A series of suicides among young people south of Perth in 2016 sparked a major overhaul of how support is offered to the people left behind after someone takes their own life. Telethon Kids Institute suicide prevention researcher, Dr Nicole Hill, was called upon to evaluate the innovative local response.
When someone takes their own life, it has a ripple effect on everyone around them that can sometimes be more like a tsunami. Everyone in that person’s life is swamped by the grief and shock – parents, siblings, friends, teachers and the wider community.
But often, the people left grieving only get support when they seek it out themselves. Many fall through the cracks.
It is this gap in services in the aftermath of a suicide that is thought to contribute to ‘suicide clusters’ – where suicide is almost contagious. People who lose a loved one through suicide have a three-fold greater risk of suicide themselves.
When the Peel and Rockingham-Kwinana (PaRK) region, south of Perth, experienced a significant suicide cluster in 2016, local services knew it was time to act.
“We were seeing very quickly some linkage between the young people that were dying and that really led us to get together and work out what the hell was going on,” according to Steve Batson, chair of the PaRK Steering Group.
Very quickly we became aware of what we didn’t know and started looking for ways to better identify and support people who are impacted by a suicide.
Steve Batson
The result is what is now known as the Primary Care Navigator (PCN) model.
When WA Police respond to a suspected suicide in the PaRK region, they ask the next-of-kin and any witnesses if they consent to their information being shared with support services.
If they do consent, that triggers a response led by the Primary Care Navigator, to determine who else in the person’s wider circle could be vulnerable after their death. This can include work colleagues, school friends, sporting team-mates and extended family. Those people are then offered appropriate support from government agencies and non-government organisations like Anglicare WA, and specialist postvention counselling services such as CYPRESS (Children & Young People Responsive Suicide Support) and ARBOR (Active Response Bereavement Outreach).
In 2021, the Youth Mental Health team’s Dr Nicole Hill was invited to conduct a thorough evaluation of the PCN model in the PaRK region.
Dr Hill is an Australian leader in youth suicide prevention research whose expertise led to her being invited last year to co-chair the International Association for Suicide Prevention’s special interest group on suicide clusters and contagion. Among other world-first outcomes, her research has provided irrefutable evidence of the existence of suicide clusters and suicide contagion, quantifying the level of risk and shifting the focus from questioning whether these phenomena are real, towards how to respond to and prevent them.
After interviewing police officers, support services and people who were bereaved by suicide, one of Dr Hill’s key PCN evaluation findings was that people impacted by suicide wanted to speak to other people with the same experiences.
This led to the establishment of the first peer support program for people with lived experience of suicide in the PaRK region, Peer CARE Connect, implemented by Roses in the Ocean.
“We found through this process that people want to speak to someone who has experienced suicide themselves,” Dr Hill said. “They want to talk to other parents or spouses who understand the guilt and shame associated with suicide.”
Dr Hill said the active offer of support, rather than leaving it to a bereaved person to seek out help, makes the model used in the PaRK region uniquely effective.
Anglicare WA’s Project Officer for Suicide Prevention and Postvention, Andrew Lillywhite, said active support was crucial after a suicide.
“It really acknowledges that simply handing a brochure over to someone and leaving them to navigate all of this on their own isn’t enough. So this approach acts as a circuit-breaker for prolonged suffering,” Mr Lillywhite said.
The PCN model also mobilises a suite of practical support networks to help loved ones after a suicide – including food deliveries, help with organising finances and even cleaning services. Dr Hill said these practical things could have a big impact on reducing the traumatic burden after a suicide.
When someone has a loved one die by suicide, it’s like a bomb going off in their world. There are so many logistical things they have to manage while dealing with their grief.
Dr Nicole Hill
Dr Hill’s thorough, evidence-based evaluation has now given Anglicare WA the confidence to advocate for the same model of post-suicide care to other parts of WA, complementing the organisation’s world-leading suicide support services.
“The postvention area is new, and this is brave work, so to have Nicole’s evaluation to solidify that this is evidence-based work is a huge boost in confidence,” Mr Lillywhite said.
“When we advocate for this to be implemented elsewhere, we have the evidence to formalise the success of what we do.”