Summary
This article provides a brief overview of all the projects funded in the first round of Australia’s National Suicide Prevention Strategy. The paper describes in detail the range of interventions delivered to various target groups in different settings - for example, community based projects for young people and primary care based projects for older people. Using the project reports as the basis for this review the authors identify 13 key processes for successful projects across all target groups, settings and approaches. This includes ‘understanding the local context’, ‘forming collaborative partnerships’, and ‘taking evidence into account.’ The paper also describes the impact that the projects have had. These included improvements in participants’ knowledge about risk and protective factors for suicide, increase in social connectedness and reductions in depressive symptomatology. The authors found that the sustainability of the projects were limited by their funding periods and they recommend that consideration is given to the issue of sustainability in future funded projects. The authors also commented that there was a lack of comprehensive/sound evaluations of the projects and call for more investment in evaluation so that the evidence base in suicide prevention can be improved.

Critique and reflective component
From the title of the paper I was anticipating a rigorous review of projects, however the paper is very descriptive in nature and relies solely on the progress and final reports of the projects. However, this paper is useful if you wish to get a quick snapshot of the range of projects funded by the National Suicide Prevention Strategy and I would recommend it to any organisation embarking on a project as the key processes identified are a useful starting point.

I am reviewing suitable support material for an organisation that experienced suicidal threats from a distressed customer. I found the square material to be excellent; easily read, comprehensive, practical and very suitable for community and health professionals. I am an ASIST suicide prevention trainer and, apart from our own training material, I rate this material the best I have seen in all states of Australia.

This article raises an issue not widely discussed within the current suicide prevention of discourse, which is suicidal ideation and suicide amongst women who are victims of domestic violence.  The author acknowledges that men may also be victims of such violence, however has selected to focus her discussion on the evidence related to women in particular.

Drawing from the literature available at the time, Guggisberg lays out a sequence of arguments, and cites the limited Australian evidence, which highlight the riskness of women who have experienced domestic violence to mental illnesses such as depression, anxiety disorders and post traumatic stress disorder. This then creates heightened risk of suicide and suicidal ideation. She also suggests that this risk has been exacerbated by a combination of inadequate recognition of the effects of such violence for women when presenting to mental health practitioners and by a national culture of victim blaming. 

Although the empirical evidence and discussion has limited depth, this appears to largely reflect the paucity of research undertaken to date, relying primarily on two studies in Western Australia and Queensland.

However, the relevance of the article lies as much in the questions which it generates as the evidence and arguments provided. Importantly, the article leads to the question as to why the risk of suicide (and self harming) amongst women who have been victims of domestic violence has failed to gain much interest amongst those concerned with suicide prevention or within the domestic violence sector itself. Considerable research and action has been taken to reduce the risk and rate of suicide amongst Australian men. With nearly one fifth of people seeking homeless services being women escaping domestic violence, the final question needs to be what efforts are now being taken to further knowledge, to raise awareness and reduce the risk for women who are already vulnerable as victims of domestic violence?

As a starting point then Guggisberg offers a valuable reminder of unasked and unanswered questions which should not be ignored by those interested in suicide prevention within our community.