Listening for a
life voice

“We call it the river of suicide.”

“When we train Mob in suicide intervention, we use a river as an analogy.

“Some people land in the river and just bob around, and you know something is not right.

“Some people are just under the surface, and others are so deep under the water that you will never know their intent is suicide.”

This is how the Faculty of Medicine’s Associate Dean of Indigenous Engagement Professor Maree Toombs uses the river analogy to emphasise the endemic state of suicide in Australia’s Indigenous communities.

“When someone has thoughts of suicide, they’re not looking forward anymore – they’re looking back,” Professor Toombs explains.

“For many Aboriginal and Torres Strait Islander peoples, the despair comes from feelings of displacement and hopelessness.

“It is a massive issue, especially in small communities. Take Cherbourg, north-west of Brisbane, for example: it has around 1200 people and 94 health services. You can see a problem right there.”

In her efforts to create change, Professor Toombs attended an Applied Suicide Intervention Skills Training (ASIST) workshop at LivingWorks Australia (LWA) in 2016. It was there that she realised one of her own family members was at risk of suicide.

The profound experience prompted Professor Toombs to create I-ASIST, the world’s first culturally safe suicide intervention program for Indigenous Australians, in partnership with LWA and Aboriginal and Torres Strait Islander communities.

The program, which led to Professor Toombs being honoured with a LiFE Impact Award, uses a train-the-trainer model to equip community members with skills to become first responders. Since its inception four years ago, more than 90 Indigenous communities have engaged with I-ASIST and more than 6000 people have been trained. Professor Toombs can’t think of a time when a participant had not been impacted by suicide.

“Some participants have had 5 or 6 direct members of their family who have taken their own life,” she says.

“They come to our program because they’ve had enough and want to be empowered to create change in their communities.”

The two-and-half day I-ASIST program begins by acknowledging the trauma caused by suicide and sharing stories.

Professor Toombs says most people cry because they think about someone they have lost.

“We make sure that everyone knows what they are in for before we begin and that they are taking part to be trained in suicide intervention,” Professor Toombs explains.

“I-ASIST teaches participants to notice when someone is not their normal self for no obvious reason.

“The responder is then prompted to ask a specific question, such as, ‘Are you thinking about suicide?’.

“The question needs to be specific because asking something like, ‘Are you thinking of doing something silly?’, could mean quitting your job and moving away.

“Participants are trained to listen to stories without judgement – the person needs to be empowered to speak without fear of judgement.

“They listen for a ‘life voice,’ which is a hesitation during discussion. For example, ‘Yes, but I wouldn’t because I’ve got kids that need me or I have family who love me, but I do need help.’

“When a ‘life voice’ is heard, participants encourage the person to identify a reason to stay alive.

“The person is then helped to create a safety plan for themselves with specific time frames, such as telling mum and dad tonight or seeing a doctor in the morning.”

Professor Toombs is humbled by the keen interest in I-ASIST from Indigenous communities and the results it is achieving.

“Between January and April 2021, there were 164 Indigenous suicide interventions recorded, and there are plans to do more, while saving lives,” she says.

“I-ASIST is also a social enterprise model that enables people who have completed the program as trainers to learn about how they can set up their own business, manage budgets and identify funding to run their own workshops.

“During the next three years, we want to train 50 train-the-trainers for 50 thousand people in Australia. Right now, we have 20 trainers and need to secure further funding to achieve our goal.

“This program is vital because large numbers of people are dying from suicide in Australia daily. Indigenous communities need the skills and tools to report suicides and support each other, rather than treat the subject as taboo.”

Professor Toombs says while nobody wants to talk about suicide, it must be discussed for the well-being of everybody.

“This reminds me about a story I heard when one elder said, ‘If we talk about suicide, it will happen.’

“Another elder replied, ‘Well, we’re not talking about it and it’s happening, so maybe we should talk about it, and it might not happen.’

“At that point, the first elder sat down and began his suicide intervention training.”

Anyone needing help should call:

• Lifeline on 13 11 14
• Beyond Blue on 1300 22 46 36
• MensLine Australia on 1300 78 99 78
• headspace on 1800 65 08 90