Judgmental attitudes in society are a major obstacle for those needing help, government’s suicide prevention adviser says

Scott Morrison’s suicide prevention adviser, Christine Morgan, says she has been shocked by the “horrific” level of stigma that Australians face when people learn they have attempted self-harm – and she says success in her endeavour will mean keeping distressed people away from emergency departments.

Ahead of a suicide prevention summit in Canberra on Wednesday, Morgan told Guardian Australia people who had attempted to end their lives faced three types of stigma – personal shame, societal stigma, and structural stigma, which she characterised as discrimination.

“When you are looking at somebody wanting to talk about their suicidation, they need to feel safe,” Morgan said. “They need to talk to somebody and not be judged for it so they can open up and reach out for support – but the barriers are very real.”

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“This is a much, much bigger issue than I had realised.”

Scott Morrison appointed Morgan, currently the chief executive of the National Mental Health Commission, to come up with recommendations to combat suicide, which is the leading cause of death for young Australians.

Wednesday’s summit, to be held at the Department of Prime Minister and Cabinet, will hear from 100 invited participants ranging from suicide prevention experts, health and education officials, business representatives, state and territory representatives, to Australians with lived experience. The health minister Greg Hunt will open the event and the prime minister will address the group at lunchtime.

Morgan who has already signalled that Australia’s mental health system, perversely, “runs the risk” of elevating the risk factors for suicide and self-harm, will produce preliminary recommendations at the end of this month, and deliver a substantial report to Morrison by the end of 2020.

She said her inquiries to date, including more than 20 consultations within communities around Australia, grappling with people’s lived experiences, had yielded widespread confusion about how to access support services.

“That is a really really big issue,” Morgan said. “But sitting behind it is gaps in services.” Gaps were harmful because suicidal people need a “continuous blanket of care and support around them”.

“One of the things that shocked me the most, and this is horrific, is stigma. It’s not lack of awareness. It is real stigma. It’s self stigma, which I kind of call shame, it’s other people’s attitudes, which is societal stigma, and it’s actual structural stigma, and I call that discrimination – it’s [fear] of what happens to me if I disclose this.”

She said judgmental attitudes were pervasive in the community, and this made sufferers less likely to be open about their distress. “All of this is complex – it is not an easy fix, any of it. How do you deal with somebody’s distress and loneliness, just come up with an initiative and they are suddenly going to feel better? We are complex human beings”.

“I think if you look at those three levels of stigma – shame, societal stigma and structural stigma – you need a different approach for each.”

Morgan said she was currently grappling with how to put science behind a suicide prevention strategy that would be activated across portfolios, not just within the health portfolio. She said the best means of doing that would be identifying recurrent stress and distress points, and crafting policy responses.

She welcomed a recent report from the Productivity Commission examining deficiencies in Australia’s mental health system, and noted the commission was “absolutely right to say we’ve got to look at aftercare” to prevent suicides.

The commission in its report cited a study suggesting that adequate aftercare could reduce the prevalence of suicide attempts that reach hospital emergency departments by about 20%, and all suicide deaths by 1%.

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It noted that up to 25% of people who attempt to take their own lives try again, and the risk of relapse is significantly higher during the first three months following discharge from hospital after an attempt.

Morgan said aftercare was absolutely critical, but she stressed her fundamental objective in this project was to keep people away from emergency, and that meant investing more in screening and prevention, so that effective intervention eliminated the crisis point. “I think we need to move away from the emergency department door. Success is going to be … doing more in community”.

She said part of this would involve screening children between infancy and 12. “It’s too late to start intervening when they are 12. Just as we look at physical health and wellbeing from conception – it’s part of the same package”.

“We do it for littlies physical wellbeing – all [additional screening] is doing is adding in the mental wellbeing component, saying how can we keep them as well as possible, and let’s start as early as we can.”

• Crisis support services can be reached 24 hours a day: Lifeline 13 11 14; Suicide Call Back Service 1300 659 467; Kids Helpline 1800 55 1800; MensLine Australia 1300 78 99 78; Beyond Blue 1300 22 4636. In the UK and Ireland, Samaritans can be contacted on 116 123 or email jo@samaritans.org or jo@samaritans.ie. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. Other international helplines can be found at www.befrienders.org.