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

Chapter Three
Individual-level factors related to suicide in
rural and remote areas of Queensland
Kairi Kõlves, Kathy McKay, Diego De Leo
As examined previously, suicide in rural areas is
affected by myriad factors, some of which are
unique from the experience of suicide in urban
areas. Chapter Two presented an analysis of
contextual factors on an aggregated level. This is
crucial when we assess suicide risk at an individual
level, especially considering that suicide risk and
protective factors differ depending on wider social,
cultural and economic environments. Consequently,
Chapter Three will continue with individual-level
analyses, comparing risk factors in rural and urban
areas of Queensland. It will also illustrate statistical
analyses with four rural case studies.
The aims of the quantitative analyses were:
• To assess suicide predictors in rural and urban
regions by comparing rural suicide to rural
sudden-death, and urban suicide to urban
sudden-death; and,
• To compare the differences between rural
suicide and urban suicide.
Methodology
Background and design of the study
This chapter will use information collected within
the frames of the Australian Research Council
Linkage Project (LP0562078) “Preventing suicide: A
psychological autopsy study of the last contact with a
health professional before suicide”. This study used a
case-control psychological autopsy study approach.
The Psychological Autopsy (PA) method was applied
when investigating completed suicides (study group)
and sudden deaths (control group), aged 35+ years
in QLD and NSW. The sudden death group included
heart attacks, road traffi c accidents (RTA) and other
accidents, but excluded accidental overdoses,
homicides and single vehicle RTAs. The PA obtained
information from interviews with next-of-kin (NOK)
and healthcare professionals about the deceased for
both suicides and sudden deaths.
PA is a valuable tool both for determining the manner
or mode of equivocal deaths and eliciting information
from important sources including medical and police
reports, personal documents, interviews with NOK,
and clinical opinions from health professionals
(Pouliot & De Leo, 2006). This method has been used
in numerous suicide studies and it has been proved
to be reliable and valid (Pouliot & De Leo, 2006;
Hawton et al, 1998). It has also been considered to
be an appropriate method to study suicide and other
death survivors. Several researchers have observed
the therapeutic effect of PA interviews on survivors
(Hawton et al, 1998; Henry & Greenfi eld, 2009).
They have found that PA is helpful to interviewees in
allowing them to fi nd meaning in the suicide, obtain
social support, experience connectedness with
others, accept the loss as real, and gain insight into
their functioning (Henry & Greenfi eld, 2009).
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