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Causes of death data 2019: what does this mean for suicide prevention?

On October 23, The Australian Bureau of Statistics released the 2019 Causes of Death data, which includes national suicide information. Preliminary data shows an increase in the number of deaths compared to the previous year.

Below, Marc Bryant, with Shayne Connell and Danielle Cuthbert, provide a response to the data, through the lens of the suicide prevention sector and lived experience.


Marc Bryant, Shayne Connell and Danielle Cuthbert write:

Despite sombre news from the latest ABS causes of death data where we have seen an increase in suicides during 2019 compared to 2018, we need to remain confident that the evidence-based strategies in place and emerging innovation and leadership, will, in time, reduce the numbers. However, there is still much to do to tackle this significant public health issue.

Every life lost to suicide is one too many. And we never forget that behind these statistics are people who have left behind devastated families, friends, work colleagues and communities. Many are looking for answers.

Until recently, I managed the Mindframe initiative, which educated the media and others, in communicating safely about suicide.

Each year we would work closely with the ABS on the data release to ensure the information provided was clearly understood by the media and the sector alike: it’s easy to read data and make assumptions and potentially add to community fear through sensationalising the facts, which may impact those already thinking of suicide. So, there is a need to be mindful when having public discussions.

Getting the balance right between reducing the stigma of suicide and not inadvertently harming at-risk audiences.

We often also hear that “nothing is happening” when we see confronting data. I was also fortunate enough to oversee the development and dissemination of the Government-funded Life in Mind digital gateway, which listed suicide prevention activities.

I remain confident that the thousands of dedicated teams and individuals going above and beyond with their various evidence-based strategies, are likely to have prevented the suicide numbers from being higher. There are also new activities being introduced (which I will mention later), some of which are in their infancy.

It will take time to see the impact of these, especially upstream where we are working on building protective factors, reducing risk factors and developing early interventions in communities and workplaces.

Suicide is a complex issue and often there is no single reason why a person attempts or dies by suicide. It is important to have accurate and up-to-date information about suicide to inform coordinated and consistent planning, policy and practice. This includes the data on death numbers and rates.

The suicide data

Causes of Death data 2019 snapshot:

  • In 2019, 3,318 deaths with an age-standardised rate of 12.9 per 100,000, equating to 9.1 deaths each day. In 2018, there were 3,046 deaths (revised this year to 3,138) with a rate of 12.2 (revised this year to 12.4) and equates to 8.3 deaths each day (revised this year to 8.6).
  • There were 2,502 male deaths, with a rate of 19.8 per 100,000. There were 816 female deaths at a rate of 6.3 per 100,000.
  • Consistently over the past 10 years, the number of suicide deaths was three times higher in males than females.

ABS suicide rates from 1989 to 2019 (Mindframe)

It’s important to note that lags between when deaths occur and when they are registered can influence the count of deaths, while the flow of information between Coroners courts, registries, the National Coronial Information System and the ABS, can influence what information is available to specify a particular cause of death.

Therefore, data for 2018 and 2017 have been revised and include additional deaths.

Table 1 below shows the state and territory breakdown, including numbers and rates, compared to the national average as well as the 2018 preliminary data. Only Queensland has seen no increase.

When we breakdown preliminary data further, we see increases (highlighted in green in the Table 2 below) in the 20 to 50 years and 60 to 79 years age groups, with 189 additional deaths.

Livingworks CEO Shayne Connell knows only too well the impact of suicide. His uncle, Lake Macquarie paramedic Tony Jenkins, died aged 54 in 2018.

“This time last year the reported suicides in Australia were 3046.  And I remember it well because one of those numbers was a member of my family. These aren’t numbers, they are people. And they are motivation for us all to take action. We need to address all areas of suicide, but with the data showing increases in male suicide across the board, we need to double our efforts to ensure our prevention work is reaching more men.

“I was heartened to see Suicide Prevention Australia earlier this year release its report, Turning the Tide: A Six Point Plan for Change, which included two key points to help men.  This included calling on the Government to develop a male suicide prevention strategy, supported by funded community gatekeeper training.

“The report recognised that those surrounding men, especially male touchpoints, if trained, can intervene early when someone is struggling – asking the question direct: ‘Are you thinking of suicide’,  keeping them safe and connecting them to services.

“At LivingWorks, we are working in traditionally male-orientated workplaces, to build networks of safety around colleagues with various training in suicide first aid. This includes defence, veterans, first responders, and tradies (led by Mates in Construction).

“Research by Orygen has shown that we can also provide suicide first aid training safely in schools. Imagine that – young people not only able to support each other in school settings but also being equipped for when they leave school and enter adulthood where suicide rates typically increase, as shown by the latest statistics.

“But we need significant investment to do this at scale, with additional coordination and inclusion of  evaluation. We currently work in an environment of responding after there has been a suicide. Isn’t it better to prepare before the events? We need everyone in any industry or community to know that we all have a role in offering help,” said Shayne.

Young people suicide

Data also revealed increases in deaths and rates for both males and females in their 20s (see Table 3 below for female deaths).  Numbers for this age group for females went from 109 to 151, almost a 50 percent increase. For males in their 20s, there were 34 additional deaths. However, suicides under 20 dropped for both sexes.

Danielle Cuthbert, 29, has worked in the mental health sector as a communications manager over the past five years. However, her connection to mental health and suicide extends further back to when she was 19 and diagnosed with anorexia nervosa.

As a female in her 20s with lived experience, Danielle said: “The past year has brought extraordinary challenges for all Australians. Bushfires, floods and the COVID pandemic has resulted in destroyed homes, separated families, isolation, lost jobs, financial distress and the most devastating of all – loss of loved ones. Life as we know it has been turned upside down and return to ‘normality’ still feels far away. It is scary, uncertain and at times, too much.

“When I saw 3318 lives had been lost to suicide in the past year, an increase from previous years, I felt deep sadness. And then I felt deflated, because yet again there hasn’t been a significant reduction in these numbers.

“I distinctly remember the first time I opened up about my suicide ideation with my family. My Dad asked me directly if I had been thinking about taking my life, and after a long silence I replied honestly, ‘yes I have’.

“My thoughts of suicide were not associated with wanting to die, but wanting to end the thoughts in my mind and feeling like a burden to those around me – seeing no other way out. No one person has resulted in me being here today. Instead, it involved a whole crew of people (professionals, friends, family, lovely strangers and a mentor), working together and offering both support and friendship in varying ways.

“Despite working in the sector and having had my own experience, I had not received training in suicide first aid until this year. I have met so many people who deal with difficult conversations in their personal and professional lives who receive no formal training and rely heavily on their instincts.

“My parents were those people. Imagine if they had training? Imagine if they felt more confident in what to say to someone having thoughts of suicide? Imagine if they knew where they could refer someone for more support? I am not saying it is up to one person to save someone’s life, but the more people around them who have the skills to offer help and connect them to care the more lives we could save – ultimately changing the heartbreaking stats we saw this year.

“I think we need to stop viewing suicide prevention as a role only for professionals, and instead equip every Australian with the skills to recognise and respond to someone having thoughts of suicide. It is only then that we will see real change.”

What now?

With the bushfires and now the COVID-19 pandemic, the Government has pledged significant funding to keep those already vulnerable safer, with the In this Together campaign led by the National Mental Health Commission (NMHC), to increased funding for helplines, the new Beyond Blue Coronavirus Mental Wellbeing Support Service, and increased mental health service provision.

The Government has also informed us of the welcome news that so far suicide data does not show increases this year. Though that does not mean we should be complacent and instead ensure we are prepared for the future potential impacts of increased mental health issues, financial difficulties, job insecurity, relationship breakdowns, and drug and alcohol misuse.

Thankfully, before COVID-19, the NMHC was already leading the new Suicide Prevention Task force, with NMHC CEO Christine Morgan now the Prime Minister’s Suicide Prevention Advisor. The Task Force is due to provide a report to the Prime Minister after an 18-month whole-of-government project.

This has coincided with the soon-to-be-released Productivity Report into Mental Health, which aims to help both the Federal Government and states, reform mental health services in Australia. These reports have to ensure we have a framework and coordination of well-funded activities that integrate, to avoid duplicity and the community believing that still nothing is happening due to mixed messages from multiple agencies.

Innovation is emerging. Online solutions and plans for lived experience involvement and peer workforces: Beyond Blue Way Back, ICLA e-Friend peer support, Roses in the Ocean training and the NSW Government’s Towards Zero Suicide plans for alternatives to emergency departments.

And let’s not forget awareness-raising and early literacy education via RUOK? Day , Movember and Facing It podcasts. And the Federal Government’s PHN suicide prevention trials sites galvanising community solutions, based on the work of Blackdog Institute’s Lifespan framework. Hundreds of other grassroots service and programs are on Life in Mind.

Community development

For LivingWorks, we are committed to developing networks of safety in communities, schools and workplaces. Where as many as possible community gatekeepers, or touchpoints, are trained in suicide first aid skills.

We are working on innovations for priority populations, including LGTBI ASIST and safeTalk, the new Indigenous ASIST (I-ASIST) two-day training developed by University of Queensland Prof. Maree Toombs, and safeYARN half-day training developed by the Thompson Institute in Sunshine Coast University. Orygen is continuing to evaluate suicide first aid in schools, including training for parents.

Meanwhile, with Victoria going through increased COVID-19 restrictions, there was an opportunity to mobilise sections of the community to utilise recently acquired skills in suicide first aid as an additional layer of community support.

So LivingWorks partnered with local health providers in Melbourne and new tech start-up Crisis Heroes, to develop a unique online space where those already trained in suicide first aid can make their skills visible and reach out to those in need.

https://twitter.com/i/status/1303262655881375745

“We don’t have a clinician on every street corner or immediately available online,” said Shayne, “but we do have more than 200,000 everyday Australians trained in suicide first aid, with at least 50,000 of these people living in Victoria. This network of safety is all around us, you just can’t see it. This is where this pilot partnership comes in, offering an additional layer of community outreach and support.

“It takes a village to protect someone from suicide. We know from our friends at R U OK? that a conversation can change a life. We need to complement these essential conversation skills and recently announced government funding for mental health services with building community capacity for suicide first aid.

So far, more than 1500 people have signed up via the Crisis Heroes platform for the online 90-minute START training, with almost 200 people activated on the site as care givers. More than 50 suicide interventions have taken place over the last six weeks.

LivingWorks recognise that people within Victoria may not always have the capacity to support each other right now, so are welcoming all Australians trained in suicide first aid to register on the Crisis Heroes platform and support those in need.

This pilot is also encouraging people who have not trained in suicide first aid, but are willing and able, to complete introductory online suicide first aid program, LivingWorks Start. Our health partners,  South Eastern Melbourne Primary Health Network (SEMPHN) and North Western Melbourne Primary Health Network (NWMPHN) in Victoria, are funding a number of START licences for residents of Melbourne’s South East and North West.

To find out more about the pilot and register for training visit www.crisisheroes.com/livingworks and follow LivingWorks on Twitter @livingworksAus.

Finally, take care and look after your own mental health, but if you feel up to it get involved in the many activities happening and be part of the movement for change to prevent more suicides. If you need support now, reach out to someone you trust, or to one of the services listed below.

Danielle Cuthbert is a communications specialist who has worked in the mental health sector over the past five years, including the Butterfly Foundation, NMHC and LivingWorks, and has mentored people recovering from eating disorders. Follow on Twitter @DanielleCuthbe8

Shayne Connell is CEO LivingWorks Australia. He holds a Bachelor of Arts degree in Psychology and an MBA from the University of Newcastle, Australia, and has been extensively involved in suicide prevention as both a LivingWorks trainer and coach—where he has delivered over 100 workshops—and as a coordinator and crisis counselling volunteer with Lifeline Australia. Follow on Twitter @ConnellShayne

Marc Bryant is Director Suicide Prevention at LivingWorks Australia. Marc previously managed suicide prevention at Everymind for 10 years, leading commonwealth Mindframe and Life in Mind programs. Marc is a member of the WHO IASP World Congress 2021 organising committee, Lifeline Hotspots Advisory Group member, RUOK? Conversation Guru, and a member of the board of directors for ICLA. Follow on Twitter @marcbryantaus

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