Suicide in Rural and Remote Areas of Australia

Abstract

The present report has been requested by the Australian Suicide Prevention Advisory Council (ASPAC) and funded by the Commonwealth Department of Health and Ageing. The report will assist the Council in their formation on advice to the Minister for Mental Health and Ageing. The size of the problem and scope of the report: Australia's rural localities face an increasing burden of death due to suicide (Hirsch, 2006). Those groups most vulnerable to suicide appear to be males, youth, farmers and Indigenous people. Data from the Queensland Suicide Register showed that, between 2005 and 2007, male suicide rates in remote areas (36.32 per 100,000) were significantly higher than male suicide rates in non-remote areas (18.25 per 100,000). Further research has also shown that the relative rate of male suicide in rural Queensland was 1.99 compared to rates in metropolitan locations (K嬶es et al, 2009). While the gap is widest between metropolitan and remote suicide rates and the rates highest among rural males, regional suicide rates are still higher and metropolitan rates and the rural female suicide rate is higher than the urban female suicide rate. The present report aimed to present a holistic examination of suicide in regional and remote Australia. It predominantly focused on the Queensland experience and has investigated a wide range of psychological, environmental and cultural factors, within this bound geographical context. Key findings: Chapter One gives a detailed presentation of past research on at-risk groups, suicide methods, and risk and protective factors. Identified gaps include the lack of research on the risk of suicide within specific sub-groups, such as females and same-sex attracted youth. This review indicates the importance of: understanding rural cultural influences, providing appropriate treatment services, and encouraging help-seeking in rural contexts. Chapter Two contains the results of an analysis on the contextual influences on suicide in metropolitan, regional and remote areas. These findings indicate that contextual stressors associated with the agricultural industry, relationship breakdown and Indigenous population were associated with greater risk of suicide in remote populations. Greater education, religiosity, and antidepressant use in rural populations were associated with lower suicide rates. The chapter highlights the importance of considering suicide as embedded within a larger framework of environmental risk and protective factors. Some of the findings from the second Chapter receive further support in the psychological autopsy study reported in Chapter Three. Compared to suicides in urban localities, relationship conflict, income and work problems, and alcohol use disorder were significant in cases of rural suicides. The quality of available health services and possible stigma associated with help-seeking are also highlighted as influences on rural suicide.