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Suicidal patients not directed to follow-up s -

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Suicidal patients not directed to follow-up services

Timothy McDonald reported this story on Tuesday, February 2, 2010 12:34:00

ELEANOR HALL: The mental health group SANE is warning that too many people who attempt suicide are
released from the emergency room without being directed to follow up services. Yet psychologists
say that one of the most important indicators of suicide risk is a previous attempt.

Timothy McDonald has our report.

TIMOTHY MCDONALD: Mental health workers say people who take their own lives have all too often
tried before.

The mental health group SANE says that's why it's so important they receive ongoing treatment after
their first suicide attempt.

The group's executive director Barbara Hocking says their new survey suggests that's not always

BARBARA HOCKING: Thirty per cent of respondents and these are people with a mental illness who have
attempted suicide or self harm, 30 per cent were not referred for ongoing mental health treatment
after a suicide attempt and almost 60 per cent were not offered psychological therapy after the

Now we are really very, very concerned about this because we know that people with mental illness
are already at high of suicide and then anyone who has made a suicide attempt is also at high risk.

So we have got a group of very high risk people who are not getting the ongoing mental health
support and help with crisis plans and psychological treatment that we know will make a big

TIMOTHY MCDONALD: Eighty per cent of the 285 people surveyed weren't given a crisis plan to follow
if they felt suicidal again.

Barbara Hocking says she's concerned that emergency departments may not have the resources or the
proper training to deal with suicide attempts.

BARBARA HOCKING: I think the problem is that we don't have enough people in emergency departments
or in general practice who have got good mental health training and who are really fully
acknowledging the link between mental illness and suicide attempts and the really very high risk
we've got when both those factors are combined.

So we want to make sure that there is funding for good mental health, people in emergency
departments and also that the emergency departments and GPs do speak with each other and do speak
with other community support programs so that the person is not left to fend for themselves.

TIMOTHY MCDONALD: Doctors agree the statistics are worrying.

Emergency rooms have procedures they're supposed to follow when dealing with suicidal patients and
each one has acute mental health care.

But the federal vice president of the Australian Medical Association Dr Steve Hambleton says the
picture gets hazier once the patient is released into the community.

He says part of the problem is that many people who attempt suicide don't go to follow up

STEVEN HAMBLETON: Acute care is provided in hospital and these are the sort of people that aren't
connected necessarily to their general practitioner and so that is the obvious place to go back for
first review but it is relying on people to actually do that.

So people may be told and may be given opportunity to see but some of them actually don't turn up
and I think that motivation is really difficult. The inpatient services simply are overwhelmed.
This is where outpatient services need to be supported better.

TIMOTHY MCDONALD: Dr Hambleton says there needs to be more support for groups who help people who
may be at high risk of self harm.

He says they can play a valuable role in helping people to keep their appointments and follow up
with the services that can help them.

STEVEN HAMBLETON: I think these are the sort of things that the self-help groups can do very well
and the community groups can do very well and the hospital service is really focused on inpatient
activity. This is where the problem breaks down.

People are not ill enough to be admitted to hospital or there are insufficient beds to keep them in
hospital and we have got to put services on the ground outside because these people are at high
risk of attempt and once you start talking about it, once you start coming in contact with health
services, this is where we need to seize the day and make sure we prevent people from bouncing back
into the system.

ELEANOR HALL: That is the AMA's federal vice president Dr Steve Hambleton speaking to Timothy