Suicide In Queensland
Suicide inQueenslandAnnual Report2020
Suicide in Queensland: Annual Report 2020Stuart Leske, Ghazala Adam, Ina Schrader, Amra Catakovic,Bridget Weir & David CromptonAustralian Institute for Suicide Research and PreventionWorld Health Organization Collaborating Centre for Researchand Training in Suicide Prevention, School of AppliedPsychology, Griffith UniversityPlease send enquiries about this publication to theAustralian Institute for Suicide Research and PreventionGriffith University, Mt Gravatt Campus,Mt Gravatt, Queensland, 4122Phone: 61 7 3735 3382 Fax: 61 7 3735 3450Email: aisrap@griffith.edu.auSeptember 2020Please cite as Leske, S., Adam, G., Schrader, I., Catakovic,A., Weir, B., & Crompton, D. (2020). Suicide in Queensland:Annual Report 2020. Brisbane, Queensland, Australia:Australian Institute for Suicide Research and Prevention,School of Applied Psychology, Griffith University.Published by the Australian Institute for Suicide Research andPrevention, School of Applied Psychology, Griffith University.The Queensland Mental Health Commission commissionedthis report.National Library of Australia Cataloguing-inPublication entryAuthors: Stuart Leske, Ghazala Adam, Ina Schrader, AmraCatakovic, Bridget Weir & David CromptonAustralian Institute for Suicide Research and PreventionTitle: Suicide in Queensland: Annual Report 2020Subjects: Suicide--Queensland--Statistics. Suicide-Research--Queensland. Suicidal behaviour--Queensland.Dewey Number: 362.2809943Australian Institute for SuicideResearchand forPreventionAustralianInstituteSuicideResearch and Prevention
ContentsDedication 3Acknowledgements 3Support services 4How to share these statistics with others 6Notes on language 6Introduction 7The Queensland Suicide Register 8Understanding suicide 8Queensland Suicide Register and interim Queensland Suicide Register methods 9Quality of the Queensland Suicide Register data 12Caveats about the interim Queensland Suicide Register data (2017–2020) 12Comparison of the Queensland Suicide Register and the interim Queensland Suicide Register with Australian Bureau ofStatistics suicide data 12Completeness of interim Queensland Suicide Register and Queensland Suicide Register data 13Section 1 Executive Summary 14Interim Queensland Suicide Register (2017-2019) 14Queensland Suicide Register (2014-2016, finalised data) 15Section 2 Current suicide rates and trends 16A focus on 2020 16Suicide trends in Queensland 17Current suicide numbers and rates in Queensland, 2017-2019 18Analysis by remoteness 19Aboriginal and Torres Strait Islander people in Queensland 19Lesbian, Gay, Bisexual, Transgender, Intersex and Queer (LGBTIQ ) Communities 22Suicides in Hospital and Health Service catchments, 2017–2019 22Suicides in Primary Health Network (PHN) catchments, 2017-2019 24Section 3 Contributing factors and circumstantial issues 25Employment status 25Marital status 25Mental health conditions 25Suicide methods 27Section 4 Conclusion 27References 28
DedicationAcknowledgement of lived experienceWe dedicate this report to individuals with a lived experienceof suicide. That is, those who have had suicidal thoughts,survived a suicide attempt, cared for someone through asuicidal crisis, or been bereaved by suicide.1We recognise and acknowledge those with lived experience,and the critical role they have in informing the way suicide isunderstood and prevented. Each life is unique and plays aninvaluable role in suicide prevention.Acknowledgement of CountryEach person represents a rich life experience: a life born, lived,contributed, tragically lost, and always remembered.We acknowledge the Yugarabul, Yuggera, Jagera and Turrbalpeoples as the Traditional Custodians of the land on whichwe prepared this report. We pay respect to Elders, past,present, and emerging, and extend that respect to otherAboriginal and Torres Strait Islander people. We acknowledgethat these lands have long been a place of research andlearning.AcknowledgementsWe acknowledge the Queensland Mental Health Commission(QMHC) for funding the Queensland Suicide Register (QSR)from July 2013, and Queensland Health for funding theregister from 1990 to July 2013. We thank the QueenslandPolice Service (QPS) and the Coroners Court of Queensland(CCQ) for sharing police reports with the AustralianInstitute for Suicide Research and Prevention (AISRAP). Weacknowledge families, friends, police, forensic pathologists,registrars and coroners who have contributed to theinformation presented in this report. We recognise themany people who support these roles. We acknowledge theDepartment of Justice and Community Safety Victoria asthe source organisation of the National Coronial InformationSystem (NCIS) data in this report, and the NCIS as thedatabase source of that data. We would like to thank currentand former QSR investigators and research assistants. Wealso gratefully acknowledge reviewers of this report at theQMHC, the Coroners Court of Queensland and AISRAP.3 Suicide in Queensland: Annual Report 2020Each life consists of many individual stories.The QSR reflects just one part of each person’s lifestory (albeit an important experience of their life). It isacknowledged that the coronial data within this reportcontains only some aspects of the person’s experience.We perceive each suicide in this report not as a number,rather, as a personal story which taken together collectivelywith all other stories of suicide are quantified for sharedunderstanding. These collective experiences assist us toreflect quantifiable commonalities and differences amonglives lost to suicide.It is important to note that staff working on the QSR maintain thehighest respect, sensitivity and compassion towards all storiesand experiences associated with the QSR.
Support servicesThe data in this report refers to real people, lives lived, and lives lost too early to suicide. One suicide is one too many, and wework with urgency to reduce the deaths by suicide in Queensland annually.We acknowledge that some content in this report may be distressing. Please contact the following services to obtain support:LifelineAll24/713 11 14www.lifeline.org.auSuicide Call BackServiceAll24/71300 659 467www.suicidecallbackservice.org.auBeyond BlueAll24/71300 224 636www.beyondblue.org.auState Mental HealthCrisis Line QueenslandAll24/713 43 25 84(13 HEALTH)National StandByResponse ServicePeople impacted bysuicide24/7eheadspaceYouth and young people9 am to 1 am Melbournetime every day1800 650 890www.eheadspace.org.auKids HelplineYouth and young people24/71800 55 1800www.kidshelpline.com.auReachOutYouth and young people24/7MensLine AustraliaMen24/71300 78 99 78www.mensline.org.auOpen Arms —Veterans and FamiliesCounsellingCurrent and ex-servingAustralian Defence Forcemembers and theirfamilies24/71800 011 046www.openarms.gov.auThirriliAboriginal and TorresStrait Islander Australiansbereaved by suicide24/71800 805 801https://thirrili.com.auCare LeaversAustralasia NetworkPeople who have grownup in orphanages,children’s homes,missions and foster care9 am to 5 pm weekdays1800 008 774https://clan.org.auCarers AustraliaCarers9 am to 5 pm weekdays1800 242 636www.carersaustralia.com.auGriefLineAnyone experiencinggrief, loss or trauma12 pm to 3 am AESTevery day1300 845 745www.griefline.org.auheadspace SchoolSupportBereavement insecondary schools9 am to 5 pm weekdays0455 079 ifeLGBTIQ Australians3 pm to 12 am every day1800 184 527www.qlife.org.auSANE AustraliaThose affected bymental health issues9 am to 5 pm weekdays1800 187 263https://www.sane.orgWellways HelplineThose affected bymental health issues9 am to 9 pm weekdays1300 111 Contactwww.au.reachout.com4
List of acronymsAESTAustralian Eastern Standard TimeABSAustralian Bureau of StatisticsAISRAPAustralian Institute for Suicide Research and PreventionATSISPEPAboriginal and Torres Strait Islander Suicide Prevention Evaluation ProjectCALDCulturally and Linguistically DiverseCAMSCollaborative Assessment and Management of SuicidalityCBPATSISPCentre of Best Practice in Aboriginal and Torres Strait Islander Suicide PreventionCBTCognitive behaviour therapyCCQCoroners Court of QueenslandDBTDialectical behaviour therapyEvery lifeEvery life: The Queensland Suicide Prevention Plan 2019-2029HHSHospital and Health ServiceiQSRInterim Queensland Suicide RegisterLGBTIQ Lesbian, gay, bisexual, transgender/gender diverse, intersex and queerNCISNational Coronial Information SystemQMHCQueensland Mental Health CommissionQPSQueensland Police ServiceQSRQueensland Suicide RegisterRBDMRegistry of Births, Deaths and MarriagesSEMSocial-ecological modelGlossary of key termsAge-standardised rateAn age-standardised rate adjusts the crude rate to consider differences inpopulation age structures over time.2Age-specific rateThe crude (i.e. unadjusted) rate in a specific age group, expressed per 100,000males, females or persons.Crude rateThe events (i.e. suicides) in a period divided by the estimated population sizehalfway through that period.3GeocodingTaking an input address or place and providing output for geographical areas andthe coordinates (latitude and longitude) of that address or location.NumbersThe number of deaths by suicide, also known as a count or frequency.Suicide clusterThree or more closely grouped deaths in three months, linked by space or socialrelationships.4Systematic reviewA process that tries to collect evidence fitting pre-specified eligibility criteria toanswer a specific research question, minimising bias by using explicit, systematicmethods described in advance in a published protocol.5Social-ecological model of suicidepreventionThe social-ecological model of suicide prevention is a four tier frameworkof individual, relationship, community and societal levels for organising acomprehensive picture of risk and protective factors associated with at least oneaspect of suicide-related thoughts or behaviour or both.65 Suicide in Queensland: Annual Report 2020
How to share these statistics with othersMindframe, a national program that supports safe mediareporting, portrayal and communication about suicide,provides the following guidelines for interpreting theAustralian Bureau of Statistics (ABS) data, which also applyto the data in this report:“The volume of the data, the complex nature of the figures andgeneral content can be problematic or triggering for individualswho are considered vulnerable or have reduced resilience.To decrease risk and promote safe discussion and sharing ofinformation presented, please consider: Avoiding simplistic explanations that suggest figures arethe result of a single factor or event Validating grief and loss Offering context and balance Promoting help-seeking information and services Checking language to avoid sensationalised or glamorisedcontent.”Reproduced with permission from Everymind from thewebpage: dataNotes on languageAISRAP follows Mindframe’s language guide when discussing suicide. Table 1 presents problematic and preferred language.Table 1 Preferred language when discussing suicideIssueProblematicPreferredPresenting suicide as a desiredoutcome‘successful suicide’, ‘unsuccessfulsuicide.’‘died by suicide’, ‘took their own life.’Associating suicide with crime or sin‘committed suicide’, ‘commitsuicide.’‘took their own life’, ‘suicide death.’Sensationalising suicide‘suicide epidemic.’‘increasing rates’, ‘higher rates.’Language glamorising a suicideattempt‘failed suicide’, ‘suicide bid.’‘suicide attempt’, ‘non-fatal attempt.’Gratuitous use of the term ‘suicide.’‘political suicide’, ‘suicide mission.’refrain from using the term suicide out ofcontext.Reproduced with permission from Everymind from the webpage: t-suicide/language6
IntroductionThe Suicide in Queensland: Annual Report 2020 providesrecent suicide trends in Queensland to help target andinform suicide prevention activities by understanding thecircumstances of suicides. This report includes suicide datafrom 1 January 1990 to 31 July 2020.The information in this report comes from a public healthsurveillance system — the Queensland Suicide Register(QSR) and the interim Queensland Suicide Register (iQSR).Public health surveillance is critical to public health andinvolves capturing, analysing and interpreting health data.7Health services use this information to plan, implement andevaluate interventions and share timely information withthose who need to know to take prompt action to preventfurther suicides.8 Surveillance is critical (Figure 1) toeffectively understand and prevent suicides.9Suicide surveillance shows the size of the problem, helpsdevelop health priorities, prioritise populations, and findpatterns in suicide methods.10 Surveillance can identifysuicide clusters in specific geographical locations like townsor physical sites. Most importantly, surveillance systemscan assess the impact of suicide prevention strategies andactivities. As the number, characteristics and methods ofsuicides vary widely between people, places and acrosstime, real-time surveillance of suicides is critical to supporttailored local, state, and national suicide preventionefforts.112. Identifyrisk&encWhat are the causes& what can buffertheir impacttorsfacWhat is the problem?proivectte1.SurveillaFigure 1 The role of surveillance in preventing suicideDefine the problem ofsuicidal behaviour throughsystematic data collectionConduct research to find outwhy suicidal behaviour occursand who it affectsScaling up effectivepolicies & programmesWhat works &for whom?ventio nsmple mtteenatioDesign, implement andevaluate interventionsto see what worksinter4. IScale up effectiveand promisinginterventionsand evaluatetheir impactand effectivenessnpeloveD3.&aluveaReprinted with permission from Preventing suicide: A global imperative, World Health Organization, page 13, Copyright(2014). Accessed 17 April 2018 at who.int/mental health/suicide-prevention/world report 2014/en7 Suicide in Queensland: Annual Report 2020
The Queensland Suicide RegisterThe QSR is a longstanding public health surveillance system operating since 1990 including records on all confirmed, probable andsuspected suicides by Queensland residents from 1990 to 2016. AISRAP manages the QSR, and the QMHC funds the QSR.In 2011, AISRAP developed the interim QSR (iQSR) to provide real-time suicide mortality data. iQSR information comes frompolice reports of suspected suicides to coronersi. The iQSR contains suspected suicides for the years 2017 to present day.Information on suspected suicides remains in the iQSR until coroners finalise investigations and deaths close in the NCIS. QSRstaff then enter these suspected suicides into the QSR.Understanding suicideSuicide has a significant human toll, with far-reaching impacts.In 2018 there were 3,046 deaths by suicide registered inAustralia.12 Queensland accounted for 25.8% of these deaths,but 20.1% of Australia’s population.13 Queensland also hadthe second-highest suicide rateii of all Australian jurisdictionsfor deaths registered in 2018.14In a representative study of 3,002 Australians, 58% reportedexposure to the suicide of someone they knew.15 This exposureto suicide is associated with an increased likelihood of suicideattempts and deaths.16 These losses produce grief in immediatefamily members.17 Society-wide, suicide also has a substantialimpact extending beyond immediate relatives and friends.18A recent systematic review found that exposure to suicideincreases the risk of suicide-related behaviours following nonkin suicide deaths.19 Non-kin close to those dying by suicidereport higher levels of distress than kin close to those dying bysuicide.20Suicidal behaviour is complex, with no simple explanationsor solutions. There are many models and theories to explainsuicidal thoughts and actions, and no single model appearsto have gained widespread acceptance worldwide. Thesocial-ecological model (SEM)21 focuses on the relationshipbetween individual and environmental characteristics,allowing for a multi-level public health approach topublic health concerns. This model suggests that society,community, relationship, and individual protective and riskfactors influence suicide (Figure 2). The SEM emphasisesthe need for prevention efforts to occur on multiplelevels, with communication between different sectors anddisciplines, to consider various levels of influence.22 Thesemulti-level efforts are more effective than their componentsalone. 23 Modern suicide prevention frameworks recognise theimportance of a social-ecological, systems-based approachto suicide prevention that involves responses both in andoutside health services.Figure 2 Examples of risk and protective factors for suicide deaths in a social-ecological modelProtective factorsRisk factorsLimited health services available,lethal means available (e.g. highfirearm ownership), unsafe mediaportrayals of suicideRestricted access to lethal meansand availability of physical andmental health careSafe and supportive work andcommunity environments,cultural connectedness,continued care after hospitalisationSocietalCommunitySocial isolation and fewsupportive relationships,lack of contact with healthservices providersRelationshipStable and supportive relationships;connecteness to family, friends,community and social institutions.Coping and problem-solving skills,reasons for living (e.g., children inthe home), moral objections to suicideIndividualRelationship conflict or separation,violent relationships,family history of suicide,intergenerational traumaMental health conditions, substanceabuse, previous suicide attempts,impulsivity, aggressioni Interested readers can find the template for this police report at https://www.courts.qld.gov.au/ data/assets/pdf ii All mentions of the ‘suicide rate’ refer to the age-standardised suicide rate. The glossary has a definition of the age-standardised suicide rate.8
The SEM helps ensure that suicide prevention plans,activities and policies are comprehensive, coordinated,complementary and responsive to the issues identified frominformation on suicides by Queensland residents. Every life:The Queensland Suicide Prevention Plan 2019-2029,24published by the QMHC on behalf of the QueenslandGovernment, outlines the multi-level, coordinated actionsin Queensland on suicide prevention. This report mentionsEvery life to indicate how the literature and QSR findingsalign with it.Queensland Suicide Register and interim QueenslandSuicide Register methodsThe QSR contains demographic, psychosocial, physical,psychological, interpersonal and circumstantial information onsuicides in Queensland from 1990 to 2016. This information isvital to try to understand to prevent future suicides.There are four primary data sources:1. The police reportiii of a suspected suicide to a coroner (Form1), which includes sections on demographic information,general and mental health, and findings from interviewingnext-of-kin, friends or acquaintances. This report is the soledata source for the iQSR but one of four QSR data sources.A QPS Officer completes this form soon after death,following an interview with the deceased’s next-of-kin orother available people who knew the deceased. AISRAPreceives police reports from the QPS and the Coroners Courtof Queensland.Other data sources used only in the QSR come from theNCIS.iv The NCIS is an online repository of Australian coronialdata that provides access to three separate data sources:2. A toxicology report to detect substances that the personmay have consumed before death.3. A post-mortem autopsy, which examines the cause ofdeath soon after a person’s death.4. The coroner’s findingv, which summarises the person’scircumsta
Notes on language AISRAP follows Mindframe’s language guide when discussing suicide. Table 1 presents problematic and preferred language. Table 1 Preferred language when discussing suicide Issue Problematic Preferred Presenting suicide as a desired outcome ‘successful suicide’, ‘unsuccessful
3 Source: Consumer Price Index (report), June quarter 2021 , Queensland Government Statisticians Office, Queensland Treasury. 4 Source: Consumer Price Index (report), September quarter 2021 , Queensland Government Statisticians Office, Queensland Treasury. 5 Source: Wage price index, Queensland and Australia, 1997-98 to 2020-21 , Queensland
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Suicide, Samaritans USA , Suicide Awareness Voices of Education , and Yellow Ribbon Suicide Prevention Program. The strategy also reflects the input of family members who have lost loved ones to suicide, those who have attempted suicide, national organizations dedicated to
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