It’s time to act to protect those at greatest risk of suicide

It’s time to act to protect those at greatest risk of suicide.

According to the findings of a study announced on April 1 by the Australian Bureau of Statistics, the rate of suicide in Australia is continuing to rise. As Dawn O’Neill CEO of Lifeline Australia states, “This is a whole of community issue. We’re in denial about this as a society.”

Not only is our society in denial about suicide but it is also in denial about the markedly increased risk of suicide amongst those abused as children. Recently we have seen scores of new revelations of child abuse both institutionally and in the private domain. Yet as a society and as communities we still struggle to acknowledge the scale or the gravity of the problem. We still grapple with a pervasive cultural disgust which prevents us from mounting a human response to help, support and protect those victimised as children. By conservative estimates there are more than 2 million Australian adults struggling day-to-day with the impact of having been abused or neglected in childhood. Amongst their many challenges, these adults are at serious risk of suicide and yet nothing is being done to address this risk. Having survived a childhood of fear and torment, being left struggling to survive in adulthood is a travesty.

A Victorian study released in February this year revealed that people sexually abused as children are more than 18 times likely to commit suicide than the general population. An earlier study released in 2001 showed that the rate of suicide for young Australian survivors of child sexual abuse is 10.7 to 13 times those nationally. It is hard to imagine what more information is required for the Government to act.

As chairperson of Adults Surviving Child Abuse (ASCA), the key national organisation working to advance the wellbeing of people and communities affected by child abuse, I am only too aware of the risk of suicide associated with childhood abuse. ASCA loses several people every year either because help is not available or because they do not know how to access it. The number of Australians at risk, and devastatingly who are lost, because of unaddressed childhood issues is staggering.
Having lost a close member of my family to suicide as a result of his child abuse and having been close to taking my own life as a result of being subsumed by the trauma of my childhood I am passionate about seeing these risks addressed.
Another well-researched 2006 study found that childhood abuse and adversity accounted for 50–78 per cent of the risk within the community for drug abuse, depression, alcoholism, and suicide attempts. As adult survivors are 3-5 times more likely to experience a major depressive episode during their life and at markedly increased risk of abusing substances including alcohol and drugs, the suicide risk in this group is compounded. Abuse of substances lowers inhibitions, and impairs judgment, all factors which make people who are already vulnerable more likely to act on suicidal plans. These same factors are also associated with domestic violence and abuse, another factor that increases the likelihood that suicide will occur.

The lived reality of many adult survivors of childhood is often one of isolation and living on the margins of society, with the disadvantage seeded in childhood compounded due to its impacts. Families especially in which the abuse is intra-familial are often disrupted due to divisions which see one part of the family support the survivor and another part ostracise them. Difficulties survivors often have with trust and forming and sustaining relationships compounds the sense of isolation and lack of support. Suicide is indeed a whole of community issue as is addressing the stigma and taboo around child abuse, its legacy and the mental health and social issues which go with it.

A crucial first step in turning these issues around would be the development of community awareness and stigma-reduction campaigns in relation to the link between child abuse and mental illness/suicide coupled with mental health promotion initiatives.

Across Australia there has been a systemic failure to provide appropriate trauma-informed services to the majority of those needing them. This has been compounded by a failure to translate advances in trauma research into education and practice. The composite failures in service provision and expertise, as well as in access and equity significantly exacerbate the risk of suicide in adult survivors of childhood trauma. Information on the psychological impacts of abuse and trauma and tools to help address them must be introduced nationally into core mental health training and curricula as a priority. Responsive and effective crisis management must be matched by affordable accessible ongoing care so that the core issues of abuse, which directly contribute to increased risk of suicide, are adequately addressed.

Not only do we need to see widespread education and training within generalist services and the expansion of specialist services but there must be a comprehensive improvement in referral pathways, including direct access to community-based services. Affordability issues also need to be addressed as the impacts of childhood abuse on education and work prospects often restrict the capacity of adult survivors to access services, even when they are available. Private services are often unaffordable and the provision of therapeutic services through the MBS scheme for trauma survivors, while a start, are generally grossly inadequate given the long-term care and support needed by the majority of these clients.

Since 1995 ASCA has offered life-affirming services to thousands of adults who have suffered sexual, emotional and/or physical abuse and neglect in childhood. ASCA’s 1300-line and psycho-educational workshops save lives. Yet ASCA receives no ongoing government funding. This year, as these new statistics are released, ASCA’s workshop program has been effectively shut down and its 1300-line is now under threat. These services are the only ones of this kind in Australia. Without them Australian adult survivors of child abuse will be more isolated and bereft, and even less able to access the help and support they need to survive in adulthood.

In this election year when we are called upon to decide which government we should support, the government needs to understand that there is a large cohort of adult survivors in the community whose needs are not being met and whose risk of suicide is substantial. As a community we need to look after our most vulnerable and protect those whose childhoods betrayed them and whose adult lives are at serious risk.