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This is about Where we, PBB Fit in To our sector The industry In which we work And as far as the public Are concerned This matters Greatly For a number of reasons It helps Professionals Who might refer to us Or take referrals from us Understand Who we are and what we do, where our work starts, where it stops, and how it fits around what they do. It also helps the public understand why we do what we do and addresses the all too common queries that relate to areas such as activism, legal reform, and mental health. An understanding of our program logic enables you to appreciate how we are positioned and why what you do matters so greatly.

At our core From the day That we started In 1999 We were and still Remain today A suicide Prevention support service Importantly We are prevention Not intervention But I’ll get into that more later. We choose to deliver our core objective by focusing on a specific demographic, that is, separated parents more often than not struggling with the issues of custodial care. This group of parents are recognized as being at very high risk of suicide. In order to understand our program logic, it is necessary to first understand a little about the journey that a person takes on the path from not being suicidal through to perhaps attempting to or actually taking their life. For this purpose, we use psychological constructs or models, a commonly accepted model, and one which well explains our work is the IMV model.

Commonly Accepted model And one which Well explains our work Is the IMV Model The IMV Model’s full name is the Integrated Motivational Volitional model It was Originally Developed in 2011, and later updated in 2018, by Professor Rory O'Connor of the University of Glasgow in the UK. Professor O'Connor is a recognized world class expert in suicide prevention. The model might seem quite complex at first sight, but PBB has developed a simple poster, which outlines the broad concept of the suicide journey represented as a stream or river. The earliest triggers on this journey are tributaries that contribute to the river, and eventually end in a waterfall. The stages of the IMV model are represented by the stages of this river. In the simplest of terms, the model comprises three key stages that a person experiences on their journey towards a potential suicide. These stages are called pre motivational, motivational, and volitional.

Let’s start with The Pre-Motivational Stage and Of which There are 3 sub-factors These are Diathesis Environment And Life Events Diathesis Refers to To my health and Well-being and includes Factors such as My genetic disposition and characteristics that either place me at less or greater risk of a particular health outcome. So maybe I have excellent resilience and this helps prevent me from getting on the journey towards suicide or on the contrary, I have poor resilience and the journey starts more easily in me than it would in another person. Factors such as resilience are of course relative because the magnitude of resilience required depends greatly on the circumstances that you are exposed to. So who you are and what happens to you forms a complex interplay that might kick things off towards a bad outcome or not. You'll be aware of large organizations that work on these types of issues, looking to develop an individual's coping mechanisms and they'll include the likes of beyond blue, black dog, headspace, got you for life or men's line. The second of these three initial factors is environment and that's best seen as the world in which I live and how that presents me with an opportunity or challenge. It refers to things such as law, culture, education, and ideology. For many of our parents, family law is an issue. So you might think of organizations that work specifically in the area of family law reform. So men's or women's rights organizations or activism groups, such as the ABF, the Australian Brotherhood of Fathers. Each has their legitimate place in trying to shape the world in which we live. And this area is characterized by the title of the subcategory environment. The last of the three initial factors within the initial pre-motivational stage is life events. Here we see major life markers, such as bereavement, homelessness, financial destitution, legal difficulties, divorce or loss of access to kids. Organisations that work in and provide support in this area, particularly for separating parents that we can relate to might include the likes of Legal Aid Relationships Australia, Mission Australia, in the case of homelessness or even the family courts themselves. In summary, the initial pre-motivational stage where most support agencies operate is characterised by an organisational focus on personal health and wellbeing, the environment in which we live and around major events that we might experience.

The second stage Is a little simpler And best characterised As the downward Spiral That follows The Pre-Motivational Stage So 2 Is typically Characterised By mental states That any of us can understand And appreciate These Are likes of A sense of defeat which might lead to humiliation, and then a sense of entrapment, the feeling that there is nowhere else to go and nothing that can be done. This second motivational stage ends with ideation. The recurrent thought of suicide as the only option left open to me. In terms of who works at this second stage, I surprise you to learn that it's almost no one and certainly not for separating parents. PBB is largely it across Australia. Our role is to capture the parents in this second stage who are not coping and to deflect them off the suicide journey and away from stage three.

Stage 3 Is Volitional The name comes from The Latin word Meaning having The will to act This is the final stage Of the suicide journey And it’s characterised By the person Demonstrating Suicidal behaviours And perhaps Making repeated attempts They are Acting out He ideation that marks the end of stage two of this IMV model. At this final stage we see crisis intervention, support services, which the best known will be the likes of Lifeline, but it will include others too like the suicide callback service. What this model, the IMV model demonstrates quite clearly is that as a country we traditionally focus on either early or late stages of interrupting the suicide journey, but we do very little to nothing in the middle stage. This is where the person is not coping. They've not found the help they needed to prevent the situation kicking off, but there's nothing really for them until they reach the point of crisis and they need to pick up the phone to Lifeline.

This mid-stage The motivational Stage then Is where PBB Operates And where our expertise Really shows We work with A very Specific or specialised Group of people Separating parents Who have very specific and specialized problems. Our role is to address the growing sense of defeat, humiliation, and entrapment that leads these parents to start to think of taking their lives. We do not need to fix them. Rather, we need to present them a social network of support of others who understand them to help address their growing isolation and to expose them to options, insights, and the wisdom of peers who might be further along the same journey that they are just embarking upon. These simple acts help avoid their spiraling down and out of control into stage three. Our job is not to change the law or culture or ideology that is best left to the activists and the campaigners. Our job is not to intervene in the final stage that is best left to experts such as Lifeline. Our role is to be a safety net for those who are spiraling downward and who cannot find a specialized understanding and care that helps them to develop appropriate coping mechanisms. Whilst what we do sounds simple, it is uniquely effective. We know that by providing a safe place amongst peers in which a mom or dad in high levels of distress can speak without judgment and to be heard by others who have specialized knowledge very quickly and very efficiently interrupts the suicide journey.

Often we can walk Away from our Supports groups wondering What it is that If anything that we’ve done And if what we’re really doing Matters Or if we’ve made any difference At all The truth is we do make a huge difference. In 2017, we surveyed 400 parents, showing that over 50% of new parents coming to PBB recently felt suicidal and had been thinking about taking their lives. By the third interaction with PBB, this drops down to below 1%. This is an incredible turnaround and one that often amazes academics and professionals in the medical sector when we present at conferences. The secret is that we are all peers and that we've walked the path before. We are extremely well placed to understand what others new to the journey are experiencing and feeling. Sometimes it's the simplest of tips or a few minutes active listening and caring that can nudge someone else off that journey. Sometimes that parent is sat in a room only listening and not even actively taking part in the discussion, but knowing that they are not alone and that there are options and hope. This is often all it takes to be a lifesaver. It's unseen, but it's real nonetheless. For a specific demographic at risk, practical peer support is the best way to ensure that we keep our mums and dads alive and in their kids' lives. A last word on focus and how this relates to all of the aforementioned. Given that we are often compelled by others to get involved more in activism or mental health initiatives or crisis intervention, it pays to understand that there are many others already there and that we occupy a place that others do not go. Diluting what we already do with scant resource is not helpful to those parents who need us most and it costs lives. A laser-like focus in our areas of expertise means more kids every year get to keep their parents and that is something I believe we can all agree is a cause worth fighting for and getting behind.