Oral Presentation (max 20 mins) National Suicide Prevention Conference 2025

Suicide Prevention Pathways: to mandate or not to mandate? That is the question. (#73)

Dave N Thompson 1 2 , Sandy Terry 1
  1. Department for health and Wellbeing, Adelaide, SOUTH AUSTRALIA, Australia
  2. University of South Australia, Clinical Adjunct, Adelaide, SA, Australia

Introduction

South Australia has a history of driving innovation in the field of suicide prevention, including establishing the first Suicide Prevention Act in Australia.

In alignment with “together towards tomorrow”, South Australian Local Health Networks (LHNs) have been collaborating to plan for, and implement Towards Zero Suicide (TZS) in health services, including Suicide Prevention Pathways (SPPs).

To ensure organisational support to develop SPPs, LHNs universally requested a consistent approach across the State. This generated new considerations to SPP development in Australia. Could SPPs be mandated? What if designated health organisations HAD to establish SPPs?

Improving care of people with suicide related distress through SPPs

The development and implementation of an SPP is key to TZS. SPPs are clinical pathways of care that guide evidence-based healthcare for people in suicide related distress and provide a path that workers and people in distress can walk together.

REGULATION - HOW? South Australia’s Chief Psychiatrist (CP) will issue a Standard that requires relevant services to establish and follow an SPP. A Standard sets out conditions that are binding on designated health facilities and are to be observed in the care or treatment of people accessing the service.  The CP has the power to issue Standards under s 90 of Mental Health Act 2009 (SA).

In April 2024, the Office of the Chief Psychiatrist (OCP) released the draft Chief Psychiatrist Standard – Requirement for Services to Establish a Suicide Prevention Pathway (SPP) and the draft Chief Psychiatrist Guideline – Suicide Prevention Pathways (SPP) for consultation. When implemented, it will address improved safety and quality within health services to reduce harm, uphold human rights, and support inclusion. Draft documents were circulated widely for comment both within SA and across other jurisdictions.

Learnings

Almost 250 items of feedback from thirty different organisations were received. Although the majority supported a Standard, feedback clearly indicated that we needed to:

  • clarify that an SPP is not a legal order.
  • use more consistent person focused plain language.
  • articulate clearer processes.
  • address the unique needs of regional LHNs.
  • expand information relating to priority population groups.
  • include the rights and needs of carers, and more.

In this presentation we will outline the development process and detail the learnings from the consultation on the CP Standard. This will support other States who are considering implementing a Suicide Prevention Act and subsequent Standards, including services who may be developing or writing their SPP guidance documents.