Psychosocial risk factors and deaths by suicide

Capturing information on risk factors relating to deaths by suicide can highlight areas of a persons 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.

A review by the Australian Bureau of Statistics (ABS) of reports and coronial findings held by the National Coronial Information System (NCIS) on deaths registered in 2017, found that 1,966 deaths by suicide in Australia had one or more psychosocial risk factors identified—63% of all deaths by suicide registered in that year (ABS 2018). 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, 2017.

The horizontal bar graph shows the proportion of coroner-certified deaths by suicide with psychosocial risk factors identified in males in Australia in 2017. 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'.

The most commonly identified risk factors for males aged under 25 and 25–34 were ‘personal history of self-harm’ (associated with about 20% of all deaths by suicide in each age group), ‘disruption of family by separation and divorce’ (associated with 14% and 15% of deaths by suicide, repectively) and ‘problems in relationship with spouse or partner’ (associated with 12% of deaths by suicide in males under 25 years and 16% in males aged 25–34, repectively).

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

‘Limitation of activities due to disability or other chronic health condition’ was the most commonly identified risk factor in deaths by suicide in males aged 65 and over (associated with 20% of deaths by suicide in this age group).

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). A ‘personal history of self-harm’ was associated with 24% of deaths by suicide in females aged 55–64 to 45% in females aged under 25).

For females aged 65 and over, ‘limitation of activities due to disability or other chronic health condition’ was the most common risk factor (associated with 19% of deaths by suicide in this age group).

‘Disruption of family by separation and divorce’ and ‘problems in relationship with spouse or partner’ were the second- and third-most common risk factors in females aged under 45, while ‘disappearance and death of family member (or primary support group)’ tended to increase with age.

Of note, ‘bullying’ was only identified as a risk factor for people aged under 25—and this was particularly seen among females (associated with 3% and 10% of deaths by suicide in males and females aged under 25 years, respectively).

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.

Reference

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