This week's World Suicide Prevention Day reminded us of the huge weight we bear as individuals and communities from suicide.
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The latest figures tell us that one in two Australian adults know someone who has died by suicide.
That's a terrible toll, both of number of lives lost and of those affected by that loss.
In Victoria in 2017, the latest figures we have, 621 Victorians took their own lives - nearly 12 people every week and double the annual road toll.
The broader statistics are also distressing.
For every death by suicide we know there are at least 20 Victorians who will attempt or reattempt suicide.
This translates each year in Victoria to 12,420 people who require immediate responses and continuing follow-up and care to address their suicidality and prevent further harm or death.
As too many of us know, that has a ripple effect, devastating families, friends, workplaces.
For every death, it is estimated that 135 persons are impacted. That translates to more than 80,000 Victorians each year.
An increase in social isolation is also a driving issue for a third risk area ... with the latest figures telling us that one in four households is now made up of one person.
Mental Health Victoria is a member of Suicide Prevention Australia which marked this year's World Suicide Prevention Day with a pivotal piece of work it developed with KPMG: Turning Points: Imagine a world without suicide.
The paper notes that never before in Australia have we seen so much momentum driving suicide prevention to the fore, making it a priority for both government and the community.
It says that the Federal Government's "towards zero" ambition for suicide rates in Australia, and the Mental Health Royal Commission in Victoria "mark a watershed moment" for prioritising suicide prevention in Australia.
That's to be seen in the appointment of a national suicide advisor within the Department of the Prime Minister and Cabinet.
In Victoria we see it also in strong local suicide prevention initiatives like the Hospital Outreach Post-Suicidal Engagement (HOPE) initiative which offers intensive support to people who have made a suicide attempt, and to their family members, to reduce the risk of recurrence.
Its 12 statewide locations acknowledge the high risk of suicide in rural and regional areas.
They include Peninsula Health, Barwon Health in Geelong, Albury Wodonga Health in Wangaratta, Ballarat Health Service (including Horsham), and Bendigo Health Service (including Mildura).
The Turning Points paper takes us all another step, asking us to imagine a world without suicide.
It tells us we need to look beyond the traditional health and human service sectors if we want that vision to become a reality.
Suicide Prevention Australia surveyed more than 1,000 people for the paper and found that Australians believe economic security and changes to family and relationships will be some of the biggest risks to suicide rates over the next 10 years.
The paper outlines some of the risk areas. They include housing and finance trends, as households are becoming "over-indebted".
That's not just through often unsustainable mortgage repayments but there's concern also about the impact of buy-now-pay-later schemes that have also been changing Australia's relationship with money, especially in younger age groups.
In employment, we are seeing the emergence of the "gig" economy, where companies are paying for a service, rather than employing someone for an ongoing role.
While there are often positives for workers in "freelancing", we're seeing people lose access to training, career advancement opportunities and other benefits associated with full time employment and potentially becoming more isolated and lonely.
An increase in social isolation is also a driving issue for a third risk area that is identified around trends in relationships and household structures, with the latest figures telling us that one in four households is now made up of one person.
Suicide is a complex, multi-factorial issue that can't be attributed to a single risk factor. But its high rate in Australia and this new report, tell us that we need to approach prevention as a whole community, to support those who are at high risk and to address those trends that are influencing the toll at an underlying level.
- To get help 24/7, phone Lifeline on 13 11 14 or the Suicide Call Back Service on 1300 659 467. Learn how to identify the signs that someone may be struggling on R U OK's website.
Angus Clelland, Mental Health Victoria CEO