Suicide – Australia's Number One Cause of Premature Death
Every 40 seconds someone commits suicide in the world.1 In Australia suicide accounts for the highest number of premature deaths, equivalent to the combined loss from cancer of the breast, skin, colon and prostate and is the leading cause of death in the younger age groups – 15-24 and 25-44 years.
Suicide may be sudden but it is often the result of a complex interaction between several risk and self-protective factors that may stretch back to childhood. Poor problem solving skills or perfectionism can aggravate the effects of risk factors.
Family history, past or current mental problems, low coping skill potential and aggression are common individual risk factors. In Australia the risk factors include indigenous status, isolation, remoteness and ready access to lethal means of suicide.2 An individual’s societal domain adds another dimension to the propensity for suicidal ideation.
The number of Australians who contemplate suicide dwarfs the numbers who go through with it. The National Survey of Mental Health and Wellbeing found up to 150 times more people with a 12-month history of suicidal thoughts, and even attempts, than the number of actual suicides. Additionally, suicidal prevalence, in contrast to actual suicides, is significantly higher in women than men (about 500:100), whereas one quarter of the 2,522 actual suicides in Australia in 2013 were among women. Australian hospitalisation rates for intentional self-harm somewhat mirror this trend, with rates for females at least 40% higher than for males.3
Some self-harm may be a form of attention-seeking, which suggests that analysis of suicide methods could shed more light on why rates of actual suicide are higher for men. More than half of suicides in Australia result from hanging, which is lethal 70% of the time.
Poisoning (except with gas) accounts for almost one-third of deaths and ranks second as a cause of premature death. It is the preferred method amongst women but is lethal 1.5% of the time. Exposure to poisoning accounted for more than 80% of hospitalisation for intentional self-harm in 2010-2011. That poisoning is the preferred method of self-harm among females - especially younger ones - could suggest that this method of attempting suicide is responsible for significantly lower suicide rates among women than males.
Australian suicide rates for men differ by birth cohort. For the under-30 age group, Generation X (born 1966-1975) had the highest rates, followed by Baby Boomers (born 1946-1965) and Generation Y (born 1976-1985). The rates for those born from 1986 to 1994 are closer to the generations born before 1946 and are thus below the rates of the three previous generations.
Socioeconomic status is also a contributor; the male suicide rate is about 50% higher for the most disadvantaged quintile compared to the least disadvantaged quintile. For females the pattern was less evident. Remote areas of Australia experience almost twice as high a suicide rate than major cities.
Suicide is the last resort for those with fragile mental health and who cannot cope. Much like in other countries, Australia’s life insurance industry suffers from worsening morbidity experience due to mental health problems. The economic impact of mental health problems is considerable. It highlights the need for financial protection products and the need to work with all stakeholders involved in suicide prevention and addressing mental health problems earlier in a more holistic way.
Income protection products require adequate terms and conditions that give claims managers the opportunity to work with other experts towards successful integration into employment. The need for exclusion clauses for an initial period and underwriting of mental health at the application stage – both financial and medical – is just as important to ensure that insurance can be offered to as many individuals as possible at affordable rates.
While Australia has experienced a reduction in suicide rates over the last three decades, rates remain stubbornly high (above 10 per 100,000) despite national suicide prevention strategies in place since 1995. The wide range of risk factors suggests that suicide prevention is complex and requires a systematic approach by healthcare providers, the community and government agencies. Life and disability insurers can also play an important role.
Follow our blog series on mental health for future posts on the complex risk challenges presented by specific disorders and behavioural issues.
- WHO 2014. Preventing suicide – A global imperative.
- National Suicide Prevention Summit 2015. Background Information. C.R.E.S.P. and Black Dog Institute.
- Australian Institute of Health and Welfare. Suicide and hospitalised self-harm in Australia. Injury Research and Statistics Series No. 93. 2014.