The Suicide Prevention Intelligence System
Suicide is the leading cause of death in Australians aged 15-44 years. Suicide services need timely data to inform prevention activities. However, data is locked up in different registries and collections, making it difficult to know where and how to access it. Information is not shared in a way that can help on the ground. Three of Australia’s analytics groups have come together to design a system that will address data needs, funded through LifeSpan.
In an Australian-first, the Black Dog Institute, supported by the Paul Ramsay Foundation, has developed a new technology platform which links multiple sources of data on suicide. Partnering with SAS Technology and the Australian National University, the Black Dog Institute is pioneering the highest quality of suicide prevention intelligence data currently available.
Black Dog Institute has identified the need for a national suicide prevention data system- similar to that of other OECD countries, and is working hard to bring Australia’s current systems in line with international best practice. The development of such a national suicide prevention data system requires work, as different suicide datasets are currently locked up within various organisations on a local, state and national level.
Unlocking Australia’s vast and various suicide datasets will take collaboration between Black Dog Institute and other organisations and agencies. This collaboration will allow Black Dog Institute and its partners to integrate and analyse the datasets, turning them into meaningful information that will provide a fuller picture of the national suicide crisis in our country.
Black Dog Institute is uniquely positioned to lead the collection, analysis and integration of this data as a trusted and credible not-for-profit organisation. This development builds on five years of ground-breaking work undertaken through Black Dog Institute’s NHMRC Centre of Research Excellence in Suicide Prevention, also the first of its type in Australia.
Using geospatial mapping analysis, the interactive visual data platform identifies suicide clusters, trends and rates, down to the postcode level. Socioeconomic and social risk factors also form part of this analysis, allowing us to both confirm and refute what we previously thought we knew about suicide in our communities, and enabling better and more targeted service provision. This analysis is currently provided to our NSW LifeSpan Trial sites, and many of the National Suicide Prevention Trial sites that we support across the country and has already influenced community decision-making around suicide prevention measures including means restriction, public space management, priority population identification and myth busting local suicide trends perpetuated by the media. There is now a need to provide this information to communities nationally.
There are several imperatives to collect data on suicide in Australia. The first is to monitor change and measure the progress of reforms at the national level. This is achieved through the collection and analysis of data on relevant indicators across multiple time points. While there are many national, state and community-based interventions designed to prevent suicide, the evidence shows deaths by suicide are increasing . A national suicide intelligence system would allow targeted reforms and informed policy making across the population.
A second reason is to obtain information about suicide rates, risk factors, treatments and outcomes. This will assist those involved in public health service and prevention planning, to improve patient outcomes. Australia lags behind Europe and the United States in this regard, and we fall short of recommendations made by the World Health Organisation for best practice in monitoring hospital admissions for self-harm at the national level.
A national suicide data intelligence system will include hospital admissions data on those who have attempted suicide and will be linked with the NSW Mental Health Ambulatory Data Collection (to assess outpatient care), NSW Emergency Department Data Collection (for re-presentations and re-admissions) and NSW Mortality Data (for all-cause mortality), and then de-identified for research purposes. Medicare and Pharmaceutical Benefits Scheme data could also be linked, with approval by ethics committees. Data linkage is costly to establish, but less costly to maintain, and it is something that needs ongoing support from governments, consistent with the Fifth Mental Health and Suicide Prevention Plan.
The third good reason to collect data is to help communities tailor their suicide prevention strategies. Visual mapping and layering of data can be used to inform the development of targeted means restriction and harm minimisation in accordance with the specific risks and needs of different communities. Again, with support from the Paul Ramsay Foundation, researchers at Australian National University and the Black Dog Institute have developed a novel interactive platform designed to support suicide intervention professionals, policy makers, academic researchers. It is currently being used to identify suicide clusters, locate local and regional services and resources, and identify modifiable risk factors in specific geographical areas. As this platform becomes better equipped to integrate the very latest data, it will be able to identify emerging suicide clusters, enable faster intervention and provide unique and valuable insights into suicide-related risk factors.
Finally, and most importantly, we need data in order to provide ‘wrap-around care’ for people who experience suicidal thoughts and/or who have attempted suicide. Currently, a person who is identified as at risk of suicide in the community, school or primary care setting cannot be followed-up across all relevant settings, which is a barrier to continuity of care. This must change. We know that public health surveillance systems do improve patient and service outcomes because we have used them before – the Australian Cancer Database contains all new cases diagnosed since 1982, and the Cancer Registry of NSW provides customised data at aggregate, linked or unit level, and gives access to cancer screening data. This improves cancer clinical service evaluation and allows integrated patient care by tracking patient outcomes.
Despite rapid progress in the assembly of epidemiological and health data sets around suicide in the last two years, these data sets now need to be expanded and consolidated. A gap remains in the provision of individual level data that tracks individuals through primary care, health systems and aftercare. Without access to this data, the Fifth Mental Health and Suicide Prevention Plan will lack the information required to adequately service communities and we will continue to fail to reduce suicide rates across the lifespan.
The above visualisation shows:
- Brisbane region Socio-economic background;
- SA2 aggregated suicide Incident Counts (10 years);
- and using point based data we can improve the locational fidelity.
The above visualisation shows:
- Nth Sydney & Central Coast SEIFA background;
- SA2 aggregated suicide Residence Counts (10 years);
- Using point based data we can improve the locational fidelity;
- Using point based Resource Data we work with distance and proximity metrics to better understand access to services;
- Proximity Buffers out to 10 km;
- and help to identify and validate data especially where there is evidence of potential underserviced regions, populations