Subscribe
Share
Share
Embed
"Never the Same" is an interview-based podcast exploring how different work streams intersect with suicide prevention, career development, and life lessons. The title draws inspiration from Heraclitus' quote, "No man ever steps in the same river twice, for it's not the same river and he's not the same man," reflecting the ever-changing nature of life and personal growth. Each episode features conversations with guests from various fields, highlighting defining moments and shifts in thinking. The podcast aims to uncover new insights for suicide prevention while offering broader perspectives on personal and professional growth.
Welcome to a bonus episode of Never the Same. This podcast is usually about my guests, accomplished people, and how their ideas have changed over time. This time is a little different. You'll hear a keynote address that I delivered at the National Suicide Prevention Conference in Australia. The response to this talk was encouraging, and several people suggested that I share it here, so I'm doing so with permission from Suicide Prevention Australia, who you can learn about in the episode notes.
In this address, I dive into projects that explore how networks of relationships shape suicide prevention. And while the focus is suicide prevention, this network perspective applies broadly to mental health, organisational effectiveness and community work. And consistent with the theme of this podcast, it reflects how my own thinking has evolved. Once you start seeing networks of relationships, it's hard to unsee them. No matter where you look. Well, I hope this gives some fresh perspectives and we'll be back next month with our usual interview format.
I'm kind of an obsessive person and when I start learning about something, I just see it everywhere. That's what Networks have been for me for the past, probably eight years and it's if anyone ever shows you an optical illusion... let's make sure I have this. So, somebody once showed me that the FedEx sign has an arrow in it. Did you ever know that? Oh, well now you can't unsee it, it's there! The arrow is there and my goal is that you would have the same experience of seeing the world through the lens of Networks as you continue through your day and in your work. It's not the only lens that you can see things through but it's the lens that I'm gonna put on today and ask you to put on and I hope that it is a helpful one in your work.
But before I get into that, I do want to acknowledge the Whadjuk people of the Noongar nation and I pay my respects to their Elders past and present. I also want to acknowledge, especially at this point in my country's history, I want to take a special moment to acknowledge gratefully the funding from the National Institutes of Health, from the Department of Defense and from the Air Force. One of the things that has made me proud of my country is some financial commitment to funding science and it's something I'm very concerned about so I want to express that gratitude here today. And also, acknowledge my relationship with SafeSide Prevention which I founded to take work that had been developed and tested in the university setting and bring it out to try to make a difference in people's lives.
So in suicide prevention, a lot of times we'll talk at high levels of society. There's been a lot of attention in recent years to the social determinants of health, things that are broadly affect people's lives and influence suicide. Then there's people talking about community and then people might even refer to individuals or their biology. But there's something that's in between these and that is this idea of Networks. This is Steve Borgatti, he said that one of the most potent ideas of the social sciences is the notion that individuals are embedded in thick webs of social relations and interactions. And this refers to, it might be in workplaces, families, military and police units that we work with, healthcare teams, neighborhoods, religious congregations; we've also begun work with youth sports leagues.
There's so many different places that you form a Network and so just to kind of define this a little bit more: Relationship Networks are that web of human connections through which resources of various kinds, support and information flow. So these could be close ties, like with family and they vary in strength and purpose as you saw that list of different kinds of networks and these networks shape how communities function, how ideas and behaviours spread and how these systems operate and so network science helps reveal how influence opportunities and support move through community.
So this is the sort of concept in the science that we're gonna be anchoring ourselves in. Social network have been embedded in all kinds of research from farming research to aging, internationally. But Steve Borgatti and scientists aren't really the first to notice that we are embedded in thick webs of social interaction and as I've had the chance to interact within different indigenous communities, these are core concepts. Any Kiwis here? Ooh. So the Maori people have a concept of Whanau, of the family and community that they're embedded within. In Native American cultures the idea of clan and here in Australia, the kinship ties of Aboriginal and Torres Strait Islander people.
This idea of relationships that not only tie us for support but also create mutual obligations and for me it's always increases my confidence in a scientific idea when it converges with ancient wisdom. These ideas around the importance of networks in our lives, not just the feelings that we have of support but the actual structure of the relationships and the relationships between people is really powerful. It's been known to be powerful since before there was science and we now apply scientific tools to try to understand these. As an example of this from that I learned about in New Zealand... I knew I was gonna jump over it.
I've been learning Maori, this of Maori language and, (attempts language interpretation) oh, somebody here say it? "Aww see, you say it so beautiful." This is Anaru Hodges from Hawks Bay who taught me about this concept, kind of pulled me aside and taught me about this idea of, 'becoming family.' Finding common ground with people and there are rituals and processes for creating relationships through shared experiences. Working towards cohesion and unity, learning from each other and building trust and understanding.
That concept and boy, when you think about suicide prevention, what do we need more than these things? I don't know about you but whenever I hear, like when I sat there and Anaru was explaining to me this idea and all of the steps that are around it, I just think, "ah, I want more of that." And I want more of that for the communities I work with, but you know, without going back and totally creating a whole culture, how can we reproduce that? Are there ways that we can understand that and actually repicably and predictably bring that about? And that's what I'm gonna share about is a few different threads of work and in different collaborations that are aiming to bring that to suicide prevention and some data showing that it really does matter for reducing suicide risk and other mental health concerns.
My colleagues wrote this paper that where they noted that although current interventions often modify social perceptions, like your sense of support or belonging, very few seek to modify the actual structure of the surrounding social networks. So let me talk to you about some basic research on how these things function in suicide and then some intervention work. So first I wanna talk about some work that we did in high schools, mapping social networks. So, a couple of concepts to get familiar with, many of you may be familiar with these already. So we've defined those relationship networks as the web of human connections through which resources, support and information flow and so the structure of a network is how the connections are arranged. And we often make these kind of diagrams where people are represented by dots.
Lines are the Ties between them and then we studied different parts, different properties and that includes for example, the Density of relationships. The Density is a measure of how interconnected people are. There's Centrality which helps you understand how influential a person is in their network and then Coreness, and you're gonna wanna remember this because the finding that I'm gonna show in a second. Coreness measures how embedded somebody is in a social group. It's not just about how many friends you have but how connected those friends are to each other.
So you could think of this as being kind of asking the question, "Would that person still be connected if others, if people on the periphery of the network were to leave?" Do they have multiple ties across multiple different groups? So you're beginning to hear how this is different from just social support or the perception of belonging but it has to do with this pattern of structure, patterns of relationships between people. Okay, so let's look at a diagram.
This is one high school from a study. In red, our students who'd had a suicide attempt. In yellow, let me see, yeah the other color shows through here. Yellow are people who've had suicidal thoughts and the size is the Coreness. That's how embedded people are in this high school network, whether their friends or friends with other friends. That blowout up top is kind of, is an exemplary group where, is a healthy and very well connected group of students. You can see that there's lots of Ties between them and that friends are friends with each other. And then down below, slightly covered by my words is a network with less interconnection with others in the group and more suicide concerns.
What was interesting about this is that you could actually map on the suicide concerns with these concepts of Coreness but the finding that really opened my eyes, had me put those glasses on of Networks, when we were doing these analyses was that there were actually lower suicide rates in schools where more students named the same trusted adults as their friends. Okay, so think about this for a second. So, Nieves and I are friends, maybe I looked to her as a trusted person and here, Geraldine also looks to me as a trusted person that would be more protective for each of us than if we just had separate adults that separate people that we trusted. So it's remarkable that it's not just about having support but it's having support from the same people that your friends have support with that was protective in suicidal behaviour.
But let's bring this a little closer to home. Let's think about our own lives and professional networks.
That's me and I am at the University of Rochester and work on, have my suicide prevention research with a few different groups. My closest colleague and person who has influenced me the most in with regard to these concepts as well is Peter Wyman. I talk to him every day and we have a group of other researchers and staff that I interact with very regularly. I also have a project with my colleague Ken Connor and my very trusted program coordinator is Dave and a junior faculty member who I mentor, who I care a lot about and I interact with a lot's named, Anna. And then I have another colleague who's a one step ahead of me in certain career decisions and then I talk with her a lot. Well, and then at Safeside Prevention, I have another network. Ann is the Chief Operating Officer and then all the other people I think on here are here today. Mel Clark, who's our Lived Experience, Family Coordinator. Dan Mobbs, Director of Workforce Education, Jamie, Tiyana, Kristina Mossgabber/ Zurich, my closest Lived Experience collaborator, Tim, Kim Borrowdale who's here and Sarah Donovan.
Now, this is kind of interesting but if I kept going like this very much longer, it'd be like, okay Tony, "we get it!" But when this starts to get interesting for my life and for my work is when I think about the connections between them drawing connections between people who have trusted and frequently interactive relationships with each other.
So when you look at this, what do you notice? Let me remove myself for a second and maybe you can see it more clearly. Each of these networks have different amounts of connection between them and some people there are not connected at all with other people and this has a very different feel for me in my work. What else do you notice? There really weren't connections between these. I was existing. This diagram will tell you so that I was existing in separate spheres of work. My work with Peter was one place. I work at Safeside.
My work with Ken Connor and then Anna, where these were all a bit kind of unconnected groups. But in 2023, I kind of noticed that and started forming connections between them. Introduced Peter to Ann, two people who I interact with a lot and I really liked that. And so I started building more connections and started connecting other people with the university, more closely together with SafeSide and then connecting Anna and Sarah was pretty great because they are kind of two birds of a feather who just hadn't flocked together yet. And then, my most recent accomplishment was connecting Dave, my program coordinator, who I was a little afraid of sharing up with the prevention team there and making these connections has definitely made me happier. And has enriched my work, I am seeing connections between things and feeling energised between these things much more.
So I'd like you to take a minute and do something similar on your way in, you received a piece of paper for drawing your own network. So what I'd like you to do is to take, and draw circles for up to seven people that you trust and regularly interact with at work. You may not have seven, different people have different sizes of networks and then once you've drawn your lines to each of them, draw the connection lines between those people. Only put lines between people who you believe trust each other and regularly interact with. Go ahead and do that and and I'll give you an next instruction. One thing I see happening is the same thing as when we do this in high school which is that people are looking over to see if someone put them. (Laughter)
So this is a small snapshot of your network but what I'd like you to do is to turn to the person next to you and share one thing that you notice about the connections that other people around you have with one another. What do you notice about your diagram? I'm just gonna give you one minute to have the conversation. So each just share one thing with one another, go ahead. Okay, so just as the conversation is getting good, I'll interrupt you. So networks change over time. That's been demonstrated in lots of studies that you could take a snapshot of a network and they change and you can imagine people leaving, change things.
External pressures change things. Different experiences that groups have together, change things. You could probably think about how, if we had time you could think about, well, what did this look like a year ago? And maybe you could envision what it could look like a year from now. And those who are in positions of leadership or organisational development could think about that. Well, how, would we like to adjust this network over the next year as one lens on maybe developing people or bringing other people on? So, that does happen naturally, networks change. Can we change networks on purpose? Can we do things that would reliably form a healthier relationship network?
So I'll talk to you about this, Connect Program, which we began developing with the United States Air Force and in the Air Force it's called Wingman Guardian Connect. And Wingman are the airmen in the Air Force, Guardians are the people on the Space Force. And so, everybody likes their name to be represented.
So it's called Wingman Guardian Connect, even though it takes a long time to say and so this began in military settings. We also have validated this program now for First Responders, Police Officers and there's work going on in Healthcare, in Religious Communities, a trial being conducted right now with African American Churches and just beginning a project in youth, Urban Youth Sport Leagues. But I'll tell you about it.
So, the Connect program was born out of observations that leadership in the Air Force had made that there was less connection among personnel in the Air Force and especially in the earlier career stages and there was some research that had shown that. And there was also a strong demand for new models for developing skills. And there was a report that came out that observed that a lot of service members thought that, that had their training for suicide prevention by PowerPoint and the observation was that might not only be ineffective but could actually be making things worse.
There was a desire to have new ways of developing skills that was more like the way we really learn skills, right? Which most of the things that we learn are not taught through a cognitive process. Most of the things we learn are because we're in relationship with people and we observe what they do or we hear something about their lives or observe it and we make changes according to that. So, and finally there was also a desire for there was a particular moment in time with it was a strong desire for research because it's very hard to conduct rigorous research in military settings and there was a desire to have randomised studies in the military environment.
So a bunch of things kind of came together to begin this collaboration and thanks to generous funding from the Department of Defense, we had almost two years opportunity to build a network enhancing intervention that strengthens the group in order to strengthen the individual. Entirely built around active experiences between people, the peer-to-peer learning, so creating the conditions for people to interact, relate, hear from each other and learn from each other. The program focuses on these four core protective strengths. I'll note that when people come to this program, this is a universal program.
People come not for suicide prevention training. In military setting as well as many settings when you say it's time to show up for your suicide prevention training, everybody, so the wall goes up. So this is "career enhancement training" which is truthful because these are the same, these are the same strengths that are critical for career success, life success, having healthy relationships, accountability, finding meaning and value in your work and life, having informal and formal guidance from other people and having activities that give you strength and balance your emotions; as well as having balance across these different strengths.
This is just to show you that it's a manualised experience so this is very specifically laid out how people facilitate this but the feeling is organic. (Tony re-attempts speaking in Maori) - Tonga, for example. We're trying for that. That came so easy that time, I must be chilling out. Thanks to lots of opportunities to try and iterate and try and iterate and try and iterate, we were able to come to this process. In addition to collecting data, which I'll share with you in a second, we also spoke with Airmen about their experiences. I'm just gonna show you a short clip of some of them speaking about their experiences. I'd say the Wingman Connect training is different in a way because it has a lot more interactivity within it. There's a lot more 'I' put into it and the more I put into it, the more I'm getting out of it. Because I'm really sharing with others and accepting other people's takes as well. And I don't think I've seen that in a lot of other trainings.
Other trainings, it seems I just watch it and then I'm supposed to get something out of that but in the end, I take away nothing. I would tell them to be upfront. Be honest with yourself and others because once you do that, then you really get the outcome of which Wingman Connect is trying to give to you by learning about yourself. Giving guidance or getting guidance from other people, finding out the balance that you need within yourself and then finding that kinship, the friendship you need too. So I would just tell them like, it's not nothing, no PowerPoint, just take it all in.
Something new that I learned during the training was that a lot of people come here with very defined purposes. People are very driven and they don't just join because they want to join. They join because they have some very solid reasons and it made me question for a second what my reasons were and I feel like that was really important. To put a mirror up to myself and really ask myself the hard ending question of why am I here? It was way more interactive. I still hold those relationships with the peers from Wingman Connect to this day.
Resiliency is more so focused on those negative effects that come from stressors, whereas Wingman Connect I believe is focused on–it's in the name–building that connection with our wingmen, with our airmen, with one another. So there are carefully designed prompts, activities, sequences for accomplishing those things and what's exciting is that we were able to see that have an effect on suicide concerns.
So we conducted a randomised trial. I spoke yesterday more in more detail about this trial but I'll just share the results of it here with you. Which is that we did, so these are people who were, the groups were randomised to either have this program or a, kind of control program that's more like training as usual, still interactive opportunities to ask questions, have discussion and some experiential exercises but not focused on that.
So that people did improve their bonds, cohesion, especially and healthy mutual expectations. And what we saw was a reduction in depressive symptoms in suicide risk at least in the short term and work problems. And this was an especially gratifying finding because this is a program that is not, it doesn't speak at all about like, not getting in trouble at work. And that's what these are so getting like negative counseling statements, getting disciplinary actions, we didn't tell anybody not to get into a bar fight but people had less problems at work and this is so encouraging to me because probably everybody in this room, we all have this intuition that if we could build a lot of these protective factors, it would help all kinds of things. Not just suicide but all of those things that cause distress and pain in our lives and separation between people.
So, that was really rewarding about this and we were able to show through kind of specific analyses about how the change happened. This is a mediation analysis but it basically just shows that the way we hoped it would happen, the way we were aiming for it to happen, that is through that group cohesion is how the effect occurred. But you think okay, what about the people in that group who might've been struggling? We didn't try to find them or directly intervene with them? And it's one of the, kind of challenges in our field is that probably 90%, I don't know exactly, of the interventions that we have depend upon identifying somebody or somebody raising their hand and identifying themselves and seeking out help. But we know that in certain environments and really almost all environments, a lot of people who have suicidal distress don't identify themselves and you can't read people's minds. And we actually got a lot of feedback from people in command structures that they felt a lot of pressure to try to do that. Try to figure out which person's slamming of a door meant that they might be thinking about suicide and another person is just feeling upset.
So we do need approaches that can address suicide risk without identifying people, singling them out. We need to also, at the same time–this is just one lens– we also have to try to reduce stigma and make things more accessible so that people do feel like they can talk about it. So it's not to say we shouldn't do that, but we do need interventions that don't rely on that. And what we found is that the normal process that happens is that as somebody has suicide concerns that they become less connected over time.
They tend to be–the ties between them and the group tend to trim. What happened is that the people in the– that happened for the people in the control group, but in the Wingman Connect group, the group kept people closer. This program is now the official resilience program of the US Air Force. It is now rolling across to every base by 2028. We've also now been validating with civilian law enforcement and I'm happy to say that, that program will now be available to first responders here in Western Australia. This is a group that attended a listening session about a year ago here and thanks to funding from the Mental Health Commission, Western Australia Workplace Connect will be available to first responders.
Another thread of work, this is about bringing professional networks together and I wanna highlight a collaboration since Working Together For Tomorrow is our theme, a collaboration with The Illawarra Shoalhaven Suicide Prevention Learning Collaborative in New South Wales and NADA, the peak body for alcohol and other drugs in New South Wales. There was an observation in the community, strongly led by people with lived experience that the world of alcohol and other drugs, which I'll refer to as AOD and Mental Health, that there were what I observed in my work network before, there were not enough Ties between them and that people were getting, sort of falling through those cracks that they felt like, if I have substance use concerns and suicide concerns, it kind of, I'm, too risky for one group and too much substance use for the other.
So we partnered up because of the approach to education that we have 'cause a while back I observed that a lot of suicide prevention education was previously driven by kind of workshops in rooms like this and then because of the need to document compliance and get lots of people trained, people began doing online training, putting people behind computers to learn their suicide prevention training and there's a place for that.
So this is not, it's always about the "and" right but I did have concerns that it couldn't be the only way. We weren't gonna prevent suicide by people cooking through online modules alone and we conducted a study with the Veterans Administration in the US which gave me an idea. We brought groups of substance use counselors together with kind of carefully designed video modules without needing to have a trainer there and let them talk and interact around those ideas and it turned out that people learned that way and we took it from that to this. People individually behind a computer but still something that could scale, which is kind of online learning that you do as a group together which can in look more, which where training can look kind of more like this, thanks to Kira Thomas in Queensland, but also if we invite, in the Illawarra Shoalhaven community had the idea that they could draw ties across different sectors through shared education and create those Networks.
This consists of some lived experience and clinical teaching demonstrations but the core is about the group interacting. People don't need more information, they need more interaction. And a group of the University of Sydney has done some very nice work on how these kinds of experiences build social capital and you know, you can't give away what you don't have and we need this in our workplaces to have those kinds of connections and capital that we could then leverage towards the people that we're aiming to serve. So the group came together, on the left Antonia Raveski who's representing NADA and on the right there you see, Jo Riley, the Executive Director of the Illawarra Shoalhaven Learning Suicide Prevention Learning Collaborative and they managed to do this.
To bring together diverse participation across the sectors, being inclusive and through structured interaction. Created a new version of the SafeSide Learning Program for AOD and early results are that people in the AOD sector are feeling more comfortable interacting and that there have been, kind of some lasting relationships built. In the interest of time, I won't show you too much from, I won't show you anything–ha–from this. You can find this– this is the welcome from it where you see the ties occurring across the community. You can find this on, I'm pretty sure you can find this on the SafeSide Prevention website and so we'll pass through that.
Finally, I'd like to just briefly talk about a Network-Informed approach to reviewing suicides. It's a totally different area that's launching next week, here in Western Australia. This comes out of an observation and my learning from colleagues in New Zealand as well as here in Australia, Dr. Kathy Turner and from Queensland has been really influential in this regard. But a lot of times when we review suicides it occurs, it's supposed to occur from like an objective review committee who asks, what happened? What policies need to be strengthened? Where did, what was the root cause of the suicide? Where we look at the individual and the care they received and that's the most common way that suicides were reviewed.
Except that people, the person who died was actually surrounded by a network of people during their lives who were often not involved at all in reviewing and figuring out what the response will be to the suicide, which to me is really, really sad. And it can often feel very alienating for family members. Staff can feel blamed or isolated or burnt out, some of you may have experienced that in if you work in a clinical setting. It was an experience like that actually brought me to suicide prevention. And so we're gonna be working together with organisations to see how can we, in the process, a painful process after a suicide, how can we involve people who mattered in the person's life and network in the review and response?
This is as I said, influenced by work in Restorative Just and Learning Culture but my colleague Kathy Turner and as well as Jo Wailling in New Zealand who has brought the ideas about restorative approaches, again drawing on First Nations wisdom in healthcare. But I think it's also it's the involvement of people and what this bit of research is beginning to show is that if we take these approaches, we can include and involve the impacted parties more in these kind of processes that get separated out from people's real network. And in the first phase of people who kind of, participated, these were some of the organisations from Western Australia. A subset of these will be meeting next week to begin learning and working together in a collaborative way to see what each organisation needs to take steps forward towards greater connectedness, even in the suicide review process.
So, I've given a kind of a wide range of different threads that all have to do with putting on that lens of network science. Of understanding that web of human connections and the structure of them and ways that we can through action actually build stronger, more protective relationship networks. And so my challenge to you is that as you go out after this session and for the rest of the conference, that maybe you wanna put on those lenses. I thank my robot for making this for me. Put on that lens and maybe think about, even today is there two colleagues who are not connected in your network who you can connect? And I think that's one way that we can advance the vision of this conference and I know the vision that Suicide Prevention Australia and all of us share, to build connections that will matter for tomorrow. So thank you very much.