WARNING: This following report includes information on suicides. For help or information contact beyondblue on 1300 224 636, or Lifeline on 13 11 14.

Suicide

The possibility of increased suicide deaths has been a long running concern throughout the COVID-19 pandemic. However, newly released data from the Australian Bureau of Statistics (ABS) show that the rate of suicide in 2020 dropped slightly when compared with previous years. The age-standardised suicide rate was 12.1 per 100,000 people in 2020 compared to 12.9 in 2019 and 12.6 in 2018 (see Chart 1).

Whilst there has not been an increase in the number of suicides during the pandemic, there is data showing heightened levels of distress and increased demand for mental health services. This article briefly explores the ABS data on suicide, data on suspected suicides from Victoria and New South Wales, and other data suggesting that the mental wellbeing of Australians has been affected by the pandemic.

It is important to note that suicide is often, but not always associated with mental ill-health. A 2007 survey found one in four people who made a suicide attempt did not access services for concerns about their mental health in the previous 12 months. The National Suicide Prevention Adviser's Final Advice calls for Governments to use all touchpoints (that is, beyond health portfolios) to respond earlier and more proactively to distress.

In 2020, there were 3,139 deaths due to suicide in Australia (2,384 males and 755 females). This compares to 3,318 suicides in 2019 (2,502 males and 816 females). For females, the suicide rate was the lowest since 2013 and for males the lowest since 2016. In 2020, suicide was the 15th leading cause of death compared to the 13th in 2019. Over 90% of people who died by suicide in 2020 had risk factors identified including depression, substance use and abuse, and issues in spousal relationships.

Chart 1: age-standardised (a) suicide rate per 100,000 by sex, 2000-2020

(a) Standardised death rates (SDRs) enable the comparison of death rates between populations with different age structures by relating them to a standard population.

Source: Australian Bureau of Statistics (ABS), Causes of Death, Australia: 2020, ABS, Canberra, 2021.

Victoria and New South Wales: suspected suicides

Both New South Wales and Victoria have tracked suspected suicides on a monthly basis throughout the COVID-19 pandemic. These two states have had the longest and most restrictive lockdowns throughout the pandemic to date and this data provides an insight to suicide mortality during lockdowns. Thus far, there is no evidence of a pattern of increase in 2020 or 2021 relative to previous years (see Table 1). While pandemic impacts would be expected to increase risk factors, this may have been countered by protective factors such as income and business supports, and investments in additional mental health and community services. Note that these figures will differ from suicide statistics reported by the ABS, which only counts suicide deaths which have been confirmed or are being finalised through the coronial process.

Table 1: suspected suicides registered in Victoria and New South Wales by month

Sources: Coroners Court of Victoria (CCV), Coroners Court monthly suicide data report: August 2021 update, CCV, 2021, p. 3; NSW Health, NSW Suicide Monitoring System, Report 10, NSW Health, August 2021, [p. 2].

Emotional and mental wellbeing

The Australian National University has been tracking the wellbeing of people during COVID-19 and in their September 2021 report found (p. iii): ‘There has been a large increase in anxiety and worry due to COVID-19 between April and August 2021, from 49.8% to 60.9%. The increase in New South Wales was from 50.7% to 67.9%, the largest increase amongst the states and territories.’ It reported that:

Life satisfaction declined substantially between April 2021 and August 2021, falling to similar low rates of life satisfaction observed at the peak of the first wave of COVID-19 in Australia in April 2020.

And:

There was only a small increase in the proportion of Australians who reported they were lonely at least some of the time since April 2021 (from 35.5% to 37.6%).

- For Sydneysiders the increase was from 35.3% to 44.3%, with the rest of Australia essentially remaining constant (at 34.0% in April compared to 34.6% in August).

Mental health services

The Australian Institute of Health and Welfare’s Mental health services in Australia report examines trends in mental health-related service usage during the COVID-19 pandemic. Some of the key findings in July 2021 include:

• substantial increases in demand have been witnessed across support organisations such as Lifeline, Kids Helpline and Beyond Blue. According to Lifeline, as at 20 August 2021, the four busiest days in Lifeline’s 57-year history all occurred in August 2021
• from mid-May 2020 to mid-Feb 2021 the weekly volume of mental health-related Pharmaceutical Benefits Scheme prescriptions dispensed tracked above the same period one year prior and
• between 16 March 2020 and 25 April 2021, over 15.0 million Medicare-subsidised mental health-related services were processed nationally, with nearly 30% (almost 4.5 million) delivered via telehealth.

There have also been recent media reports of increased demand for psychologists and increased emergency department mental health presentations.

Conclusion

Suicide can result from complex interactions between multiple stressors and risk factors, for example family crisis, relationship breakdown, loss of social connection, financial distress, health concerns, job loss or business failure, which may have been exacerbated for some people by the COVID-19 pandemic. Given the uncertainties around the pandemic itself and its medium and long-term impacts, it is important to continue to track suicides and other indicators of distress to help inform policy decisions to achieve a more responsive system that can better support people in our community.