Psychosocial risk factors and deaths by suicide
Capturing information on risk factors relating to deaths by suicide can highlight areas of a person's 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.
As part of the National Suicide and Self-harm Monitoring Project the AIHW has funded the Australian Bureau of Statistics (ABS) to identify and code (using ICD-10) psychosocial risk factors for deaths referred to a coroner, including deaths by suicide.
In 2020, the ABS added codes for the capture of the COVID-19 pandemic as a risk factor based on how it was described as part of the coronial investigation:
- F41.8 Pandemic-related anxiety and stress
- Z29.0 Isolation or quarantine (hotel or home), and
- Z29.9 Prophylactic measures put in place through health directives for pandemic response, including closure of business and stay at home measures.
Although there was a 6.3% reduction in the number of deaths by suicide from 2019 to 2021, there were 81 people who died by suicide in 2021 (2.6% of all suicides) who had the COVID-19 pandemic mentioned in either a police or pathology report, or a coronial finding. However, for people who died by suicide and had the COVID-19 pandemic mentioned as a risk factor, it did not appear as an isolated risk (they had, on average, 6 risk factors and 3 psychosocial risk factors). It is important to remember that circumstances relating to suicide are complex and multifaceted and a combination of multiple factors contribute to a person taking their own life rather than a single reason.
In 2021, of those who died by suicide with issues relating to the COVID-19 pandemic as a risk factor:
- over 65% also had mood disorders, including depression
- almost 40% also had problems relating to employment or unemployment
- 11 people also had problems related to the social environment, including social isolation (this is down from 25 in 2020)
- the majority of people lived in New South Wales, Victoria, or Queensland.
When COVID-19 was mentioned as a risk factor it manifested in different ways. For some people direct impacts from the pandemic, such as job loss, lack of financial security, family and relationship pressures, and not feeling comfortable with accessing health care were noted. For others, a general concern or anxiety about the pandemic and societal changes were stated or anxiety about contracting the virus itself.
From 2017 to 2021, around two-thirds of all deaths by suicide had at least one or more psychosocial risk factor identified. 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, 2021.
The horizontal bar graph shows the proportion of coroner-certified deaths by suicide with psychosocial risk factors identified in males in Australia in 2021. 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.
From 2017 to 2021:
- 'Personal history of self-harm' was the most commonly identified risk factor in males and females in all age groups (except 65 and over) with 16% and 33% respectively.
- ‘Limitation of activities due to disability’ was the most commonly identified risk factor in males and females aged 65 and over (25% and 22% respectively).
- ‘Disruption of family by separation and divorce’ and ‘Problems in relationship with spouse or partner’ were common risk factors in males and females aged under 55.
- ‘Problems related to other legal circumstances’ was a common risk factor in males aged 25–54 (associated with more than 10% of deaths by suicide).
- 'Other problems related to housing and economic circumstances' emerged as another common risk factor in males aged 35-64 (associated with 9% of deaths by suicide in these age groups).
- ‘Disappearance and death of a family member’ was also identified as a frequently occurring psychosocial risk factor in males and females.
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.
ABS (Australian Bureau of Statistics) 2022. Causes of Death, Australia 2021. ABS Catalogue number 3303.0.