Legislative Council, Tuesday 15 August 2023

Ms FORREST (Murchison) - I intend to speak briefly to this report. I also note that I have a significant hearing impairment at the moment. If members have questions or make comments, I will more than likely not be able to hear you. If there is anything urgent you want me to respond to, you may need to put it in writing to me. Apologies for that.

Ms Rattray - Does that mean no interjections, Mr President?

Mr PRESIDENT - It means the member will not hear any interjections.

Ms FORREST - I will keep talking over the top of people. This short inquiry process was a decision about the then newly established Gender and Equality Joint House Committee.

The reason the committee decided to have a look at suicide and suicide ideation is that there has been a lot of commentary in the media lately about the gendered nature of suicide and suicide ideation. It was to determine generally, as short inquiry processes are, as to whether a fuller and more complete investigation should be undertaken in light of the evidence we could get from the minister and Premier, and to determine whether now was the most appropriate time to look more fully at it or not.

I note we are dealing with particularly sensitive information. There would be many families in this place and beyond this place who may be watching and who have been impacted by suicide and even significant mental health and suicide ideation. If anyone is watching this or reads this at a later time, if they are struggling with any concerns regarding that - and the report also includes it - in our commentary and the Hansard, that Tasmania Lifeline is available on 1800 984 434 from 8 a.m. to 8 p.m. every day and the Lifeline Crisis Support Service is available 24 hours a day on 131114. I will probably repeat that again at the end because it is important we do not underestimate the impact for some people who have had some experience of dealing with a loved one who may have completed suicide or at least contemplated or attempted it.

The report is fairly brief because I wanted to hear from the Government and particularly the minister and Premier as to what the Government was doing in this area of mental health and suicide and suicide ideation. Firstly, we wanted to understand what data there was, but also to understand or better appreciate the awareness the Government had of their policy makers in the gendered nature of suicide. Where there is a gendered impact, it might not just be a gendered impact. We did touch on this in our inquiry. There are many other aspects of our humanity that may have higher rates of suicide or suicide ideation than just the male/female divide. What we wanted to understand from the Government was what they were doing in more bespoke or more targeted prevention measures in that area.

The Government has responded to this report and has basically accepted and agreed with all the recommendations - not that there were many - because, as we heard during the committee process, a lot of this work the Government has embarked on in the last year or two has considered the various factors that increase the risk for individuals of significant mental health problems, suicide and suicide ideation.

Sometimes, in these sorts of areas where the data can be so complex and dense, it is hard to specifically pull out what the key factors might be that push someone to this point. We do know, all of us would know, from our electorate offices and being in society at the moment, people are struggling in many parts of their lives. More people are becoming homeless. People are struggling with cost-of-living pressures and all those other societal challenges can feed into someone's poor mental health.

As we noted in the report, this does require a whole-of-government approach. You cannot just say, 'well, we will just focus in the mental health space', because if you are not looking at all the other underlying factors of intergenerational poverty, intergenerational disadvantage, of homelessness, perhaps women and children escaping family violence, all of those things can actually lead to a poor mental health outcome for individuals and increase that risk.

Going to the first recommendation of the committee - the committee made the recommendation that the whole-of-government approach be taken to:

(a) address the social and economic drivers of suicide ideation and suicide as critical focus for effective prevention; and

(b) actively build sustained community networks.

The Government has been in the process of implementing new strategies in this area, through policy development. As that work was fairly new when we undertook this inquiry, the committee determined that a fuller inquiry was probably inappropriate at that time. It would be better to give some of these strategies, which include the Tasmanian Suicide Prevention Strategy 2023-2027, a chance to be in place and then perhaps look at whether they are working. Are they bringing the rates down, and within this strategy document, are there adequate considerations of the gendered nature of suicide and suicide ideation? There are higher rates in certain members of our community, like in our LGBTIQA+ and a range of other vulnerable groups.

Yesterday, I was speaking to the new CEO of Huntington's Australia - except for Victoria, the organisation has joined up into one national body. From memory, she said the suicide rate amongst people with Huntington's disease is 13 times higher than the national average. So, here we have another cohort of people who are invisible in many respects. It is one of those rare diseases that is not well known. In fact, its rate is higher than motor neurone disease, and I think all of us know about MND and you can thank people like Neale Daniher for that. He has done an enormous amount of work in raising awareness about that.

However, Huntington's disease has a terribly tragic end for all the people who have it, who are at higher risk of suicide. That was one of the things when we went through the process of saying, well, it is not just a gendered issue, but there is still a gender overlay to this that we need to consider. Sometimes, in pulling out the data, it can be difficult to drill down into it.

The Premier said to us that he has acknowledged that suicide prevention is a whole of government, whole-of-community issue. We know this is a matter very close to his heart. He was a former Lifeline counsellor himself and he has always wanted, and continues to maintain, the Mental Health and Wellbeing portfolio.

In February this year, the Government signed the National Mental Health and Suicide Prevention Agreement with the Commonwealth. In March, the Tasmanian and Commonwealth governments signed the Tasmanian Bilateral Agreement for Mental Health and Suicide Prevention. These agreements commit both governments to implementing systemic mental health and suicide prevention reform. Because this is only a fairly new agreement, resourcing will need to go into that. We thought it was more appropriate that the follow-up review be done when there was more information available.

Another thing the Premier did say to us was that through the consultation they had done, they heard that male suicide was more than a mental health issue. It is a complex social issue caused by a range of factors and requires a targeted response. The Government is aware of that. They are aware that you need a targeted response to deal with the gendered nature of it.

He went on to say that the new strategies will prioritise initiatives, activities and yearly implementation plans throughout the life of the strategy, which goes through to 2027, including activities that address the complex issues that contribute to men's suicide, suicide ideation and suicidal distress.

Mr Dale Webster, Deputy Secretary of Health, said that we know males die by suicide at a higher rate than females. However, females are more likely to attempt suicide and be diagnosed with depression, which is one of the main factors leading to suicide. Men are more likely to die as a result of their attempt. This is a global phenomenon and is also reflected in the national statistics on suicide. He said the 2021 preliminary data showed that males died by suicide three times the rate of females in Tasmania, while for the period of 2012-2018, males died by suicide at nearly four times the rate of females.

Clearly, suicide completion is a massive and tragic outcome for someone who is struggling not just with mental health necessarily, but other societal pressures and societal issues. We cannot just think we will fix the mental health space over here because that will not necessarily fix it. Sadly, there is no silver bullet here, so to speak.

It seems that men are more likely to complete suicide and perhaps use more lethal methods, and the data supports that. There is no coming back from that. It really is tragic. I am sure while every member in this Chamber may not have had a direct family member or close friend commit suicide, you will know someone who did. It is a tragic outcome and something that families probably never really recover from, and that stays with them forever.

It is important to note that not only the gendered nature of suicide and suicidal ideation requires targeted and specific approaches; the Government clearly identified that. We will wait to see how that plays out. We will certainly hope that the numbers reduce significantly. In fact, zero is the goal here.

Other factors, like the cost-of-living pressures; people feeling completely isolated, disenfranchised in their current living experiences; members of the LGTBQI+ community; or people with medical conditions such as Huntington's disease, are more at risk. They can be picked up and targeted through those strategies so that we have targeted approaches for different groups.

This is a really complex issue. The data collection is difficult and as we know, sometimes depending on what the coroner finds, people will determine that a motor vehicle crash, for example, is a suicide, not an accident. This is a big call. They have to be pretty clear that is the case because some people do not want their family to know that is how they have chosen to die. They would do anything, almost, to try to ease that pain for their family. Those poor people who feel so distressed that this is the choice they make must be in a terribly difficult place, then seeking to protect their family from that. The person who is gone does not see the reaction of the family. They would be quite distressed themselves if they did at times.

In the past, I have read suicide notes from people who have completed that they have provided to their dear loved ones. It is really difficult. Most of the times, they think they are doing the right thing. They think that is the solution for their family, which is really tragic. It is only when we can intervene earlier and help people avoid getting to that place, that we are actually going to make a difference.

This report was a look at what is happening at the moment. Is the Government aware of these particular issues, of the gendered differences and also, along the way, is it aware of the other factors that may make a particular cohort of individuals more vulnerable? What are we doing in a targeted, strategic way to try to assist those people? Are we supporting the family and community, building those family connections and those community connections? At the end of 2027, go back and revisit and see what the outcomes have been from the strategies. I know the Government will review its own strategy, but the decision was to give them the opportunity to do that and maybe refocus after that.

It is a tragic outcome for any person to contemplate, to be in that position where they see that there is an option, but also for the families, loved ones and friends that are left behind. It is something that often people cannot make sense of.

I reiterate those numbers if anyone is feeling distressed by the conversation or the comments I have just made, or any other member might make, in relation to this. It is Tasmania Lifeline, available from 8 a.m. to 8 p.m. on 1800 984 434, or the Lifeline crisis support service available 24 hours a day on 131114. I note the report.