SUICIDE in RURAL & REMOTE AREAS of AUSTRALIA - Living is for ...

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Suicide in rural and remote areas of Australia
In metropolitan locations, male suicide was adversely
affected by unemployment. This result aligns with
previous research on the relationship between suicide
and social factors (Chuang & Huang, 2007; Milner et
al, 2010). Aside from the loss of a job, unemployment
may increase the risk of suicide by creating the feeling
of role loss. This may be particularly detrimental to
males, considering the emphasis males place on
the role of “breadwinner” (Möller-Leimkühler, 2003).
The adverse infl uence of mobility (measured as the
proportion of person who lived overseas in the past
year) on male suicide may be indicative of wider
disruption in social and community networks. In the
past, researchers have argued that mobility within a
neighbourhood reduces social integration (bonds
and relationships in society), leading to higher risk
for suicide (Congdon, 1996; Middleton et al, 2006,
Thorlindsson & Bernburg, 2009). This may provide
some explanation for our results.
A higher number of GPs services (per 100 persons)
was related to lower female suicide in metropolitan
and remote areas, perhaps providing support for past
research on the relationship between GPs and suicide
rates in a population (Mann et al, 2005). However,
further investigation would be needed into how many
of these GP services concerned the identifi cation
and management of suicide before this explanation
can be confi rmed. Expenditure on psychotropic
medication, such as antipsychotics, anxiolytics,
hypnotics and sedatives, and psychostimulants,
was associated with an increase in female and male
suicide within metropolitan areas. This may be related
to the higher suicide rates of persons taking these
types of medications in metropolitan localities, who
may already be at high risk due to mental illness
(Hawton et al, 2005; Siris, 2001) or other conditions
for which psychotropic medication is prescribed, such
as chronic pain. It is also necessary to consider that,
compared to remote areas, there are more hospitals
in metropolitan areas, as well as out-patient facilities
and other services for mental health treatment (Dixon
and Welch, 2000; Fraser et al, 2002). Therefore, the
adverse effect of these psychotropic medications
on suicide may be due to the infl uence of a specifi c
high-risk sample group residing in metropolitan areas.
However, confi rming this explanation would require
further analysis controlling for rates of individual
mental health contacts and actual number of deaths
due to overdose of psychotropic medications.
The proportion of males/females with a family (e.g.,
partner and child) was associated with a decrease
in male suicide in remote areas and with lower
female suicide rates in remote areas. These apparent
protective effects of having children have been noted
in previous studies in suicide research (Qin et al,
2003; Stack, 1997; Stack; 1996-97). A possible
explanation for these results is that they provide an
indication of social support – or social integration – in
society (Durkheim, 1897/1951).
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