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Suicide in Australia

CHAIR —Welcome. I understand you have all had information on parliamentary privilege and the protection of witnesses and evidence. I invite one or each of you, depending how you want to start, to make an opening statement and then we will ask you some questions.

Ms Hillman —First of all, thank you for giving us the opportunity to speak here today. I think it is a very important inquiry and I am looking forward to seeing the outcomes from it.

As I said, I am the manager with ARBOR. I have been involved in suicide bereavement in WA for the last 10 years and suicide prevention for the last 12 years. Josephine Hudson is our chair. She is also a grief and loss specialist. She is here to answer any queries and provide information on grief and loss specific to suicide bereavement. As Mark said, she is one of our inaugural peer supporters. She has been with us since day one when we started services. She is here to talk about here experiences and her involvement with ARBOR.

What I want to do is to briefly give you the background on suicide bereavement in WA. I know that you would have had a lot of submissions talking about the statistics and the particular issues and difficulties involved with being bereaved by suicide and working through that loss, so I really do not want to go into that here. I more want to give you a bit of background on what has been happening in WA over the last 10 to 12 years that I have been involved.

The first point is that pretty much historically in WA there has been very little done. Things started happening five or six years ago. To start off with, we recognised this gap in the late 1990s. Bereaved people were not getting support. We were talking about youth suicide prevention and other prevention strategies, but we were not talking about people at risk because of their losses. We conducted a pretty small study—a needs assessment—with people bereaved by suicide. It was really just a fishing expedition at that point in time. But a couple of key things came out of that, and you will see these things in the literature over and over again. People did not know where to look for support. They did not know who to approach or where to get help, and they certainly were in no state to go out searching for it. They wanted direct contact from a support service. I remember people saying, ‘I want someone to knock on my door and say, “I’m so sorry; how can I help?”‘ They also wanted the provision of written material—things that they could hold on to and look at when they wanted emotional and other support. They also wanted the opportunity to talk to others who had been through the same experience.

At this point, in early 2000, we formed the bereavement support working group of what was then the Youth Suicide Advisory Council. It is now the Ministerial Council for Suicide Prevention, which you probably know about. It is going through a new incarnation as we speak. Within that, we sought funding to develop an information support pack, which was one of the recommendations, for people bereaved by suicide. This is a resource that we developed in conjunction with people bereaved by suicide. We had a reference group of about a dozen folks who had come out the other side, I guess. They really influenced what the pack looked like, what was in it, how it was disseminated and the like. I have copies of it floating it around. The very first WA one came out in 2001. It was distributed through WA.

The key thing with it was the dissemination process. It was what we term an active process. It was not a resource that was developed and then sat in an office waiting for people to find it; it was actually distributed. Since that point in time it has been distributed through the coroner’s office, because that is the one place where every death by suicide is recorded and a family member is on their books as being notified. What happens is that they get a copy of this pack. Either it is sent out after a phone call and a discussion or it is posted out with a letter.

In 2003, it went national. I have a copy here. It was developed by what was then Community Life, which was a national initiative. Essentially, it was exactly the same material. It was distributed through coroners’ offices as well, so again there was that active dissemination process. It was not distributed in New South Wales, because they had a resource that they used, and it was not distributed in Tasmania because, at the time that this was funded to go national, Tasmania was funded to develop their own pack. We updated the pact in a second national print, the third print all together, in 2007. That is the version that is just running out at this point in time. It is again distributed through coroners’ offices in that active way.

A fourth version came out last month. I briefly looked at some transcripts and saw that there was a bit of contention about who knew about it and who had heard about it. It is essentially the same document. It has a different format and there were a couple of minor changes. The main difference with this one is that it will not be disseminated through an active process. It sits in an office in a national distribution centre in Canberra or Sydney and people have to know that it exists and call to get themselves a copy sent out.

CHAIR —Why is that?

Ms Hillman —That is a very good question. We were not involved in the development of this last version. It went out to tender. I do not know a lot about it, but the people who got the tender were toing and froing with DOHA a lot about it and what the mandate was. There was a lot of confusion as well. We developed it as a resource for bereaved people, not for professionals. Professionals wanted to get their hands on it, because it had a wealth of information and helped them to work with bereaved people.

The talk when they were looking at this pack was that it was for professionals and all their consultation was with professionals not with bereaved people. I did have a couple of discussions reminding them that it actually was not a resource for professionals. Yes, they like it and they find it handy, but it was a resource for people who were bereaved, not for professionals. That is why it looks like this, with brochures that people could take out. It was not overwhelming. They could take out one piece of paper, read it and leave the rest aside. When we were developing it, I remember showing them all the different formats for what it could be, including a booklet, and the consensus was really that they did not want anything overwhelming, anything that looked like a book or anything that had too many words in it, and those kinds of things. I think that was probably one of the issues.

I did speak with Chris Killick-Moran from the suicide prevention area in DoHA. I asked him why there was not a dissemination strategy with this last one and what that dissemination strategy was going to be, if anything. He said that they had not talked about it and that they would. The next I heard was when I got an email saying, ‘This resource is available’, so I ordered some, and we use them with our clients. From there the bereavement support working group put in some funding to develop an active intervention model, and we sit here as that model, ARBOR. The funding was through the National Suicide Prevention Program, and ARBOR is an initiative between Curtin University and the Telethon Institute for Child Health Research. Our goals are to provide early information and support to reduce the risk of suicide and to raise awareness of the complexities of suicide bereavement amongst allied health professionals.

We have on our expert reference group people bereaved by suicide who inform the process of the model. We are largely based on the work of Frank Campbell, who I assume you would have heard about a number of times. He is based in the US and touted the active response model. He has a loss team that goes out pretty much immediately at the time of loss to families bereaved by suicide. Certainly that was something we wanted to do. We needed to recognise that the coronial system in the US is a medical system and the coronial system here is a legal system, so there were certain difficulties with going out immediately like that. We developed a direct referral relationship with the coroner’s office for every death by suicide. It takes a number of years for a finding to come down but, if it seems apparent that the death was likely to have been a suicide, the counsellors will ring the family. They will offer their condolences and their support and they will also let them know about us. If a family wants referral to u, that referral is made to us and then we contact the family directly.

CHAIR —Sorry, I am interrupting, I know, but I might as well ask while that is in my head.

Ms Hillman —That is all right.

CHAIR —What is the time frame?

Ms Hillman —That we contact families in?

Senator MOORE —For the whole referral process.


Ms Hillman —The coroner’s office contacts within a day to two weeks, and once we get that referral we contact within 24 hours.

CHAIR —Then it could be two weeks before you are contacted.

Ms Hillman —It could be two weeks, yes. We have responded to families within days and we have supported people 11 years down the track. We certainly are set out to be an early intervention service. There have been some difficulties with that, certainly. For one, the counselling service in the coroner’s office is understaffed and they have so much work to go through that sometimes it sits back before they can actually contact the family. But we are working on that. They have just got another counsellor on board, fortunately, so hopefully that will make a difference.

One of the things that makes ARBOR unique as a suicide postvention service within Australia is that direct relationship with the coroner’s office. We are an active postvention model rather than a service that gets built and waits for people to find it. I think that is really important with this type of grief and loss. We are also a high-capacity service. We can respond to up to 6 new referrals a week and we average three home visits a week with families. So this kind of model suits larger areas like large towns and cities.

We also have peer support, which is unique to the services in Australia. These are people bereaved by suicide themselves who we train and support to support those newly bereaved, and they work hand in hand with our counsellors. It is a peer supporter and a counsellor who go out to families in their homes. We currently have a team of about 15 peer supporters working with us.

Our staff are full-time workers with ARBOR, so this is what they do day in and day out. They are grief and loss specialists. They are suicide sensitive. They all have postgraduate qualifications in counselling or the like.

The other thing that makes us unique is that we provide more than one-off support. We found from the evaluation of the initial pilot phase of ARBOR that people who just got a home visit were not doing too well six months down the track and actually could have done with more support. Those who got more support were still struggling through but were getting that support and reaching out more, so they were getting support that they needed. So not only do we do home visits; we offer ongoing counselling and we offer peer support. People can sit one on one with our peer supporters and talk about those mutual shared experiences.

We started up support groups in WA because WA, strangely enough, unlike any other state, just did not have support groups running. On and off you would have a self-help group which would last a little while and then disband, but there were no professionally facilitated support groups in WA. I have never been able to work out why. We worked hard to try and get other services to start them up and in the end we started them up ourselves.

We also do return-to-work support. That involves assisting our clients who move back into the workplace. We might go into a workplace and provide information for staff or for managers on how best to support this person coming back to work.

Our clients stay with us for an average of about three months at this stage. In that pilot period, we supported about 390 people bereaved by suicide.

I guess the major issue for us has been the continuity of funding. The funding is a three-year cycle, one would say, although it was delayed coming on, so it was about 2½, and the second round of funding was delayed also. The biggest issue was that our funding finished in May 2009—last year—but we did not get a new contract signed until October 2009, so for five months the staff and the service were in limbo and it was really destabilising. We had to wind down services, so people were not getting the support that they needed, because we did not know whether next week we were still going to be here or not. For our staff it was the same. They did not know whether next week they would have a job, so they really struggled through that period. I speak a little bit distantly from that because I was on maternity leave last year, so I was there just before it started and then I came back after it finished. But what we are focusing on now is rebuilding the service back up to capacity. The next funding round finishes in June 2011, so there is heightened anxiety, shall we say, around staff already about whether they are going to go through that again. I do not expect they will stay around to go through it again. I do not blame them.

The only other thing I want to touch on, really briefly, is the overall issues of suicide bereavement in WA. With the vast distances—we are a massive state—and the remoteness, it is really difficult to provide services throughout this state, and I think that needs to be recognised. I think too that on the west coast we feel quite isolated from the decisions that are made on the east coast. They are often made without consultation sometimes with the state office, let alone the community here, and that can be quite difficult. You find out about that after the fact.

I mentioned the underresourcing of the Coronial Counselling Service. Another issue is that there are only a few good grief and loss practitioners around. Grief and loss are a very hard area to work in. It takes a special kind of person. And then, when you add the complexity of suicide bereavement on top of that, you are really narrowing the opportunities to refer clients who might need it for longer term support. We do find that difficult. Your previous speaker would have much more knowledge and skills in this area than I do, but supporting Aboriginal people bereaved by suicide is another very complex area. Really a different approach is needed there.

We would like a more integrated approach between state and federal governments. We talk with one and we talk with the other but seldom do the two of them talk to each other and, if they do, it tends to be just rhetoric and there is no action at all. There is a need to further the evidence base on the impact of suicide and I think that an evaluation of these funded services needs to be more comprehensive. It needs to include details of methodological issues, because it is very difficult to evaluate well suicide bereavement services. There are ethical issues. You cannot have a control group. We are not going to offer some clients support and say to others, ‘No, sorry, we want to use you as comparison,’ and ‘It is not going to happen.’ When you are making comparison with general population samples you are really comparing oranges with apples. No-one actually says, ‘While we are not really comparing similar groups, here is what we found.’ They just say, ‘Here is what we found,’ and that is a shame.

There is a bit of competition between services, I think, and a bit of a ‘divide and conquer’ mentality. I would like to see services working closer together rather than having to compete to prove their worth and compete for funding, which is generally how it is. And of course raising awareness of suicide bereavement and help-seeking amongst the general community is really important and services like ours do not get funded to do that as much as they should to do the work that needs to be done. They are the issues I have. I will hand over to Marg who wants to talk a little bit in her capacity as a peer supporter with us.

Mrs Doust —Our daughter died about six a half years ago from suicide and what we went through as the result of her death was something that I did not want anyone else to go through. It was a strong feeling that I had very soon after her death that other people should not have to go through what we went through, and I guess that was the beginning of my wanting to do something about it.

All the time through my grief I really wanted to tell somebody about her death, to really talk about it, and I could not because it would give pain to anyone I talked to about it and then I would feel bad about making them feel bad. A lot of them could not deal with it anyway because they just did not have the tools and it was very hard on them. So I was constantly questioning myself about how I was handling her death: was I reacting normally; was I going crazy? I did believe for a long time that she would come home. I knew that she could not but I just could not stop the feeling that she was coming home. They were very strange feelings, thinking that you are going crazy. I felt guilty because I was able to go back to work and carry on like normal and not cry all the time—and I was thinking: is this normal? So I knew from the start that I wanted to do something to help stop this awful way people have to suffer.

About three years later the Ministerial Council for Suicide Prevention told me that there was going to be a project using volunteers and I went along to see the presentation by Frank Campbell. For the first time since her death I felt that I was really understood. The presentation was about everything that I would have needed if I could have used it at the beginning. Thankfully, I was included in the first intake of the peer support volunteers and my journey with others brought me a great deal of comfort and healing for myself as well as confidence in helping other people.

The training itself was another healing process for me as well. It was in a safe environment with all the support that I needed. Going out as a peer supporter, I feel that we bring hope to those that we visit. In the comfort of their own home we give them our individual attention, listening to them and answering their questions. We bring to them skills we have learned through our own life, turning our own grief experience into something useful and adding to that the training we gain from ARBOR. At the home visit we offer an open meeting with empathy and encouragement with the knowledge that we too have been in the same place. Knowing that we have survived and are there to help them gives them so much encouragement. The level of understanding we can offer gives them comfort. They can feel free to talk about things that they cannot often talk about with others.

The actual physical difference in people who have been visited by our counsellors and peer support volunteers is visible on the day you go to see them. When they open the door they are broken and sad and sometimes they are crying and terribly distressed. But after some time talking and realising that you really understand them, you can see the physical changes in their faces and their body language. It gives me a great sense of achievement. It is an incredible thing to be able to share those hard earned lessons with people who do not have the hindsight.

CHAIR —Ms Hudson, do you want to make an opening statement.

Ms Hudson —Very briefly, I see my role in coming to this inquiry as being able to provide some insight into bereavement counselling. When we talk about postvention—working with clients after a suicide has occurred in a family and working with a bereaved family—we are also talking about prevention in that process. The other aspect that I am able to speak to is around the area of research and having the knowledge to be able to train people to actually do the work of a counsellor in grief and loss.

Senator ADAMS —The practical aspect of your approach and the way you work is very interesting. This is what really worries me with referral: I do not think there is enough information out there for people at the moment about actually being referred. I come from a rural area, which makes it even harder. Do you speak on the phone to people? If someone from a rural area rings, are you there for them?

Ms Hillman —We do. We are funded to provide services in the Perth metropolitan area only, but we do not turn anyone away. Our goal, if we get someone from a rural and remote area, is to provide telephone support. They can come up and see us if they do not live too far away and we try to link them in with supports in their own area. That is probably the most difficult component of it. One of our counsellors at the moment has a client who is in the eastern states and they have telephone contacts regularly scheduled and provide support that way as well. That particular client moves between WA and the eastern states quite a bit, so it just worked out to be the best way to support her.

Senator ADAMS —Do you do any work with the Division of General Practice? What worries me is antidepressants being given for something that probably should have been worked through first. Often it is a quick fix and then things start to deteriorate.

Ms Hillman —That is a really good point. What we are developing in our training is trying to get practitioners to realise that the signs of depression are really similar to the signs of grief. What you need to do is actually work through the grief. Putting someone on antidepressants will generally just mask that grief and the grief work that needs to be done will not be done. Unfortunately, it is a misconception out there that people are depressed. Often people will go to their GPs and talk about how they are not sleeping, not coping and struggling but they will not actually disclose a loss. I think it puts GPs in quite a difficult position as well. So providing information around investigating further as to whether there are any triggers or losses involved is important.

Senator ADAMS —Do you work with health services as well here in the metro area?

Ms Hillman —We do a little. It is probably more referral relationships. We are just finalising a day of training for practitioners and one of our objectives in this funding period is to raise awareness amongst allied health professionals of the complexity of suicide bereavement. That certainly will involve more people from health services and the like.

Senator ADAMS —How is the training of your support people done? Do you get volunteers? How do you actually get people to come to take up those positions?

Ms Hillman —We recruit, basically. We use networks that we might already have. We advertise. There is a screening process that people go through. There is first a written application. It is very hard to judge via time where people are in their journey. We have a general ‘three years down the track’ rule, but three years down the track could be a microsecond for someone but much further along in the grief journey for someone else, so we also have an interview with potential peer supporters. They then have three days training as well. That again is part of the screening process. It is fairly rigorous, I would say.

We had some research conducted on our first rollout phase, the 18-month pilot, which looked at the effects on our peer supporters of being involved in this work. The measures were things like the Beck Depression Inventory, the anxiety inventory, complicated grief and the like. The research indicated that there were no negative benefits of being involved in this work as a peer supporter and that actually there were some positive benefits, as Marg did mention.

Senator ADAMS —I was going to ask you that, because it is really good to see, when you have gone through that experience, that you have the strength to come and help other people. There is no-one better able to really understand how a person feels than someone who has actually experienced something themselves. It is fine to read books and say, ‘I can do this or that,’ but if you have actually experienced something like that it is very good. That is the reason I was asking how you recruited your peer supporters.

Senator MOORE —Ms Hillman, I want to go back to the tender your group had for support for people who are bereaved. Did you actually put an application in for that tender?

Ms Hillman —We did in the first National Suicide Prevention Strategy funding round. It was in about 2006 I think.

Senator MOORE —Who got it?

Ms Hillman —The institute and Curtin. There was a bit of toing and froing because it could only be appointed to one body, so it went to Curtin. But the Curtin Centre for Developmental Health is a joint initiative between Curtin and the institute, and that is where it sits.

Senator MOORE —And the subsequent one?

Ms Hillman —It was not a tender process. There were discussions for six to nine months beforehand about whether or not there was going to be further funding. That was my understanding with all of the projects actually. There was not another open tender process. There were discussions and feedback on what worked—feedback from evaluations and state offices—and then decisions were made.

Senator MOORE —Were you involved in those discussions, seeing that your organisation had produced the previous support packages?

Ms Hillman —The ‘support packages’? Sorry; I thought you were talking about ARBOR.

Senator MOORE —You quite pointedly told us about the history—which is fine; we need to have that on record—but I am really interested in that tender.

Ms Hillman —We did tender for the very first pack. It was quite a small amount of money to R&D and produce it. I honestly do not recall about when it went out nationally. I think probably we had discussions about getting more in WA, and then Community Life came in and did that. We were not actually involved in that, apart from trying to get them not to have it red. We had very heated discussions about that, but that was their corporate colour. When it came back to the second national print we were approached to do it. I do not think it went out to tender. There was just a discussion with DoHA in Canberra.

Senator MOORE —Like a brand new contract?

Ms Hillman —Yes.

Senator MOORE —And then what happened?

Ms Hillman —The fourth one did go out to tender.

Senator MOORE —And did you tender?

Ms Hillman —We did not. I did not actually know that it was out. I was not notified and I did not see it in any papers or anything like that, so we did not know it was happening.

Senator MOORE —Okay. Who got it?

Ms Hillman —It was a consultancy firm in the eastern states. When I found out about it, I did have a couple of discussions with them. They were very good. I think they were having some issues with working out what the funding body wanted and what they were there to produce. My understanding, as I said, is that they only consulted with service providers, not with bereaved people. But I did point that out to them a couple of times.

Senator MOORE —The point was that they did not tell you they were putting the tender out and just left it for people to seek it out. That is how the tendering process works.

Ms Hillman —We would have been happy to have tendered for it, but we needed to know that it was available.

Senator MOORE —We will follow through on the details of that tender. I normally have the list of all the funded agencies with me, but it gets too heavy to lug around. My memory is that a lot of the money for support to families has gone to the Jesuit services in Melbourne. They seem to have been very successful in that round. There is also the crisis support centre, with whom we met the other day. Have you had anything to do with them? They are in the process of putting together a list of regional support. Have they spoken to you about that?

Ms Hillman —I have only been back in the role for two months, but there was nothing in the handover from the previous manager, no.

Senator MOORE —I will follow up specifically with them about your agency. I think it is particularly interesting that we have had evidence in most states about the needs that families have when they are placed in this situation. There has been, as you said, a range of feedback about what they want. But it is true that they want something. In Queensland we had particularly negative reports about just being given a handful of leaflets at the time. People felt that was probably not useful at all and maybe even had a negative impact. I am particularly interested in the proactive way of doing things. I know that the model that your group uses has a relatively small sample because the funding is only Perth-centric, which is a fairly small area. You would be evaluating that. Do people tell you that they do not want to be contacted; it is not what they are seeking? Can you give me any idea of the number of people who would say that?

Ms Hillman —The research suggests that 50 per cent of people generally have their own resources and support systems. They have the resilience to work through this stuff themselves. So we are really talking about the other 50 per cent. When the coroner’s office makes contact, some people say, ‘No, not right now,’ or ‘No. We’re doing okay.’ That does not mean that there are not people who then make contact with us. When the coroner’s office speaks to them, the counsellors get in touch with the families. They will then say: ‘We have this resource. Can we post it out to you?’ They also include a flyer for us, so we find that people, down the track, will contact us because they have that information.

Senator MOORE —In their own time.

Ms Hillman —Yes.

Senator MOORE —Different members of the family have different needs. It is not one size fits all. We have been told today that a new suicide plan has been put out by the government. They have recently announced the successful bidder to coordinate that. It is the telethon people. It is my understanding that they are already a partner that you work with. Have you been involved with them in working on widening the service? Obviously there is a need. There is no question about that. You have already mentioned the geographic issues in your state. There is no question about that. With regard to the kinds of services that you are able to provide to people in Perth who know about you, have you been able to enter into a discussion with Curtin and the telethon people about whether there is anything in the future planning for Western Australia that would engage your kinds of services elsewhere?

Ms Hillman —We certainly have. I know that in the consultation process for the development of the suicide prevention state plan bereavement issues came up. In each of those consultations it was quite a prominent issue. We have spoken to them about it and we have had initial discussions with people in other centres, including those over east, about putting in an ARBOR model. I think that it is needed. It fits well into those larger areas, but not the rural and remote areas, which are much more difficult to service. The model would need to be looked at for applicability in those areas. In the first funding round we did look a lot more at supporting Aboriginal people bereaved by suicide and at times we had Aboriginal workers within our service. That had its own positives and negatives. We were a non-Aboriginal service so it was difficult for one Aboriginal person to be sitting in there—

Senator MOORE —and to be all things Aboriginal to them.

Ms Hillman —Yes. As for Aboriginal people, I heard this from your previous speaker. He mentioned his uncle and his aunt—and he is not unaffected by suicide—and the issue in working with your own community, when you are an Aboriginal person, is that it is your personal experience and you are supporting the family within that. It is very difficult. We did engage some consultants to develop a model of support for Aboriginal suicide bereavement statewide. That involved some local community action as well as a response team based in Perth working together throughout the state. I can provide you with that paper to have a look at. It is just a discussion paper at this stage and it has only gone out to academics and workers in the field. The next stage is to take that to further community consultation. It is with DoHA. At the end of the funded project we left it with DoHA. That is where that is.

Senator MOORE —My last question is in terms of the state suicide plan, which I think is a really good process. Have you been one of the agencies with whom they have been discussing at state level the future of the suicide strategy in the state?

Ms Hillman —We have been to some extent. I have had a meeting with Minister Jacobs. It is a difficult one. The ministerial council was previously based at the institute and had a number of key service providers and experts in the field who came together to address the issues. Bereavement support was certainly one of those issues. It has now been rejigged with the new government. I am yet to see how that is going to work in its current capacity. I am interested to see what happens after that. We have had some initial discussions. They have not been fruitful, to be honest. It seems to be: ‘Oh, the federals are funding that. Talk to them about more funding rather than to the state.’

Senator MOORE —We are speaking with them tomorrow. As you said, there is this interplay between state and federal levels. It has always been and it always will be the way, but how you actually had that clearly communicated is difficult.

CHAIR —I know I am just about to take us a little bit over time but I have one further issue that I would like to follow up. A lot of the evidence that we have received indicates that the risk of people who have already suffered a suicide bereavement in the family is heightened. How do you deal with that when you are providing your support services?

Ms Hillman —As I said, our counsellors are all skilled practitioners. They all have postgraduate qualifications. Dealing with suicide risk is an everyday thing with what we do. There is not only the risk of suicide within families. Suicide within generations of families is very real. We deal with it as I hope any practitioner would when they deal with clients with suicide risk. Because we are specialists in this area, we go in knowing that these clients are at heightened risk. We know this in advance and we work with that.

CHAIR —Do you also support people that were not necessarily members of family but were close to somebody?

Ms Hillman —We have supported friends, work colleagues and people who found the body and who were no relation whatsoever—quite an exhaustive list of relationships.


Ms Hillman —What I want to see for something like ARBOR is ideally that real early intervention process. Our coronial system is a legal rather than a medical system. In the US, the coroner, who is equivalent to our forensic pathologist, goes out when there is a death by suicide to the home or the scene immediately; police are there; there might be 20, 30 or 40 people there. But Frank Campbell’s loss team is called out and they go out and provide initial information and support to the family. That is what we would have liked to do here. But, because of the legal system in place and the need for legal paperwork to be served and legal decisions to be made within 24 hours, we had to allow that process to happen before we could be involved. Ideally, that is what we would like to be doing—we would like to have every death by suicide attended, there and then, with family.

CHAIR —Have you done any work around the delay in response? Sometimes the coroner tells you almost immediately—from the answer you gave to a question earlier—and sometimes it is two weeks. Have you done any work around the impact of that delay?

Ms Hillman —We have not done any research, but there is a little bit of literature out there and I know that Frank Campbell, again, has done work in this area. The main, key positive that comes out is that people who are approached sooner seek help sooner. Off the top of my head, it was something like: people who were visited by the loss team initially sought help within something like 39 days whereas for those who had not had that initial contact it was something like two years or 2½ years before they actually sought help, but 2½ years down the track your life is a mess if you have not dealt with what you need to deal with. So you have a whole lot of other baggage there as well.

CHAIR —We have received evidence from a number of people, particularly parents, who have said, ‘I didn’t know what to do.’ They just did not know what to do. Some people got a few pamphlets; some people got nothing. It seems to me that that time delay is pretty critical. That has certainly come out from the evidence we have received in submissions and from witnesses to date, anyway. It seems to me that that is really important.

Ms Hillman —There were some messages relayed from the state coroner today, actually, about a particular family that we were involved with quite early on, and it has actually been written up in the police report how much they appreciated our response and our support. So there certainly is evidence for it. Frank Campbell came over and trained us to operate, as best we can, under his model regarding legal and medical obligations. He said that they have never been turned away—they have never been told, ‘We’re not interested in hearing from you; go away,’ by any of the hundreds and hundreds of families that they have visited within hours of a loss. So I think there is a little fear about that, and some people look back and go, ‘Ooh, I’m not sure,’ but most people look back and go: ‘Yes—anything would have helped. Just sit next to me or make me a cup of tea; give me some resources and make contact in a week.’

Senator MOORE —Have you got any funding or capacity to help people who are families of people who have attempted suicide, particularly the families of those people who have attempted suicide a number of times—those families that live on the edge, sometimes for a long time? Is there any capacity in your service for that, or can you just not do it?

Ms Hillman —We have not got any funding to do that. We do sometimes get calls from people who are supporting someone who is suicidal. The Ministerial Council for Suicide Prevention, previously, before its present incarnation, did seek funding from a variety of different sources. It did develop a resource—which I have here, actually—which we call in-house the ‘carers pack’, which is a bunch of information about how, as a carer of someone who is suicidal and has been attempting suicide, you can best support them and how you can look after yourself in that process. So there have been initiatives around that. It is certainly something that could be expanded, but at the moment we do not have the funding or capacity to do that.

CHAIR —Thank you. As we have with every witness today, we have gone over time. We could have kept talking with each of our witnesses for a long time. We very much appreciate your coming and sharing your information and stories with us. It really does help us to understand the issues and to frame what we hope will be significant recommendations. Thank you.

Committee adjourned at 5.09 pm