technology
are you?” This signals to the person that it
isn’t safe to discuss their suicidal thoughts
because the health professional is going to
judge them.
The emphasis in our project is to
train health professionals to have more
compassionate conversations with people
experiencing suicidal thoughts.
First-person saver
Innovative project uses games
technology to tackle suicide.
By Wade Zaglas
C
urtin University is using games
technology to create web-based
video simulations aimed at
helping mental health experts identify
and better communicate with people
contemplating suicide.
As the World Health Organization points
out, suicide is the second leading cause of
death in people aged 15–29 worldwide,
and one person dies of suicide in the world
every 40 seconds. Research also shows
that most people who suicide have been
in contact with a health professional in the
year leading up to their death.
Such statistics are concerning, given
the high rates of mental health issues in
Australia and other Western countries, and
the introduction of a wide range of mental
health services and initiatives that are
seemingly being underutilised.
In light of this, Dr Anna Fagence from
Curtin’s School of Nursing, Midwifery
and Paramedicine developed a project to
help make identification and treatment
of people with suicidal ideation more
effective. The project was recently awarded
a grant by the WA Department of Health.
Aged Care Insite spoke to Fagence about
some of the issues surrounding suicide
and the benefits of the web-based video
simulations in identification and prevention.
ACI: Is suicide on the rise, and if so, why?
AF: In general, as a trend, yes. The
Australian Bureau of Statistics’ rates have
fluctuated over the last 20 years, with a low
in 2006 (10.2 per 100,000 people) and a
peak in 2015 (12.9 per 100,000). Currently,
the rate is 12.1 per 100,000. It’s the 14th
leading cause of death for all Australians
and the leading cause for Australians
aged 15–44.
The reasons are multifactorial, but often
it’s when we become overwhelmed by
things that are happening in our lives.
This can occur in the context of a mental
illness or when we’re under considerable
life stress such as financial trouble, a
relationship breakdown or loss, loneliness
and social isolation, or chronic illness. The
person begins to see death as a way to
end pain.
Most of us experience fleeting, low-level
suicidal thoughts at least once in our lives
– for example, wishing we would not wake
up tomorrow. What is much less common
is acting upon those thoughts.
What are some of the challenges faced
by health professionals in identifying and
helping suicidal people?
Health professionals often assess suicide
risk by counting how many risk factors
someone has for suicide, but research
shows that these risk factors aren’t very
good in practice at accurately identifying
who is at risk. Health professionals
currently aren’t able to reliably predict who
will move from thought to action.
What does seem to help identify people
who are at risk is a solid empathetic
relationship between the health
professional and the person. Health
professionals who have better relationships
with people and communicate respectfully
and with compassion provide a safe
environment where people can discuss
their suicidal thoughts without fear of
judgement from the health professional.
However, health professionals often
don’t do this, so people may not feel
comfortable enough to share their
thoughts with them. For example, some
health professionals ask questions like: “So,
you’re not thinking of doing something silly
How will games technology be used to
develop these video simulations?
Based on gamification principles, serious
games simulations incorporate engaging
game design elements into healthcare
simulation, where players have objectives,
make decisions during the game, and get
to see how those decisions and choices
influence outcomes. Our project uses
live-action serious video game simulations
to train health professionals to be better
communicators with people experiencing
suicidal thoughts (e.g. to not use
stigmatising or judgmental language).
How will the simulation help healthcare
professionals practise and improve their
communication skills when talking with
people experiencing suicidal thoughts?
Upon entering the game, point-of-view
videos will play where a person will advise
the health professional player that they
have been experiencing some distressing
thoughts but will not disclose the nature
or extent of those thoughts. Health
professional players will then be asked to
make a series of decisions about how to
proceed with the conversation.
Some choices will lead to the health
professional player developing a good
relationship with the person, who will
then share more of their suicidal thoughts.
Some choices will lead to the person not
sharing their suicidal thoughts because the
health professional player has chosen to
poorly communicate with the person.
Health professionals will receive a score
based on how well they communicated
with the person and will be able to play
multiple times to better their score.
We’re heavily involving people with lived
experience of suicidal thoughts to help us
construct these serious game simulations
to ensure we capture the right sort of
communication.
Once completed, these simulations
will initially be made available to health
professional students and practising health
professionals in WA (including rural and
remote areas). However, being web-based,
there’s considerable scope to make them
available nationally and internationally with
additional research funding. ■
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