Evaluation of suicide prevention activities

6.4 Individual level contact or activity data

Page last updated: January 2014

This section provides an analysis of individual contacts or activities, under the following headings:

6.4.1 Number of individual contacts or activities

In the six month period October 2012 to March 2013, a total of 16,222 individual contacts or activities were recorded. A contact or activity is defined as an episode of service that may be delivered in one or more sessions over a period of time. Contacts or activities can be delivered face-to-face, by telephone or online. This varies from one project to the next based upon their scope and function.

The number of contacts or activities in each month of the six-month MDS period was broadly consistent, with reduced activities recorded in December 2012 period as identified in Table 6-6.

    Table 6-6: Number of individual contacts or activities reported by month

    Collection period
    No. of
    activities
    %
    October 2012
    3,014
    18.6
    November 2012
    2,762
    17.0
    December 2012
    2,281
    14.1
    January 2013
    2,719
    16.8
    February 2013
    2,618
    16.1
    March 2013
    2,828
    17.4
    Total
    16,222
    100.0
Top of page

6.4.2 Mode of delivery

Table 6-7 identifies the mode of delivery (ie, face-to-face, telephone or online) for individual contacts or activities. Telephone sessions represented the primary mode of service delivery (59.2%), with face-to-face and online sessions representing 38.7% and 2.1% respectively.

Lower levels of contact or activity were recorded in December 2012 across all modes of delivery. This was most pronounced in relation to face-to-face contacts or activities. The reduction in telephone-based contacts or activities was less pronounced, possibly reflecting the greater accessibility of these services during the holiday period.

Table 6-7: Number of individual activities by mode of session

Mode
Oct 12
Nov 12
Dec 12
Jan 12
Feb 12
Mar 13
Total
Share of total
Face-to-face (n)
1,337
1,204
853
1,029
921
917
6,261
-
Face-to-face (%)
21.4
19.2
13.6
16.4
14.7
14.6
100
38.7%
Telephone (n)
1,621
1,492
1,384
1,607
1,621
1,843
9,568
-
Telephone (%)
16.9
15.6
14.5
16.8
16.9
19.3
100
59.2%
Online (n)
52
60
14
83
74
66
349
-
Online (%)
14.9
17.2
4.0
23.8
21.2
18.9
100
2.1%
Total (n)
3,010
2,756
2,251
2,719
2,616
2,826
16,178
-
Total (%)
18.6
17.0
13.9
16.8
16.2
17.5
100
100%

Note: Information not available for 44 (0.3%) of 16,222 individual responses.

Key findings

  • In the six month period from October 2012 to March 2013, a total of 16,222 individual activities were reported.
  • The most frequently reported mode of delivery for individual activities was telephone. Top of page

6.4.3 Session type

The majority of individual contacts or activities (94.5%) involved direct client contact (Table 6-8). Non-direct contacts or activities (such as case planning and engagement with community leaders) and supportive services activities accounted for the remainder (5.5%).

    Table 6-8: Number of individual activities by session type

    Session type
    No.
    %
    Direct client contact
    15,049
    94.5
    Non-direct client case planning with professionals
    379
    2.4
    Non-direct case planning/management with families, careers and/or significant others
    95
    0.6
    Non-direct engagement with community leaders
    7
    <0.1
    Supportive service – community
    319
    2.0
    Supportive service – family, friends
    82
    0.5
    Total
    15,931
    100.0

    Note: Information not available for 291 (1.8%) of 16,222 individual responses.

    Key findings

    The majority of individual contacts or activities (94.5%) involved direct client contact. Top of page

6.4.4 Duration of contact or activity

The duration of each contact or activity ranged from 0-15 minutes to 7 days or longer, however approximately half (51%) of all contacts or activities were less than 15 minutes duration (Table 6-9). Overall, 85.6% of contacts or activities were of less than one hour in duration.

Further exploration of MDS data has identified that almost half (42.1%) of all contacts or activities of less than one hour duration were attributable to the National Suicide Call Back Service, a service that provides up to six 50-minute telephone call-back counselling sessions for up to six months.

    Table 6-9: Duration of contact or activities

    Duration of contact
    No.
    %
    0–15 mins
    8,141
    51.0
    15–30 mins
    2,560
    16.0
    30–45 mins
    1,319
    8.3
    45 mins–1 hr
    1,647
    10.3
    1 hr–1 hr 15 mins
    936
    5.9
    1 hr 15 mins–1 hr 30 mins
    363
    2.3
    1 hr 30 mins–1 hr 45 mins
    79
    0.5
    1 hr 45 mins–2 hrs
    272
    1.7
    2–4 hrs
    355
    2.2
    4–8 hrs
    166
    1.0
    1 day
    29
    0.2
    2 days
    47
    0.3
    5 days
    44
    0.3
    7 days or longer
    6
    <0.1
    Total
    15,964
    100.0

    Note: Information was not available for 258 (1.6%) of the 16,222 individual responses.

    Key findings

    Individual contacts or activities ranged widely in duration from 15 minutes to 7 days; however most contacts or activities (85.6%) had a duration of less than one hour. Top of page

6.4.5 Activity mechanism

Activity mechanism refers to the context in which care was provided to an individual. A list of these mechanisms is provided in Table 6-10. In the majority of cases (89.9%) care was provided directly to the individual client rather than by working with family, peer groups, workplace, educational or community groups.

    Table 6-10: Activity mechanism of individual activities

    Activity mechanism
    No.
    %
    Individual
    14,181
    89.9
    Family
    582
    3.7
    Peer group
    176
    1.1
    Workplace
    285
    1.8
    School
    130
    0.8
    Tertiary education setting
    16
    0.1
    Community
    171
    1.1
    Other
    235
    1.5
    Total
    15,776
    100.0

    Note: Information not available for 446 (2.7%) of 16,222 individual responses.

    Key findings

    The majority of individual contacts or activities were undertaken directly with the individual client rather than via other avenues such as through family or friends. Top of page

6.4.6 Age groups

Age group data was not provided for 7,410 (45.7%) of individual contacts or activities (Table 6-11). The National Suicide Call Back Service did not provide age information for any individual contacts, and accounted for 3,941 (53.2%) of the 7,410 activities for which age was not reported.

In those cases where age group was recorded, a spread across age groups was evident. Children (0-14 years) accounted for 7.5% (660 out of 8,812) of individual contacts or activities.37,38 Youth and emerging adults (15-24 years accounted for 24.5% (2,158 out of 8,812) of individual contacts or activities. The age cohorts 25-29, 45-49 and 50-54 accounted for the greatest proportion of the remaining contacts or activities. A marked decline was evident in the number of contacts or activities in age groups over 55.

    Table 6-11: Age groups of individual contacts or activities

    Age
    No.
    %
    0-4
    1
    <0.1
    5-9
    159
    1.0
    10-14
    500
    3.1
    15-19
    1,193
    7.4
    20-24
    965
    5.9
    25-29
    765
    4.7
    30-34
    708
    4.4
    35-39
    640
    3.9
    40-44
    714
    4.4
    45-49
    874
    5.4
    50-54
    818
    5.0
    55-59
    414
    2.6
    60-64
    377
    2.3
    65-69
    220
    1.4
    70-74
    198
    1.2
    75 or older
    266
    1.6
    Unknown
    7,410
    45.7
    Total
    16,222
    100.0

Key findings

The age of individuals to whom services were delivered broadly reflects the Australian population age distribution. The notable exception was children aged between 0 and 14 years who, as would be expected, received proportionally fewer services than their share of the Australian population.Top of page

6.4.7 Sex

For a small proportion of individual contacts or activities (7.2%), sex was not stated or inadequately described. For those participants for whom information regarding sex was provided (n=15,056), over half (58.1%) were female, with males representing 41.9% (Table 6-12). This signifies an imbalance in the sex composition of the individual contact or activity participants.

When sex distribution is explored by age group, the under-representation of males is further illustrated (Table 6-13). Few exceptions exist where the proportion of males exceeds that of females. Males exceeded females in the age cohorts for children (5-14 years) and over 75 year age groups, where the proportion of males is up to twice that of females. For many other age cohorts, females outnumbered males by a 2:1 ratio.

Several reasons may account for the difference in participation by gender, including:

  • The greater help-seeking behaviour of females over males
  • The fact that more men than women suicide, hence women present for postvention support more often than men.
Given that over three-quarters (76.0%) of people who died by suicide in 2011 were male, this finding is of importance in reviewing the appropriateness of activities provided to this age group of men and the willingness of this cohort to seek help.39

It is noted however, that in the absence of data on those who are not using the services and the reasons why, the extent to which these gender differences can be apportioned to these or other factors/barriers is unknown.

The following Table 6-13 provides further detail of sex distribution, broken down by age cohort.

    Table 6-12: Sex of individual contact or activity participants

    Sex
    No. of activities
    %
    Male
    6,312
    38.9
    Female
    8,744
    53.9
    Not stated/inadequately described
    1,166
    7.2
    Total
    16,222
    100.0

    Table 6-13: Age and sex distribution of individual contacts or activities

    Age
    Male
    Female
    Not stated
    Total
    0-4 (n)
    -
    1
    -
    1
    0-4 (%)
    -
    100.0
    -
    100.0
    5-9 (n)
    110
    49
    -
    159
    5-9 (%)
    69.2
    30.8
    -
    100.0
    10-14 (n)
    287
    158
    54
    499
    10-14 (%)
    57.5
    31.7
    10.8
    100.0
    15-19 (n)
    368
    610
    214
    1,192
    15-19 (%)
    30.9
    51.2
    18.0
    100.0
    20-24 (n)
    364
    561
    21
    946
    20-24 (%)
    38.5
    59.3
    2.2
    100.0
    25-29 (n)
    349
    412
    4
    765
    25-29 (%)
    45.6
    53.9
    0.5
    100.0
    30-34 (n)
    241
    465
    2
    708
    30-34 (%)
    34.0
    65.7
    0.3
    100.0
    35-39 (n)
    216
    423
    1
    640
    35-39 (%)
    33.8
    66.1
    0.2
    100.0
    40-44 (n)
    198
    516
    -
    714
    40-44 (%)
    27.7
    72.3
    -
    100.0
    45-49 (n)
    217
    654
    2
    873
    45-49 (%)
    24.9
    74.9
    0.2
    100.0
    50-54 (n)
    278
    538
    2
    818
    50-54 (%)
    34.0%
    65.8
    0.2
    100.0
    55-59 (n)
    176
    238
    -
    414
    55-59 (%)
    42.5
    57.5
    -
    100.0
    60-64 (n)
    139
    237
    1
    377
    60-64 (%)
    36.9
    62.9
    0.3
    100.0
    65-69 (n)
    108
    112
    -
    220
    65-69 (%)
    49.1
    50.9
    -
    100.0
    70-74 (n)
    93
    105
    -
    198
    70-74 (%)
    47.0
    53.0
    -
    100.0
    75 or older (n)
    190
    74
    2
    266
    75 or older (%)
    71.4
    27.8
    0.8
    100.0
    Unknown (n)
    2,698
    2,937
    835
    6,470
    Unknown (%)
    41.7
    45.4
    12.9
    100.0
    Total (n)
    6,032
    8,090
    1,138
    15,260

    *Information not available for 962 (5.9%) of 16,222 individual responses.

    Key findings

    Fewer males than females participated in suicide prevention individual activities. Top of page

6.4.8 Aboriginal and Torres Strait Islander status

Aboriginal and Torres Strait Islander status was not reported for more than half (53.0%) of all individual contacts or activities (Table 6-14). Almost two-thirds (65%) of these unknown contacts or activities were attributable to the National Suicide Call Back Service.

A total of 2,379 individual contacts or activities were recorded for people of Aboriginal and/or Torres Strait Islander descent. The majority of these (2,255 out of 2,379, 94.8%) were of Aboriginal, but not Torres Strait Islander origin.

    Table 6-14: Aboriginal and Torres Strait Islander status of individual contacts or activities

    Aboriginal and Torres Strait Islander status
    No. of
    activities
    %
    Aboriginal but not Torres Strait Islander origin
    2,255
    13.9
    Torres Strait Islander but not Aboriginal origin
    74
    0.5
    Both Aboriginal and Torres Strait Islander origin
    50
    0.3
    Neither Aboriginal nor Torres Strait Islander origin
    5,249
    32.4
    Not stated/inadequately described
    8,594
    53.0
    Total
    16,222
    100.0

Key findings

Data collected from NSPP projects suggests that Aboriginal and Torres Strait Islander peoples are receiving a high number of suicide prevention services (14.7% of total contacts or activities compared to an estimated 2.5% of the population).40 This suggests that the NSPP-funded projects are successfully targeting this group who have a significantly higher rate of suicide than the non-Indigenous population. Top of page

6.4.9 Ethnicity

Ethnicity details were self-reported by either the individual client or project staff and were captured using a few text data entry field. In nearly half (49.1%) of individual contacts or activities, no information was provided in this field (Table 6-15). Where details were provided, Australian represented the largest single ethnicity category reported. Although not mutually exclusive, Australian and Aboriginal and Torres Strait Islander were listed as too distinct categories in the self-reported responses and are presented accordingly in Table 6-15.

Over 60 ethnicities were identified in the CALD category. These are listed in Table 6-16. The 'other' category generally comprised people of English-speaking background. These included British, Canadian, English, Irish, Scottish and New Zealander.

    Table 6-15: Ethnicity of individual activities

    Ethnicity
    No. of
    activities
    %
    Australian
    5,472
    33.7
    Aboriginal and Torres Strait Islander
    1,127
    6.9
    CALD
    1,305
    8.0
    Other
    357
    2.2
    Not stated
    7,961
    49.1
    Total
    16,222
    100.0
    Top of page

    Table 6-16: Ethnicity (CALD)

    Table 6-16 is presented as a list in this html version. It is formatted as a table in the original PDF version even though it is really just a list.

    Note: This is as reported in the MDS. It is noted to be a mix of countries and ethnicities.

    Ethnicity (CALD):

    • Afghanistan
    • Arabic
    • Argentinian
    • Asian
    • Asian descent
    • Bangladeshi
    • Bhutanese
    • Bosnia
    • Brazil
    • Bulgarian
    • Burma (Republic of the Union of Myanmar)
    • Burundi
    • Cantonese
    • Chilean
    • China
    • Colombian
    • Congo, Democratic Republic of
    • Cote d Ivoire
    • Croatian
    • Danish
    • Dutch
    • Egypt
    • El Salvador
    • Eritrean
    • Ethiopia
    • Fiji
    • Filipino
    • French
    • German
    • Greek Top of page
    • Indian
    • Indonesian
    • Iran
    • Italy
    • Japan
    • Jordanian
    • Lebanese
    • Liberia
    • Macedonian
    • Malaysian
    • Maltese
    • Maori
    • Mauritius
    • Mozambique
    • Oromo
    • Pakistani
    • Papua New Guinea
    • Persian
    • Peru
    • Polish
    • Russian
    • Sierra Leone
    • Somalia
    • South African
    • South Korean
    • Sri Lankan
    • Sudan
    • Swedish
    • Syrian Arab Republic
    • Tanzanian
    • Thai
    • Turkish
    • Ugandan
    • Ukrainian
    • Vietnamese
    • Yugoslav
    • Zimbabwe

    Key findings

  • The NSPP-funded projects have reported that over 60 different ethnic groups have been involved in individual suicide prevention activities.
  • Notwithstanding the large number of different ethnic groups involved in individual activities, CALD clients appear to be under-represented, with only 8.0% of the total number of activities assigned to CALD clients. Top of page

6.4.10 Refugee status

Refugee status details were either not stated or unknown for 8,329 (51.4%) of individual contacts or activities (see Table 6-17). For the contacts or activities for which refugee status was reported (n=7,893), 7.8% were activities delivered to refugees, with 92.2% delivered to non-refugees.

    Table 6-17: Refugee status of individual activities

    Status
    No. of
    activities
    %
    Refugee
    614
    3.8
    Not a refugee
    7,279
    44.9
    Unknown
    8,329
    51.4
    Total
    16,222
    100.0

Key findings

Refugees living in the community are accessing NSPP-funded services. Given the relatively small cohort of refugees living in the community and their high suicide risk, it is noteworthy that 3.8% of individual activities reached this target group. Top of page

6.4.11 Target group

This section identifies the group or groups which were targeted by each NSPP project for suicide prevention activities. Projects were able to assign multiple target group codes to a single contact or activity; hence the values presented in Table 6-18 exceed 16,222, the total number of individual activities.

Overall, the most frequently reported target group was whole-of-community (36.5%). Men (23.6%), people bereaved by suicide (17.8%), Indigenous populations (16.5%) and people living with a mental illness (16.3%) were the four other target groups most frequently cited. The inclusion of men as one of the top five target groups is surprising given that, as earlier reported (Section 6.4.7), only 41.9% of individual contacts or activities involved men. This suggests incongruence between the projects' perceived focus on men as a target group and actual service uptake by men.

    Table 6-18: Target group composition of individual contacts or activities

    Target group
    No. of
    activities
    %
    People bereaved by suicide
    2,889
    17.8
    Men
    3,826
    23.6
    Children
    418
    2.6
    Youth
    1,257
    7.7
    Indigenous populations
    2,674
    16.5
    People living with a mental illness
    2,649
    16.3
    People who have previously attempted suicide
    966
    6.0
    People who have self-harmed
    1,245
    7.7
    Rural and remote communities
    1,767
    10.9
    LGBTI populations
    325
    2.0
    CALD communities
    139
    0.9
    Refugee communities
    375
    2.3
    Older people
    393
    2.4
    People living with an alcohol or other drug problem
    273
    1.7
    Whole-of-community
    5,920
    36.5
    Workforce
    766
    4.7
    People affected by workforce redundancies
    64
    0.4
    People affected by natural disasters
    33
    0.2
    People at risk (no previous attempts of suicide or self-harm)
    226
    1.4
    Those engaged with the justice system
    27
    0.2
    Other
    808
    5.0

    Note: Multiple target groups could be selected.

Key findings

  • The NSPP-funded projects are providing individual activities to a wide range of people from specific target groups.
  • The provision of individual contacts or activities to LGBTI and CALD community members is relatively fewer than other high-risk groups. It would be expected that activity should at a minimum reflect the proportion of those groups in the general population. Top of page

6.4.12 Referral pathways

Multiple referral sources and destinations could be listed in relation to each individual activity; hence the totals presented in the following tables exceed 16,222, the total number of individual activities reported.

A broad range of referral sources were noted (Table 6-19). Although nearly a third of referral sources (29.4%) were unknown, self-referrals were the most frequently listed referral source (30.9%). This finding reflects strong help-seeking behaviour. Health providers (including emergency departments, inpatient units, community and primary care) were listed as the referral source for 5.6% of individual activities. Referrals from mental health providers (including inpatient units, community care and Aboriginal mental health services) were listed for a further 3.4%.

Referral destinations are shown in Table 6-20. Overall, on-referral of persons engaged in individual activities was not the norm. Referrals were unnecessary for 32.1% of individual activities. No further action or referrals were required for a further 1.2% of individual activities. Collectively, health providers, mental health providers and community social services were listed as referral destinations for 6.2%, 8.6% and 12.6% of individual activities respectively.

    Table 6-19: Individual activity by referral source

    Referral source
    No.
    %
    Self-referral
    5,018
    30.9
    Health provider – emergency department
    489
    3.0
    Health provider – inpatient
    76
    0.5
    Health provider – community care
    127
    0.8
    Health provider – primary care
    209
    1.3
    Mental health provider – inpatient unit
    111
    0.7
    Mental health provider – community care
    423
    2.6
    Mental health provider – Aboriginal mental health services
    12
    0.1
    Community and social service (government)
    156
    1.0
    Community and social service (non-government organisation)
    501
    3.1
    Education sector
    439
    2.7
    Juvenile justice
    70
    0.4
    Housing provider
    8
    <0.1
    Employer
    233
    1.4
    Police
    501
    3.1
    Coroner
    396
    2.4
    Internal referral
    358
    2.2
    Migration/settlement service
    32
    0.2
    Community event or activity
    145
    0.9
    Other
    1,245
    7.7
    Unknown
    4,775
    29.4
    Top of page

    Table 6-20: Referral destination for individual activities

    Referral destination
    No.
    %
    Referral not necessary
    5,210
    32.1
    Health provider – emergency department
    161
    1.0
    Health provider – community care
    587
    3.6
    Health provider – primary care
    252
    1.6
    Mental health provider – inpatient unit
    215
    1.3
    Mental health provider – community care
    1,113
    6.9
    Mental health provider – Aboriginal mental health services
    57
    0.4
    Community and social service (government)
    1,543
    9.5
    Community and social service (non-government organisation)
    502
    3.1
    Education sector
    214
    1.3
    Juvenile justice
    10
    0.1
    Housing provider
    221
    1.4
    Employer
    9
    0.1
    Police
    268
    1.7
    Coroner
    4
    <0.1
    Internal referral
    975
    6.0
    Migration/settlement service
    8
    <0.1
    Self-management
    238
    1.5
    Other
    516
    3.2
    No further action required
    195
    1.2
    Not applicable
    1,299
    8.0

Key findings

  • The NSPP-funded projects are receiving referrals from a number of different sources, indicating intersectoral collaboration.
  • There was a high rate of self-referrals, which reflects strong help-seeking behaviour among those using NSPP-funded services.
  • Referrals are also frequently made from NSPP-funded projects. This indicates a multi-disciplinary approach which is an important aspect of embedding suicide prevention activity in the broader community. Notably, significant numbers of referrals were made to health and mental health services. Top of page

6.4.13 Geographical distribution of contacts or activities

Analysis of the geographical distribution of individual contacts or activities by state is restricted by the substantial number of activities (19.6%) for which state details are unknown (Table 6-21). These unknown cases are largely attributable to one organisation, the National Suicide Call Back Service. This telephone-based service did not have state details for 2,999 (51.7%) of their 5,803 individual activities, which in turn represents 94.3% of all unknown state designations for the period.

The highest proportion of individual activities is found in New South Wales followed by Queensland, Victoria and Western Australia. These four states correspond to the four states with the highest populations in Australia.41

    Table 6-21: Individual activities, by state/territory

    State or territory
    No.
    %
    New South Wales
    4,021
    24.8
    Victoria
    2,174
    13.4
    Queensland
    3,016
    18.6
    South Australia
    538
    3.3
    Western Australia
    2,172
    13.4
    Tasmania
    520
    3.2
    Northern Territory
    299
    1.8
    Australian Capital Territory
    303
    1.9
    Unknown
    3,179
    19.6
    Total
    16,222
    100.0

37 Emerging adulthood is defined as the period from late teens through the twenties, with a focus on ages 18-25 years. JJ Arnett, 'Emerging Adulthood – A theory of development from the late teens through the twenties', American Psychologist, vol 55, no 5, 2000, pp.469-480.
38 The ABS commonly uses the age group 0-14 years for children and 15-24 years for youth, although this does not necessarily apply to all output. Australian Bureau of Statistics, accessed 24 June 2013, Defining children and youth
39 ABS, Causes of Death, Australia, 2011.
40 ABS, Population Distribution, Aboriginal and Torres Strait Islander Australians, 2006.
41 Australian Bureau of Statistics, Australian Demographic Statistics, December 2012, Summary 3101.0, ABS, Canberra, 2013, accessed 16 April 2013.