Two significant studies on suicide and mental health that were released this week propose two very different approaches to reducing suicides.
One suggests increasing funding for the workforce in mental health, according to the House of Representatives Select Committee on Mental Health and Suicide Prevention. Recruiting and educating more health professionals is part of this.
Although this may seem admirable, I contend that the data indicates it is unlikely to succeed.The other report, also released today, offers the most recent statistics on suicide and self-harm. It is from the Australian Institute of Health and Welfare (AIHW). There are no suicide prevention recommendations in this report. On the other hand, it highlights child abuse and neglect as a significant modifiable risk factor for suicide across the lifespan.
Further research supports this method of avoiding suicide that involves addressing the root reasons. Yet, the report of the select committee hardly made any note of this.In my personal response to the select committee report, I made the case that expanding treatment options is not likely to lower suicide rates.
Australia has significantly boosted funding on mental health services and grown the mental health workforce over the past 15 years or so.
Yet, over this time, there has been an increase trend in the suicide rate. The AIHW survey showed a 13% increase in suicide-related fatalities between 2003 and 2019.
One can argue that if services had not increased, suicide rates would have climbed even higher over this time, or that the increase in services was insufficient to fulfill demand.
Nevertheless, a look at long-term suicide rates in Australia over three decades reveals no indication that numerous service innovations and mental health reforms have had any impact.
While it might be expected treating mental health problems with talk therapy or medication would reduce suicide deaths, there is very little evidence from randomised trials to support a reduction in suicide as a result of treatment.
A major limitation of any attempt to reduce suicide is that suicidal feelings often arise relatively quickly in response to overwhelming events. These include relationship breakdown, loss of a job, financial crisis or trouble with the law.
Suicidal actions can also be impulsive. This may be particularly the case for males and is more likely when the person has been using alcohol. In such circumstances, if a mental health professional was present, they may be able to support the person and prevent a suicide.
However, in practice, it is unlikely a professional will be present when a crisis occurs. This is why it is important everyone in the community has basic suicide prevention skills, as they may be in the best position to provide support on the spot.
