Suicide Prevention Service Review, 2017.

Also see: 

Healthcare Management Advisors. Suicide Prevention in Aboriginal and Torres Strait Islander Communities: Learnings from a meta-evaluation of community-led Aboriginal and Torres Strait Islander suicide prevention programs. 2016.

The Enemy Within (National)

The Enemy Within comprises core programs of Walu-Win Gundyarri. These programs are focused on suicide prevention, healing and strengthening social and emotional well-being.

Joe Williams is the Director of the Enemy Within. He is a proud Wiradjuri Aboriginal man born in Cowra and raised in Wagga Wagga NSW. Joe played in the National Rugby League before switching to professional boxing in 2009. He has won world boxing titles, along with awards for suicide prevention. In 2015, Joe was awarded the title Wagga Wagga Citizen of the Year for his work in community mental health and suicide prevention. In 2017, he was a finalist in the National Indigenous Human Rights Award for his work with suicide prevention and his fight for equality for  Aboriginal people.  The following year, Joe was conferred the highest honour of Suicide Prevention Australia’s LIFE Award for his outstanding work in suicide prevention in communities across Australia.

CONTACT
Phone Spokesperson Mel Frearson: 0406192268
Email Joe Williams: info@joewilliams.com.au

Enemy within comprises core programs of Walu-Win Gundyarri. These programs are focused on suicide prevention, healing and strengthening social and emotional well-being of people within communities across Australia. Walu-Win Gundyarri sessions have been delivered in over 300 communities since the inception of Enemy within in 2014. Participant numbers since inception has reached many tens of thousands of people all ages, across Australia, NZ and USA.

Walu-Win Gundyarri programs are open to all, regardless of age or race. There are variations of delivery depending on age dynamic and with sessions specifically dedicated to Aboriginal and Torres Strait Islander (hereon just Aboriginal) audiences. Enemy Within caters for males and females of any age and from a variety of communities.

Programs are often developed in partnership with the community so that the program is tailored to its needs. To achieve this, Joe talks in depth and works closely with stakeholders, Elders and leaders within community. Joe reaffirms the importance of role modelling and looks to mentor young people in becoming the best version of themselves. Joe is almost always head facilitator, unless stepping back from this role is seen as empowering the community to  develop its own outcomes. Joe has the ability to connect and deliver with individuals in diverse situations, whether one-on-one, small or large groups, classroom settings or yarning circles.

Joe delivers a variety of workshops with the type delivered depending on the needs of the community. Often, Joe delivers to schools, sports clubs and community groups. Sometimes the delivery comprises a camp and various presentations of Enemy Within consisting of topics around addiction, substance misuse, wellbeing and trauma. There are also cultural programs for Aboriginal audiences only, which deal with identity, connection, generational trauma and healing by practising culture.

The Enemy Within website has gained traction in communities across the country and internationally. New invitations from communities to deliver Enemy Within are generated from news of the positive impacts left in communities where these  programs have been delivered. The Enemy Within programs, are sought as both prevention and postvention measures in reducing and healing from suicides.

Main objectives are to:

  1. Educate participants to understand and better manage mental health challenges
  2. Reduce the stigma of mental health challenges
  3. Promote a connection to self, land and community in participants
  4. Provide tools to help participants engage with others who are having mental health challenges
  5. Enable participants to understand the impacts of trauma in individuals

This program addresses disconnection, cultural wellbeing, suicide prevention and the impacts of trauma.  It also helps break down the stigma associated with talking about mental health challenges and reconnects individuals to themselves, family and community.

We could not find any evidence that this program has been evaluated. However, testament to the quality of Joe’s programs are the awards he has received for his work.

To be updated in 2021

To be updated in 2021

The Yiriman Project: Connection to Country (Kimberley, WA)

The Yiriman Project is a community cultural-connectedness program to assist young people to reduce risk-taking and self-harming behaviours and to gain meaningful employment.

CONTACT
Jen Klewitz
Women’s Project Coordinator
Mobile: 0439 648 020
yirimanwomen@westnet.com.au

Scott Herring
Men’s Project Coordinator
Mobile: 0428 764 269
yiriman@westnet.com.au

In 1997, the Yiriman Project (Yiriman) was initiated by Aboriginal Elders in the West Kimberley out of a deep concern regarding the large numbers of young people engaging in drug and alcohol misuse associated with anti-social behaviour and infringement of the law as well as self-harm and suicide. The primary aim of Yiriman was to take young people on-country in order to develop a sense of their cultural heritage to enhance their self-esteem and self-identity in order to prevent suicide. The Elders followed long-established traditions by setting up an organisation that would take young people, Elders and other community members on trips to country to hunt and collect food, meet others, interact with Elders, take care of country and walk as a way to learn stories and Aboriginal songs1, become healthy, build skills and respect traditions. Yiriman began in the Jarlmadangah Burru Aboriginal Community, approximately 100 kilometres south-east of Derby, Western Australia (WA) and has continued to operate under the clear direction of the Elders. Yiriman is an intergenerational, on-country, cultural program, conceived and developed directly by Elders from four Kimberley language groups: Nyikina; Mangala; Karajarri; and Walmajarri, the four cultural blocks of the West Kimberley region. Occasionally, Yiriman is involved in supporting similar projects in the North and East Kimberley regions. Yiriman is backed by the Kimberley Aboriginal Law and Culture Centre (KALACC) which is the principal organisation for the maintenance of customary law and life in the region.

Yiriman consists of hosting ‘back-to-country trips’ where young people, Elders, other community members and stakeholder groups are brought together. Stakeholder groups include land-care workers, educationalists, health practitioners, researchers and government officials. Yiriman trips vary in length, with some lasting only a couple of days to others which take a couple of weeks depending on the destination, the work done and the time of the year. Programs focusing on youth caring for country last a little over a month to offer longer diversion programs for youths, especially young men, to remove themselves from negative influences such as alcohol, drugs and crime.

The key aim is to ‘build stories in young people’ and keep them alive and healthy by re-acquainting them with country. There are four main cultural groups Nyikina; Mangala; Karajarri; and Walmajarri with similar cultural, geographical, language and kinship ties spanning a vast region of traditional lands stretching from the coastline south of Broome, inland to the desert areas south and just east of Fitzroy Crossing in the Kimberley in the far north of WA.

The Yiriman model aims to provide young people with opportunities to participate more fully in community events and in life, but also to enable their inclusion in a range of other events. These include land-care, cultural education, fire management, scientific and economic development, healthcare and education, tourism, training for employment and language regeneration.

Through the Yiriman Project, young people have been able to spend increasing time on country. Many have spent periods of two weeks on country learning culture from their elders. For example, on the Karajarri Women’s Cultural Camp in 2018, over 80 women and girls attended, along with 20 staff from eight different service providers. During the course of the camp, there was a range of workshops providing information and hands-on experience with bush medicines, bush dyeing, seeded jewellery-making and the likes. From these emerged the exchange of knowledge and activities between different age groups and cultural exchange generally.

Opportunities for participation in culture and life have been provided by the Walmajarri Women’s Tuesdays which began in August 2013 and continue. These workshops are held in partnership with Ngurra Art Centre and Marninwarntikura Women’s Resource Centre. These workshops have focused on art, jewellery making, seed and plant collecting day trips, artefact making workshops. These activities are held in the Ngurra Art Centre and other venues in the surrounding areas.

Picture book reports are regularly produced to show what has happened on trips using digital images, language, direct quotes and limited text. These picture books are also a way of publicising the Yiriman projects.

In 2016, a report2 from a three-year evaluation of the Yiriman project was published online. This report provides strong evidence of its effectiveness. Community members are respectful and supportive and Yiriman, with the support of Elders, has continued to conduct on-country trips and to support the cultural development of young people from the communities over four language groups. In 2015, Yiriman was recognised nationally with the award of Reconciliation Australia’s Indigenous Governance Award. Professor Mick Dodson, a member of the selection board summarised:

There is good evidence that taking young people and members of older generations on country is important for their health. There are definitely immediate healthy effects of taking young people away from their poor diets and living conditions. There is also evidence that Yiriman has assisted in the campaign to minimise young people’s involvement in the justice system.

He added that Yiriman’s achievements over almost two decades, demand the attention of government, philanthropic organisations and the broader community2.

In the Report of the Inquiry into Aboriginal Youth Suicide in Remote Areas, it was recommended that Yiriman be funded so that it could be used as a model across the Kimberley and in other areas3.

The Yiriman Project builds strengths and capacity in Aboriginal communities and resilience in individuals and families. In communities, it promotes the capacity to initiate, plan, lead and sustain strategies to promote community awareness and to develop and implement community suicide prevention plans. It also provides materials and resources appropriate for the needs of Aboriginal peoples from diverse community settings.

The Yiriman Project also identifies high levels of suicide and self-harm in communities and facilitates a planned response. It also provides culturally appropriate community activities that engage youth, build cultural strengths, leadership, life skills and social competencies through on-country trips, resulting in life promotion and resilience-building. The project is specifically developed for Aboriginal families and children and is founded on long-term, sustainable prevention strategies that build resilience and promote social and emotional well-being.

The Yiriman Project has undergone a robust evaluation identifying the rigour and effectiveness of the program for its context, with validated and culturally responsive and strength-based methodologies underpinning its approach to suicide prevention. It takes an upstream approach to addressing many of the risk factors for youth suicide and regards the role of connection to country, culture and law as critical for the youth from the remote regions. Yiriman was rated very highly as strong evidence of effectiveness and best practice and was also recommended in the Western Australian Coroner’s Report released in March 2019.

  1. Palmer D. Singing on country and singing for country. The Routledge Handbook of Community Development Research 2018:90.
  2. Palmer D. ‘We know they healthy cos they on country with old people”: Demonstrating the value of the Yiriman Project, 2010-2013. 2016. https://researchrepository.murdoch.edu.au/id/eprint/42383/1/Yiriman%20Project.pdf.
  3. Thorburn K, Marshall M. The Yiriman Project in the West Kimberley: an example of justice reinvestment? 2017 [Available from: https://researchonline.nd.edu.au/cgi/viewcontent.cgi?article=1137&context=arts_article accessed 2019 May 22.

Waltja is a community based organisation that works with families from Central Desert Indigenous communities to address major issues affecting their communities.

CONTACT
CEO Sharijn King
Mobile: (08) 8953 4488
manager@waltja.org.au

3 Ghan Road, Alice Springs NT

Waltja’s work focuses on addressing the many gaps in service delivery for children, youth, elders and people with disabilities in the remote communities of Central Australia. Waltja means ‘Family’ and our services follow the life-cycle of the family.

Our programs support youth, mothers and fathers, and elders in day to day activities and we aim to alleviate social distress and improve community relations more broadly.

All programs are the result of in depth consultations with the community and guidance is provided by our Indigenous board of directors.

At the core of Waltja’s work is a desire to develop members of the Central Australian community’s capacity for self-management and determination. Because at Waltja everyone is family, and in a family we support each other.

Irene Nangala talks about the Waltja Way
“Waltja learns what is happening in the community from the Directors. Directors talk to Executive. Executive talks with workers. Waltja workers are invited by the Directors to come to the community. They stay; they meet the Directors and their families. They make friends. They become family.

“Waltja workers listen to all people in the community with the Directors, young and old, men and women. We work together Anangu* with Kardiya,* workers with Directors, Waltja with community. It gives Waltja a better understanding of what people need, and gives us a strong voice with communities and with government. We make family from far and near. That’s why we called it Waltja – family.”

* Anangu is Luritja for Aboriginal people and Kardiya is Luritja for Non-Aboriginal people.

To be updated.

To be updated.

Wesley LifeForce Suicide Prevention Training for Indigenous Community Workers (National)

The Wesley LifeForce Suicide prevention training is a culturally responsive suicide prevention resource and training package with protocols and the curriculum specifically adapted for Aboriginal and Torres Strait Islander community workers.

Contact: Mary McNamara, Training Services Manager
Phone: (02) 9857 2570  Mobile: 0427 735 423

Email: Mary.McNamara@wesleymission.org.au

The Wesley LifeForce Suicide Prevention Training is an exemplar of an innovative initiative to adapt an existing mainstream suicide prevention program led by highly experienced Aboriginal community consultants using culturally responsive and reciprocal learning processes. In 2014 the Wesley Suicide Prevention Services engaged The Seedling Group to adapt the Wesley LifeForce Community Suicide Prevention Training Program to be culturally responsive for facilitators working with Indigenous peoples and to develop a resource for use by Indigenous community workers. The group consulted with local communities in Halls Creek in The Kimberley, Katherine in the Norther Territory and Thursday Island in the Torres Strait to receive feedback in order to develop a program that would be culturally appropriate for the participants. A key outcome required was the documentation and provision of a program design with content options informed by theory, research and cultural protocols, underpinned by professional practice and documented program logic. The initiative took place over a six months period.

The program has been designed to be adaptable to individual communities rather than ‘one size fits all’. The basis of the program is respectful knowledge sharing rather than facilitator led presentations. Starting in 2015, Wesley LifeForce carried out a series of suicide prevention workshops led by Aboriginal mental health workers. The aim of the workshops is to equip the participants with adequate knowledge about the high incidence of suicide in Australia, especially among Aboriginal and Torres Strait Islander people, and factors contributing to suicide. More importantly, the training improved participants’ confidence in identifying warning signs of suicide and intervening accordingly.

Wesley LifeForce is currently rolling out a Train the Trainer program: The Aboriginal and Torres Strait Islander Suicide Prevention Training project. This will equip Indigenous community workers to become a suicide prevention resource in their communities and facilitate suicide prevention workshops.

The key aims of the project were to:

  • Develop a culturally responsive training model in development and design, while adapting the existing Suicide Prevention Training program
  • Develop a resource to encourage the inclusion of collective healing and knowledge exchange, through the development of a training model which is both culturally appropriate and responsive to the individual or collective Indigenous community members attending. Discussions are held as yarning circles to enhance community capacity and engagement, to help increase community strength and resilience
  • Develop an evaluation framework to evaluate the efficacy of the program in suicide prevention

The outcomes of the project:

  • Recommendation, protocols and curriculum for a culturally responsive training package were developed to deliver suicide prevention training to Aboriginal and Torres Strait Islander community workers
  • Feedback was obtained from community members who would receive the training and represent the end user. This enabled cultural diversity to be incorporated into the integrated framework. Indigenous communities all gave their voice to guide the development of the project. Communities participated in the focus groups and also a pilot training program
  • Community members identified the best people to attend the training and focus groups
  • The consultants spent time in the community before and after the training and focus groups, to provide further information and exchange of knowledge as part of a reciprocal learning process
  • Consultations for the adaptation took place in three sites based on the communities’ needs and on the team’s existing connections and relationships with community members on a personal and professional level in Katherine, Northern Territory, Halls Creek, Western Australia and Thursday Island in the Torres Strait
  • Evaluation of the focus groups and the pilot training were conducted at the end of each session. Certificate of participation in focus groups and training were provided to attendees. Follow-up of participants by the team, or by agreed community members, was carried out following each session
  • Based on the consultations and evaluation follow-up, the Seedling Group research consultants identified the key features considered essential for effective community suicide awareness workshops and training. This included the key elements involved in the facilitation, delivery and evaluation

Facilitation

  • Relationships built with key community members before introducing the training into the community
  • A key Aboriginal or Torres Strait Islander local training assistant who is a recognised member of the community engaged to recruit community members for the training so that appropriate people are included on invitation lists
  • Local Aboriginal and/or Torres Strait Islander businesses utilised where possible for venue and catering purposes, accommodation and transport within the community
  • Care needs to be taken to ensure culturally appropriate opening and closing protocols are observed
  • The trainer and the local Indigenous training assistant review the presentation before the group training to ensure it is acceptable for that community
  • Group work is encouraged, as it is a cultural way of sharing knowledge and learning. This also allows those less articulate in Standard Australian English or less confident members of the group to be heard and ask questions of peers. Small groups working together offer safety and were requested by focus groups
  • Housekeeping to include how to proceed if the training is distressing participants in any way. It is likely that Aboriginal and Torres Strait Islander participants in this training will have been affected first hand by suicide, so the trainer should be trained to handle these situations during facilitation

Delivery

  • Spend time on introductions – it is critical when facilitating this training in community. This step is paramount to building trust with participants
  • Training should be given in a more informal ‘yarning circle’ or ‘round table’ setting
  • Sharing of knowledge, rather than imparting of knowledge; emphasising reciprocal learning
  • The opportunity for participants to add cultural content as a part of the training should be allowed and encouraged
  • In communities where English is the second, third or even the fourth language, an interpreter (e.g. someone in the community) should be engaged to translate the information
  • Include groups like Police and Community Youth Centres who have a strong relationships with some homeless groups in a number of communities
  • Pre-training evaluations and post-training evaluations carried out to measure effectiveness for different population groups
  • Using the qualitative evaluation process of “most significant change” to see how this training influences changes over time

Evaluation Findings
The key findings from this process provide important insights into the design and delivery of any program and service.

  • The project was planned with the concepts of community capacity building, community engagement and culturally acceptable knowledge sharing protocol as its core features
  • The project was planned to include full and fair participation of and input from the community members. This is considered not only an ethical and moral research practice, but a basic human rights practice
  • The critical importance of developing a resource that is very different from just an adaptation of an existing program. The developed program incorporates existing knowledge from the old program, however it is grounded in collective healing knowledge and a reciprocal learning focus. It is intended to improve the range and quality of suicide prevention knowledge skills and training material and programs available to the Aboriginal and Torres Strait Islander Peoples
  • The reciprocal learning within the training model enables the training to be effective in any situation
  • A problem with other training packages is the lack of interaction and ability for each community to raise their community needs and direct the knowledge transfer to best suit their needs. The inclusion of a community co-facilitator adds strength to the reciprocal learning for the community, as well as offering a small strategy of “continued or after care” response to knowledge to support the participants and community members following the training. It is also a critical step in building sustainable relationships with service providers like the Wesley Mission and community members. It is also a real example of culturally responsive reciprocal practice
  • Through the pre and post workshop evaluations, there was a strong increase in participants’ knowledge regarding the incidence of suicide in Australia and factors contributing to suicide. The participants also demonstrated an improved ability to identify suicidal behaviours, communicate with a suicidal person and conduct a suicide intervention. This provides evidence for the training’s capacity to improve people’s competence in addressing suicide in their community. Its aim is not only to increase awareness around suicide in the Aboriginal and Torres Strait Islander communities but also increase participants’ confidence in suicide intervention

The Wesley LifeForce training adapted model strengths and capacity in Aboriginal and Torres Strait Islander communities and resilience in individuals and families. Specifically, it promotes the communities to have the capacity to initiate, plan, lead and sustain strategies to promote community awareness and to develop and implement community suicide prevention plans. It also provides materials and resources appropriate for the needs of Aboriginal and Torres Strait Islander peoples in diverse community settings. The training program also improves suicide awareness among “gatekeepers” and “natural helpers” in communities affected by self-harm and suicide.

The evaluative assessment is based on several in-depth interviews and email correspondence with the two Indigenous practitioners involved in adapting the training program. Although the community training program specifically for Aboriginal and Torres Strait Islanders community workers was only recently launched in 2015, the program was developed on the basis of informed community perspectives. Many of the people who participated in the consultation to ensure the training is culturally responsive were Elders and families with lived experiences who spoke directly to their needs. This is consistent with recommendations in the Suicide Prevention Australia position (2010) and The Fifth National Plan. There is considerable evidence that confirms that community-led, grass roots suicide prevention practices are more successful in reducing trauma and death than programs designed and implemented by external agencies. Therefore the need for training specific to Indigenous communities is critical (Silburn et al., 2014). This adapted program includes elements that have been identified in both the national and international research in Indigenous suicide and the Strategy as essential for effective practice (Culture is Life 2014).

It is rated as promising evidence of effectiveness and practice. The inclusion of Indigenous community consultants in suicide prevention training and the inclusion of a ‘continuity care’ strategy and partnership increase the ability of Wesley LifeForce suicide prevention service which is rolled out nationally to provide effective culturally responsive practice providing all of the identified elements identified and reported by Kelleigh and Tujagu (2015) are implemented in all Indigenous community suicide prevention training.

To be updated in 2021

YAM: Youth Aware of Mental Health (ACT & NSW)

A school-based program for young people age 13 to 17 years where they learn about and discuss mental health through role-play, presentation and discussions.

Schools will need to contact a partnering organisation to find out if YAM is available in their local area. More information is available by contacting Education team at:

education@blackdog.org.au

https://www.blackdoginstitute.org.au/education-services/schools/yam/

YAM is delivered in schools in five one-hour sessions where students role-play and discuss everyday situations. Topics discussed that are important to them include relationships with peers and adults, mood changes, feeling sad or stressed. Students then reflect on how they might feel and discuss how to handle challenging situations. YAM is delivered in Australia in the ACT as part of the LifeSpan Trial, and across NSW in partnerships with organisations.
YAM has been adapted to be culturally appropriate for delivery with Aboriginal and Torres Strait Islander young people.

The objective of YAM is to raise awareness about suicidality and factors that protect it. This is done by improving mental health literacy and teaching skills to cope with adverse life events and stress, so that young people seek help before reaching crisis point.

The results demonstrated that YAM was effective in reducing new cases of suicide attempts and suicidal ideation by 50% and new cases of depression by 30% in youth participating in YAM.

 

YAM was evaluated in a European union-wide randomised controlled trial with over 11,000 youth participants. YAM has the strongest evidence base of school programs with outcomes specific to reducing suicidal ideation and behaviour, and depression and anxiety, thereby encouraging healthy lifestyle choices among young people.

YAM is evaluated in an Australian context through the LifeSpan Suicide Prevention Trials, based on the ATSISPEP recommendations for suicide prevention in Aboriginal and Torres Strait Islander communities highlighted in the ‘Solutions that work: What the evidence and our people tell us’ report.

The evaluation highlighted the success factors of YAM, with the creation of an open, non-judgemental safe space being more critical than having Aboriginal and Torres Strait Islander instructors, which was considered not an important factor.

In 2017, a review was commissioned by Black Dog Institute and led by Leilani Darwin and Julie Turner, experts in suicide prevention and school-based programs for Aboriginal and Torres Strait Islander young people. The review indicated that YAM is relevant and appropriate for Aboriginal and Torres Strait Islander youth. Cultural changes have been made to the language used in YAM to make it culturally safe and appropriate for delivering with Aboriginal and Torres Strait Islander young people. Various other culturally appropriate changes made include delivering an Acknowledgement of Country in the opening session of YAM, creating an open space for sharing, and ‘Yarn with Elders’ in order to feel better.

Young, Strong and Deadly (NSW)

Young, Strong & Deadly is an early intervention mental health and addiction prevention program for young Aboriginal & Torres Strait Islander people between 13-28 years of age.

14 Oak Street, Katoomba, NSW, 2780
email: admin@acrc.org.au
Tel: 4782 6569

Website: https://www.acrc.org.au/services/

The Young, Strong and Deadly program is funded through the Nepean Blue Mountains Primary Health Network (NBMPHN) to help bridge the gaps in services relating to health and taking action to close these gaps. Delivered by the Blue Mountains Aboriginal Culture & Resource Centre, this program is based in culture and impacts both the young participant and the broader community through these young people. Participants learn about connecting to culture and their own self-worth, traditional stories that demonstrates morals like protecting their land and each other. This cultural foundation creates a safe space to discuss mental health issues, including depression, anxiety, addiction and suicide prevention.

Delivered primarily through schools, the program is designed to strengthen young people’s connection to country and cultural identity, creating a positive sense-of-self and community. This creates a sense of belonging that increases their personal resilience and decreases their risks of mental illness and addiction.

According to Wentworth Healthcare (provider of the Nepean Blue Mountains Primary Health Network) CEO, Lizz Reay, research supports this program’s foundation. “There is a strong link between the connection to culture and a positive sense of identity. Being in touch with culture can have a protective factor that helps to decrease the impact of stressful life events and experiences. In this program, learning from Elders allows these young people to draw on long-held wisdom and to reconnect to the strengths of cultural knowledge”.

Manager’s comments about the program –
“I love seeing the change in the young people we work with. I love seeing them smile and express who they are. I love seeing the positive impacts this program can have on a young person’s life,” he said.

Participant’s comments about the program –
One young person said, “It’s made me feel a lot more-stronger about myself, my identity, who I am as a person. It’s meant reconnecting with my family and ancestral heritage.”

“It’s good for us, because we get to get out there and impart some knowledge on the younger kids. I guess that’s how we retain our culture, isn’t it? From generation to generation.” – Young adult participant.

To be updated.

Yuendumu/Warra-Warra Kanyi (Warlpiri, NT)

Warlpiri Youth Development Aboriginal Corporation (WYDAC) aims to develop strength, health, confidence and leadership in Warlpiri youth by promoting positive and meaningful future pathways for young Warlpiri people. The success of the program is based on the strength of Warlpiri youth, families and their communities, and the ongoing commitment of staff. The program was created by, and for, Warlpiri people, and is governed by a Warlpiri Committee.
The WYDAC is comprised of a variety of programs operating at five different Warlpiri sites – Yuendumu, Willowra, Nyirrpi, Lajamanu and Mt Theo Outstation. The entire organisation employs over 70 staff with more than half being Warlpiri people.

Warlpiri Youth Development Aboriginal Corporation (WYDAC) began in 1993 due to the efforts of Elders from the Yuendumu Community in the Warlpiri region of Central Australia. Their program, Warra-Warra Kanyi (WWK) is a counselling and mentoring service that combines formal, tertiary counselling skills with a local Warlpiri approach to target high-risk behaviours in Warlpiri people aged from 12-25 years. It targets a variety of risks, most notably relationship issues, family violence, substance misuse (alcohol and cannabis) and suicidal and other self-harming behaviours. Members of the WWK team have one of four roles: the WWK Coordinator/Counsellor, the WWK Youth Mentor, a team of Trainee Mentors, and the WWK Senior Cultural Advisor.

Trainee Mentors are young people who had participated in the Youth Development Project and who had demonstrated a clear interest and capacity for helping at-risk peers. They are casually employed and operate under the close supervision of the WWK Counsellor (and sometimes a WWK Youth Mentor). Trainees are matched with clients according to important local and cultural factors such as gender, family group and skin name. This ensures that trainee mentors are well-placed and in frequent contact with their at-risk peers. Trainee mentors sometimes report ‘early warning’ signs and represent the crucial link between a developing crisis and professional assistance. Usually, trainee mentors have struggled with and resolved their own issues. Hence, their mentorship is relevant and effective.

Senior Jaru Pirrjirdi members are employed as WWK youth mentors to work with a WWK Counsellor to target critical youth issues. These mentors are young Warlpiri people who have demonstrated strength, skill and capacity in caring for their at-risk peers. The WWK youth mentors work very closely with and report to the WWK counsellor, who in turn supervises them and supports their development. The WWK youth mentors are active collaborators in the care of their clients. Youth mentors will often have genuine, direct, honest and insightful advice on preventative behaviours, coping strategies and positive pathways. The Counsellor is always available to community members. Clear on-call protocols ensure that during periods of annual leave, gaps are covered by other WYDAC staff members. The WWK team engage with youth issues such as alcohol or other substance abuse, sexual health, relationship breakdown, domestic violence, depression and grief, and suicidal behaviours.

The WWK Project has five main elements:

  1. Prevention and education
  2. Early intervention
  3. Peer mentoring and counselling
  4. Community and family engagement
  5. Re-engagement with the youth development project

This is a significant underlying factor in reducing suicide risk for Warlpiri young people. This aspect of the program utilises the Mt Theo Outstation. The physical site of Mt Theo has enormous significance as a cultural site for Warlpiri people. Any young person who is misusing cannabis has the opportunity of cultural rehabilitation and detoxification supported by experienced Warlpiri carers at Mt Theo. This assists Warlpiri youth to deal with cannabis misuse through respite from community life. Mt Theo fosters a strong link with Warlpiri culture and with all the inherent benefits embedded in that culture for at-risk Warlpiri youth. Hence, a strong, positive, healthy Warlpiri identity is forged, promoted, practised and imparted.

Counselling and mentoring services take place in the bush and out of community, perhaps while hunting or sitting together waiting for the kangaroo to cook. Weekly young men’s mentoring trips in the bush to hunt are regular events that involve the youth mentors, trainee mentors and at-risk young men.

Elders are involved, provide support and are Senior Cultural Advisors, particularly for the non-Warlpiri staff of WWK, other WYDAC and external agency staff. A Senior Cultural Advisor plays an important outreach and support role to the Mt Theo Outstation and to other Warlpiri communities requesting support. Finally, Senior Cultural Advisors play an important supervisory role in the development of culturally relevant Warlpiri mentoring and counselling resources.

Experience enables the WWK team to identify critical periods or situations when a risk is likely to develop. This ability is crucial in developing a ‘local calendar’ which highlights high-risk nights, weeks or periods of the year. This allows preparation of resources, and early preventative work by staff with families and peers and external agencies such as the police.

The WWK is a clinical and culturally safe program that provides extensive wrap-around services and rapid, local crisis responses to prevent suicide attempts from becoming completed suicides. The WWK is an accepted support for youth who have had suicidal issues over a sustained period. It also deals with the problems underlying these issues and moves young people forward towards positive and meaningful pathways.

The program is now a comprehensive program of youth diversion, development, leadership and rehabilitation throughout the Warlpiri region. Most critically Warlpiri people themselves created the program, and its ownership, design and growth remain under the control of the governing committee of Warlpiri people.

The factors crucial to the program’s success are:

  1. The employment of a permanent, locally based, tertiary qualified counsellor and a second qualified person to provide relief, ensuring a 24 hour on-call service
  2. The peer mentoring system which is critical in raising awareness during a crisis
  3. Its local nature in the developing of responses to local needs under the direction of local people, employing local people and relying on Elders to ensure cultural safety and to provide cultural direction
  4. Addressing suicidal behaviour by working to address cannabis misuse
  5. Having a holistic view of youth development which includes education, development, well-being and diversion.
  6. Having responsive, local and informed people available in the community on a permanent basis to successfully address suicide attempts

The overarching aim of the WWK– Mt Theo Program is to create meaningful and positive futures for Warlpiri youth.

Key objectives are to:
1. Decrease the incidence of suicide attempts by building resilience to protect against suicidal ideation and self-harming behaviours
2. Strengthen the program structure as part of a systemic and culturally appropriate solution to underlying issues within the community
3. Develop a pool of strong, trained and confident young mentors who can deal with community issues of suicidal ideation and other harmful behaviours
4. Graduate program participants into employment and positions of strategic power in the community

The Program achieved unprecedented success in successfully ending chronic petrol sniffing in Yuendumu, through a two-step focus. The first step was the consistent removal of any petrol sniffers to the remote Mt Theo Outstation for one or two months of cultural respite and rehabilitation under the care of Warlpiri Elders. The second step was creating a seven day/night youth diversionary service in Yuendumu filled with sports, art, bush trips and discos to keep Warlpiri youth entertained and engaged. In 2002, the program expanded with reason for removal to the Mt Theo Outstation broadening beyond petrol sniffing to other substance abuse, or indeed any risk issues. The following year, there was a deepening of the basic youth program beyond an entertainment and diversion focus. The youth diversion activities continued but were extended to build a more comprehensive program incorporating education, training, cultural activities, mentoring, leadership, group project work, bush trips, career pathways and crisis response for Warlpiri youth from 16-25 years.

The success of the Project in Yuendumu resonated loudly in other Warlpiri communities. At the express invitation of these communities, youth diversionary programs began in Willowra (2005), Nyirrpi (2008) and Lajamanu (2009). As with the Yuendumu Program, these services grew from an initial diversionary base to broader, more comprehensive development programs. In 2008, services were again augmented by the creation of the Warra-Warra Kanyi (WWK) Counselling Program in Yuendumu.

In 2015, an evaluation of the Warlpiri Youth Development Aboriginal Corporation Youth Development Program was published1. Key findings were that:

The program provides high-quality diversionary programs which will assist crime prevention
Evidence from the 2006 participants indicated that most now enjoy a good quality of life
About 92% of 2006 participants are currently employed
About 50% of 2006 participants have used counselling services at some time during their progression from childhood to adulthood
A high proportion of people who have been clients of the counselling service have gone on to take up leadership roles within the community.

The Warra-Warra Kanyi Project was rated very highly as strong evidence of effectiveness. It demonstrates the importance of a clinical and cultural model as an effective means of supporting and empowering young people. The WWK is both a clinical and cultural program that provides extensive and appropriate wrap-around services and rapid, consistent, accessible, local and informed crisis response to address suicide attempts thereby preventing them from becoming completed suicides. The WWK is a culturally safe and accepted source of support for young people who have experienced suicidal thoughts, impulses, threats or attempts over a sustained period. It also deals with the issues underlying these problems and moves young people forward on a positive and meaningful pathway.

The impacts of the program are sustained. It supports inclusion and engagement across the community and is underpinned by local governance and community control. Building strong cultural identities in young people also builds their sense of connection and confidence. This has proved highly effective in enabling them to move away from cycles of violence, self-harm and suicide, substance misuse, and criminal behaviour. The program has grown significantly since its inception into a comprehensive program. It is an example of the importance of a team comprised of people with local knowledge and qualified experience who are responsive, local, informed and available in the community on a permanent basis. The program also emphasises the ability of families and community to recognise suicide risk, respond and communicate concerns as early as possible.

Shaw G. There is a path: an evaluation of the Warlpiri Youth Development Programs, incorporating the WETT (Warlpiri Education and Training Trust) Youth Development Program, 2015.

Yawardani Jan-ga (Equine Assisted Learning, WA)

Kimberley Aboriginal Equine Assisted Learning (EAL) program, run by Aboriginal people for Aboriginal people aged 6-25 years. Individual, paired, and group sessions are offered where participants are guided through different experiences with horses designed to increase mindfulness, awareness, confidence and regulation.

CONTACT
Professor Juli Coffin

Phone: 0436454422
Email: yawardani.smb@telethonkids.org.au

Through attending EAL sessions young people develop their own leadership style to support them with life’s challenges. Corporate and referrer demonstration sessions are also available, aimed to enhance Yawardani Jan-ga’s integrated service model and increase community and service provider understanding of the program. Yawardani Jan-ga (Horses Helping) is the first program of its kind in the Kimberley, in Australia and in the world. Program is available in Broome, Halls Creek, Derby and outreach sites on request.

Remote communities outside the regional centres will have access to Yawardani Jan-ga with portability supported by the new horse truck and more than 20 local Aboriginal people certified as EAL Practitioners across the Kimberley. This mobile service is funded by:

  • Kimberley Aboriginal Medical Services and Yura Yungi Medical Service (training of community members in 2021)
  • The National Indigenous Australians Agency (horse truck)
  • Mineral Resources, Healthway, and NHMRC

 

 

The program aims to increase awareness and regulation of emotions to achieve a calm state, through interactions with horses. EAL Practitioners explore seven broad themes, including boundaries, healthy relationships, kind and helpful thoughts, feelings as natural, and facing life challenges, Program is self-directed and participants have many choice points, where they have control and choice over which horse they want to take for the session, how they want to engage the horse. These choice points give participants a sense of control which improves self-esteem, emotional wellbeing and develops self-confidence, which in turn improves engagement with life. This enhanced engagement with life provides the necessary foundation for youths to improve engagement in school.

Building resilience and confidence through greater awareness and better regulation of emotions, healing for trauma, and leadership development. Facilitators report that youths demonstrated greater confidence through their body language and improved engagement in school.

A total of 850 EAL sessions have been delivered to approximately 500 participants with 70 currently engaged in the program. The EAL program has been featured in multiple media coverage since it commenced in 2019:

ABC Kimberley 2021

Broome Advertiser: Indigenous trainees saddle up to help kids (September 2020)

Outback Magazine: Horses helping kids (May 2020)

ABC: Experts turn to the healing power of horses to stem escalating suicide rates in Aboriginal youths (Sept 2019)

Telethon Kids: Social and Emotional Wellbeing of Aboriginal Young People(Project Page)

Australian Government – Health

Mary Mackillop Today

An evaluation will be conducted on the program across different areas including community, participants, and practitioners. Data is currently being collected. 

Program is designed and implemented by Aboriginal community members in the Kimberley region, and delivered by trained EAL Aboriginal Practitioners to Aboriginal youths. Program is built on evidence based Equine Assisted Learning (EAL) to meet the individual needs of participants that facilitate their re-engagement in their education. The program is an evidence-based official clinical trial. Professor Juli Coffin is an Equine Assisted Learning specialist, certified in Equine Assisted psychotherapy.

Coffin, J. (2019). The Nguudu Barndimanmanha Project-Improving Social and Emotional Wellbeing in Aboriginal Youth Through Equine Assisted Learning. Frontiers in Public Health7(278), 1-11.

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