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Situational Approach Fact Sheet November 2019 Final

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Situational Approach Fact Sheet November 2019 Final Male Suicide Prevention AUSTRALIA FACT SHEET SUICIDE PREVENTION AND MENTAL DISORDERS The toll of suicide deaths in Australia continues to rise – despite substantial funding provided to the suicide prevention sector. This FACT SHEET presents some important information that is often over-looked in the current approach to suicide prevention in Australia. It is vital for effective suicide prevention that information that is presented to the community gives a fair and honest account of the key issues and factors involved in suicide deaths. SUICIDE – RATES AND NUMBERS ECONOMIC COST DEPRESSION/MENTAL DISORDER DEFICITS OF CURRENT APPROACH CONTENTS A. FACTS AT A GLANCE ................................................................. 2 B. SOME INFORMATION ABOUT THESE FACTS ............... 3 C. REFERENCES .................................................................................. 7 D. LINKS TO USEFUL PAPERS AND RESOURCES ........... 9 PREPARED BY John Ashfield PhD, Anthony Smith and Neil Hall PhD FACT SHEET SUICIDE PREVENTION AND MENTAL DISORDERS – JUNE 2019 COPYRIGHT © DR JOHN ASHFIELD AND ANTHONY SMITH 2019 1 ////// A. At A Glance Suicide – Rates and Numbers Depression/Mental Disorder • Suicide deaths in Australia now amount to • The rate of anti-depressant use in Australia around 3,000 per annum (3,128 in 2017) is amongst the highest in the world • There is common agreement in Australia • There is a great deal of disagreement in that the suicide figures are considerably expert opinion over the effectiveness and under-reported dangers of anti-depressants • There are a range of factors that contribute • Workplace ‘mental disorder’ claims are to suicide deaths misleading because they are due largely to • The majority of all suicide deaths are work place stress people who are not employed • Clinically diagnosed psychiatric disorders • The majority of Australian suicide deaths are a factor in only a relatively very few are city dwelling adults suicide deaths • There are significant gender differences in suicide deaths and intentional non-fatal self-harm Deficits of current approach • There are significant shortcomings in the scope of current suicide research Economic Cost • There is growing concern about the • As well as the enormous social cost of significant deficits within the current suicide deaths, there is an enormous approach to suicide prevention Australia economic cost • There is a significant cost burden on the insurance industry due to suicide • Current suicide prevention programs and campaigns are costly, and largely ineffectual FACT SHEET SUICIDE PREVENTION AND MENTAL DISORDERS – JUNE 2019 2 COPYRIGHT © DR JOHN ASHFIELD AND ANTHONY SMITH 2019 ////// B. Information about these facts Suicide deaths in Australia now amount The majority of Australian suicide deaths to around 3,000 per annum. (3,128 in are city dwelling adults1, 9 2017)1 The five (5) cities of Sydney, Melbourne, This is about twice the rate of fatalities Brisbane, Adelaide and Perth together from all motor vehicle accidents and make up over half (54.18%) of all suicide homicides combined.1 These numbers have deaths in Australia. In general, the rural been rising steadily for a decade or more – rate for suicide deaths is higher than for despite the substantially increased funding metropolitan areas. However, this is a into the suicide prevention/mental health considerable generalisation: rates of suicide sector over this period. deaths vary enormously if measured by local government areas for both rural and metropolitan areas9. Some metropolitan There is common agreement in Australia areas have both higher rates of suicide that the suicide figures are considerably deaths as well as considerably higher under-reported.2 numbers of suicides than the general rural rates and numbers. It is generally agreed that the suicide figures are under–reported by 20-30%. Gender Difference: there is significant gender difference in suicide deaths and There are a range of factors that intentional non-fatal self-harm 10 contribute to suicide deaths. These include unemployment, relationship At least 75% of all suicide deaths in 1 breakdown, isolation, financial stress, history Australia are men ; most incidents of self-harm, drug and alcohol abuse, and of intentional non-fatal self-harm 11 mental health difficulties3 are female . Acknowledging gender difference and developing strategies to suit is vital if we are to reduce the numbers of suicide deaths and incidents of intentional The majority of all suicide deaths are non-fatal self-harm. people who are not employed.4, 5 Suicide deaths among those who are not Many men (probably the great majority) employed account for at least 55% of all who kill themselves do so at their first 12 suicide deaths of people of working age. attempt There are even higher rates of suicide deaths among women of working age who are not employed – 68.2%. Many of the suicide deaths of people of working age and who are not employed (several hundred per year) are nevertheless not classified as ‘unemployed’ and consequently are often simply overlooked altogether.4, 5 International research shows that unemployment is a significant factor in suicides in many Western Countries6 and that providing appropriate support for those who are not employed can impact on suicide rates.7,8 FACT SHEET SUICIDE PREVENTION AND MENTAL DISORDERS – JUNE 2019 COPYRIGHT © DR JOHN ASHFIELD AND ANTHONY SMITH 2019 3 ////// Economic Cost As well as the enormous social cost to Current suicide prevention programs and suicide deaths, there is an enormous campaigns are costly and ineffectual economic cost.13 Huge budgets are dedicated to suicide The economic cost of suicide deaths is prevention. The figure has been rising calculated to be $1.75 billion per annum steadily since the mid-1990s to almost for 2012 – and rising. The estimated cost $50 million per year for 2015-16.17 This is to the community of suicide deaths for the federal government figure alone for people who are NOT Employed (over 55% the National Suicide Prevention Strategy of all suicide deaths) is at least $800 million (NSPS). It doesn’t include substantial per year – yet for this target group we federal funding for suicide prevention in spend very little in prevention. broader programs and services across social On top of this there is an increasing welfare and mental health services;17 nor economic cost attributable to the rising does this figure include substantial funding numbers of diagnoses for ‘mental health’ from state governments. More recently, the issues such as depression. level of funding has increased dramatically with the 2019-20 Budget and a $461 million investment in youth mental health and suicide prevention strategy.18 There is a significant cost burden on the insurance industry Despite this substantial and continually increasing funding for suicide prevention These increasing costs are having a and mental health, improvement in significant impact on particular industries, these areas have not been achieved; in especially the insurance industry14 fact, the numbers of both suicide deaths Suicide deaths cost the insurance industry and diagnoses of depression have risen 15 in excess of $240 million per year , and substantially over the last decade.1,19,20 work related mental disorder claims cost at The current approach to suicide prevention least $480 million per year16 often includes program activity such The overwhelming majority (almost 90%) as ‘mental health literacy’ and ‘mental of these claims is due to stress in the work- health first aid’ – these programs are place rather than a pre-existing ‘mental often favoured as work place training illness’. programs. However, their content and There is now a good deal of concern approach generally serves to perpetuate within the insurance industry itself that this the paradigm of ‘treatment of mental already substantial and further escalating disorder’. The delivery of these programs cost of mental health claims is impacting is an enormous cost burden on the on the viability of the industry. A genuine workplace. attempt at a new approach to the issue A key strategy that has been used as of suicide prevention and mental health suicide prevention has been expensive is required; simply adopting activities and ‘awareness-raising’ campaigns – despite partnerships of the current approach will the fact that the World Health Organisation only exacerbate the problem and support (WHO) itself reports: status quo outcomes. There is little evidence linking awareness campaigns to a reduction in suicide...21 FACT SHEET SUICIDE PREVENTION AND MENTAL DISORDERS – JUNE 2019 4 COPYRIGHT © DR JOHN ASHFIELD AND ANTHONY SMITH 2019 ////// Depression/Mental Disorder The rate of anti-depressant use in Australia Clinically diagnosed psychiatric disorders is amongst the highest in the world are a factor in only a relatively very few In Australia, antidepressant utilisation nearly suicide deaths trebled between 1990 and 1998, and has Statistical data that has been relied on in continued to increase.19, 20 Of OECD nations, the past, has been largely based on the Australia is currently the second-highest Psychological Autopsy method, and has been prescriber of antidepressant drugs.22 discredited.25 More recent research suggests that other key factors such as employment status account for far more suicides than 4 There is a great deal of disagreement in ‘mental disorders’. Many men who suicide ‘expert opinion’ over the effectiveness and have no psychiatric history or known mental
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