Would you know how to respond if someone revealed they were having suicidal thoughts?
For healthcare workers, that moment can change the direction of a conversation instantly. What follows is often shaped by a familiar clinical pathway: assess the risk and determine the level of danger.
But a growing movement is challenging that approach, asking a different question: what if the first response was not assessment at all?
At the centre of that shift is Care · Collaborate · Connect: a world-first, needs-based suicide prevention approach now marking 10 years of reshaping how people respond to distress.
Over the past decade, tens-of- thousands of people across Australia have been trained in the approach, including through psychological first-aid programs aimed at equipping participants to respond with care.
Clinical psychologist and researcher Dr Helen Stallman, founder and CEO of Care · Collaborate · Connect, has spent more than 25 years working in prevention and treatment of mental illness.
She says the problem is not lack of care, but the structure of the response.
“Despite the pervasive ‘just ask for help’ messaging, we’ve heard so many stories – in research, in clinical practice and in the news – of people being harmed when they’ve asked for support,” Dr Stallman says.
“Sadly, too many people have died after being told they were ‘not at risk enough’ and denied help.
“This breaks my heart.
“Care · Collaborate · Connect began from my desire to help my clinical psychology students meet the needs of people asking for help when they’re distressed.
“It grew from there, as many more health professionals and the general public wanted to use this needs-based approach.
“We’ve even had parents using these skills with children as young as 18 months to promote healthy coping.”
Dr Stallman says the traditional model often shifts too quickly into risk assessment.
“The traditional approach, when someone is upset, is to ask whether they’ve thought about suicide, calculate their risk of dying by suicide and then manage that risk,” she says.
“We know this approach doesn’t work.
“Worse, it loses the opportunity to actually help people feel better: to care, to sit with them, to listen and to validate what they’re experiencing.”
Instead, her model prioritises connection and support before anything else.
That shift, she says, is already changing how people respond.
“The biggest feedback we receive is that people share far more about what’s been happening and what they need, because they trust they won’t be harmed,” Dr Stallman says.
Evidence from evaluations of the program suggests measurable improvements in knowledge, confidence and coping.
In a published evaluation of online suicide-prevention training, health professionals showed significant improvements in knowledge, attitudes, confidence and self-care, with moderate-to-very large effects.
In community-level psychological first-aid training, 97.7 per cent of participants reported improved skills and confidence to support others when they’re upset, along with large improvements in their own coping.
“The training helps the helpers, too,” Dr Stallman says.
“At an individual level, that deeper trust and sharing, combined with genuine care, reduces the overwhelming distress that can lead to suicide.”
Rather than focusing only on risk, the model uses a coping continuum to understand distress through a range of modifiable biopsychosocial (interconnected biological, psychological, and social) factors.
Dr Stallman says these factors often overlap, particularly for people experiencing disadvantage.
Indigenous Australians die by suicide at twice the rate of non-Indigenous Australians, and men are around three times more likely to die by suicide than women.
“Suicide results from overwhelming distress, which is caused by one or more modifiable biopsychosocial drivers: unhealthy environments, undeveloped life skills, a diminished sense of belonging, inadequate health behaviours such as sleep, nutrition and exercise, inadequate coping support, a poor perception of one’s innate resilience, and inadequate treatment of illness,” Dr Stallman says.
“People experiencing all sorts of social disadvantages are far more likely to face stress across several of these areas at once.
“But while some groups are more represented in the statistics, statistics never tell us what is happening for an individual.
“Understanding that takes time and care to listen, and that is exactly what our training teaches.”
On average, nine Australians die by suicide every day, and seven of those are men, the Australian Men’s Health Forum reveals.
Sunshine Coast Health medical director of child and youth mental health services Dr Chris Lilley spoke about the importance of highlighting and reflecting on male suicide figures in a Men’s Health Week media release last month.
“We know that there are treatment and care opportunities for men in both physical and mental health and it’s important to recognise that and create a situation where people can access it sooner rather than later,” he says.
Dr Lilley says a simple conversation can make a difference.
“It’s actually quite easy, but it’s about being brave enough to ask the first question,” he says.
“The most important place for men to start is actually with your general practitioner (GP).
“They know all the local resources.”
During a man’s lifetime, one in three will have a substance-abuse disorder.
Dr Lilley says physical and mental health are very closely linked: “Getting out and getting some exercise, looking for relaxation in your life, making sure you get good sleep, managing your nutrition, reducing your alcohol – all of those are really good strategies for managing your physical and mental health.”
For Dr Stallman, the anniversary of Care · Collaborate · Connect is about reflection and hope.
“Over the past 10 years, we’ve been able to contribute to developing a culture of care and connectedness in our community, and I’m so grateful to see people receiving quality support – whether they’re talking with family, friends or health professionals,” she says.
“My hope is that one day no one will feel so alone that suicide seems like their only option, and that everyone who reaches out is met with quality support.”
FAST FACTS
- One-in-two young people are impacted by suicide by the time they turn 25
- Males are around three-times more likely to die by suicide than females
- Indigenous Australians die by suicide at twice the rate of non-Indigenous.
Top 3 things to do when someone shares suicidal thoughts
- Stay connected. When you show you care regularly, people know they can talk to you in a crisis.
- Make time to care, collaborate and connect.
Care: sit with them, listen and let them know that what they’re feeling makes sense.
Collaborate: work together to identify what helps them cope.
Connect: link them with additional support if they need it.
- Get trained. Anyone can learn these skills. Find online self-directed courses for health professionals, the general public and schools at carecollaborateconnect.org. The free My Coping Plan app also helps people record their healthy coping strategies and the people they trust for support, so it’s all in one place when they need it.
If you or anyone you know needs help:
- Lifeline on 13 11 14
- Headspace on 1800 650 890
- Suicide Call-Back Service: 1300 659 467
- Beyond Blue on 1300 224 636.
