1. Krysinska, K., Martin, G. and Sheehan, N. The University of Queensland “The Mental Health of a Nation is judged by the care with which those most in need are assisted to regain control of their own lives”

2.  Pitjantjatjara child ACH 1975  CAMHS Ngarrindjerri Riverland position 1996 to date  Elcho Island visit (Terry Yumbulal) (NYSPS Liaison), 1996  Auseinet position 1997-2006  Masters & Grad Cert program 1998 to date (Sharon Cruse)  Yunggorendi First Nation Centre, Flinders Uni and Nunkuwarrin Yunti  2 nd Year Medical student patient 1998  Spirituality and Suicide Conference, Brisbane 2004  Mount Isa child 2008  Mornington Island service planning, 2009

3. From Nanna, Christmas 1955

4.  Our literature review was based on 9 Key Principles consistent with existing Australian and International declarations, frameworks, policy, plans and strategies  Our recommendations derive from the best available evidence (both national and international) in promotion of social and emotional wellbeing, and prevention of suicide through early intervention in social, family, personal and biological determinants along the trajectory to suicide.

5.  Direct Involvement of Community Members and Development of Local Workforce  Ensuring Program Sustainability and Organization Capacity  Evidence ‐ or Theory ‐ Base for Programs  Appropriate Program Evaluation  “Researching Ourselves Back to Life”  Community Empowerment  Recognition of Human Rights, Transgenerational Trauma, Loss and Grief  Development of Individual, Family and Community Social and Emotional, and Spiritual Wellbeing  Acknowledgement and Recognition of Aboriginal and Torres Strait Islander Diversity and Importance of the Local Context

6.  Mackay 2008  Children’s Commission Report 2008  2 cases  “Suicide Prevention for Indigenous Australians: A Social and Emotional Wellbeing Approach”  pdf from

8. Nearly 1 million people in 2007

11.  “National suicide prevention strategies have been proposed despite knowledge deficits about the effectiveness of some common key components  the most promising interventions are physician education, means restriction, and gatekeeper education. Many universal or targeted educational interventions are multifaceted, and it is not known which components produce the desired outcome”

12. National Strategies are successful if they provide…  communication program to the whole population  education for relevant groups (‘gatekeepers’)  reduced access to means (bridges, firearms, etc)  a strategy on drugs and alcohol  a critical mass of clinical services with relevant and sufficient highly trained professionals  improved services managing suicidal people, as well as improved linkages with the community  proper evaluation with a formative approach  a strategy for Indigenous peoples

13.  The estimated resident number of Indigenous Australians (June 2006) is 517,200 including 463,900 Aboriginal Australians, 33,100 Torres Strait Islander Australians and 20,200 people identifying as both Aboriginal and Torres Strait Islander, altogether comprising 2.5% of the total population (ABS&AIHW, 2008).

14.  Best available data indicate that overall mortality rates among Indigenous males and females are almost three times higher than for non ‐ Indigenous Australians, and there is a 17 ‐ year gap between life expectancy at birth for Indigenous and non ‐ Indigenous males and females (59 v 77 yrs and 65 v 82 yrs respectively) (ABS&AIHW, 2008).

15.  Among Indigenous Australian males, overall suicide rates are almost three times higher than suicide rates for non ‐ Indigenous Australian males, with biggest differences in younger ages (ABS&AIHW, 2008).  Suicide rates among Indigenous Australian females aged 10 ‐ 24 are five times the rate of other Australian females, although in age groups 45 ‐ 54 and over, suicide rates are similar or lower compared to rates for non ‐ Indigenous Australian females.

16.  The situation of Indigenous Australians looks grim even by comparison to other Indigenous populations (Freemantle et al., 2007), and not much has changed since 1995 when Ring observed that “expectations for life for Indian populations in Canada and the United States, and for the Maoris in New Zealand are at least 10 years more than for Australian Aborigines, an enormous difference” (Ring, 1995; p. 228).

17. MaleFemaleTotalRank% All deathsOR Suicide (X60-X84) Indig Aust 742910354.2 2.8 Non-indig 1,5884442,032141.5 Accidental Poison. (X40-X49) Indig Aust 241337141.5 3.75 Non-indig 408156564390.4 Assault (X85-Y09) Indig Aust 221537141.5 15 Non-indig 10062162510.1

18. 129/12,0061.1%129/12,0061.1%

19.  Interpret with caution  183 (1.94%) respondents identifying as Aboriginal or Torres Strait Islander compared to 2.29% in the population ( Χ 2 =0.63, p=0.426).  4 week prevalence 2.4% (1.1% NI)  Females 4.2%, (n=4)  Males 0% (none)  Lifetime prevalence 15.7% (n=29) (8.1% NI)  Higher for women (17.8%, n=19)  Males 13% (n=10)

20.  Sufficient Indigenous professional capacity to sustain development and implementation of programs toward Social and Emotional Wellbeing at the local level;  Coordinated local training in Mental Health First Aid, ASIST, Drop the Rock and other relevant programs where evaluation shows them to be effective;  Provision of relevant crisis management at the local level for suicidal people.  Sufficient local awareness of mental health systems and how these are accessed.

21.  Suicide Awareness for Aboriginal Communities manual and workshop King, Appleby, & Brown, 1995  Yarrabah Men’s Health Group Mitchell, 2005; Patterson, 2000  Family Wellbeing Empowerment Program Mitchell, 2005; Tsey et al. 2004a, 2004b, 2005, 2007  Healing Our Way self-help resource Mitchell, 2005  Indigenous community suicide intervention forums Indigenous Psychological Services  Toughin’ it out. Survival skills for dealing with suicidal thoughts pamphlet Bridge, Hanssens, & Santhanam, 2007  Health Interactive Technology Network (HITnet) Hunter, Travers, Gibson, & Campion, 2007

22.  Applied Suicide Intervention Skills Training (ASIST) LivingWorks  Increasing the Capacity of Local Counsellors “Drop the Rock” Royal Flying Doctor Service of Australia (Qld)  Learning from the experts: Building bridges to implement successful life promotion and suicide prevention expertise across Aboriginal communities Centre for Rural and Remote Mental Health Queensland et al.  Something Better Queensland Police-Citizens Youth Welfare Association  Napranum Life Promotion Queensland Police-Citizens Youth Welfare Association

23. Issues  Lack of co-ordinated service response to self-harming behaviour  Lack of follow-up services  Inappropriateness of psychological testing tools  Interdisciplinary training (eg Wesley Mission Lifeforce program)  Issue of stigmatisation of 'Mental Health’  Appropriate referrals  Better data on suicide and deliberate self harm patterns  Better data required on help-seeking behaviours  Lack of accommodation for young people exhibiting high risk behaviour