Thread by @TracyWesterman

I wrote this for the Australian in reaction to the Fed Govts claims they put $134M into 'Indigenous suicide prevention'. This crudely translates to $250K per death by suicide of an Indigenous person; throw state & other funding in, you are close to $1M per suicide death 1/22

Yet as a country facing this growing tragedy of Indigenous child suicides, we have NO nationally accepted evidence based programs across the spectrum of early int'vn & prevention. Staggeringly, funded programs are NOT required to show they are reducing MH or suicide risk 2/22

Given this: can Govt claim they are funding suicide PREVENTION? If you are not measuring risk, you can't claim prevention. Its that simple
More importantly we are failing to gather ANY evidence of what is working to reduce suicides to inform future program & treatment focus3/22

The core driver is that suicide is badly understood & myths about so-called CAUSES of Indigenous suicide are portrayed as if they exist as a direct linear relationship. Suicide RISK factors are being incorrectly stated as suicide causes & this is critical to this whole issue 4/22

So,
Poverty is not the cause of suicide
Abuse is not the cause of suicide
Alcohol is not the cause of suicide, nor is Foetal Alcohol Syndrome by the way!
They are all very likely risk factors, but they are not CAUSES 5/22

If you eliminate a cause, you eliminate the end result (suicide); if you take these individual risk factors out (alcohol, abuse), they do not have that same result. So, for eg, what separates person A who has been abused & becomes suicidal from person B who does not? 6/22

Is it that the abuse has manifested as depression in Person A vs B who is NOT @ suicide risk? While this is an essential Qu–we dont have clear evidence of such causal r'ships nationally-staggering given this has been a focus of mainstream suicide research for decades 7/22

For eg; Research in mainstream pop'ns has depression (often comorbid with drug use) as an established causal pathway in approx 50% of cases of suicides. Research then shows if you eliminate depression via treatments of best practice we can elimin up to 50% of suicide deaths! 8/22

Sadly, the only thing we are measuring to est program 'success' or in this case failure is the suicide death rate!
It gets worse. The Indigenous suicide death data is reported SOLELY as demographic stats (ie. gender, age, location) which is completely USELESS to clinicians 9/22

If we JUST determined Indigenous suicide causal pathways it would change the paradigm of this entire area. Causal pathways inform treatment focus; enable measurement of treatment outcome, ensure program accountability & enable us to develop robust evidence of what is working10/22

presenting alcohol, poverty & colonialism as suicide causes offers little value to clinicians who need to focus on what is THERAPEUTICALLY alterable & treatable in clients. It distracts from true causes of Indigenous suicide that enable a genuine opportunity for prevention 11/22

Restrict alcohol if communities want that, but DON'T call it suicide prevention
Send high risk kids to 'culture' & 'elder camps' but DON'T call it suicide prev'n
Build a basketball stadium or fund a sports program but DON'T call it suicide prev'n
Communities DESERVE BETTER! 12/22

Our people are not killing themselves because they are poor. They are killing themselves because of racism; trauma impulse control reactions, most likely comorbid with depression & alcohol, drug use, isolation & lack of access to culturally & clinically competent services 13/22

The most distressing outcome of failing to understand suicide causes is it further stigmatises bereaved Indigenous parents, inferring that most, if not all are perpetrators or alcoholics 14/22

Perpetrating such stereotypes contributes to a general lack of empathy for Aboriginal ppl bereaved by suicide. It is a 'they did it to themselves" mentality that is not only unhelpful, but inaccurate and unkind 15/22

When a non-Indigenous child dies by suicide, we rightly look for deficits in society or systems and how we need to "do better" as a society. When an Indigenous child dies by suicide, we look for deficits in our families, in our culture as explanatory. 16/22

My research & unique psychometric tool (the WASCY/A) has firmly established over 20 years now that Indigenous suicide causal pathways are different. If found, amongst other things that 64% of suicide risk is accounted for by impulsivity 17/22

Those with impulse control issues have limited capacity to self soothe. This is common with ppl who have trauma & compromised attachment. It is no surprise that most Indigenous suicides are triggered by interpersonal conflict. At risk ppl look like they 'over-react' 18/22

Just as trauma frequently becomes a central organising principle in the psychological structure of the individual, trauma has become a central organising principle in the psychological structure of WHOLE communities. 19/22

Known as 'repetition compulsion' it means that trauma responses are normalised & engrained in high risk communities. Suicide clusters are an obvious & common consequence of trauma repetition compulsion when communities are isolated from practical and psychological support 20/22

We have gone ahead & developed unique whole of community suicide intervention progs which show suicide risk reduction. Not a cent of Govt funding for any of it btw! This approach needs to be a national one. It applies scientific rigor & is DATA DRIVEN around what is working 21/22

The Westerman Jilya Institute for Indigenous Mental Health has recently obtained a research grant from @lotterywest which will focus on the national collation of this causal pathway data. Its exciting but LONG overdue work. 22/22