FEATURE
Predicting the unpredictable Suicide prevention is the hardest in the hard basket, but data and strategic thinking are making the impossible seem possible.
Mental health is difficult: It’s difficult to diagnose, to treat, to predict and to understand. Suicide is beyond difficult as there are so many individual factors that lead to someone intentionally taking their life, which makes it a uniquely problematic phenomenon to research. This is reflected in the national suicide rate, which has gradually risen in the past 10 years. According to the Australian Bureau of Statistics (ABS), in 2008 suicide was the leading cause of death among people aged 15-44 in Australia. The ABS also reported that men were three times more likely to intentionally take their own lives. The median age for suicides was 44.3 years of age for males and 44.7 for females. In writing this piece, the topic of prevention strategies for at risk cohorts was broached with Professor Andrew Page. In his response, he reframed suicidal ideations as something to be considered as a variable risk factor that’s not just applicable to certain at-risk cohorts, rather, just one: everyone. “What we need to be looking at is what would increase that risk within us, because thoughts of killing yourself are wide spread. We've looked within university cohorts and over the past year, close to half of them have thought about killing themselves at some point in time, so 16 | JULY 2020
we know that this is not an isolated problem.” Prof Andrew Page is the Pro Vice-Chancellor of Research, School of Psychological Sciences at the University of Western Australia and part of the research leadership team at the Young Lives Matter Foundation (YLM).
Prevention by prediction
Suicidal ideations are like most other aspects of mental health – variable – and experienced by many people at one or many points in their lives, usually innocuous enough not to raise alarms. Anxiety, depression, obsessive thoughts, rigid thinking. Sound familiar? In small enough cases they can be useful in navigating through life, or triggers to address the causality, yet in prolonged and chronic cases, they can be debilitating. This way of looking at whole population suicidal variability is not just an interesting idea to reframe suicide, it’s a practical tool that can measure risk, save lives and also reduce stigma. Part of Prof Page’s work, in collaboration with Perth Clinic, and with YLM is the development of a world first tool, the Dynamic
Developmental Vulnerability Index (DDVI), which utilises artifical intelligence and machine learning to predict suicidal or self-harm behaviours. The phases of suicidal ideations begin with fleeting thoughts of suicide, progressing to planning or attempting suicide, to the ultimate tragedy of the action itself. It’s the subtlety and significance of these phases that the DDVI has been designed to identify for intervention. The Young Lives Matter Foundation (YLM) was formed with the singular purpose of developing new interventions that would reduce the suicide rate, such as the DDVI. The YLM team is comprised of a multidisciplinary group of mathematicians, statisticians, psychologists, and psychiatrists. “Young Lives Matter is about looking at creative and innovative ways that we can more effectively predict self-harm and suicide, especially with youth, so that we can more effectively target preventative efforts,” Prof Page told Medical Forum. The impetus for YLM to specifically look at predication was based on what hasn’t been done, rather than focusing on what has already been done. “When we looked at what was happening across the nation, there was a lot of work on prevention but there was less work in terms of prediction. And if you have finite
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James Knox reports.
