Introduction by Croakey: Mental health experts are calling for a strengthened national approach to suicide prevention, following the release of the Australian Bureau of Statistics Causes of Death data for 2023.
Also, the data highlight the critical need for culturally safe support for Aboriginal and Torres Strait Islander peoples, who are disproportionately affected by suicide, according to Professor Pat Dudgeon, Director of the Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention (CBPATSISP).
Below, in separate commentaries, Dr Jaelea Skehan, Director of Everymind, and Professor Pat Dudgeon emphasise the value of drawing upon local and community strengths.
A draft of the National Suicide Prevention Strategy is open for public consultation until 27 October.
Jaelea Skehan writes:
Last week, the Australian Bureau of Statistics (ABS) released the latest national Causes of Death dataset, including official suicide data for Australia in 2023.
The numbers, and the people behind them, make it clear that our suicide rates have stayed stubbornly high over the past decade.
There are still far too many people dying by suicide each year and far too many impacted as a family member, friend, colleague, teammate, first responder, neighbour or professional.
The data is also a reminder of the disparities that exist across our communities, with some groups and some communities disproportionately impacted by suicide.
The preliminary data shows that there were 3,214 deaths by suicide in 2023 with an age-standardised rate of 11.8 per 100,000 people.
This equates to an average of 8.8 deaths by suicide in Australia each day. In 2023, suicide was the leading cause of premature mortality with 107,537 years of life lost.
While the data appears to represent a small overall decrease from 2022, comparing the 2023 data to previous years is not advised.
Preliminary numbers for 2023 are expected to increase due to the high number of open cases in NSW, with the ABS advising that a revision of the 2023 data can be expected in early 2025.
Differences by gender and age
As with previous years, more than three-quarters (75.3%) of people who died by suicide in Australia were male. There were 2,419 male deaths with an age-standardised rate of 18.0 per 100,000 and 795 female deaths with an age-standardised rate of 5.8 per 100,000.
Males aged 55-59 years had the highest suicide rate overall, and males aged 45-49 years accounted for the largest proportion of deaths due to suicide (9.9%). Females aged 50-54 years had the highest suicide rate for females (10.0 deaths per 100,000).
More than 80 percent (82.5%) of people who died by suicide were aged under 65 years, with suicide the leading cause of death for people aged between 15-44 years. Males who died by suicide lost on average 35.1 years of life and females who died by suicide lost on average 36.9 years of life.
Limitations with national data means that only a binary approach to gender can be reported in datasets like those released today, with no specific data for LGBTIQ+ communities. Improved inclusion of these communities within our national data must be a priority for policy and practice.
Where you live matters
For the first time, this year’s dataset provides a breakdown of suicide deaths by geographical remoteness, and the picture is not good for those living outside of the city.
In the five-year period between 2019 and 2023 the suicide rate in remote and very remote Australia was consistently higher than suicide rates in both regional areas and major cities. In particular, the suicide rate for males living in remote and very remote Australia was more than double the rate for males living in major cities.
Factors contributing to elevated suicide rates in regional, rural and remote Australia are multifaceted and may be influenced by social, economic, health and environmental conditions specific to these regions as well as access to health and other supports.
The 2023 data showed that people living in major cities were more likely to have a specific mental health condition recorded (45.2%) compared to those in remote and very remote Australia (30.8%). Alcohol and other drug use was most commonly mentioned as a risk factor for those living in remote and very remote Australia, while problems related to employment or housing were more common in major cities and inner regional areas.
There are significant structural and workforce barriers to implementing suicide prevention reforms in regional, rural, and remote communities and unique risk factors contributing to distress across these communities.
To date, most suicide prevention reforms and investments have been targeted at urban and regional communities, with little consideration of how to design a rural-first approach that draws on local strengths, as outlined in a recent Manna Institute report.
Clear national strategy needed
Data without action is of little assistance to our communities. The data released last week must be considered alongside other available data, including data from the National Suicide and Self-harm Monitoring System and lived and living experience knowledge, to tailor and implement effective suicide prevention action.
The suicide prevention sector has been united behind a whole of government approach to suicide prevention that focuses on an improved service system as well as addressing the range of factors that contribute to suicidal distress.
Organisations have recently called for a firmer commitment from the Federal Government to prioritise suicide prevention across the country, especially in the light of the delayed draft National Suicide Prevention Strategy being released last month as ‘advice’. This strategy is positioned to work alongside the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy, which is also yet to be released by government.
With the number of lives lost to suicide staying above 3,000 per year and 3.3 million Australians aged 16-85 experiencing suicidal thoughts or behaviour at some point in their lives, there has never been a more important time for a strengthened national approach.
Pat Dudgeon writes:
For non-Indigenous Australians, suicide rates have been relatively consistent over the last few years. In contrast, the number of Aboriginal and Torres Strait Islander people who take their own lives continues to climb, at a rate of 30.8 suicides per 100,000 people.
This rate is more than double that of other Australians. This is also the highest rate in the ABS time series and represents an increase of about 30 percent in the last five years.
In 2023 alone, 275 Aboriginal and Torres Strait Islander people took their lives. Suicide also remains the leading cause of death among Aboriginal children.
The ABS has recently improved the process for identifying Aboriginal and Torres Strait Islander deaths across several jurisdictions.
Although trends over time should therefore be interpreted with caution, there can be no denying that Aboriginal and Torres Strait Islander suicide rates show a pattern of increasing over time.
The 2023 ABS data reinforces the harsh reality that in Aboriginal and Torres Strait Islander communities, losing loved ones to suicide is not exceptional – it is tragically commonplace. Despite a Closing the Gap target to bring down Aboriginal and Torres Strait Islander suicide rates by at least 15 percent by 2031, suicide rates have increased for another year.
Culturally safe support vital
There is strong evidence that Aboriginal and Torres Strait Islander suicide is linked to the lasting impacts of colonisation, intergenerational trauma, grief, loss, and social and economic disadvantage. Research also shows the impact of racism and discrimination on mental health and wellbeing.
This is important to consider, as in 2023 we saw increases in explicit and implicit racism during and following the Voice to Parliament Referendum which was held on 16 October 2023.
Reports from 13YARN – an Aboriginal and Torres Strait Islander crisis support hotline – reveal almost a 50 percent increase in the number of calls received after the referendum, with 19 percent of all calls attributed to racism. We also know that there are other risk factors for suicide at the individual level, including relationship conflicts and breakdowns, grief and loss, and living in remote/rural regions.
Effective suicide prevention responses need to acknowledge all of these elements and re-empower Aboriginal and Torres Strait Islander peoples.
Effective suicide prevention strategies also need to work within a culturally-informed model of mental health and wellbeing. This includes embracing the concept of social and emotional wellbeing, which encompasses connections to mind, body, spirit and connection to Country, kinship, community and culture.
Further information
A full breakdown of data, by age, gender and state, with graphs that demonstrate trends over time will be available at Life in Mind.
Visit Mindframe for guidelines and resources supporting safe reporting and communication about suicide data. A general summary of today’s data release, prepared by Everymind, is available here.
Support services
Lifeline: 13 11 14 or text 0477 13 11 14 for 24/7 crisis support and suicide prevention services
13YARN: 13 92 76
The Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention (CBPATSISP)
Suicide Call Back Service: 1300 659 467
Kids Helpline: 1800 55 1800
MensLine Australia: 1300 78 99 78
Beyond Blue: 1300 22 4636
QLIFE: 1800 184 527
StandBy Support After Suicide: 1300 727 247
headspace: 1800 650 890
See Croakey’s archive of articles on prevention