4102.0 - Australian Social Trends, 1994  
ARCHIVED ISSUE Released at 11:30 AM (CANBERRA TIME) 27/05/1994   
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Contents >> Health >> Causes of Death: Youth suicide

Mortality and Morbidity: Youth suicide

Youth suicide rates in Australia are higher than in many other countries, and are increasing. Death rates from suicide are considerably higher for young men than for young women, and for young rural men than for young urban men.

Overall, suicide is still a fairly rare event,claiming around 17 lives per 100,000 population per year in 1988-92. In comparison, cancer claimed over 180 lives per 100,000 population. Nevertheless, for the younger age groups which have low levels of mortality, the suicide rate of 16 per 100,000 population, competes with road accidents as the leading cause of death. In 1992, suicide accounted for 378 male and 77 female deaths in the 15-24 years age group. Thus any change in the suicide rate for young people has the potential to affect the overall level of youth mortality significantly.

The age-specific pattern of suicide has changed over the past 20 years. During the 1970s suicide rates tended to increase with age for both males and females. For males this pattern changed in the 1980s and early 1990s. During this period the youth suicide rate increased and suicide rates at older ages decreased. The increase in youth suicide rates, in particular the rate for males, and the consequent potential years of life lost has become a cause for concern.

Possible causes of increases in suicide rates include drug and alcohol dependence, family breakdown, unemployment and financial distress. However, clear relationships are hard to establish, and in particular to generalise to the population level.

Suicide

To be classified as suicide a death must be recognised as due to other than natural causes. It must also be established by coronial inquiry that death results from a deliberate act of the deceased with the intention of ending his or her own life.

Suicide rates can vary considerably from year to year. In statistical terms a considerable proportion of this variability may be due to chance. Figures therefore need to be interpreted with caution. To counteract the volatility in the data to some degree and to overcome problems with small numbers that can occur when dealing with detailed disaggregations, most figures presented in this review have been averaged over 5 years. Where data have been averaged, the mid-year of the average is presented in tables.

Years of potential life lost

Years of potential life lost measures the amount of life lost in a population as a result of premature mortality. In this instance, premature mortality is taken as deaths of persons aged 15-24 years from suicide.

SUICIDE RATES(a) BY AGE AND SEX
5 year mid-year
15-24 years
25-34 years
35-44 years
45-54 years
55-64 years
65-74 years
75 years and over
Total
rate
rate
rate
rate
rate
rate
rate
rate
Males
    1975
14.8
18.3
23.1
27.0
23.1
30.2
30.4
20.9
    1980
18.0
22.7
22.6
23.9
23.9
24.3
30.6
27.5
    1985
21.4
26.4
22.7
23.2
24.9
26.9
35.7
24.3
    1990
26.5
29.5
25.8
24.3
23.2
26.2
35.1
26.7
Females
    1975
4.6
7.2
10.8
13.9
13.4
10.0
7.0
9.2
    1980
4.5
6.7
8.6
11.7
10.2
9.0
6.7
8.0
    1985
4.8
6.0
7.0
9.7
8.8
7.9
7.4
7.0
    1990
4.9
7.1
6.9
7.3
8.1
7.7
8.4
6.9
Persons
    1975
9.8
12.9
17.1
20.6
18.1
19.3
15.3
15.2
    1980
11.4
14.9
16.0
18.0
17.0
16.1
15.4
15.1
    1985
13.3
16.3
15.0
16.6
16.8
16.6
17.7
15.6
    1990
15.9
18.4
16.5
16.0
15.7
16.2
18.3
16.7
(a) Rates per 100,000 population in the same age and sex groups.

Source: Causes of Death
International comparison
The youth suicide rate in Australia is high by international standards. Of the 24 countries on which the World Health Organisation reported in 1992, Australia had the fourth highest suicide rate for 15-24 year olds. If the same countries are compared in terms of their suicide rates for the population as a whole Australia falls in the mid-range.

It is generally acknowledged that suicides are under-reported as a cause of death. The degree of under-reporting varies from country to country, partly for cultural and social reasons, but also because of differences in legal requirements and administrative procedures in arriving at a verdict of suicide1.
SUICIDE RATE(a) 15-24 YEAR OLDS
Males
Females
Persons
5 year mid-yearYear
rate
rate
rate
Iceland1991
61.0
4.9
33.3
Finland1991
42.2
7.3
25.1
New Zealand1989
37.9
7.0
22.6
Australia1991
26.7
6.4
16.7
Switzerland1991
26.0
6.2
16.2
Canada1990
24.6
5.0
15.0
Norway1990
22.1
6.3
14.4
Sweden1989
19.8
8.3
14.2
USA1989
22.2
4.2
13.3
Hungary1991
19.6
5.3
12.6
Singapore1990
13.3
7.7
10.6
Germany1990
14.4
4.3
9.5
Poland1991
15.8
2.4
9.3
Ireland1990
14.2
4.1
9.3
France1990
14.1
4.4
9.3
Denmark1991
12.0
3.6
7.9
UK1991
11.5
2.3
7.0
Japan1991
9.1
4.7
7.0
Netherlands1990
8.2
3.6
5.9
Spain1989
8.4
1.9
5.2
Israel1989
6.2
3.6
4.9
Portugal1991
6.9
2.1
4.6
Italy1989
5.1
1.6
3.4
Greece1990
5.2
1.1
3.2
(a) Rate per 100,000 population in the same age and sex groups.

Source: World Health Organisation (1992) World Health Statistics Annual


Years of potential life lost
More than 230,000 years of potential life were lost as a result of suicide deaths of young Australians (aged 15-24 years) in the decade to 1992. The years of potential life lost from suicide have consistently increased as a proportion of the total from all causes of death, from 12% in 1983 to 23% in 1992. In contrast, the proportion of years of potential life lost as a result of deaths of young Australians due to motor vehicle traffic accidents has declined, from 46% in 1983 to 31% in 1992.

YEARS OF POTENTIAL LIFE LOST(a), MALES AGED 15-24 YEARS


(a) Suicides and motor vehicle traffic accidents as a proportion of all causes.

Source: Causes of Death


Sex differentials
Men in general are four times more likely to commit suicide than women. In the 15-24 years age group men are more than five times more likely than women to commit suicide.

There has been speculation on the reasons for such a marked sex difference in suicide rates. These include the links between unemployment and low self-esteem, particularly among young men2. A further hypothesis is that at least part of the difference is due to a higher success rate among men, who often use more violent means3.

Methods of suicide
In 1972, the leading method of suicide for young men was using firearms or explosives (44%). However, by 1992, suicide by hanging, strangulation or suffocation had become their leading method of suicide (33%). The shift in method occurred in the mid to late 1980s. During this period the death rate for young male suicide by firearms and explosives decreased marginally, from 9 to 8 per 100,000, while the rate for suicides by hanging, strangulation and suffocation increased substantially, from 3 to 8 per 100,000. These data contradict much of the recent literature which has focused on the greater use of firearms as the cause of the increase in young male suicides.

In contrast, the most prevalent method used by young women was poisoning by solid or liquid substances, accounting for 29% of cases in 1988-92. Although the incidence of suicide from hanging, strangulation and suffocation also increased among young women during the mid to late 1980s the corresponding rate was much lower than that of young men (less than 2 per 100,000). Firearms were used in 13% of cases and hanging, strangulation and suffocation in 24%.

Support for the argument that the higher male suicide rate is due in part to their success rate comes from hospital separations data. In both Queensland and South Australia (the only two States for which data are available) female separation rates for attempted suicide or self-inflicted injury are similar to male separation rates. This could be interpreted as an indication that men and women actually attempt suicide or other self- destructive acts at approximately the same rate and that it is the higher success rate among men which leads to their higher completed suicide rate. However, without further detailed research this conclusion must be treated as speculative.


SELECTED METHODS OF SUICIDE, MALES AGED 15-24 YEARS


Source: Causes of Death
METHODS OF SUICIDE, 1988-1992
Males
Females
15-24 years
All ages
15-24 years
All ages
Method of suicide
%
%
%
%
Poisoning by solid or liquid substances
7.8
12.2
28.6
38.4
Poisoning by gases in domestic use
0.3
0.3
0.3
0.4
Poisoning by other gases and vapours
17.3
21.9
14.9
12.9
Hanging, strangulation and suffocation
31.4
26.5
24.3
20.6
Submersion (drowning)
0.9
1.9
1.8
5.7
Firearms and explosives
30.9
26.4
12.8
6.2
Cutting and piercing instruments
0.8
1.8
1.2
1.9
Jumping from a high place
3.7
3.8
9.4
7.1
Other and unspecified means
7.0
5.3
6.7
6.8
Total
100.0
100.0
100.0
100.0

Source: Causes of Death
Hospital data

Hospital data need to be interpreted with some caution. Cases are only reported as attempted suicide or self-inflicted injury/poisoning when the discharging medical officer can confirm this fact. Some under-reporting may therefore be involved. Further, because there are potential differences in reporting procedures, comparisons between States should be made with caution. It should also be noted that not all cases of self-inflicted injury will have suicide as the intended result. At best the figures presented here can be seen as an indicator of self-destructive behaviour.

RATE OF HOSPITAL SEPARATIONS(a) RELATED TO ATTEMPTED SUICIDE OR SELF-INFLICTED INJURY, 1990
State
15-24 years
25-34 years
35-44 years
45-54 years
55-64 years
65-74 years
75 years and over
Total
rate
rate
rate
rate
rate
rate
rate
rate
Queensland
      Males
94.0
72.0
46.6
30.6
17.5
13.2
23.1
45.1
      Females
102.5
69.9
55.2
43.3
20.2
10.8
14.6
48.7
South Australia
      Males
123.7
118.7
82.1
71.5
20.0
19.2
36.1
70.2
      Females
128.8
107.8
93.5
88.0
32.2
29.8
34.4
74.9

(a) Rates per 100,000 hospital separations. Separations comprise discharge, transfer to another hospital or death in hospital.

Source: Hospital Morbidity, Queensland; Hospital Statistics, South Australia; Estimated Resident Population


Deaths in custody
The Royal Commission into Aboriginal Deaths in Custody focused attention on the high proportion of Aboriginal and Torres Strait Islanders who die in custody. However, deaths in custody for the total population also increased substantially in the late 1980s. In the 12 years from 1980 to 1992, 185 young men and 7 young women died in custody. During this period 70% of young men died from hanging and 16% from natural or drug-related causes. Hanging also accounted for two thirds of the female deaths in custody4.

In 1987 deaths in custody from self-inflicted and natural causes increased for both the Aboriginal and Torres Strait Islander population and the non-Aboriginal and Torres Strait Islander population. The total number of deaths in custody of young men increased four-fold in one year, from 7 in 1986 to 29 in 1987. 24 of these deaths were from hanging, accounting for nearly a quarter of all young male suicide deaths from hanging, strangulation and suffocation. Since 1987, however, the numbers of deaths in custody have reverted to their previous rate, whereas the suicide rate from hanging, strangulation and suffocation for young men in the total population has continued at the higher level.
DEATHS IN CUSTODY RATES(a), MALES AGED 15-24 YEARS


(a) Rates per 1,000 male prisoners aged 15-24.

Source: Australian Institute of Criminology


Urban/rural differences
The most marked geographic differences in youth suicide rates are between young men in urban and rural areas. Suicide rates for men of all ages and for women differ little between rural and urban locations. However, for young men the rural suicide rate is considerably higher. As with the difference in suicide rates between men and women this may at least in part be due to higher success rates due to the use of more violent means.

In the period between 1987 and 1991, over 50% of youth suicides committed in rural areas involved the use of firearms. In urban areas the corresponding proportion was 23%. Conversely, poisoning by gases and vapours other domestic use gases was higher in urban than in rural areas, 18% compared to 10% respectively.

A recent study5 found that the greatest increases in suicide rates for youth have occurred in the smaller rural towns, with populations less than 4,000 people. The study suggests that the general movement of young people from inland to coastal areas may have resulted in greater social disadvantage for those who remain in rural areas.
METHODS OF SUICIDE BY URBAN/RURAL LOCATION, 1987-1991
Urban
Rural
Total
Method of suicide
15-24 years
All ages
15-24 years
All ages
15-24 years
All ages
%
%
%
%
%
%
Poisoning by solid or liquid substances
12.0
20.0
6.9
10.5
10.9
18.0
Poisoning by gases in domestic use
0.4
0.4
0.0
0.2
0.3
0.4
Poisoning by other gases and vapours
18.0
20.1
10.4
17.9
16.3
19.6
Hanging, strangulation and suffocation
30.7
25.3
27.8
21.4
30.0
24.5
Submersion (drowning)
1.0
2.8
0.2
2.6
0.8
2.8
Firearms and explosives
22.7
18.0
50.2
41.8
29.0
23.0
Cutting and piercing instruments
1.1
2.0
0.2
1.5
0.9
1.8
Jumping from a high place
5.8
5.1
0.8
1.3
4.7
4.3
Other and unspecified means
8.2
6.3
3.5
2.7
7.1
5.6
Total
100.0
100.0
100.0
100.0
100.0
100.0

Source: Causes of Death
URBAN/RURAL SUICIDE RATES(a), 1987-1991
Urban
Rural
Sex
15-24 years
All ages
15-24 years
All ages
rate
rate
rate
rate
Male
25.0
21.3
36.6
22.6
Female
5.1
6.0
5.0
4.0
Total
15.2
13.6
21.6
13.5

(a) Rates per 100,000 in the same age and sex group.

Source: Causes of Death


Endnotes
1 Ruzicka, L.T., Choi C.Y. (1993) Suicide mortality in Australia, 1970-1991 Journal of the Australian Population Association Vol. 10, no. 2.

2 Hassan, R. (1990) Unlived lives: trends in youth suicide Australian Institute of Criminology Conference, Adelaide.

3 Haines, J. et al (1992) Trends in youth suicide: a comparison between youth and other suicide Australian Institute of Criminology Conference Proceedings No. 13 Preventing youth suicide.

4 Australian Institute of Criminology, unpublished data.

5 Dudley, M. (1994) Suicide among young Australian, 1964-1991: urban-rural trends Public Health Association Conference on Suicide Prevention Strategies, Canberra.




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