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Effectiveness of Australian youth suicide prevention initiatives

  • Andrew Page (a1), Richard Taylor (a2), David Gunnell (a3), Greg Carter (a4), Stephen Morrell (a2) and Graham Martin (a5)...
Abstract
Background

After an epidemic rise in Australian young male suicide rates over the 1970s to 1990s, the period following the implementation of the original National Youth Suicide Prevention Strategy (NYSPS) in 1995 saw substantial declines in suicide in young men.

Aims

To investigate whether areas with locally targeted suicide prevention activity implemented after 1995 experienced lower rates of young adult suicide, compared with areas without such activity.

Method

Localities with or without identified suicide prevention activity were compared during the period of the NYSPS implementation (1995–1998) and a period subsequent to implementation (1999–2002) to establish whether annual average suicide rates were lower and declined more quickly in areas with suicide prevention activity over the period 1995–2002.

Results

Male suicide rates were lower in areas with targeted suicide prevention activity (and higher levels of funding) compared with areas receiving no activity both during (RR = 0.89, 95% CI 0.80–0.99, P = 0.030) and after (RR = 0.86, 95% CI 0.77–0.96, P = 0.009) implementation, with rates declining faster in areas with targeted activity than in those without (13% v. 10% decline). However, these differences were reduced and were no longer statistically significant following adjustment for sociodemographic variables. There was no difference in female suicide rates between areas with or without targeted suicide prevention activity.

Conclusions

There was little discernible impact on suicide rates in areas receiving locally targeted suicide prevention activities in the period following the NYSPS.

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Copyright
Corresponding author
Dr Andrew Page, Discipline of Epidemiology and Biostatistics, School of Population Health, University of Queensland, Herston Road, Herston, QLD 4006, Australia. Email: a.page@sph.uq.edu.au
Footnotes
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Declaration of interest

None.

Footnotes
References
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
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Effectiveness of Australian youth suicide prevention initiatives

  • Andrew Page (a1), Richard Taylor (a2), David Gunnell (a3), Greg Carter (a4), Stephen Morrell (a2) and Graham Martin (a5)...
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eLetters

Suicide prevention

Saxby Pridmore
Professor of Psychiatry
16 November 2011

Congratulations to Page et al (2011) for their paper showing little discernible impact of the targeted suicide prevention strategies of the National Youth Suicide Prevention Strategy implemented in Australia in 1995. Suicide prevention initiatives have not reduced national suicide rates in the USA (Institute of Medicine, 2002) or elsewhere (De Leo & Evans, 2004).

Distress (Horwitz & Wakefield, 2007) and suicide (Pridmore, 2011)have been medicalized, and ensuing responses have failed to reduce suiciderates.

There are many unknowns in suicide. What we do know is that ever since records have been kept (over a century in many cases) some constraints remain. For example, the suicide rate of Lithuania has been higher than Australia, which has always been higher than the UK, which hasalways been higher than Greece. The rate in Scotland is higher than England, in Tasmania is higher than New South Wales, and in Alaska is higher than Washington, DC. This is not because one people is sicker than another, but because cultures (what we think, drink and do) and other factors differ.

Changes in socioeconomic circumstances influence suicide rate, usually in relation to major events such as countries being engaged in war(decrease rate) or experiencing economic collapse (increase rate).

If we want to influence national suicide rates we need to get beyond the idea that we can do it my locating all the sick people and treating them, to thinking about how we can change the cultures and the social determinants which support the higher rates.

De Leo, D., & Evans, R. (2004) International Suicide Rates and Prevention Strategies. Cambridge, MA: Hogrefe & Huber.

Horwitz, A., & Wakefield, J. (2007). The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder. Oxford: Oxford University Press.

Institute of Medicine (2002) Reducing suicide: and American imperative. Washington, D.C.: National Academy Press.

Page, A., Taylor, R., Gunnell, D., et al (2011) Effectiveness of Australian youth suicide prevention initiatives. British Journal of Psychiatry, 199, 423-429.

Pridmore, S. (2011) Medicalization of suicide. Malaysian Journal of Medical Sciences, 18, 77-82.

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Conflict of interest: None declared

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