Issue 7
Monday, 02 September 2019
Charles Darwin University
CDU Menzies HDR student Bernard Leckning’s PhD project helped inform the guidelines
CDU Menzies HDR student Bernard Leckning’s PhD project helped inform the guidelines

New guidelines target self-harm, suicidal thoughts

By Paul Dale

Menzies School of Health Research has developed evidenced-based guidelines for best practice psychosocial assessment of Aboriginal and Torres Strait Islander people presenting to hospital with self-harm and suicidal thoughts.

Commissioned by the Centre for Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention (CBPATSISP), the guidelines aim to improve the quality of care and outcomes.

CBPATSISP Director Professor Pat Dudgeon said there was growing evidence that the legacy of colonisation has contributed to the disproportionate rates of suicide and suicidal behaviours and other disadvantages experienced by Aboriginal and Torres Strait Islander people.

“The effects of colonisation are evident in the structural barriers and lack of access to culturally responsive hospitals and family support services that underscore the urgent need for these guidelines as part of a broader suicide prevention strategy.”

The guidelines contain 227 evidence-based recommendations, which have been endorsed by an expert panel of Aboriginal and Torres Strait Islander and non-Indigenous professionals as well as those with lived experience.

CDU Menzies HDR student, and lead author of the guidelines, Bernard Leckning said his PhD project helped inform development of the guidelines.

“I’ve been investigating patterns in the characteristics and outcomes of hospital-treated self-harm and suicidal thoughts in the NT and looking at patterns in the socio-demographic and clinical characteristics of the Aboriginal cohort which helped identify areas of focus in the guidelines focused,” Bernard said.

Aboriginal clinical psychologist, Dr Tanja Hirvonen said assessing risk of suicide was a complex task in any setting, but particularly in the hospital setting, as it could be a discomforting time for people. 

“There is a pressing need to respond adequately and carefully during this time,” she said.  

The guidelines provide the principled basis for culturally appropriate health care and contain recommendations for appropriately and effectively interacting with and engaging Aboriginal and Torres Strait Islander people in ways that are empowering and de-stigmatising.

Dr Hirvonen said developing the guidelines highlighted that the type of assessment tool used was significant.

“But just as critical is ensuring the right information is gathered and people are appropriately supported during a very critical time in their lives, within a culturally safe model of practice and care,” she said.   

Recommendations in the guidelines for evaluating risks, strengths and needs of Aboriginal and Torres Strait Islander people have a strong grounding in the concept of social and emotional wellbeing to ensure that assessments inform the most appropriate and effective options for care in the hospital and recovery in the community. 

A number of recommendations have been included to help clinicians respond in developmentally and culturally appropriate ways to self-harm and suicidal thoughts among young Aboriginal and Torres Strait Islander people.

Professor Dudgeon said the guidelines would be distributed widely.

“We will advocate to ensure that relevant agencies, such as the Australian Indigenous Psychology Association, are supported to develop cultural competence training and engage hospitals in embedding these guidelines into practice at a national level.”

The guidelines can be found online from CBPATSISP and Menzies websites.