BACKGROUND NOTE, 29 July 2011

Suicide in Australia

Joanne Simon-Davies
Statistics and Mapping Section

Key points

•        In Australia, 2132 deaths were as a result of suicide in 2009—six deaths per day.[1]

•        Even though suicide deaths are relatively small (out of a total of 140 760 registered deaths), it is a leading cause of death, ranked 14th in 2009 (the same as in 2000) but, more significantly, ranked 10th as a cause of death amongst males.

•        Suicide is predominantly a male cause of death with 76.6 per cent of all suicide deaths in 2009.

•        In 2009, the median age of suicide deaths was 43.4 years for males and 44.9 for females. In comparison, the median age of all deaths is 77.8 years for males and 83.9 for females.

•        In 2009, suicide was the leading cause of death for young people aged 15–24 with almost a quarter (22 per cent) of all deaths within this group as a result of suicide.

•        In 2007, the number of people who had serious thoughts about taking their own life was 368 100 and 65 300 had attempted suicide—equivalent to 179 attempts per day.

•        Suicide deaths are significantly higher for Indigenous Australians. Suicide accounted for four per cent of all Indigenous deaths in 2009 (97 deaths) compared to 1.5 per cent for the total population.

Introduction

According to the World Health Organization, each year approximately one million individuals commit suicide worldwide—one death every 40 seconds. Many more attempt suicide (around 10–20 million) each year. [2] Suicide is ranked as one of the three leading causes of death among people aged 15–44.[3]

Suicide is a preventable death that has very complex issues underlying it. These deaths have a lasting effect on families and friends and, for those touched by suicide, it can be devastating. Suicide is often not discussed openly with the question of ‘Why did the person commit suicide?’ remaining unanswered and the wondering if it could have been prevented making it even more tragic.

Even though the true cost of suicide and attempted suicide on the economy and society is unknown, it is, no doubt, substantial. As a result, it continues to be a major health issue not only in Australia but internationally.

Purpose of paper

The purpose of this paper is to examine the availability of suicide statistics and limitations of the data. The paper also presents the most recent data from a range of sources and provides analyses of these data. However it is beyond the scope of this paper to examine the complex issues of why people commit suicide or the social and economic costs to the community.

Defining and classifying suicide

According to the World Health Organization, suicide is defined as ‘an act deliberately initiated and performed by a person in the full knowledge or expectation of its fatal outcome’.[4]

For a death to be classified as a suicide in Australia, it must be:

… established by coronial enquiry that the death resulted from a deliberate act of the deceased with the intention of ending his or her own life (intentional self-harm).[5]

The classification used to code all deaths is the International Classification of Diseases (ICD). [6] Suicide is coded to X60–X84 (known as intentional self-harm) which falls within the External Causes chapter. The process of classifying any death is complex; suicide deaths can be even more difficult where documentation is required. If a death cannot be determined as suicide it cannot be classified within X60–X84 and instead is placed in Y87.0 (undetermined intent).

Suicide and self-harm

The cause of death classification refers to suicide as intentional self-harm however it needs to be noted that the term ‘intentional self-harm’ has a broader scope. A review of suicide statistics in Australia by the Australian Institute of Health and Welfare (AIHW) gives two examples of where a person dies as a result of self-harm, but not done with the intent to die:

•        A person could die as a result of a self-inflicted overdoes of medication, undertaken with the intention of influencing another person and not with the intention of dying.

•        A person could die from self-inflicted suffocation undertaken with the aim of erotic pleasure.[7]

According to a recent article on self-harm in the Medical Journal of Australia, self-harm is different to suicide as it is the ‘deliberate damage to the body without suicide intent’. As self-harm doesn’t always lead to medical intervention, the number and frequency of cases are hidden and reliable statistics are very difficult to obtain.[8]

Data sources

The ABS releases the annual Causes of Death publication (cat. no. 3303.0). These statistics are compiled from administrative data made available by the Registrar of Births, Deaths and Marriages in each state and territory and from the National Coronial Information System (NCIS). The NCIS is a national database used by all state and territory coroners to enter (progressively) any death that they are investigating.

Limitations of suicide data

Determining the true number of suicide deaths in Australia is not straightforward. There is an ongoing debate on whether the number of suicides is accurate or whether it is seriously under-reported and therefore hiding the severity of the problem. According to the recent report by the Senate Community Affairs References Committee, The hidden toll: Suicide in Australia, it is possible that the number of suicides is higher than those published by the ABS.[9] This is a debate which the ABS is fully aware of, as can be seen in their most recent report:

...concerns have been raised by key users of cause of death data regarding the quality of external causes data (e.g. deaths due to intentional self-harm (suicide), homicide, Sudden Infant Death Syndrome (SIDS) and motor vehicle accidents). The ABS have been addressing these data quality concerns.[10]

To make improvements in the quality of cause of death data, in particular those listed above, the ABS is tackling the quality concerns in two ways:

By increasing the length of time from the end of the reference period to publication of data from 11 to 15 months to allow for a longer time period to receive information on coroner certified deaths.

By introducing a process of revisions to the cause of death data.[11]

The ABS expect the already published 2008 and 2009 suicide numbers to increase as data are subject to an ongoing review process. The revisions enable any additional information relating to the coroner findings to be recoded up to 24 months after initial processing. As a result some cases are still open and the cause of death is yet to be determined by the coroner; therefore, care should be taken in using and interpreting the most recent suicide data.[12] Only time will tell if the changes made by the ABS improve the quality of suicide data and produce more accurate statistics.

Difficulties coding to suicide

As discussed previously, determining the true number of suicide deaths is not straightforward. One reason is the difficulty in deciding confidently whether a death was suicide. Sometimes the circumstances of a death leaves doubt over whether the person intended to commit suicide at all. Such scenarios include:

•        Unobserved falls or drowning which may be accidental;

•        Single vehicle accidents where a driver has crashed into a fixed object;

•        Hangings where there is a possibility of autoeroticism or there may be questions about the capacity of the person to understand the seriousness of their action (for example young children);

•        Drug overdoses which may be accidental. [13] [14]

The WA State Coroner, Mr Alastair Hope says that there is:

...a ‘grey area’ between recklessness and intent.  He used the example of a person driving a ‘...vehicle in a manner which is so reckless that it would be very difficult to decide whether she wanted to die or just did not care.’[15]

This is evident in Table 1 where it is possible that additional suicide deaths may be hidden in the categories ‘accidental death’ and ‘undetermined intent’  particularly those deaths attributed to the mechanisms of poisoning or hanging.[16] However, as the coroner needs to determine the ‘burden of proof’ to establish that a death was suicide and not an accident or assault, making a finding of suicide can be difficult.

Table 1: Selected external causes of death, mechanism by intent, 2009 (a) (b)

Accidental
death

Intentional
self-harm (c)

Assault

Un-
determined
intent

Other
intent (d)

Total

Poisoning

779

566

3

345

..

1713

Hanging

220

1093

6

127

..

1446

Drowning and submersion

182

43

1

54

..

280

Firearms

6

164

30

24

..

224

Contact with sharp object

9

55

74

22

..

160

Falls

1370

81

0

29

..

1480

Other (e)

2736

130

95

393

225

3579

Total

5322

2132

211

994

225

8884

(a) Cause of death data for 2009 are preliminary and subject to a revisions process as a result care needs to be taken in interpreting figures relating to suicide.
(b) Data cells with small values have been randomly assigned to protect the confidentiality of individuals. As a result, some totals will not equal the sum of their components. Cells with a zero value have not been affected by confidentialisation.
(c) Includes ICD-10 codes X60-X84 and Y87.0.
(d)  Includes Complications of medical and surgical care (Y40-Y84) and Legal intervention and operations of war (Y35-Y36)
(e) Includes sequelae, explosives, smoke/fire/flames, blunt object, jumping or lying before moving object, crashing of motor vehicle, other and unspecified means.
.. Nil or rounded to zero (including empty cells)
Source: ABS, Causes of Death 2009, cat. no. 3303.0, ABS, Canberra, 2011, p. 29.

To complicate matters, in the process of categorising a death as suicide, a coroner considers the following:

•        How the family will react if the death is found to be suicide as it can be a very sensitive issue in some families often due to their cultural practices and religious beliefs.

•        The person trying to obscure the fact that his or her death is due to suicide, perhaps out of concern for insurance entitlements of dependents.

•        Surviving family members might also obscure the facts to avoid the emotional trauma; an inquiry, or the perceived shame of having a family member take their own life.

•        Deaths which involve assisted suicide may not be recognised or reported as such. [17]

Statistical summary: suicide in Australia

Summary

In Australia, 2132 deaths were reported as a result of suicide in 2009—six deaths per day—higher than transport accident deaths (1479). Even though suicide deaths are relatively small (out of a total of 140 760 registered deaths), it is a leading cause of death, ranked 14th in 2009 (the same as in 2000) but, more significantly, ranked 10th as a cause of death amongst males.

Suicide is predominantly a male cause of death with 76.6 per cent of all suicide deaths being males. Among young males aged 15–24, almost a quarter (22.1 per cent) died as a result of suicide (2009). This was the same for males aged 25–34, with 22.5 per cent dying as a result of suicide.

For total deaths in 2009, the median age was 77.8 years for males and 83.9 for females. However, for those who commit suicide, the median age is considerably lower at 43.4 years for males and 44.9 for females. Median age for suicide deaths has been slowly increasing as seen in Table 2.

Table 2: Median age: suicide deaths, 1995 to 2009 (a)

1995

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

Males

37.2

39.0

39.0

39.3

40.6

41.4

41.4

43.7

41.7

42.4

42.5

Females

41.1

40.2

41.1

43.2

41.2

43.3

44.1

45.1

44.5

43.5

43.5

Persons

37.9

39.3

39.6

40.3

40.7

41.8

41.8

..

42.5

42.7

..

(a) Data for 2009 are preliminary and subject to a revisions process, therefore care needs to be taken in interpreting figures relating to suicide.
.. not published by the ABS
Source: ABS, Causes of death 2009, cat. no. 3303.0, ABS, Canberra, 2011, Data cube—suicide, table 11.2.

Currently, the highest age-specific suicide rate was observed for males aged 85 years and over (28.2 per 100 000) even though the actual number of deaths is quite small (36 deaths in 2009). For males aged 40–44 the rate was 22.9 per 100 000 and 22.7 for males aged 35–39. For females, the highest rate was recorded for those aged 50–54 (8.8), followed by 30–34 (6.4).[18]

Table 3: Suicide, age-specific death rates by 5 year age groups by sex, 2009 (a) (b)

Age

Male

Female

Total

15–19

9.3

3.4

6.5

20–24

15.4

4.4

10.0

25–29

18.9

5.7

12.4

30–34

20.9

6.4

13.6

35–39

22.7

6.1

14.3

40–44

22.9

6.0

14.4

45–49

22.1

5.8

13.9

50–54

21.1

8.8

14.9

55–59

17.2

6.2

11.6

60–64

18.2

5.0

11.5

65–69

13.0

4.6

8.8

70–74

13.9

3.7

8.6

75–79

22.3

3.7

12.3

80–84

16.9

4.4

9.7

85 and over

28.2

5.3

13.1

All ages

14.9

4.5

9.7

(a) Data for 2009 are preliminary and subject to a revisions process, therefore care needs to be taken in interpreting figures relating to suicide.
(b) Deaths per 100,000 estimated resident population as at 30 June for each age group and sex.
Source: ABS, Causes of death 2009, cat. no. 3303.0, ABS, Canberra, 2011, Data cube—suicide, table 11.2.

Historical suicide rates

Since 1921 (see Table A in the Appendix) the rate of suicide has fluctuated considerably, therefore it is important to look at the rate over time to see where these changes have occurred and what major events may have influence these movements. The age-standardised death rate is the preferred measure to follow changes over time as it takes into account changes in the population size.

For the total population, the suicide rate peaked in 1963, reaching 17.5 per 100 000 persons. However for male suicide deaths the highest rate occurred during the Great Depression of 1930 when the rate reached 28.1 deaths per 100 000, followed by 23.7 in 1963 and 23.6 in 1997. For females, the peak occurred in the 1960s when the rate rose above 10 deaths per 100 000. This increase among women in the 1960s has been attributed in part to the unrestricted availability of hypnotic and sedative drugs.[19]

Over the last decade there has been a gradual decline of male suicide deaths, from 23.6 deaths per 100 000 (1997) to 14.9 deaths per 100 000 (2009). However an increase occurred in 2007 and 2008 (16.2 and 16.7 respectively) after a dip to 13.6 deaths in 2006.  This increase could be attributed to improvements in data collection and review as discussed in Limitations of suicide data. Data for 2008 and 2009 will be revised, mostly likely upwards, as a result caution needs to be taken when interpreting the most recent data.

Figure 1: Age-standardised death rate by sex—suicide, 1921–2009

Further historical data are presented in the Appendix of this paper. Appendix Table A has data from 1921–2009 by the number of suicides, crude rate and age-standardised death rate, while Appendix Table B has data from 1999–2009 by age-specific death rates by sex.

Mental health and wellbeing

The severity of suicide is highlighted in the ABS National Survey of Mental Health and Wellbeing (2007) where respondents were asked if they had experienced ‘serious thought about’, ‘made plans to commit’ or ‘attempted’ suicide in the 12 months prior to the survey.[20] The number of people who indicated that they had serious thoughts about suicide was 368 110 people or 2.3 per cent of persons aged 16–85 years. The number of people who had made plans to commit suicide was 91 000 and 65 300 had attempted suicide—equivalent to 179 attempts each day.

Table 4: Suicidal behaviour of 16–85 in the 12 months prior to interview by sex, 2007 (a)

Suicide behaviour (b)

Male

Female

Persons

'000

Ideation (c)

146.7

221.3

368.1

Plans

33.5

57.5

91.0

Attempts

*22.6

42.7

65.3

No suicidal behaviours (d)

7 797.6

7 836.5

15 634.1

Total aged 16–85

7 949.8

8 065.5

16 015.3

(a) The scope of the survey is people aged 16-85 years, who were usual residents of private dwellings in Australia, excluding very remote areas. People usually resident in non-private dwellings, such as hotels, motels, hostels, hospitals, nursing homes, and short-stay caravan parks were not in scope.
(b) Suicidal behaviour in the 12 months prior to interview. The components, when added, may not add to the total as a person may have one or more of the following: suicidal ideations, plans or attempt suicide.
(c) Ideation refers to the presence of suicide behaviours.
(d) Includes not stated.
* estimate has a relative standard error of 25-50 per cent and should be used with caution.
Source: ABS National survey of mental health and wellbeing: summary of results, 2007, cat no. 4326.0, ABS, Canberra, 2008, p. 38-40

Of the 368 100 people who had serious thoughts, 60.1 per cent were female; of those who made plans, 63.2 per cent were female and of those who made attempts, 65.4 per cent were female.

Whilst many more females than males have had serious thoughts or attempted suicide, the number of females who die as a result of suicide is relatively small—23.4 per cent of all suicide deaths in 2009. This may be due to the mechanism used in suicide (see Table 4). More females used less reliable methods such as poisons (40.5 per cent compared to 22.3 per cent of males) whilst males tended to use more extreme and final methods, such as hangings (54.3 per cent) and firearms (9.6 per cent).  However, in saying this, 41.7 per cent of females also used hanging as a mechanism of suicide.

Table 5: Suicide by mechanism used by sex, 2009

Mechanism used

Male

Female

Total

no.

%

no.

%

no.

%

Poisoning

364

22.3

202

40.5

588

26.4

Hanging

885

54.3

208

41.7

1147

51.4

Firearms

157

9.6

7

1.4

174

7.8

Other (a)

225

13.8

82

16.4

321

14.4

Total

1631

100.0

499

100.0

2230

100.0

(a) Includes drowning and submersion, falls, contact with sharp object, explosives, smoke/fire/flames, jumping or lying before a moving object and crashing a vehicle.
Source: ABS, Causes of Death 2009, cat. no. 3303.0, ABS, Canberra, 2011, Data cube—suicide, table 11.4

Of those who had serious thoughts, made plans, or attempted suicide, the majority had a diagnosis of a lifetime mental disorder and had experienced symptoms in the 12 months prior to interview.[21] Of the 368 100 people who had reported serious thoughts about committing suicide, almost three-quarters (71.7 per cent) fell into this category and of the 65 300 who attempted suicide, 94.2 per cent had a lifetime mental disorder and had symptoms in the 12 months prior.[22]

Men in rural and remote regions

According the 2010 AIHW report ‘A snapshot of men’s health in regional and remote Australia’, male suicide death rates increase with remoteness.  Males living in inner regional areas experienced death rates that were eight per cent higher than major cities and in very remote areas 78 per cent higher.[23] 

The standardised mortality ratio (the ratio of observed deaths to expected deaths) by remoteness areas provides a comparison between one area and another. As seen in Table 6, male suicides in very remote areas are almost three times as prevalent as in major cities—for every one suicide in major cities, there are 2.89 suicides in very remote areas.  For outer regional, suicide is almost 1.5 times greater.

Table 6: Standardised mortality ratio: suicide deaths by ASGC RA, males, 2004–06 (a)

Total males

Non-Indigenous males

Major cities

1.00

1.00

Inner regional

1.18

1.46

Outer regional

1.43

1.59

Remote

1.78

1.43

Very remote

2.89

1.25

Outside major cities

1.33

1.50

(a) Standardised mortality ratio refers to the ratio of observed deaths to expected deaths.
Source: AIHW, A snapshot of men’s health in regional and remote Australia, Rural health series no 11, cat no. PHE 120, p. 26

In regards to other measures of regional suicide deaths, data on causes of death by occupation of the deceased are no longer available, making it difficult to determine, for example, the number of farmers who commit suicide. Any data available are now out-of-date.[24]

For the number of suicide deaths by Statistical Division by states and territories (2008 and 2009) see Appendix Table C.

Indigenous suicide deaths

Identifying a deceased person as of Aboriginal and/or Torres Strait Islander origin can be difficult to determine and, as a result, the ABS has raised concerns regarding the quality of Indigenous deaths data.  The identification of an indigenous person may not be made by the family member, it could be a health worker or the funeral director during the death registration. This can result in wrong information being recorded or not enough information being provided on the indigenous status of the deceased. According to the ABS:

... it is recognised that not all Indigenous deaths are captured ... leading to under identification.  While data are provided to the ABS for the Indigenous status question for 98.9 per cent of all deaths, there are concerns regarding the accuracy of the data.[25]

As a result, the ABS requests that:

Caution should be exercised when interpreting data for Aboriginal and/or Torres Strait islander Australians ..., especially with regards to year-to-year change.[26]

Even taking this into account, suicide death rates are significantly higher for Indigenous Australians. Suicide accounted for four per cent of all Indigenous deaths in 2009 (97 deaths) compared to 1.5 per cent for the total population.[27]

Children and young people

The number of children under the age of 15 who commit suicide appears to be very small.  The ABS have raised concerns regarding the statistics and believe the number of suicides to be an underestimation. For this reason only limited data are published.[28] Between 1998 and 2008:

•        There were an average of 10.1 suicides deaths per year of children under the age of 15.

•        The average number of suicides of boys was 6.9 whilst of girls it was lower at 3.2.

•        The approximate rate for boys was 0.3 per 100 000 and 0.2 per 100 000 for girls.

•        The highest number was in 1999 with registered 17 deaths; the lowest was in seven deaths in 2006.

In 2009, the leading cause of death for young people aged 15–24 was suicide, with 259 deaths (20.5 per cent of all deaths within this age group). Of these deaths, 77.2 per cent were male deaths. These are preliminary statistics and once the 2009 deaths data are revised, it is expected that the number of suicide deaths will increase.

Table 7: Leading underlying causes of death among 15–24 year olds, 2009 (preliminary) (a)

15–24 years

Males

Females

Persons

Males

Females

Persons

Number

Age-specific death rate

Intentional self-harm (b)

200

59

259

12.5

3.9

8.3

Car occupant injured in transport accident

161

71

232

10.0

4.7

7.5

Accidental poisoning by & exposure to noxious substances

37

11

48

2.3

0.7

1.5

Motorcycle rider injured in transport accident

40

3

42

2.5

0.2

1.3

Other forms of heart disease

23

11

34

1.4

0.7

1.1

Assault

25

7

32

1.6

0.5

1.0

Malignant neoplasms of lymphoid, haematopoietic and related tissue

18

12

30

1.1

0.8

1.0

Accidental drowning and submersion

25

3

26

1.6

0.2

0.8

Episodic and paroxysmal disorders

16

6

22

1.0

0.4

0.7

Event of undetermined intent (c)

86

32

118

5.4

2.1

3.8

Total deaths 15-24 year olds

907

355

1262

56.5

23.6

40.6

(a) Data cells with small values have been randomly assigned to protect confidentiality.

(b) Care needs to be taken in interpreting figures relating to suicide.

(c) Event of undetermined intent refers to those cases where the intent of death is still unknown and yet to be determined, e.g. assault, accidental or suicide. The number of deaths within this category is expected to decrease when the 2009 figures are revised and once coroner cases are finalised.
Source: ABS, Causes of death 2009, cat. no. 3303.0, ABS, Canberra, 2011, data cube—underlying causes of death, table 1.3

Hospital data

Hospital separations can be used as an indicator of the size of the potential suicide situation by looking at those harming themselves (intentional self-harm) and needing hospitalization. Hospital separation is a term used in hospitals to count an episode of admitted care for a patient. An episode of care can be a total hospital stay (from admission to discharge, transfer or death), or a portion of a hospital stay (e.g. moving from intensive care to rehabilitation). [29] The same person may undergo more than one separation during the reference period.  As a result, the same individual could appear more than once in the separation statistics.

Most suicides deaths are males; however hospital separations for intentional self-harm show a large number of female separations. It is important to note that not all those who self-harm are intentionally attempting a fatal outcome and many of those that do self-harm do not visit a hospital for treatment; therefore, this does not give the true picture of self-harm injuries (see Suicide and self-harm).

Table 8: Hospital separations by intentional self-harm (a), by age and sex Australia (2008–09)

Males

Females

Total

Males

Females

Age

No. of separations

Per cent

0-14

138

488

626

22.0

78.0

15-24

2 663

6 011

8 674

30.7

69.3

25-34

3 039

4 021

7 060

43.0

57.0

35-44

2 905

4 346

7 251

40.1

59.9

45-54

1 763

2 985

4 748

37.1

62.9

55-64

923

1 140

2 063

44.7

55.3

65-74

332

351

683

48.6

51.4

75-84

226

250

476

47.5

52.5

85+

83

95

178

46.6

53.4

Total (a)

12 072

19 687

31 759

38.0

62.0

(a) Includes separations for which age was not reported

Source: AIHW Australian hospital statistics 2008–09, Health services series no. 33. Cat. no. HSE 71. customised

In 2008–09, 31 759 hospital separations were classified as a result of self-harm. This is similar to 2007–08 with 31 506 separations (29 per cent were persons aged 24 years and younger).[30] 

Even though there are limited statistics on the number of young children committing suicide, hospital separations show the number of children (aged 0-14) in hospital for intentional self-harm. In 2008–09, there were 626 separations within this age group—488 females and 138 males. However, according to the AIHW report Young Australians: their health and wellbeing 2007, it is likely that only a minority of young people who self-harm seek medical treatment, and survey data suggests that only ten per cent of young people who self-harm present for hospital treatment.[31]

Comparative international suicide statistics

Comparing international suicide statistics can be problematic due to different methodologies used (e.g. determining suicide when it isn’t clear cut), data quality issues and the frequency of collections. However, in saying this, all countries, including Australia use the International Classification of Deaths (ICD–10), coding suicide to X60–X84 (known as intentional self-harm).  This does provide some consistency.

Table 8 lists those countries in the Organisation for Economic Co-operation and Development (OECD) by the suicide rate per 100 000 by sex.  Data are from various sources and have different reference periods. 

Greece had the lowest rate of suicide at 3.0 per 100 000 people (2009), whilst the highest was Japan at 24.4 per 100 000 people (2007). Australia ranked 9th lowest at 9.7 (2009). Males, as in Australia, have a much higher rate of suicide compared to females across the OECD. The highest rates of male suicide was in Hungary (37.1 per 100 00 males in 2009) and Japan (35.8 per 100 00 males in 2007) with the lowest rates in Greece (5.2 in 2009) and Mexico (6.8 in 2006).  

Table 9: International suicide deaths comparisons: Age-standardised death rates per 100,000 population (a)

OECD

Males

Females

Total

Source

countries

Year

Suicide rate

Australia

2009

14.9

4.5

9.7

(a)

Austria

2009

20.9

5.7

15.4

(b)

Canada

2007

19.3

1.0

10.0

(c)

Czech Republic

2009

21.8

3.7

12.4

(b)

Denmark p

2009

15.8

4.3

9.9

(b)

Finland

2009

27.3

9.5

18.3

(b)

France (metropolitan)

2008

23.2

7.5

14.9

(b)

Germany

2009

15.1

4.4

9.5

(b)

Greece

2009

5.2

0.9

3.0

(b)

Hungary

2009

37.1

8.8

21.8

(b)

Iceland

2009

18.3

4.6

11.5

(b)

Ireland

2009

18.6

4.7

11.6

(b)

Italy

2008

8.7

2.4

5.4

(b)

Japan

2007

35.8

13.7

24.4

(d)

Rep. of Korea

2006

29.6

14.1

21.9

(d)

Luxembourg

2008

13.2

2.9

7.8

(b)

Mexico

2006

6.8

1.3

4.0

(d)

Netherlands

2009

12.0

5.0

8.5

(b)

New Zealand

2007

17.4

4.9

11.0

(e)

Norway

2009

16.5

6.5

11.5

(b)

Poland

2009

28.2

4.3

15.8

(b)

Portugal

2009

13.4

3.1

7.8

(b)

Slovakia

2009

19.8

1.9

10.3

(b)

Spain

2008

10.4

2.8

6.5

(b)

Sweden

2009

17.7

7.1

12.3

(b)

Switzerland

2007

21.8

9.1

15.1

(b)

United Kingdom

2009

17.5

5.2

..

(f)

United States

2007

18.4

4.7

11.3

(g)

OECD average

2006

17.6

5.2

11.1

(d)

p: provisional value
Sources:
(a) ABS, Causes of Death 2009, cat. no. 3303.0, ABS, Canberra, 2011.
(b) European Commission, Eurostat database.
(c) Statistics Canada, Mortality, Summary List of Causes: 2007, cat no. 84F0209X, p. 14.
(d) World Health Organisation, Mental health, country report.
(e) The Ministry of Social Development, The social report: 2010, New Zealand, p. 29 .
(f) Office for National Statistics, Statistical Bulletin, Suicide rates in the United Kingdom, 2000–2009, UK, 2011, pp. 4, 6.
(g) U.S. Department of Health and Human Services, Division of Vital Statistics, Centre for Disease Control and Prevention, National Centre for Health Statistics, National Vital Statistics Report: 2007, vol. 58, no. 19, 2010, USA, p. 76.

Conclusion

As discussed in the paper, determining the true number of suicide deaths is not straightforward. It is complex and may take a Coroner sometime to determine confidently whether a death was suicide. Due to the lengthy process, any data in this report for 2008 and 2009 will be revised, most likely upwards. As a result, care needs to be taken when using and interpreting data on suicide.

Notwithstanding the data difficulties surrounding suicide statistics, the data are sufficiently robust to see general trends.  These trends include:

•        the rate of suicide is slowly declining in Australia;

•        many more males than females continue to commit suicide;

•        the suicide rate of indigenous people and those in remote areas remains higher than the general population; and

•        the majority of those who attempt suicide have had a previous diagnosis of a mental illness.

In the Senate Inquiry The hidden toll: Suicide in Australia, the following recommendations are listed in relation to data accuracy: [32]

Recommendation 2: The Committee recommends that Commonwealth, State and Territory governments, in consultation with the National Committee for Standardised Reporting on Suicide, implement reforms to improve the accuracy of suicide statistics.

Recommendation 3: The Committee recommends that the Standing Committee of Attorneys-General, in consultation with the National Committee for Standardised Reporting on Suicide, standardise coronial legislation and practices to improve the accurate reporting of suicide.

Recommendation 4: The Committee recommends all Australian governments implement a standardised national police form for the collection of information regarding a death reported to a coroner. 

In time, suicide data in Australia may more accurately report the true number of people who are dying tragically by taking their own life.

Publications and reports

Australian Bureau of Statistics

•        Causes of Deaths, Australia (cat. no. 3303.0)—annual http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3303.02009?OpenDocument

•        Suicides, Australia (cat. no. 3309.0)—annual http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3309.01921%20to%201998?OpenDocument

•        Suicides, Australia, 1921–1998 (cat no. 3309.0) http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3309.01921%20to%201998

•        National Survey of Mental Health and Wellbeing: Summary of results, 2007 (cat no. 4326.0) http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4326.0Main+Features12007?OpenDocument

Australian Institute of Health and Welfare

•        A review of suicide statistics in Australia, July 2009 http://www.aihw.gov.au/publications/index.cfm/title/10754

•        A snapshot of men’s health in regional and remote Australia, March 2010 http://www.aihw.gov.au/publications/phe/120/10742.pdf

•        Young Australians: their health and wellbeing, 2011 http://www.aihw.gov.au/publication-detail/?id=10737419261&tab=2

•        Australian Hospital Statistics—annual http://www.aihw.gov.au/publication-detail/?id=10737418863

Other reports

•        The Senate, Community Affairs Reference Committee, The Hidden Toll: Suicide in Australia, June 2010 http://www.aph.gov.au/senate/committee/clac_ctte/suicide/report/report.pdf

Appendix

Table A: Suicide deaths by year of registration by sex, 1921–2009: number, crude rate and age-standardised death rate (a)

Person Count

Males as percentage of total

Crude suicide rate (b)

Age-standardised death rate (c)

Year

Male

Female

Total

Male

Female

Total

Male

Female

Total

1921

510

111

621

82.1

18.4

4.1

11.4

22.6

4.8

14.0

1922

441

92

533

82.7

15.6

3.4

9.6

19.8

3.8

12.0

1923

492

107

599

82.1

17.0

3.8

10.5

21.0

4.3

12.9

1924

534

119

653

81.8

18.0

4.2

11.2

22.2

4.7

13.7

1925

569

131

700

81.3

18.8

4.5

11.8

23.3

5.1

14.4

1926

583

128

711

82.0

18.9

4.3

11.7

22.8

5.1

14.2

1927

598

142

740

80.8

18.9

4.7

12.0

22.7

5.3

14.2

1928

635

142

777

81.7

19.7

4.6

12.3

23.6

5.2

14.6

1929

644

141

785

82.0

19.7

4.5

12.3

22.9

5.0

14.1

1930

791

152

943

83.9

24.0

4.8

14.6

28.1

5.2

16.8

1931

689

138

827

83.3

20.7

4.3

12.7

24.5

4.7

14.7

1932

598

156

754

79.3

17.9

4.8

11.5

20.9

5.2

13.1

1933

633

157

790

80.1

18.8

4.8

11.9

21.4

5.1

13.3

1934

643

183

826

77.8

19.0

5.6

12.4

21.8

5.9

13.9

1935

612

181

793

77.2

17.9

5.5

11.8

20.1

5.8

13.0

1936

611

178

789

77.4

17.8

5.3

11.6

20.1

5.5

12.8

1937

573

148

721

79.5

16.6

4.4

10.5

18.6

4.6

11.6

1938

574

172

746

76.9

16.4

5.0

10.8

18.2

5.3

11.7

1939

602

179

781

77.1

17.1

5.2

11.2

18.9

5.4

12.1

1940

468

175

643

72.8

16.0

5.0

10.6

17.2

5.3

11.2

1941

463

161

624

74.2

12.9

4.6

8.8

14.4

4.6

9.4

1942

432

162

594

72.7

12.0

4.5

8.3

12.8

4.6

8.7

1943

376

140

516

72.9

10.3

3.9

7.1

11.6

4.0

7.7

1944

362

178

540

67.0

9.9

4.9

7.4

11.0

5.0

7.9

1945

394

173

567

69.5

10.6

4.7

7.7

11.8

4.7

8.2

1946

513

219

732

70.1

13.7

5.9

9.8

15.0

6.1

10.4

1947

546

200

746

73.2

14.4

5.3

9.8

15.8

5.4

10.5

1948

578

159

737

78.4

15.0

4.1

9.6

16.4

4.2

10.2

1949

599

174

773

77.5

15.1

4.4

9.8

16.7

4.6

10.5

1950

567

193

760

74.6

13.8

4.8

9.3

15.4

4.9

10.0

1951

608

197

805

75.5

14.3

4.7

9.6

15.6

4.9

10.2

1952

694

225

919

75.5

15.9

5.3

10.6

17.6

5.5

11.5

1953

698

261

959

72.8

15.6

6.0

10.9

17.4

6.2

11.7

1954

724

245

969

74.7

15.9

5.5

10.8

18.0

5.8

11.7

1955

701

245

946

74.1

15.1

5.4

10.3

17.2

5.6

11.2

1956

751

270

1 021

73.6

15.7

5.8

10.8

17.7

6.2

11.8

1957

844

326

1 170

72.1

17.3

6.9

12.1

19.4

7.2

13.2

1958

910

297

1 207

75.4

18.3

6.1

12.3

20.7

6.5

13.4

1959

827

288

1 115

74.2

16.3

5.8

11.1

18.4

6.1

12.1

1960

778

314

1 092

71.2

15.0

6.2

10.6

17.1

6.6

11.7

1961

901

348

1 249

72.1

17.0

6.7

11.9

19.0

7.3

13.0

1962

1 011

458

1 469

68.8

18.7

8.6

13.7

21.2

9.3

15.2

1963

1 143

575

1 718

66.5

20.8

10.6

15.8

23.7

11.6

17.5

1964

1 071

549

1 620

66.1

19.1

10.0

14.6

21.9

10.8

16.2

1965

1 075

610

1 685

63.8

18.8

10.8

14.9

21.4

11.9

16.5

1966

1 017

607

1 624

62.6

17.4

10.5

14.0

20.0

11.6

15.6

1967

1 125

653

1 778

63.3

18.9

11.1

15.1

21.9

12.2

16.9

1968

1 022

505

1 527

66.9

16.9

8.5

12.7

19.3

9.3

14.1

1969

1 025

477

1 502

68.2

16.6

7.8

12.2

19.2

8.6

13.7

1970

1 076

475

1 551

69.4

17.1

7.6

12.4

19.4

8.3

13.7

1971

1 150

588

1 738

66.2

17.5

9.0

13.3

19.8

9.9

14.7

1972

1 085

540

1 625

66.8

16.2

8.2

12.2

18.4

8.9

13.5

1973

1 036

492

1 528

67.8

15.3

7.3

12.4

17.2

7.9

12.4

1974

1 073

494

1 567

68.5

15.6

7.2

13.3

17.5

7.8

12.5

1975

1 050

478

1 528

68.7

15.1

6.9

12.2

16.9

7.5

12.0

1976

1 098

406

1 504

73.0

15.6

5.8

11.3

17.3

6.2

11.6

1977

1 128

438

1 566

72.0

15.9

6.2

11.4

17.4

6.6

11.9

1978

1 126

469

1 595

70.6

15.7

6.5

11.0

17.0

7.0

11.8

1979

1 198

479

1 677

71.4

16.5

6.6

11.6

17.6

6.9

12.2

1980

1 199

408

1 607

74.6

16.3

5.5

10.9

17.6

5.9

11.6

1981

1 259

413

1 672

75.3

16.9

5.5

11.2

18.1

5.8

11.8

1982

1 318

459

1 777

74.2

17.4

6.0

11.7

18.5

6.3

12.2

1983

1 308

418

1 726

75.8

17.0

5.4

11.2

18.0

5.6

11.6

1984

1 309

403

1 712

76.5

16.8

5.2

11.0

17.6

5.3

11.3

1985

1 428

399

1 827

78.2

18.1

5.0

11.6

18.7

5.1

11.8

1986

1 531

451

1 982

77.2

19.1

5.6

12.4

19.8

5.7

12.6

1987

1 773

467

2 240

79.2

21.8

5.7

13.8

22.5

5.7

13.9

1988

1 730

467

2 197

78.7

21.0

5.6

13.3

21.5

5.6

13.4

1989

1 658

438

2 096

79.1

19.8

5.2

12.5

20.1

5.2

12.5

1990

1 735

426

2 161

80.3

20.4

5.0

12.7

20.7

4.9

12.7

1991

1 847

513

2 360

78.3

21.4

5.9

13.7

21.7

5.9

13.7

1992

1 820

474

2 294

79.3

20.9

5.4

13.1

21.1

5.3

13.1

1993

1 687

394

2 081

81.1

19.2

4.4

11.8

19.3

4.3

11.7

1994

1 830

428

2 258

81.0

20.6

4.8

12.6

20.7

4.7

12.6

1995

1 873

495

2 368

79.1

21.1

5.5

13.1

21.1

5.5

13.0

1996

1 931

462

2 393

80.7

21.5

5.1

13.1

21.5

5.1

13.0

1997

2 143

577

2 720

78.8

23.6

6.2

14.7

23.6

6.2

14.6

1998

2 150

533

2 683

80.1

23.1

5.7

14.3

23.2

5.6

14.3

1999

2 002

490

2 492

80.3

21.3

5.1

13.2

21.3

5.1

13.2

2000

1 864

503

2 367

78.7

19.6

5.2

12.4

19.6

5.2

12.4

2001

1 936

521

2 457

78.8

20.1

5.3

12.7

20.1

5.3

12.7

2002

1 817

503

2 320

78.3

18.6

5.1

11.8

18.6

5.1

11.8

2003

1 737

477

2 214

78.5

17.6

4.8

11.1

17.6

4.8

11.1

2004

1 661

437

2 098

79.2

16.6

4.3

10.4

16.6

4.3

10.4

2005

1 658

444

2 102

78.9

16.4

4.3

10.3

16.4

4.3

10.3

2006

1 398

401

1 799

77.7

13.6

3.9

8.7

13.6

3.9

8.7

2007

1 699

530

2 229

76.2

15.3

4.6

9.9

16.2

5.0

10.6

2008(d)

1 785

497

2 282

78.2

16.0

4.5

10.2

16.7

4.6

10.6

2009(d) (d) (d)(d)

1 633

499

2 132

76.6

..

..

..

14.9

4.5

9.7

(a) Includes ICD-10 codes X60—X84 (intentional self harm) and Y87.0 (sequelae of intentional self-harm, assault and events of undetermined intent).
(b) Crude death rate per 100 000 estimated resident population as at 30 June from 1992. For years prior to 1992, the crude death rate was based on the mean estimated population for the calendar year.
(c) Standardised death rates (SDRs) enable the comparison of death rates between populations with different age structures by relating them to a standard population. The ABS standard populations relate to the years ending in 1 (e.g. 2001). The current standard population is all persons in the Australian population at 30 June 2001.
(d) Causes of death data for 2008 and 2009 are preliminary and subject to a revisions process.
Source: ABS, Causes of Death 2009, cat. no. 3303.0, ABS, Canberra, 2010

Table B: Suicide deaths by age-specific death rates by age and sex: 1999–2009 (a) (b)

Age group (years)

Year

15-24

25-34

35-44

45-54

55-64

65-74

75-84

85 & over

All ages(g)

Male

1999

23.3

35.4

29.3

24.4

20.6

22.3

28.3

39.8

21.3

2000

19.8

33.3

30.2

22.4

16.4

19.2

22.7

46.4

19.6

2001

20.4

34.0

30.3

23.4

19.0

19.9

22.8

31.7

20.1

2002

19.0

30.9

29.0

22.6

16.2

17.8

20.0

34.0

18.6

2003

18.0

28.3

25.7

22.1

15.1

19.5

21.1

31.8

17.6

2004

13.8

27.3

25.6

18.7

15.8

20.3

23.3

33.1

16.6

2005

16.1

25.2

24.7

22.6

14.7

14.2

19.0

33.9

16.4

2006

12.9

16.1

20.1

20.5

15.5

13.8

15.5

34.5

13.6

2007

15.4

23.2

24.5

21.6

17.2

14.8

21.3

29.3

16.2

2008

14.4

22.7

26.4

23.0

17.2

18.7

20.1

27.5

16.7

2009

12.5

19.8

22.8

21.6

17.6

13.4

20.0

28.2

14.9

Female

1999

5.6

8.0

7.1

7.7

5.0

4.3

3.9

3.0

5.1

2000

5.8

7.3

8.9

5.2

5.9

6.0

5.0

3.4

5.2

2001

4.8

7.5

8.0

8.0

5.3

4.8

5.3

6.5

5.3

2002

4.2

7.1

8.1

7.0

5.9

4.4

4.6

7.9

5.1

2003

3.6

7.7

6.8

6.8

5.9

4.8

3.5

2.6

4.8

2004

5.1

5.4

6.0

6.4

3.9

4.1

6.4

2.5

4.3

2005

4.1

5.5

6.2

6.0

4.6

5.3

5.8

3.4

4.3

2006

3.8

4.0

5.7

5.1

5.4

4.4

4.8

4.1

3.9

2007

4.6

6.2

7.1

7.4

7.2

4.6

4.1

4.8

5.0

2008

4.0

5.8

7.1

7.5

5.0

4.8

3.5

3.8

4.6

2009

3.9

6.0

6.1

7.2

5.6

4.2

4.0

5.3

4.5

Total

1999

14.6

21.7

18.1

16.1

12.9

12.9

13.9

14.2

13.2

2000

12.9

20.2

19.5

13.8

11.2

12.4

12.4

16.6

12.4

2001

12.8

20.7

19.1

15.7

12.2

12.1

12.6

14.3

12.7

2002

11.8

19.0

18.5

14.8

11.1

10.9

11.1

16.0

11.8

2003

10.9

17.9

16.2

14.4

10.5

11.9

11.0

11.7

11.1

2004

9.5

16.3

15.7

12.5

9.9

12.0

13.7

12.1

10.4

2005

10.2

15.3

15.4

14.3

9.7

9.7

11.5

13.1

10.3

2006

8.5

10.1

12.9

12.7

10.4

9.0

9.5

14.0

8.7

2007

10.1

14.7

15.7

14.4

12.2

9.6

11.7

12.9

10.6

2008p

9.3

14.3

16.7

15.2

11.1

11.6

10.9

11.7

10.6

2009p

8.3

13.0

14.4

14.3

11.6

8.7

11.2

13.1

9.7

(a) Includes ICD-10 codes X60—X84 (intentional self harm) and Y87.0 (sequelae of intentional self-harm, assault and events of undetermined intent).
(b) Deaths per 100 000 estimated resident population as at 30 June for each age group and sex.
(c) Crude death rate per 100 000 estimated resident population as at 30 June. Includes deaths of persons aged under 15 years and age not stated.
(d) Causes of death data for 2008 and 2009 are preliminary and subject to a revisions process.
Source: ABS, Cause of Death 2009, cat. no. 3303.0, ABS,  2010

Table C: Suicide deaths by statistical division of usual residence, 2008 and 2009 (a)

Statistical division of usual residence

2009

2008

Sydney

320

355

Hunter

59

48

Illawarra

31

42

Richmond-Tweed

13

33

Mid-North Coast

26

25

Northern

5

11

North Western

2

5

Central West

15

11

South Eastern

9

26

Murrumbidgee

16

11

Murray

13

12

Far West

3

3

New South Wales

512

582

Melbourne

337

366

Barwon

30

37

Western District

9

7

Central Highlands

30

19

Wimmera

7

6

Mallee

12

9

Loddon

22

20

Goulburn

24

22

Ovens-Murray

11

10

East Gippsland

10

7

Gippsland

18

27

Victoria

510

530

Brisbane

194

211

Gold Coast

59

73

Sunshine Coast

36

27

West Moreton

15

11

Wide Bay-Burnett

39

42

Darling Downs

32

32

South West

3

0

Fitzroy

27

28

Central West

1

3

Mackay

20

21

Northern

17

41

Far North

36

42

North West

1

5

Queensland

480

536

Adelaide

145

125

Outer Adelaide

10

16

Yorke and Lower North

6

1

Murray Lands

5

9

South East

9

8

Eyre

1

3

Northern

8

11

South Australia

184

173

Perth

187

219

South West

27

20

Lower Great Southern

8

6

Upper Great Southern

4

8

Midlands

6

10

South Eastern

8

9

Central

12

5

Pilbara

5

3

Kimberley

13

16

Western Australia

270

296

Greater Hobart

39

27

Southern

6

7

Northern

26

27

Mersey-Lyell

12

12

Tasmania

83

73

Darwin

20

23

Northern Territory - Bal

18

15

Northern Territory

38

38

Canberra

32

36

Australian Capital Territory - Bal

0

0

Australian Capital Territory

32

36

Other

16

11

Total (including Other Territories)

2132

2282

(a) Causes of death data for 2008 and 2009 are preliminary and subject to revision.
Source: ABS, Cause of Death 2009, cat. no. 3303.0, ABS, 2010, customised data request.

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[1].              Australian Bureau of Statistics (ABS), Causes of death, Australia, 2009, cat. no. 3303.0, ABS, Canberra, 2011, p. 37, viewed 29 June 2011, http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/83A6580246688CEBCA2578840012A073/$File/33030_2009.pdf

[2].              H Hendin et al, eds, Suicide and suicide prevention in Asia, WHO, Geneva, 2008, p. 1, viewed 29 June, 2011, http://www.who.int/mental_health/resources/suicide_prevention_asia.pdf 

[3].              World Health Organization (WHO), ‘How can suicide be prevented?’, WHO website, viewed 29 June 2011, http://www.who.int/features/qa/24/en/index.html

[4].              Organisation for Economic Co-Operation and Development (OECD), ‘Health at a glance 2009: OECD indicators’, Suicide, OECD website, viewed, 29 June 2011, http://www.oecd-ilibrary.org/sites/health_glance-2009-en/01/07/index.html?contentType=/ns/Chapter,/ns/StatisticalPublication&itemId=/content/chapter/health_glance-2009-9-en&containerItemId=/content/serial/19991312&accessItemIds=&mimeType=text/html

[5].              ABS, Causes of death, 2009, op. cit., p. 25.

[6].              The International Classification of Diseases (ICD) is endorsed by the World Health Organization (WHO) and is primarily designed for the classification of diseases and injuries with a formal diagnosis. The ICD–10 is the current classification system, which is structured using an alphanumeric coding scheme. Each disease or health problem is assigned a 3–digit identification code, which is assigned to the deceased by a doctor or coroner. World Health Organization (WHO), ‘International Classification of Diseases (ICD)’, WHO website, viewed 29 June 2011, http://www.who.int/classifications/icd/en/

[7].              J E Harrison et al, eds, ‘A review of suicide statistics in Australia’, Injury research and statistics series no. 49, Australian Institute of Health and Welfare (AIHW), Cat. no. INJCAT 121, Canberra: AIHW, 28 July 2009, p. 2, viewed 29 June 2011, http://www.aihw.gov.au/publications/index.cfm/title/10754

[8].              G Martin, SV Swannell, PL Hazell, JE Harrison and AW Taylor, ‘Self-injury in Australia: a community survey’, Medical Journal of Australia, vol. 193, no. 9, 1 November 2010, p. 506, viewed 29 June 2011 http://www.mja.com.au/public/issues/193_09_011110/mar10485_fm.html

[9].              Senate Community Affairs References Committee, The hidden toll: suicide in Australia, The Senate, Canberra, June 2010, p. 15, viewed 29 June 2011, http://www.aph.gov.au/senate/committee/clac_ctte/suicide/report/index.htm

[10].              ABS, Causes of death, 2009, op. cit., p. 39.

[11].              Ibid., p. 39.

[12].              For more information on the ABS revision process see Explanatory Notes, page 39, points 28 to 32 Australian Bureau of Statistics (ABS), Causes of death, Australia, 2009, cat. no. 3303.0, ABS, Canberra.

[13].              AIHW, A review of suicide statistics in Australia, op. cit., p. 19.

[14].              Senate Community Affairs References Committee, The hidden toll: suicide in Australia, op. cit., p. 20.

[15].              Ibid., p. 20.

[16].              ABS, Causes of death, 2009, op. cit., p. 29.

[17]              AIHW, A review of suicide statistics in Australia, op. cit., p. 19.

[18].              The age-specific death rate refers to the number of deaths during the reference year at a specified age per 100 000 of the estimated resident population of the same age at the mid-point of the year (30 June).

[19].              Australian Bureau of Statistics (ABS), Suicide, Australia 1921–1998, cat no. 3309.0, ABS, Canberra, 2000, p. 4, viewed 30 June 2011, http://www.abs.gov.au/AUSSTATS/abs@.nsf/allprimarymainfeatures/0251B225B0D8F5A5CA257130007050B9?opendocument

[20].              Australian Bureau of Statistics (ABS), National survey of mental health and wellbeing: summary of results, 2007, cat. no. 4326.0, Canberra, 008, pp. 38–40, viewed 30 June 2011, http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/6AE6DA447F985FC2CA2574EA00122BD6/$File/43260_2007.pdf

[21].              According to the ABS, to estimate the prevalence of specific mental disorders, the 2007 Survey of Mental Health and Wellbeing used the World Mental Health Survey Initiative version of the World Health Organization’s Composite International Diagnostic Interview (version 3). Through this interview process a diagnosis was determined in regards to mental health. This was not a clinical diagnosis undertaken by a doctor. Ibid, p. 53. For more information on determining mental disorders see: Appendix 1, ICD-Diagnoses, National survey of mental health and wellbeing: summary of results, 2007, cat. no. 4326.0 pp. 65–73.

[22].              According to the ABS, a lifetime mental disorder refers to a person who has had a mental disorder at some point in their life, but may not have experienced symptoms in the previous 12 months. Mental disorders include: anxiety disorders (i.e. panic disorders, agoraphobia, post-traumatic stress disorder), affective disorders (i.e. mood disturbances such as depressive episodes or bipolar affective disorders), substance use disorders (i.e. alcohol harmful use, drug use disorder).

[23].              Australian Institute of Health and Welfare (AIHW): A snapshot of men’s health in regional and remote Australia, Rural health series no 11, cat no. PHE 120 Canberra, AIHW, p. 26, viewed 30 June 2011  http://www.aihw.gov.au/publications/phe/120/10742.pdf

              The Remoteness Classification is part of the Australian Standard Geographical Classification (ASGC RA). The ASGC RA allocates one of five remoteness categories to areas—Major cities, Inner regional, Outer regional, Remote and Very remote. While the ASGC RA provides a useful aggregation of remoteness categories for statistical purposes, the classification of cities and towns to remoteness categories does not always correspond with common perceptions, for example the Inner regional category contains cities such as Campbelltown, Hobart and Darwin. Furthermore, areas that are defined as ‘remote’ may differ dramatically in their location, economic activities, climate and demography. As the five categories are broad, it is likely that health status will vary within each of them. Where appropriate, this aggregated data should be considered alongside specific area statistics. Ibid., p. 4.

[24].              An example of a report that contains suicide data by farming occupation is The mental health of people on Australian farms–the facts, 2008 by Fragar L, Henderson A, Morton C, and Pollock K., Farm Health and Safety Joint Research Venture, Rural Industries Research and Development Corporation, p.20, https://rirdc.infoservices.com.au/items/08-139

[25].              ABS, Causes of death, 2009, op. cit., p. 42.

[26].              Ibid., p. 43.

[27].              Ibid., p. 31.

[28].              The only data available on the number of suicide deaths for under 15 year olds are from the 2008 Causes of death report, no figures were released in the 2009 report. Australian Bureau of Statistics (ABS), Causes of death, Australia, 2008, cat. no. 3303.0, ABS, Canberra, 2009, p. 65, viewed 30 June 2011, http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/E8510D1C8DC1AE1CCA2576F600139288/$File/33030_2008.pdf

[29].              Australian Institute of Health and Welfare 2010, Australian hospital statistics 2008–09 Health services series No. 17. Cat. no. HSE 84. Canberra: AIHW, p. 351, viewed 30 June 2011 http://www.aihw.gov.au/publications/hse/84/11173.pdf

[30].              Ibid., p. 389

[31].              Australian Institute of Health and Welfare 2007, Young Australians: their health and wellbeing 2007, cat. no. PHE 87, Canberra, AIHW, p. 28, viewed 30 June 2011 http://www.aihw.gov.au/publications/aus/yathaw07/yathaw07.pdf

[32].              Senate Community Affairs References Committee, The hidden toll: suicide in Australia, op. cit., p. xvii