Discuss about the Suicide Prevention Strategies for Mental Health.
According to the most recent suicide rate statistics from the year 2013 men over 85 have the highest percentage of suicides out of the whole Australian population (Beautrais, 2006). But this phenomenon is not new only the attention that these numbers has garnered is new and in many ways positive. More than 40 men in every 10,000 of this age group die by suicide. These figures are double than the rate of men dying by suicides under 35. It is seven times higher than women in all age groups. There are only a few exceptions in yearly figures but the rates in older male suicides have always been high. While these rates fluctuate from year to year so the question arises here is why the suicides in older men are higher in comparison to others?
We need to study about the reasons that are responsible for these high rates. (Joiner, 2011)Some of these reasons were studied in the Interpersonal model by T.E Joiner in his book “Lonely at the top: The high cost of men’s success.” Where he discusses how two components comprise to higher male suicides. These two components are physical pain insensitivity and fearlessness about death. Men have a higher acquired capability to kill themselves when they are considering suicide. Perceived burdensomeness and thwarted belongingness are some factors in men’s suicide and also contribute to his theory. (Kolves, 2011)Men usually have a tendency to not identify and respond to the negative distress or emotions they feel. This results in severe emotional responses and chronic and adverse life events. They are more inclined to not share and communicate their feelings of hopelessness and despair. Men also have a fewer social connections and therefore they normally portray a stoic attitude towards misfortune. (Beghi, 2010) They do not seek help for emotional distress as they often feel it is a sign of failure and weakness. They prefer to solve problems on their own and which does not help in case of emotional or mental distress.
Older adult suicides are triggered by many factors such as loss of control over health issues and financial issues that lead to feelings of hopelessness and despair (Berk, 2006). In their seventh decade of life their thoughts comprise of life assessments. They think about the achievements and accomplishments of their past and what oppurtunities they have for their future. Often for older adults confidence and satisfaction is nonexistent or elusive. There are numerous challenges of older age that results in depression and other mental health issues in older men. Good mental health is a necessity for building and maintaining a good life. (Brownhill, 2005) Yet one in five Australians deal with mental health issues each year. Most people who suffer from mental health problems experience intermittent or on-off symptoms which let’s them sustain community, work and family life.
Life events like loss of loved ones or pets, loss of paid income, retirement and fear of loss of self are difficult to manage at an old age. They experience fear of losing their independent status which results in anxiety. Many studies in Gerontology have shown that there is a relationship between happiness in later life and flexibility and activity. Therefore there is a relationship between unhappiness and possible suicide in older age (Denney, 2009). Social support, health and finances are important in life satisfaction and loss of any one of these factors can lead to depression and suicidal thoughts. Anger and frustration are also a result of frustrated psychological needs, hopelessness, feelings of helplessness and psychological or physical pain. Beliefs and attitude of autonomy, responsibility and dignity also play an important part in suicide. Older adults have experienced problems and stressors throughout their life that have developed successful coping mechanisms that enable them to deal with distress and disappointment (Harwood, 2000). But elders who are experiencing a more elevated risk of suicidal tendencies embrace a perceptive of inability to tolerate the negative circumstances and perceive themselves as powerless to change the circumstances. For them life has no meaning and they think themselves as a burden on others. Suicide may appear as an impulsive act but often people have contemplated suicide for years before initiating an act. The correlation between suicide and major depression has been proved by many studies but one study by Hawton, Harwood, Jacoby and Hope in the year 2000 proved that there is an increased risk of suicides in older men who have poor social support. These studies were able to derive some predictors for suicide behavior in older men. Some of these predictors are depression, poor social support, alcohol abuse, financial factors, rural location, and indigenous heritage (Page, 2007). According to the data made available by ABS for the year 2010 the age standardized death rate by suicide was 2.5 times higher in (ABS) Aboriginal and Torres Strait adult males in comparison to non- Indigenous adult males (Hunter, 2006).
In our society many people think that depression is a part of growing old. But family members, friends and professionals have to be careful and alert to notice any changes in behavior in older adults. These changes can be eating problems, and sleep problems (Mishara, 2005). Community healthcare programs that focus on the spiritual, cultural, emotional and social underpinnings of the community wellbeing will be effective in preventing suicides in older men. Effective suicide prevention programs are based on the understanding that suicides can be prevented. A reason for the high rates of suicides in men related to men characteristics such as they do not recognize the symptoms of emotional distress, they do not want professional help but rather prefer to work things out (Witte, 2012). Therefore it is crucial that the interventions and services that are designed for them are specifically addressing their needs. These programs acknowledge the unique characteristics of men. The address the risk factors that are present in the community and maintain networks of services and individuals. There are 3 types of suicide prevention programs. Some which build resilience in individuals, some that are crisis intervention programs and other that are postvention programs. NSPS or the National Suicide Prevention Strategy is providing a platform for Australia’s national policy for preventing suicides by emphasizing on early intervention, promotion and prevention. Australia is the first country that has taken a nationally coordinated approach to prevent suicides. The main objectives of this strategy is to build individual resilience and give the person the capability to self help, improve the community strength in suicide prevention, by providing suicide preventing activities, implementing quality and standards in suicide prevention, having a coordinated approach to suicide prevention and improving and understanding the evidence based suicide prevention. This strategy is a systems based approach on a regional level that approaches suicide prevention by PHN’s or Primary Health Networks in partnerships with the Local hospitals, territories and States. They have a flexible funding pool. Through this policy the government has refocused their efforts in preventing suicides in Aboriginal and Torres Strait Islander (ABS) communities by considering the recommendations that were made in (ABS) Aboriginal and Torres Strait Islander Suicide Prevention Strategy. It is a joint commitment by the territories, states and the Australian Government to prevent suicides and to ensure that people who had attempted suicides in the past are being given proper follow up support. From July 1st 2016 the Primary Health Networks are tasked to commission regional suicide prevention services and activities that will work with the local hospitals and other organisations to support the people who are at a risk of attempting suicides. Primary health networks will recognize and identify (ABS) Aboriginal and Torres Strait Islander communities in their region those are at risk of suicide (De Leo D, 2011). One of the components of this strategy is LIFE framework that was developed in 2000 and was updated in the year 2007. This framework is providing an operational framework for the National Suicide Prevention Strategy by outlining the purpose, vision, proposed outcomes, action areas and principles for suicide prevention in the country. In the year 2011 this framework was adopted all over Australia by all jurisdictions (Esler D, 2008).
The practice of blaming men for “not seeking help” and “bottling up their emotions” has to change as it is simplistic, and lazy. It is a way to quiety avoids dealing with the grave, complex and sad issue of “Male suicides”. In order to understand suicide in men we need to acknowledge the cultural and psychobiological demands and realities in a man’s life. We have to get rid of our Ageist attitude that believes that it is normal for an older person to get depressed. The rapidly aging population of Australia needs a change otherwise this issue will only increase with the growing numbers.
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Brownhill, S. W. (2005). Big build: hidden depression in men. Australian and New Zealand Journal of Psychiatry , 921-931.
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Esler D, J. F. (2008). The validity of a depression screening tool modified for use with Aboriginal and Torres Strait Islander people. Australian and New Zealand Journal of Public Health , 317–21.
Harwood, D. H. (2000). Suicide in older people: Mode of death, demographic factors, and medical contact before death. International Journal of Geriatric Psychiatry , 736-743.
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Joiner, T. (2011). Lonely at the top - The high cost of men’s success. New York: Palgrave MacMillan.
Kolves, K. I. (2011). Marital breakdown, shame, and suicidality in men: A direct link? Suicide and Life-Threatening Behavior , 149-159.
Mishara, B. H. (2005). Comparison of the effects of four suicide prevention programs for family and friends of high-risk suicidal men who do not seek help themselves. Suicide and Life-Threatening Behavior , 329-342.
Page, A. M. (2007). Further increases in rural suicide in young Australian adults: Secular trends, 1979-2003. Social Science and Medicine , 442-453.
Witte, T. G. (2012). Stoicism and sensation seeking: male vulnerabilities for the acquired capability for suicide. Journal of Research in Personality , 384-392.