This white paper considers emerging research and experiential evidence and its potential to drive system reform and reduce suicide.

More people die by suicide than in road accidents every year. The causes of and motivations behind suicide are complex, influenced by factors such as a person’s age, gender, sexual orientation, socioeconomic status and cultural background, as well as the intersections between them. Contributors to suicidal crisis can include historic or distal factors such as childhood adversity, family history of suicide or mental illness, and previous suicide attempt, as well as proximal factors like physical and mental health problems, discrimination and a range of adverse life events (e.g. interpersonal conflict, relationship breakdown, disrupted community or cultural obligations, unemployment, housing, financial or legal problems). Distal risk factors can increase the likelihood of and vulnerability to proximal factors, and the effects of these events can accumulate over a person’s lifetime, becoming sources of significant trauma.

The Australian approach to suicide prevention has changed significantly in recent years. Critical shifts in government funding of suicide prevention research and implementation have occurred, specifically with respect to multi-level approaches in which regional suicide prevention alliances guide the simultaneous implementation of a number of evidence-based strategies, such as community training, school-based programs, improved media reporting of suicide, means restriction and improved crisis response. Access to best evidence-based medical, psychological and psychiatric treatment and workforce training is also a crucial element. The impact of Black Dog Institute’s LifeSpan integrated suicide prevention framework and other multi-level models of suicide prevention in Australia are not yet known. However, an international review of all evidence on suicide prevention concluded that no single strategy is superior to another; rather, combinations of both individual-, community and population-level strategies should be assessed with rigorous research designs. While each of these models, if implemented well and with enough reach and dose, can prevent many suicides, more is required to decrease the high and continued rates we are seeing and ultimately prevent suicide.

These evidence-based practices must be supported by policy settings that focus on improving the social conditions in which people live so that regional, state and national strategies are working hand-in-hand. Understanding which policy features can reduce suicide risk is particularly important in Australia now, with the National Suicide Prevention Taskforce (NSPT) advising the government to consider myriad policy responses to mental health and suicide prevention. This has already occurred to some extent with the response to the COVID-19 pandemic via higher welfare payments, employee payments and tax relief measures.

This white paper is a call to action to extend the tremendous work that has been accomplished to date. It focuses on four priority areas across all ages in suicide prevention based on emerging priorities and opportunities:

• new models of care,
• social determinants of health,
• suicide awareness campaigns as well as
• scientific and research innovations in suicide prevention.