Rates of suicide are higher among people in regional and remote areas, those of low socioeconomic status, and Indigenous people – all populations for whom experts say improved access to services is needed, a report has found.
The Australian institute of health and welfare (AIHW) released its report on Wednesday, finding that in 2010-11 more than 2,280 people took their own lives, though suicide rates have declined more recently from a peak in 1997-98.
The suicide rate was found to be higher among the approximate third of the Australian population who live in regional or remote locations, as well as among people living in disadvantaged areas, and was almost twice as high among people of Aboriginal or Torres Strait Islander descent.
In big cities the rate of suicide was below the average 10.1 deaths per 100,000 and increased with remoteness of living, up to 18.1 deaths per 100,000 people in “very remote” areas.
Deaths among men living in areas with high socioeconomic disadvantage were almost 1.5 times the rate of those living among the least disadvantage. There was a less marked pattern for women.
Research from the National Rural Health Alliance indicates that it is not living in remote areas that leads directly to mental illnesses, but rather factors including socioeconomic disadvantage, lack of access to mental health services and community resources, and environmental hardship, which contribute.
“There’s a range of factors,” Dennis Pashen, president of the Rural Doctors Association of Australia told Guardian Australia.
In non-Indigenous rural populations, where the suicide rate is high, “it might be economic disadvantage, drought, depression, access to guns, alcohol and drug use. All these things [can] combine,” he said.
Among Indigenous populations, “there’s the socioeconomic disadvantage experienced by remote communities, the lack of employment, lack of income, lack of valued employment, there’s also cultural dislocation,” he said.
An Indigenous campaign launched last month sought to draw attention to the high rate of suicide in remote Indigenous communities, including among children.
Elders and community leaders called for greater engagement with Indigenous people when working on prevention strategies, as some said a disconnection from culture was a contributing factor.
The AIHW figures for Indigenous suicide rates were in line with data from a report on Indigenous disadvantage released last month.
That report found that between 2004-05 and 2012-13 admissions to hospital for self harm increased by 48%, and the proportion of adults reporting high or very high psychological distress rose from 27% to 30% over the same period.
According to the AIHW on Wednesday, in the 12 years from 1999-2000 admissions for female self harm were 40% higher than for men. The female rates were “markedly” higher than males in the teenage years.
In the five years to 2010-12 rates of admission of Indigenous people were 2.5 times higher than non-Indigenous among men, and twice as high among women.
Prashen said there was probably a “fair gap” between mental health services outside cities and in metropolitan areas, and that unemployment and other signals of disadvantage need to be addressed to improve mental health and reduce the cost burden on the state.
“The problem we’ve got in rural and remote areas is we now know – and it varies from year to year – between 59% and 60% of health costs are attributable to mental health issues. This includes depression, suicidality, alcohol, drugs, domestic violence, child abuse,” he said.
“Unless you start to address some of the employment issues, the socioeconomic disadvantage, and unless you start to address that cultural disparity and grief that’s out there you’re not going to make much headway.”
“A lot of these issues which actually impact cost-wise on the disease burden in rural and remote communities, are attributable to mental health issues. It’s cheaper to treat it than it is to ignore it and pick up the pieces afterwards.”
This article first appeared on ‘The Guardian’ on 4 December 2014.