Alive and Kicking Goals
Knowledge Circle Practice Profiles

Overview

Practice focus

Peer education and workshops for suicide prevention, counselling, mentoring, community development and capacity building in Indigenous staff and community members

Delivered by

The Alive and Kicking Goals (AKG) program is delivered by the Men's Outreach Service (located in Broome) in partnership with the Broome Saints Football Club. The Men's Outreach Service is a non-Indigenous not-for-profit organisation, however the AKG program's strategic direction and decision-making is the responsibility of an Indigenous youth steering committee.

Location(s)

The AKG program is based in Broome (Western Australia), however its educational workshops are delivered to schools and community groups thoughout the Kimberley region in northern Western Australia.

Issue being addressed

The AKG program aims to address the very high rate of youth suicide in the Kimberley region. Tighe and McKay (2012) estimate the overall Indigenous suicide rate of 10 per 10,000 in northern Western Australia is higher than the national average (8.6 per 100,000) and that the group most at risk of suicide are Indigenous males aged 20-34 living in remote areas. It is also estimated that in the Kimberley an 18 year-old man is seven times more likely to die by suicide than his non-Indigenous counterpart (Hope quoted in Tighe and McKay 2012).

Service type

Mental health education and suicide prevention, counselling and mentoring.

Target population

The AKG program is targeted at Indigenous youth (12-25 years) in Broome and the Kimberley region. However, the program maintains an 'open door' to all members of the community.

Aims and objectives

The AKG program aims to reduce the high suicide rate among Aboriginal and Torres Strait Islander youth in and around Broome through educational suicide prevention workshops run by Indigenous staff (including educational DVDs made by the community), one-on-one mentoring and professional counselling within a culturally appropriate environment. It also aims to improve the functioning and wellbeing of clients and strengthen communities' culture and resilience.

The project was initiated and is led by Aboriginal people in the Kimberley. The program began in 2008 after young men playing in the Broome Saints Football Club decided they wanted to do something to address the issue of Indigenous youth suicide in the community.

Program basis

The AKG program is broadly based on the practice, common in non-Indigenous communities, of using peers and local community leaders to educate the community about how to respond to suicide and suicidal behaviour. AKG are not aware of any other cases in Australia where Indigenous communities have used a youth peer education model to prevent suicide.

The AKG program includes:

  • Indigenous volunteers and AKG staff conducting evidence-based suicide prevention psycho-education workshops in schools, prisons and communities (or any other interested organisations). These workshops also use educational DVDs featuring community members.
  • Peer mentoring provided by volunteers and staff for anybody in the community that needs support to deal with the impacts of suicide.
  • Counselling (with individuals or groups) provided by a qualified psychologist.
  • Partnering with the Black Dog Institute to develop a smartphone application aimed at suicide prevention that will be trialled in Indigenous communities in the Kimberley.
  • Developing (with funding from beyondblue) new suicide prevention DVDs featuring young Indigenous women and the establishment of a women's reference group.

Cultural relevance

Local community context

There were several important local community factors that needed to be considered in running the program, including:

  • The stigma within the community about discussing the issue of suicide and seeking help to deal with suicide.
  • Community reluctance about approaching mainstream mental health services that were not felt to be culturally appropriate.
  • The lack of a mental health inpatient facility in Broome, which was a deterrant to community members seeking help as they feared they might be transported to Perth for treatment.
  • The prevalence within the community of people who had lost friends and relatives through suicide and the high levels of community grief.
  • Cases of community backlash questioning why the issue of suicide was being brought up.
  • The need to build the capacity of the community, something the program played a role in addressing by employing staff and empowering volunteers to address the issue.
Involvement of Aboriginal and Torres Strait Islanders

Indigenous people had a very high level of involvement in planning, designing and implementing the program. The program currently has an Indigenous steering committee, four Indigenous project workers (the program manager is non-Indigenous) and is supported by more than 20 Indigenous volunteers.
The program began in 2008 after young men playing in the Broome Saints Football Club decided they wanted to do something to address the issue of youth suicide in the community. Guided by a non-Indigenous psychologist (who played in the club and is now the AKG program manager and counsellor), the young men developed a suicide prevention community education program that could be run by Indigenous staff. These volunteers also participated in the creation of the DVDs that are used in the workshops.

Since its inception, the program has received funding to allow it to employ four local Indigenous community workers. Decisions about the management and direction of the program are decided by the Indigenous steering committee. The community has also partnered with the Black Dog Institute to develop, test and research the 'ibobbly' application for touch screen technology. The ibobbly ('Bobbly' is a local Indigenous term for 'brother/bro') application is the first suicide prevention and self help application designed for use by Indigenous people on mobile phones or tablet devices.

Cultural practices and materials

As a program designed and led by the Indigenous community, the AKG program uses a variety of culturally appropriate practices, including:

  • The employment of local Indigenous staff and volunteers to conduct all the workshops.
  • Using local artwork and designs in the DVDs and educational materials.
  • Using educational materials from the Strong Spirit, Strong Mind resource developed by a local Indigenous elder.

Evaluation

Evaluation status

A formal external evaluation was completed for the AKG program in December 2012 by the Australian Institute of Suicide Research and Prevention at Griffith University.

Link to evaluation

The evaluation is available on request from the Men's Outreach Service.

Evaluation details

The evaluation collected data through the following methods:

  • Pre and post workshop qualitative surveys were used to collect data from everyone who had attended a workshop during the data collection period.
  • Focus groups were used to gather data from community members who had not attended an AKG workshop but could still provide useful feedback.
  • Surveys were also conducted with school principals and/or teachers about their perceptions of the AKG workshop, their school and community.

Through the mix of surveys and focus groups, a wide range of participants were included which helped create a strong understanding of the program's results.

The Indigenous community were heavily involved in the design, planning and implementation of the evaluation. In particular the community had input into:

  • The aims of the evaluation. Specifically, they wanted it to provide them with a description of the program's results but also tools for ongoing monitoring and evaluation.
  • The design of the data collection tools, in particular ensuring they were appropriate for people who were young, may not speak English as a first language or were not used to providing written responses.

Effectiveness

Most effective aspect

The most important and effective aspect to the program's success was that the community owned and led the AKG program from the beginning. AKG have managed to maintain the same staff since the program began thereby building long term relationships with clients.
Previously some community members were reluctant to engage with mental health services due to the stigma and fear of the mental health system, whereas AKG supported them to get the best possible help when needed.

Demonstrated outcomes

The evaluation indicated the DVDs and workshops were overwhelmingly well received in the community. The evaluation showed positive changes had occurred in all the domains investigated, indicating the program's positive impact on community attitudes and knowledge. Evidence indicated that the young men who were part of the program were a particular source of pride and strength for the community.

The results from the pre and post-workshop surveys were:

  • 449 people participated in the surveys. Approximately 44 percent of participants demonstrated a positive change after attending the DVD and workshop. In addition, participants' language use about suicide and help-seeking was also found to have improved as a result of seeing the DVD. Many reported that the DVD (which is a major tool in the workshop) was positively received by communities. They responded well to seeing fellow community members talk to them about the importance of suicide awareness and prevention.
  • The results from the focus groups indicated that participants had a deeper knowledge of appropriate suicide interventions and referral pathways after they had attended an AKG workshop.
  • The findings from the school surveys demonstrated a very positive appraisal among the teachers of the AKG.
Other evidence

Other evidence indicating the success of the program includes:

  • There has been no turnover in AKG staff or in the steering committee membership in the time the program has been running (since 2008), indicating individual and community commitment to the program.
  • The program has been flexible in its delivery, being able to adapt to use social media in its advertising, referral pathways and communication with the community.
Resourcing

The AKG program has been funded through the Western Australia Country Health Service

Evidence base and opportunities

Specific research about the AKG program is contained in:
-Tighe J & McKay, K (2012). Alive and Kicking Goals!: Preliminary findings from a Kimberley suicide prevention program. Advances in Mental Health, 10(3): 240-245.
-McKay, K. 2012. Alive and Kicking Goals! Final Report. Brisbane: Australian Institute for Suicide Research and Prevention
-Tighe J, McKay, K & Maple, M (2013): ‘I'm going to kill myself if you don't ...’: contextual aspects of suicide in Australian Aboriginal communities. International Journal of Culture and Mental Health. (http://www.tandfonline.com/doi/pdf/10.1080/17542863.2013.861499)
-Shand F, Ridani R, Tighe J & Christensen H (2013). The effectiveness of a suicide prevention app for indigenous Australian youths: study protocol for a randomized controlled trial. Trials 2013, 14:396 (http://www.trialsjournal.com/content/14/1/396)

Other sources of information about strategies to respond to Indigenous suicide and suicidal behaviour and to improve mental and emotional wellbeing can be viewed here:
http://www.aihw.gov.au/uploadedFiles/ClosingTheGap/Content/Publications/2013/ctgc-rs18.pdf
http://www.aihw.gov.au/uploadedFiles/ClosingTheGap/Content/Publications/2013/ctgc-rs19.pdf
http://www.aihw.gov.au/uploadedFiles/ClosingTheGap/Content/Our_publications/2014/ctgc_ip12.pdf

 

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