Main findings

This study used national Australian coronial data to provide updated population-level suicide rates for major occupational skill classes and to uncover new information on suicide trends following the year 2010. We found there was limited evidence of a reduction in disparity trends between lower-skilled occupation classes and the highest-skilled class of managers following the GFC. Our hypothesis was therefore only partially supported, with the finding that among males there was a significant reduction in the disparity between managers and labourers and technicians/trades workers for the period 2013–2015, relative to the GFC period of 2007–2009.

Interpretation of our findings

Although there have been several reports of increased suicide among the general population in response to the GFC in England,^{Reference Barr27} Spain^{Reference Lopez Bernal28} and the USA^{Reference Reeves29} up to 2010, as well as reports of increased disparity between lower-class and the highest-class occupations in Australia,^{Reference Milner, Niven and LaMontagne20} follow-up studies beyond this period are limited. Extending this research, this study showed a decrease in the divergence in suicide rates among the employed population was largely not observed beyond the initial GFC period with the exception of male labourers and technicians/trades workers over the period 2013–2015. This finding aligns with past research from Australia regarding the GFC among construction workers, which described a peak in suicide risk among machine operators and labourers relative to skilled trade workers in 2008 followed by a decline between 2009 and 2010.^{Reference Milner, Niven and LaMontagne10} It is thought that the higher burden of suicide among labourers and other low-skilled workers may reflect population-level risk associated with lower socioeconomic status and social disadvantage.^{Reference Roberts, Jaremin and Lloyd17,Reference Pitman30}

Although it is reasonable to assume that the effect of the GFC on the employed population was heterogeneous, having an impact on different groups at different times, the reduction in suicide risk among male labourers and technicians/trades workers may be related to government initiatives during a period of economic uncertainty. During the period 2008–2009, the Australia government implemented the $10.4 billion Economic Security Strategy and the $42 billion National Building and Jobs Plan stimulus initiatives.^{Reference Rudd31} Although it is beyond the scope of this study to determine whether the relationship between such significant stimulus initiatives and the reduction in suicide among these groups is causal, the initiatives gave preference to direct cash payments to low- and middle-income households over tax cuts, as well as a focus on long-term construction projects. For example, the National Building and Jobs Plan supported extensive construction projects commissioning an estimated 10 000 new school buildings and 20 000 new social housing dwellings.^{Reference Ferran32} Indeed, data from the Australian Institute of Health and Welfare supports increased commencement and completion of construction projects between 2013 and 2015.³³ Such investments in construction infrastructures may have helped to retain construction employment opportunities across different communities, reducing levels of job insecurity and household economic stress, which are known risk factors for suicidal behaviour.^{Reference Roberts, Jaremin and Lloyd17,Reference Blomqvist34,Reference Shand, Duffy and Torok35}

Another possible explanation for the observed risk reduction among male labourers and technicians/trades workers is the development of a construction industry-specific suicide prevention and early intervention programme, MATES in Construction, established in 2008 by the Building Employees Redundancy Trust.^{Reference Gullestrup, Lequertier and Martin36} The programme was designed to improve mental health and suicide prevention literacy and connect workers to available help and support services.^{Reference Gullestrup, Lequertier and Martin36} An evaluation of MATES in Construction has shown the programme to be effective in reducing suicide risk, with male suicide rates in the Queensland construction industry reduced by 7.9% during the first 5 years of the implementation against an overall increasing rate of male suicide.^{Reference Martin, Swannell and Gullestrup37}

Although, to our knowledge, this study provides the most up-to-date examination of suicide by occupation class in Australia, the findings still confirm the results previously reported by Milner et al,^{Reference Milner, Niven and LaMontagne20} indicating that overall suicide rates remain highest among machinery operators/drivers, labourers, technicians/trades workers and farmers/farm managers and that this risk was elevated among males. Associations between potential forces exerted by social, workforce, interpersonal and economic stressors that may have influenced suicide risk in these occupations were not examined in this study as such variables are not routinely coded in NCIS data. Previous studies have shown that both work (for example low job control or poor co-worker and supervisor support) and non-work factors (such as relationship breakdown or conflict) are associated with psychological distress and suicide.^{Reference Milner38–Reference Arnautovska, McPhedran and De Leo40} These factors align with past research on suicide among males employed in construction,^{Reference Heller, Hawgood and De Leo5} mining^{Reference McPhedran and De Leo11} and agricultural industries.^{Reference Oo, Liu and Lim41} For example, male construction workers in Queensland, Australia, who died by suicide were more likely to have reported recent relationship problems and multiple stressful life events preceding death, compared with males who died by suicide in other occupations.^{Reference Heller, Hawgood and De Leo5} Issues such as long working hours, workplace pressure, job insecurity, non-disclosure of personal problems to colleagues and marital breakdown were also identified as potential contributing factors to suicide among construction workers.^{Reference Heller, Hawgood and De Leo5} Future studies exploring occupation-specific psychosocial job stressors are needed to improve current understandings of the relationship between the contextual factors related to occupation and suicide.

Limitations

In terms of limitations, we acknowledge the complexities of coronial determinations regarding suicide. In some instances, it may not be possible for a coroner to make a finding of suicide because of legal evidence thresholds required to make such a finding, and there may be differing practices within and between coronial jurisdictions in Australia. Additionally, because of the substantial time required for the coronial process to make a final determination for suicide deaths, and for these cases to be updated in the NCIS database, this study only included closed cases up to and including 2018 (2018 captured 99.4% of closed NCIS intentional self-harm cases at the time of extract). By choosing the most recent year with the highest proportion of closed cases, this study was unable to examine the impact of the COVID-19 pandemic on the Australian workforce. Given the significant economic and mental health impact of the public health measures taken during the COVID-19 pandemic, future studies should examine the potential toll on suicides across occupations at a more granular level than major occupational skill classes, such as among specific healthcare, retail, hospitality and creative arts occupations.

Although it would have been desirable to analyse occupation categories by indigenous status and country of birth, this was not possible because of the small number involved even after combining 3 years of cases. Future occupational-specific suicide research should incorporate both indigeneity and migrancy to explore their influence on the role of occupational class disparity in suicide.

It is also necessary to comment on the finding that rates of female suicide over the entire study period were highest among the male-dominated occupational class of technician/trades worker, as well as evidence of increasing disparity between female managers and female labourers and community/personal service workers for the period 2016–2018 relative to the GFC period of 2007–2009. However, we acknowledge these findings may be spurious because of the small number of female suicides in these occupational classes. In stating this, there is evidence that female technicians/trades workers report experiencing discrimination in hiring practices, male-dominated workplace culture, sexual harassment, negative attitudes from male co-workers, fewer career opportunities and poor working conditions.^{Reference Oo, Liu and Lim41} Specific data on these factors are needed and future studies should apply novel mixed-methods approaches to understand the influence of the workplace environment on females who engage in antecedent behaviours to suicide, that is, self-harm and suicidal ideation.

Finally, it is possible that occupation-related free-text fields may have been misreported in coronial documents or miscoded by investigators, the latter of which may have occurred despite coding by three independent researchers and the replication of a structured approach used in a previous study.^{Reference Milner, Niven and LaMontagne20}

Implications

Together, these findings show that skilled manual and lower-skilled work is enduringly associated with a considerable risk of suicide compared with other non-manual and higher skilled occupational groups. Machinery operators/drivers, labourers, technicians/trades workers and farmers/farm managers were particularly at high risk, compared with managers. Although this study demonstrated some evidence to support a reduction in the suicide rate disparity between the lowest- and highest-occupational classes following the GFC, disparities remain.

To better inform workplace suicide prevention activity, future research should seek to understand and address the contextual drivers associated with suicide among the employed population most at risk at a more specific level of occupation classification. This information could in turn provide helpful information to help guide government policy, particularly during periods of economic instability.