A Defence members reactive stress to factors (such as interpersonal trauma, vocational, financial, and/or legal difficulties) can precipitate suicide, self harm, or harm to others. Suicide and self harm behaviour can also be associated with a number of psychiatric disorders including depressive and personality disorders and substance misuse.
Seeking help for suicidal behaviour can be a complex and sensitive issue for a Defence member. Therefore, it is important for Defence members who need support to have confidence in the ability of mental health professionals, commanders and managers to maintain their confidentiality and privacy. It is equally important for Defence members to know that seeking support when at risk of suicide is more likely to enable optimal and coordinated support.
Defence members at risk of suicide who are effectively supported, are more likely to recover and continue to contribute to Defence and the broader community.
The Suicide Prevention Program is driven by the assumption that suicide is preventable, and that prevention and early intervention are critical to positive mental health and wellbeing outcomes for all people, including those who are most vulnerable. Each step in the program presents an ongoing opportunity to reduce stigma, promote understanding of suicide behaviour and risk factors, and increase protective factors. The first three steps of the program include training activities that begin with awareness, build to alertness and develop skills and confidence to action. Step four is specifically for mental health professionals.
Step 1: Suicide Prevention Awareness
Suicide Prevention Awareness consists of a mandated 1-hour annual awareness presentation for all ADF members as well as mental health promotion initiatives throughout the year. The mandatory training and initiatives provide targeted information, self-care strategies and resources on suicide prevention. This step aims to:
- enhance the awareness of risk and protective factors
- increase literacy on how and where to seek help
- increase confidence to provide an initial response to someone at risk of suicide
- increase participation in prevention efforts
- enhance safety
- reduce stigma
The mandatory awareness training can be presented by Defence mental health personnel, medical officers or Chaplains, or accessed via the Defence online learning system (Campus).
The promotion activities are coordinated nationally and toolkits are provided for local implementation by unit leaders and Command. They include R U OK? Day, World Mental Health Day and World Suicide Prevention Day.
Step 2: Suicide Prevention Alertness
This step moves from awareness to alertness. A series of three, 3-hour workshops designed specifically for Defence in the Keep Your Mates Safe (KYMS) suite develops mental health literacy and suicide prevention skills. This step builds on the annual awareness training and develops a deeper understanding of mental health as well as specific skills in responding to someone who may be at risk of suicide. This step aims to:
- increase knowledge of common mental health issues, including suicide and deliberate self-harm
- recognise signs of mental distress, including risk of suicide
- develop understanding of how to support peers and encourage mentally healthy workplaces
- develop and practice skills to provide an initial response to someone who may be at risk of suicide in a timely and compassionate way, directing them to appropriate professional support
- increase safety of self and colleagues
Step 3: Suicide Prevention Skills Training
This step is primarily targeted at junior leaders, commanders and managers and Chaplains as they have been identified as most likely to interact with people at risk of suicide, however is open to all interested personnel. Defence uses the 2-day Living Works ASIST (Applied Suicide Intervention Skills Training) program at this level as it provides participants skills to identify at-risk individuals and provide initial mental health support. ASIST is supported by numerous peer-reviewed studies demonstrating it is effective at reducing suicidality.
Participants are taught to de-escalate a crisis and improve the safety of those at risk. The objectives of ASIST are:
- Understand the ways personal and societal attitudes affect views on suicide and interventions
- Provide guidance and suicide first-aid to a person at risk in ways that meet their individual safety needs
- Identify the key elements of an effective suicide safety plan and the actions required to implement it
- Appreciate the value of improving and integrating suicide prevention resources in the community at large
- Recognise other important aspects of suicide prevention including life-promotion and self-care
Step 4: Mental Health Risk Assessment Training (MHRAT) for Mental Health Professionals
This training was developed by Phoenix Australia for Defence mental health professionals and medical officers. MHRAT aims to develop the skills required to assess and manage members at risk for suicide, self-harm and harm to others within the Defence environment. Defence staff who complete MHRAT are required to complete a refresher every two-years.
The key training objectives of MHRAT are for participants to:
- demonstrate their knowledge of Defence policies and documents required to undertake a mental health risk assessment and identify key components of immediate management
- identify and discuss the purposes of collecting health information within Defence and how to manage release of this information
- identify the key principles of mental health legislation in Australian States and Territories
- recognise the importance of static and dynamic risk factors in risk assessment
- explain the importance of assessing capacity for decision-making, changeability and confidence in assessment and the benefits of seeking collateral information
- assess risk of suicide, self-harm and harm to others by asking recommended questions
- formulate and provide a rationale for identified mental health risk assessment outcomes observing the limits of confidentiality
- identify and discuss immediate management options both within and outside Defence for individuals assessed to be at high, medium and low risk
- integrate and document assessment information and immediate management plans using appropriate systems and templates
The above training and initiatives are coordinated through the ADF Centre for Mental Health (ADFCMH) regional mental health teams.
ADF Mental Health & Well-being: Suicide - PDF 0.7MB