Summary

There is ongoing concern within the Australian Defence Force (ADF) and the wider Australian community about suicide in serving and ex-serving ADF personnel. In particular, ex-serving ADF personnel may face increased risk of suicide.

Recent government inquiries have highlighted the need to improve the integration of service responses to meet the health and wellbeing needs of serving and ex-serving ADF personnel (JSCFADT 2015). The need to invest in prevention and early intervention strategies to improve health and wellbeing outcomes for these groups has also been highlighted. The Government has introduced further suicide prevention and mental health support services for serving and ex-serving ADF personnel and their families (AG 2017).

In response to concerns about suicide amongst serving and ex-serving ADF personnel, the AIHW is commissioned by the Department of Veterans’ Affairs (DVA) to report the number and rate of suicide deaths in three ADF service status groups—personnel serving full time, personnel serving in the reserves, and ex-serving personnel (see Box 1).

We acknowledge and pay our respects to those who have passed away, or been affected, by suicide. We are committed to ensuring our work continues to inform improvements in mental health, suicide awareness and prevention.

What is in this report?

This online report National suicide monitoring of serving and ex-serving Australian Defence Force personnel provides annual updates to information on the level of suicide among serving and ex-serving ADF personnel with at least 1 day of ADF service since 2001 across three service status groups (Box 1).

Box 1: ADF service status groups

Serving full time: ADF personnel serving in a regular capacity in the Royal Australian Navy (Navy), Australian Army (Army) or the Royal Australian Air Force (Air Force) on or after 1 January 2001, on continuous full-time service, or participating in a gap year program.

Reserve: ADF personnel in the active or inactive reserve forces for the Navy, Army or the Air Force on or after 1 January 2001. Most personnel leaving full-time service transition to the inactive reserve forces, unless prevented by medical or other grounds.

Ex-serving: ADF personnel in the serving or reserve population on or after 1 January 2001, who were subsequently discharged.

This information is presented in two formats:

  • numbers of suicides among the three ADF service status groups, in tables, for both men and women
  • comparisons of rates of suicide across the three ADF service status groups and with the Australian population, in interactive graphs.

A brief summary of the latest information and analysis of results over time is provided for each of the service status groups. These different measures are provided to account for differences in the study population (Box 2).

Box 2: Notes on the study population

While the size of the serving and reserve populations has remained relatively stable over the study period, the ex-serving population in this study started at zero (0) on 1 January 2001 and increases each year as more personnel are discharged. Changes in numbers of suicides over time need to be interpreted in the context of changes in the size of these populations.

The information in this report is based on fact of death information from the National Death Index (NDI), cause of death information from the National Mortality Database (NMD) and Defence Suicide Database (DSD), as well as information on the three ADF service status groups from Department of Defence personnel systems. For more detail, see Data sources.

The study includes ADF personnel with service on or after 1 January 2001, based on when the Department of Defence personnel system was introduced. Numbers of suicides are reported from 2001 onwards, based on the latest available cause of death data. Rates of suicide are reported from 2002 onwards, based on available population data for the three ADF service status groups. While some numbers of suicides can be reported on a yearly basis, 3-year rolling aggregations are used to report the more detailed information. Rates of suicide are reported in 3-year aggregations for 2007 onwards as changes to the Australian Bureau of Statistics (ABS) coding guidelines were applied for deaths registered from 1 January 2007 and comparable rates for prior years cannot be calculated.

This report is the second annual update to the ongoing monitoring of suicides in serving and ex-serving ADF personnel. The first detailed report, Incidence of suicide in serving and ex-serving Australian Defence Force personnel: detailed analysis 2001-2015, was released in January 2018. The report examined the incidence of suicide among serving and ex-serving personnel and further identified characteristics that may be associated with suicide risk.

Each annual release will update previously published numbers of suicides to incorporate any updates to the source data. The 2019 online report updates numbers and measures of suicide published in the 2018 online report. These updates add more recently identified suicides, leading to small increases in some suicide rates. The main reasons for changes to previously published results are:

  • a lag in cause of death information for the most recent year of data, where a death is registered in the following year
  • revisions to cause of death data by the ABS
  • improvements in information available to the study.

More detail on these reasons for changes to previously published information is provided in the Technical Notes.

National suicide monitoring of serving and ex-serving ADF personnel: measures

The following measures are to be reported on annually:

For the period from 1 January 2001 to the most recent year of available cause of death data:

  • The total annual numbers of suicides for men and women across the three ADF service status groups (combined).
  • The total annual numbers of suicides for men and women in the serving and reserve populations (combined).
  • The total annual numbers of suicides for men and women (combined) in the ex-serving population.

For 3-year periods, from 2001–2003 to the most recent 3-year period:

  • Numbers of suicide deaths for:
    • all ADF personnel (for men and women across the three ADF service status groups combined)
    • ADF personnel by ADF service status group (for men and women combined)
    • all ADF women (for the three ADF service status groups combined)
    • all ADF personnel under 30 years of age (for men and women across the three ADF service status groups combined)
    • ex-serving personnel under 30 years of age (for men and women combined).

For the period from 2002 to the most recent year of available cause of death data:

  • Standardised Mortality Ratios (SMRs) comparing rates of suicide for men in each of the three ADF service status groups with rates for men in the Australian population, adjusted for age.
  • An SMR comparing rates of suicide for ex-serving women with rates for women in the Australian population, adjusted for age.

For 3-year periods, from 2007–2009 to the most recent 3-year period:

  • Suicide rates for the three ADF service status groups (men only), with comparison to rates for all Australian men of the same age.
  • SMRs comparing rates of suicide for men in each of the three ADF service status groups with rates for men in the Australian population, adjusted for age.
  • Age-specific suicide rates for ex-serving men aged under 30 and those aged 30 years and over, with comparisons to the rates for Australian men of the same age.

Important factors to consider when reading this report are outlined in Box 3.

Box 3: Factors to consider when reading this report

The reported suicide data are calculated from certified deaths information only; that is, official cause of death information recorded by the Registrars of Births, Deaths and Marriages in each state and territory and the National Coronial Information System.

Within Australia, cause of death information is coded by the ABS. Practices and guidelines for coding intentional self-harm (suicide) have changed over time. These changes have improved the data quality for suicides recorded in Australia. For these reasons, the key measures in this report are presented from 2007 onwards. See the Technical notes for further details of these changes.

This study may exclude an unknown number of deaths suspected to be suicides and attributed to another cause after a coroner’s investigation.

Deaths data included in this report, or previously published, may be based on preliminary or revised data and as such are subject to further revision. See the Technical notes for further information on ABS cause of death revisions.

This report uses data from the NDI to identify fact of death, supplemented with cause of death information from the NMD. Analysis of the NMD for all Australian deaths shows a lag in the reporting of cause of death information for a small percentage of all deaths for the most recent year of published data. As such the most recent year of published data in this report is subjected to additional revision in the following year. These revisions may identify additional suicide deaths.

Differences between the results of this study and other publicly reported estimates may be due to the study scope and/or the source of cause of death information.

The data presented here cannot be used to estimate the number of suicides among people who left the ADF before 1 January 2001 and cannot be extrapolated to the broader ex-serving population. As only certain administrative information about individuals was available in the Defence Personnel Management Key Solution (PMKeyS) data used in this study, it was not possible to account for the wide range of social, demographic and psychological factors that may contribute to suicide risk.

Some results are based on low numbers. Rates produced using low numbers can be sensitive to small changes in numbers of deaths over time.

Confidence intervals are presented in this report to reflect uncertainty in the suicide rates calculated for the three ADF service status groups and the Australian population. Confidence intervals provide one way to assess the randomness that may occur in suicides over time and are presented for each time point (3-year rolling aggregations). As time passes and more data become available, greater confidence can be attached to any differences in outcomes between the ADF population and the comparable Australian population.

See the Technical notes for more information.

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References

  • JSCFADT (Joint Standing Committee on Foreign Affairs Defence and Trade) 2015. Review of the Defence Annual Report 2013-14. Canberra: Joint Standing Committee on Foreign Affairs, Defence and Trade.
  • AG (Australian Government) 2017. Australian Government response to the Foreign Affairs, Defence and Trade Committee Report: The constant battle: suicide by Veterans. Tabled by the Minister for Veterans’ Affairs.