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Thursday, October 23, 2014

Child Suicide in Australia; however does this happen?

Child deaths from suicide (9-14 years) appear to be a hidden problem, which may well be increasing in Australia. A ‘Trends and Issues’ Paper (No 19, Commission for Children and Young People and Child Guardian (CCYPCG), January 2014), reported on a total 169 suicide deaths of children and young people registered in Queensland between 1 July 2004 and 30 June 2013 (9 yrs) and drawn from the Queensland Child Death Register (2004–13). Unfortunately, the CCYPCG ceased operation on 30 June 2014, and its functions moved elsewhere (http://www.ccypcg.qld.gov.au) as part of the implementation of far-reaching recommendations from the Queensland Child Protection Commission of Inquiry (Carmody Review). (http://www.childprotectioninquiry.qld.gov.au/__data/assets/pdf_file/0017/202625/QCPCI-FINAL-REPORT-web-version.pdf) As a result, the Trends and Issues’ Paper No 19, is complex to find on government sites, but is available for download elsewhere. (http://www.iasp.info/pdf/web_resources/child_deaths_prevalence_of_youth_suicide_in_queensland.pdf)

Of the 169 suicides, 124 (73.4%) were aged 15–17 years (average 13.8 suicides per year). However, 44 suicides (26.0%) were of children aged 10–14 years (average 4.9 suicides per year), and one was a child aged 9 years (2011). For the most recent year (2012-13), for young people aged 15–17 years (10 deaths), suicide was the second-leading external cause of death (5.5 per 100,000). However, suicide was the leading external cause of death for children aged 10–14 years (12 deaths, 4.1 per 100,000 children), and the rate was the highest since 2004. Of these 22 suicides, 15 (68%) were male and 7 female. Only 6 suicides (27%) were from an indigenous background (17.1 per 100,000), but this rate was 5.5 times higher than the non-Indigenous (3.1 per 100,000). Only 1 of the 22 was from a remote background, with 7 from regional Queensland, and the rest (14) from metropolitan backgrounds. Eleven were from low to very low socioeconomic backgrounds, with 5 from moderate, and 6 from high or very high. Eleven (50%) were known to the child protection system, (7.1 per 100,000) a rate 3.9 times more than expected. There were 18 hangings, 1 gunshot, 1 jumping from height and 1 in front of a train, and 1 poisoning. The number of hangings seems surprising, and challenges our thinking; our expectation might have been that children would take medication in an extreme moment of frustration or emotional pain. But to organise a hanging perhaps suggests the more deliberate nature of these deaths.

Do the Queensland rates differ from the national rate or from other states and territories?
It is complicated. Queensland figures are from 1st July to the following end of June, while ABS figures are specific to a given year. The latest report from the Australian Bureau of Statistics (http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0~2012~Main%20Features~Age~10010) is from beginning 2008 to the end of 2012 (5 years), for ages 5-14 years, with a total of 57 suicides from all states and territories, 14 from Queensland. The equivalent number for the same 5 years in the CCYPCG report could be up to 26 deaths, so there may be a disparity.

For New South Wales (http://www.ombo.nsw.gov.au/__data/assets/pdf_file/0005/12389/CDRT_Annual_Report_2012_web.pdf), nine children under 15 are reported as suicides, whereas the ABS report suggests 12.

Northern Territory
A thorough report from the Northern Territory demonstrates marked increases in child and youth suicide, but covers the period 2006-1010, and does not overlap the ABS period reporting (http://www.childrenscommissioner.nt.gov.au/pdfs/other_reports/nt_youth_suicide_public_release_final_with_ISBN.pdf).

After an extensive online search, I cannot find parallel figures for Victoria, Western Australia, Tasmania or the ACT. If anyone can point me in the right direction, I would be very grateful.

The National Children’s Commissioner, Ms Megan Mitchell, has recently completed a national consultation on how children and young people under 18 years can be better protected from intentional self-harm and suicidal behaviour.(https://www.humanrights.gov.au/about/commissioners/ms-megan-mitchell-national-childrens-commissioner) Findings are scheduled be reported in her 2014 Statutory Report to Parliament. One can only hope that she has access to exact figures from all states and territories to compare with ABS data.

One real issue for child suicide is perhaps not the numbers, as much as the human tragedy. The Queensland Commissioner, in noting that half the children were known to the child protection system, suggested these children often “live in circumstances characterised by substance misuse, mental health problems, lack of attachment to significant others, behavioural and disciplinary issues or a history of abuse or violence”. This harks back to many comprehensive reports on how a child can get to the point of suicide. In one of the earliest, David Shaffer (1974) found the most common precipitants were conflict or a ‘disciplinary crisis’ with parents, teachers or police, fights with peers or friends. Annette Beautrais (2001) reports somewhat more complexity, while Dervic and colleagues (2008) note that precipitants may be less easy to identify and child suicide seems to have a brief stress-suicide interval.
If this latter point is true, then more or better services may not solve the problem; we may not get to see the child in time to assist change. We need to focus our prevention efforts more broadly on assisting parents to understand the consequences of trauma, and make changes. We also must assist schools to improve their efforts toward adopting more social and emotional learning programs aimed at helping children toward better mental health, with strategies like mindfulness to work through conflict and trauma.

References
Beautrais, A.L. (2001) Child and young adolescent suicide in New Zealand.
Australian and New Zealand Journal of Psychiatry 35(5): 647-53.
Dervic, K., Brent, D.A. and Oquendo, M.A. (2008) Completed Suicide in Childhood. Psychiatric Clinics of North America 31(2): 271-91.
Shaffer, D. (1974) Suicide in Childhood and Early Adolescence. Journal of Child Psychology and Psychiatry 15(4): 275-91.

Tuesday, October 21, 2014

Suicide Prevention: a thought (6)


Wake up.
Look around.
Start a conversation.
Caring is the thing that makes us human.

Haiku on Drop/ Best/ Crazy/ Fault

Drop

Beware of drop bears
In the Australian bush
Camping a nightmare

Single drop of blood
Gives facial recognition
In new forensics

Childhood taste bud treat
Lemon drops sherbet middles
Mouth watering crunch

Best

Very best wishes
The kindest of all regards
Yours unfaithfully

The best of all worlds
Our search for others gave none
This is it you guys

In my Sunday best
Hang on mate, it's Wednesday
Technicality

Crazy

Try to imagine
A world without pin stripe suits
Let us be crazy

Seaside crazy golf
Battered artificial grass
Let frustration go

Open up your heart
Let sunshine brighten your mind
Crazy dark days gone

Relax, laugh out loud
Let others think you crazy
In their twisted minds

Fault

Cannot see the fault
To me she is much more harmed
Than other harming

Line drawn in the sand
Cross and it will be your fault
The cracks will appear

Fault in the wiring
Brilliant natural artist
Could not spell his name

Sunday, October 19, 2014

Haiku on Pull/ Help/ Jump/ Remember

Pull

Struggle on Fridays
Must pull myself together
Perhaps one more snooze

When first together
I worked hard to cajole you
Now you pull and push

Searching for profits
Banks pull wool over your eyes
Lambs to the slaughter

Help

Help me to help you
I am totally perplexed
By your responses

Bitter little pill
Swallowed with sourest of milk
Does not help really

Help yourself my dear
My love unconditional
Please take what you need

Jump

Think before you jump
Is this a good decision
Or simply a whim

He's a good jumper
Wrapping her tight in his arms
Keeping her warm

Trampoline of life
Jump till we overbalance
Laughing as we learn

Remember

The plot, remember?
On the 5th of November
Guy Fawkes, gunpowder

I remember you
Can’t quite get your name
So when did we meet?

Still I remember
The moment you and I met
Fifty years ago

Suicide Prevention: A thought (5)


World Suicide Prevention Day - Today, Tomorrow, Any and Every Day.  http://child2100.blogspot.com/2014/09/world-suicide-prevention-day-today.html?spref=tw 

Tuesday, October 14, 2014

Essays on Prevention in Mental Health

THIS IS NOT A TEXTBOOK. IT IS NOT A COMPREHENSIVE TREATISE ON PREVENTION.

Rather, it is a series of essays over 20 years trying to work out how to apply principles of prevention to a range of everyday mental health problems we all come across.

It WILL challenge your thinking.

A compilation of published work about prevention in mental health from 1995-2004

ESSAYS  On Prevention in Mental Health
Essays on Prevention in Mental Health
Best known for his work in prevention of suicide in young people, Graham has researched the problem and possible solutions since 1987.
This book brings together papers and editorials reflecting development of ideas about Promotion of Mental Health, Prevention of Mental Illness, and Early Intervention (PPEi) over the years 1995-2014. The book also acts, in part, as an historical record of the development of the nationally funded Australian Network for Promotion, Prevention and Early Intervention (AusEinet, 1997-2009).These ‘Essays’ are written in a direct conversational style, yet grounded in emerging theory and international practice of the time. It is hoped that some of the essays will be of sufficient interest to provoke others to consider the broad implications and applications for prevention in mental health.
324 pages.
Martin, G., 2014. Essays on Prevention in Mental Health. Family Concern Publications, Brisbane

Haiku on Watch/ Wide/ Abandon/ Puny

Watch

Time measures itself
Does not need a second hand
To watch time passing

Grumbling second hand
Why I have to watch my time
With you an hour slow

Watch yourself she said
Rolling gently over him
A mirrored ceiling

Wide

She had a wide smile
And child-bearing hips to match
Generous spirit

Go on, take a punt
Chance the river in full flood
It only looks wide

The wide open road
Stretched for miles across cultures
Linking east with west

Abandon

Abandon the stage
All instruments left behind
Coda completed

Abandon Mondays
Never feel the blues again
Cure for depression

Abandon the mine
Seeking the golden sunshine
You share so freely

Puny

Such a puny word
With no associations
Sadly no haiku

Charles Atlas promise
Puny into Powerful
It never did work

Cooling off the world
A legislative promise
Puny Carbon tax