Psychosocial risk factors and deaths by suicide

Capturing information on risk factors relating to deaths by suicide can highlight areas of a person's life experience that may need additional attention to provide the most effective suicide prevention interventions. However, it is important to note that the presence of one or more of these risk factors in an individual’s life does not necessarily mean they will have suicidal behaviours. The vast majority of people who experience these risk factors will not experience suicidal behaviours.

As part of the National Suicide and Self-harm Monitoring Project the AIHW has funded the Australian Bureau of Statistics (ABS) to identify and code (using ICD-10) psychosocial risk factors for deaths referred to a coroner, including deaths by suicide. Following on from a pilot study (ABS 2019), the ABS reviewed reports and coronial findings held by the National Coronial Information System (NCIS) on deaths registered in 2017, 2018 and 2019. Approximately 2,000 deaths by suicide each year in Australia had one or more psychosocial risk factor identified—approximately two-thirds of all deaths by suicide registered each year (ABS 2020). The types of psychosocial risk factors associated with deaths by suicide were age dependent and differed throughout the lifespan.

Most frequently occurring psychosocial risk factors in coroner-certified suicide deaths by age and sex, Australia, 2019. 

The horizontal bar graph shows the proportion of coroner-certified deaths by suicide with psychosocial risk factors identified in males in Australia in 2019. The user can choose to view the data by sex, by age groups, and by the number of deaths by suicide with psychosocial risk factors identified. The risk factor identified in the greatest proportion of coroner-certified deaths by suicide in males at all ages was a ‘personal history of self-harm’ followed by ‘disruption of family by separation and divorce'. Data for 2017 and 2018 are also available to view.

From 2017 to 2019, the most commonly identified risk factors for males aged under 25 and 25–34 were a ‘personal history of self-harm’ (associated with about 20% of all deaths by suicide in these age groups in 2019), ‘disruption of family by separation and divorce’ (associated with 16% of all deaths by suicide in these age groups in 2019) and ‘problems in relationship with spouse or partner’ (associated with 12% of all deaths by suicide in males under 25 years and 17% of deaths by suicide in males aged 25–34).

These 3 risk factors featured across all male age groups to varying degrees; however, ‘problems related to other legal circumstances’ and ‘other problems related to housing and economic circumstances’ also emerged as common risk factors in middle-aged males (35–44, 45–54 and 55–64 years).

‘Limitation of activities due to disability’ was the most commonly identified risk factor in deaths by suicide in males aged 65 and over in 2017 to 2019.

In females, a ‘personal history of self-harm’ was the most common risk factor identified in all age groups, except for those aged 65 and older (for whom it was the second-most commonly identified risk factor in each year). In 2019, a ‘personal history of self-harm’ was associated with 19% of deaths by suicide in females aged 65 and older and 37% of deaths by suicide in females aged under 25.

For females aged 65 and over, ‘limitation of activities due to disability’ was the most common risk factor in each year (associated with 23% of deaths by suicide in this age group in 2019).

‘Disruption of family by separation and divorce’ and ‘problems in relationship with spouse or partner’ were generally the second- and third-most common risk factors in females aged under 45.

‘Disappearance and death of family member’ was also identified as one of the most frequently occurring psychosocial risk factors in each male and female age group.

Of note, ‘Social exclusion and rejection’ was only identified as a frequent risk factor for males aged under 25 (associated with 4% of deaths by suicide in this age group in 2019) while 'Bullying' was only commonly seen among females aged under 25 (associated with 4–10% of all deaths by suicide in females in this age group in 2017 to 2019).

‘Problems in relationship with parents and in-laws’ also only commonly occurred in those aged under 25 years (associated with 4–7% and 5–10% of deaths by suicide in males and females in this age group).

‘Unemployment, unspecified’ was a frequent risk factor in males in all age groups (associated with 2–6% of deaths by suicide in 2017 to 2019) except those aged 65 and older; however, this was not a common risk factor in females of any age.

There is no national standard for the collection of data on psychosocial factors—each state and territory has its own legislation and processes relating to coroner-certified deaths meaning that the type of information collected and held by the NCIS database differs slightly by jurisdiction. Also, due to the method used for the collection of data, protective factors are not included.

The ABS reviewed and coded psychosocial risk factors (defined as social processes and social structures which can have an interaction with individual thought, behaviour and/or health outcomes) associated with deaths by suicide in 2017 through a review of police, toxicology and pathology reports and coronial findings held by the NCIS. The AIHW is working with the ABS to continue this work and embed psychosocial risk factors in future national mortality data sets.

References

ABS (Australian Bureau of Statistics) 2020. Causes of Death, Australia 2019. ABS Catalogue number 3303.0

ABS 2019. 1351.0.55.062 Psychosocial risk factors as they relate to coroner-referred deaths in Australia, 2017. Viewed 28–08–2020.