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

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Suicide in rural and remote areas of Australia 41 As noted, there were substantially fewer signifi cant associations between contextual variables and female suicide. Durkheim (1897/1951) explained that females were more likely to be immune from the harmful effects of contextual changes in the social environment because of their greater involvement in the domestic sphere, particularly with family life (Kushner & Sterk, 2005). Comparatively, male gender roles are more heavily orientated towards occupation and fi nancial factors, which may explain their vulnerability to factors in the social environment (Möller-Leimkühler, 2003). As reported above, those variables which appeared to be related to a decrease in female suicide rates included family (in remote areas only), religion, and GP services. However, the effect of expenditure on psychotropic medication was related to an increase in female suicide rates in metropolitan areas, as was divorce. Both these results were similar to fi ndings from males in metropolitan areas. Conclusions Results of this ecological analysis suggest marked differences in suicide occurring in remote areas, compared to regional and metropolitan areas. This is not only apparent in terms of the sheer numbers of suicides in remote areas, but also in terms of the contextual infl uences on suicide rates. In remote areas, male suicide was mostly often connected to agricultural employment and the ethnic distribution of the population, as well as spending on antidepressants and education. In comparison, an increase in suicide in metropolitan areas was connected to other kinds of psychotropic medications, unemployment and population mobility. Regardless of area of residence, divorce was found to have a universally negative infl uence on the male suicide rate. There were fewer signifi cant associations between contextual factors and female suicide, which supports the idea that males are more sensitive to environmental infl uences on suicide than women. However, female suicide appeared to be more strongly related to treatment services provided by GPs than males. The different contextual infl uences on suicide in metropolitan, regional and remote areas indicate the need for contextually-relevant suicide prevention strategies, rather than a single and uniform intervention applied across all groups in a population. Specifi cally, results suggest the importance of greater focus on detrimental circumstances or ‘risks’ within a population, such as stressors associated with agricultural employment in remote areas, and unemployment in metropolitan areas. The negative infl uence of divorce indicates the need for suicide intervention and prevention initiatives to be directed at males undergoing relationship breakdowns. GriffithBook FINAL 20/09.indd 41 15/11/12 4:28 PM
42 Suicide in rural and remote areas of Australia Our analysis also suggested a number of protective elements, such as GP services access and antidepressants in rural areas, as well as family and religious social bonds. Suicide prevention initiatives could capitalise on these positive infl uences through actively promoting family and friend networks as factors that are protective against suicide, and by training GPs in how to identify and manage suicide in rural areas. GriffithBook FINAL 20/09.indd 42 15/11/12 4:28 PM
Page 1 and 2: Australia’s rural localities face
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92 Suicide in rural and remote area
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