(Biographical details. Authors: Sharon Hoogland, Randall Pieterse. 2000. Pub: Wesley Mission, Sydney.)

Contents

INTRODUCTION
Understanding More about Suicide
Summary Suicide Fact Sheet
Suicide Defined
Suicide Statistics and What they Do Not Tell Us
Causes of Suicide

SUICIDE IN 1998: AN OVERVIEW
1998 and 1997 Statistics Compared
1998 and 1997 Numbers Compared - States and Territories

TRENDS AMONG SELECTED GROUPS
Youth Suicide
Middle-aged Suicide
Aboriginal Suicide
Gay and Lesbian Suicide
Rural and Remote Communities

MIDDLE-AGED (25-44) MALE SUICIDE
Statistics at a Glance
Factors Influencing Suicide in Middle Aged Men:
Male Health
Mental Health/Depression
Marital Status
Substance Abuse
Unemployment/Underemployment
Choice of Method
Problem Gambling

WESLEY MISSION SERVICES
How Wesley Mission is helping

RECOMMENDATIONS

Introduction
Understanding More about Suicide

Dealing with the issue of suicide is both challenging and complex. Given that the nature of the topic in itself is distressing, the complex circumstances and psychological variables of people in crisis only make it more difficult. What is most disturbing about suicide is that survivors are left asking the unanswerable question 'why', and wondering what they could or should have done to have prevented it from occurring. It is impossible to identify any single cause of suicide but the study of suicidal behaviour allows us to identify a whole range of risk factors, and to coordinate our efforts for their alleviation.

A report such as this, cannot address all the issues and influences associated with suicide. The focus of this report is to create awareness about suicide in Australia and, in particular, to draw attention to middle-aged male suicide.

Suicide affects hundreds of thousands of Australians every year. Whilst the incidence of suicide is relatively rare (in 1998, 2% of all deaths were attributed to suicide),1 they are nonetheless premature, needless deaths which have a devastating impact on extended family relationships, workplaces, schools and ultimately, the community as a whole.

Suicide is a complex issue which, while tragic, confronts families, friends and wider communities. It results most often from an accumulation of risk factors, and it intersects with problems and concerns across society: mental health, drugs and alcohol, family issues, employment, cultural identity, law enforcement and criminal justice, education and poverty.2

Statistics are useful for measuring, over a period of time, the number of suicides which have occurred; for highlighting the actual patterns of suicide; and for enabling the analysis of quantitative differences. No amount of data however, can accurately measure the profound impact and deep distress which surrounds the actual suicide.

Recent trends show male suicide is rising in certain age groups. Whilst there has been extensive discussion of suicide by young men, the tragedy of suicide in older men has been sadly overlooked. A study of suicide in Australia shows that in 1998 the incidence of suicide in the younger age groups did not rise significantly. Unfortunately, however, middle-aged male suicide is increasing, with more men aged between 24 and 44 taking their own lives. The rate of suicide in men over the age of 75 is also a growing concern.

Over the past year, Australia has seen many instances of tragic suicides among middle aged men, some of whom took other family members to their death with them. In each case, the individual was unable to cope with the specific pressure they were experiencing and reached a solution which was absolutely final.

The same generation of boys that effectively started the youth suicide crisis in the late 1970s are continuing to take their own lives, as they progress to adulthood, and middle age.3 The number of Australian men aged 25-44 taking their own lives has increased 44% since 1979.4

The Commonwealth government has already begun to address this issue. In August this year, a National Advisory Council for Suicide Prevention (NACSP) was formed to replace the National Advisory Council for Youth Suicide Prevention. 5 This change reflects the now obvious need to address suicide at all age levels, not simply youth. The council's report, Living is for Everyone (LIFE): A Framework for prevention of suicide and self-harm in Australia, released in October, also reflected this change in emphasis.6

While the suicide rates for Australian 20 to 44 year old females are stable, as well as being less than 25 per cent of the male rates, there is little doubt many are also suffering a malaise. Other guides, such as figures on attempted suicide or crisis counselling or prescriptions for anti-depressants, point to a far higher prevalence of depression in the female population than in the male. It appears males and females respond to crises in different ways. Perhaps it's more archetypal for males to seek solutions (even final solutions), whereas females may seek solace.7

Aimed at suicide prevention, Wesley Mission Sydney's LifeForce program continues to draw public attention to the issue of suicide and offers training for lay-persons and significant care-givers to identify the warning signs of the person in crisis, intervene appropriately and refer the person in crisis to appropriate qualified help. Since our focus is primarily on public education, we have sought to represent suicide, in this report, in a manner which will motivate lay people to be more proactive in addressing this tragedy in their communities, by developing strategies to support and care for those who may experience emotional crisis as a result of a variety of life circumstances.

Summary Suicide Fact Sheet

THE FACTS ARE:

• 2,683 people took their own lives in Australia during 1998.8
• Which means an average of seven suicides per day.9
• For every completed suicide there are over 30 attempts.10
• Therefore there are over 210 people a day attempting suicide.
• There are 8.5 times more deaths by suicide in Australia than by homicide (2683 suicides compared to 307 homicides).
• There are 1.5 times more deaths by suicide in Australia than by road accidents (2683 suicides compared to 1713 road accidents).

GENDER FACTS

• 2,150 of these suicides were males.9
• Male suicides outnumber female suicides by a ratio of 4:1.
• The all-age standardised rates of male suicide registered in 1997 and 1998 were the highest since 1963 and, before that, 1931.9
• Suicide is the leading external cause of death among men.9
• Suicide is the second leading cause of death among 25 - 44 year old males.9
• Suicide rates for males increased from 16.5 in 1979 to 23.1 in 1998.9
• Suicide rates for females decreased from 6.6 in 1979 to 5.7 in 1998.9
• For every completed male suicide there are five attempts.
• For every completed female suicide there are 35 attempts.
• Homosexuality issues may be involved in up to one third of young men under 24 who suicide.11

YOUTH SUICIDE

• Suicide is the second leading cause of death among 15 - 24 year olds.9
• Youth suicide accounts for 16.6% of the total number of suicides in 1998.
• The largest increase in death by suicides was in the 14 - 24 years age group between 1921-25 and 1996-98.14

MIDDLE AGED SUICIDE

• Men aged 25 - 44 made up about 40% of total suicides for 1998.14
• Men aged 25 - 44 have the highest age specific rate of suicide with an 80% higher suicide incidence rate than that of women of the same age 9
• The number of suicides by men aged 25 - 44 has risen by 44% since 1979.12

ELDERLY SUICIDE

• Men aged over 80 years have a suicide incidence rate six times greater than that of women the same age.11
• Elderly suicide accounted for nearly 20% of total suicides in 1998.
• 600 Australians over the age of 55 killed themselves in 1997.

RURAL SUICIDE

• Suicide is more common amongst males in rural and remote areas.14
• The rate of suicide increases in communities with populations of less than 4,000.

INDIGENOUS AUSTRALIANS

• Approximately 86% of all Indigenous suicides are by males.9 (Only four States have indigenous death data considered to be of publishable standard.)
• Aboriginal suicide rates are possibly two to three times that of non-Aboriginal Australians.15

METHODS OF SUICIDE

• The four most common methods of suicide among men are: firearms (27%), hanging (26%), carbon monoxide (20%) and poisonings (19%).14
• The most common methods among women are: hanging, poisonings, carbon monoxide and firearms.14

FOUR LEADING EXTERNAL CAUSES OF DEATH 1998

Source: Australian Bureau of Statistics (1999), Causes of Death Australia 1998. Canberra

AUSTRALIAN DEATHS BY SUICIDE (COMPARING 1997 AND 1998)

Source: Australian Bureau of Statistics (1999), Causes of Death Australia 1998. Canberra

Table 1: Suicide rates per 100,000 population.16

Year Male Female Year Male Female
1980 16.3 5.5 1990 20.4 5.0
1981 16.9 5.5 1991 21.4 5.9
1982 17.4 6.0 1992 20.9 5.4
1983 17.0 5.4 1993 19.2 4.4
1984 16.8 5.2 1994 20.6 4.8
1985 18.1 5.0 1995 20.8 5.5
1986 19.1 5.6 1996 21.2 5.0
1987 21.8 5.7 1997 23.3 6.2
1988 21.0 5.6 1998 23.1 5.7
1989 19.8 5.2

Suicide Defined

According to Butterworth's Concise Australian Dictionary:
Suicide can be defined as the deliberate act of taking one's life.17

According to Shneidman, suicide is
a conscious act of self-induced annihilation, best understood as a multidimensional malaise in a needful individual who defines an issue for which suicide is perceived as the best solution.18

Kosky et al. further observes that
suicidal behaviour can be interpreted as a manifestation of distress associated with loss or abandonment, a release from despair, an expression of hostility or revenge, an appeal for help, a wish to test fate or to be reunited with a loved one, or a response to the disordered thinking of a psychotic illness or drug intoxication.19

David Lester argues that
death caused by one's own voluntary act is not necessarily a sufficient criterion to use when judging whether the psychological process of suicide has occurred. There are examples of cases where people have died accidentally by suicide and other examples of cases where a person intended to die but who lived because they were accidentally found.

Such cases make it clear that we cannot understand the suicide process simply by looking at the end result of the actions taken. In the same way, we cannot assume that certain life circumstances invariably cause suicidal acts. Many persons who find themselves in similar situations do not behave suicidally. Some people kill themselves because they are disturbed about an event that would not upset other people. The process that leads to suicide cannot be determined by looking at whether death actually occurred, nor by investigating whether a person's life was objectively miserable. Rather, we must examine the purpose of the suicidal act within the pattern of the individual's life.20

The complexity of circumstances and the multidimensional nature of suicide means that attempting to pinpoint the exact cause for a suicidal event is difficult. As this report asserts, there are many factors and issues, often interacting, which can lead a person to suicide. At the point of the suicidal crisis, however, there is a far greater degree of commonality, than the circumstances and issues which might have led individuals to suicide.

Suicide Statistics and what they do not tell us

Statistics 'mask' the individual and their personal struggles. The suffering of a suicidal person is much more significant than an analysis of statistics can reveal. "All that anguish, the slow tensing of the self to that final, irreversible act, and for what? In order to become a statistic."21 Despite this, numbers do matter, and statistics provide vital insights into the scale, development and circumstances of suicidal behaviour. They record its social impact.

To be classified as a suicide, death must be recognised as due to other than natural causes. It must also be established by coronial inquiry that death results from a deliberate act of the deceased with the intention of ending his or her own life.22

It is in determining the intent behind the suicidal behaviour, that a number of difficulties arise. Evidence of the deceased's intent, societal attitudes, the wishes of family and the guidelines for registration of suicide as the cause of death, impact on the accuracy of suicide statistics. How is it possible to clearly determine that a motor accident fatality was an 'accident' or indeed a suicide, or a death registered as an overdose was not in fact a suicide?

In addressing the accuracy of suicide statistics Lester argues:
Not only is it possible that there is a systematic bias about the certification of deaths by suicide, but there may also be deliberate attempts to conceal suicidal deaths. There are clearly many reasons to attempt to hide the fact that a death was caused by suicide. Some religious groups refuse normal funeral rites to people who commit suicide. Insurance policies often do not pay the survivors any benefits beyond the premiums after a death by suicide within two years of taking out the policy, and they frequently pay more for a death judged to be accidental than for a suicide or a natural death. We can only presume that the reporting of suicidal deaths would be more accurate if less opprobrium were attached to suicide by society.23

It is even more difficult to calculate rates of attempted suicides:
metaphorically, completed suicides are just the tip of the self-destructive iceberg, we need also to consider attempted suicide? Although various attempts have been made to define accurately the incidence of suicide in Australia, the same cannot be said about attempted suicide. There is a paucity of data on the rate of attempted suicide in Australia, not only because distinguishing intentional from unintentional death is inordinately difficult, but also because no register exists at this time to provide accurate data.24

Causes of Suicide

A number of theories have been developed to explain the cause of suicide. Psychiatric theories emphasise mental illness; psychological theories emphasise personality and emotional factors; while sociological theories stress the influence of social and cultural pressures on the individual. In the table below, a list of factors based on each of the three disciplines has been compiled to assist in understanding the complexity of suicide.

Part 2 of This Article

http://www.wesleymission.org.au/visionvalues.html

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