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

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Suicide in rural and remote areas of Australia
Initial information about the deceased was gathered
from the Queensland Offi ce of State Coroner,
Queensland Police Service (Queensland) and Glebe
Coroners Court (Sydney). Subsequently, a letter
introducing the study to potential informants, along
with the study information sheet and consent form,
was sent to participants. On receipt of the consent
form, or a NOK’s signed authorisation form (given
by Queensland Police Service), clinical interviewers
followed-up with a phone call to invite the NOK to
participate and arrange a time and place for the
interview. Clinical interviewers then conducted semistructured
interviews with the NOK of the deceased
which lasted 1 to 3 hours. These interviews aimed
to establish the presence or absence of recognised
predictive factors for suicide by following a semistructured
format and using validated scales/
questionnaires. During the study period (2006-
2008), information on 261 suicide victims and 182
sudden death victims from NOKs was collected.
Healthcare professionals (HCP) were identifi ed
through the interviews with the NOK and with
other HCPs, from coroner’s fi les, and medical fi les
(Queensland Health). HCPs were fi rst contacted
via a formal letter and followed-up approximately
1 week later by a phone call, asking agreement for
participation. HCPs were offered $100 for their
professional time. The HCP interview was conducted
with professionals (e.g., GPs, counsellors, social
workers) with whom the deceased had contact
during the six months before death. The HCP
interview took approximately one hour to complete.
Information gathered in the interview included: a
description of the last contact, treatment compliance,
functional capacity, and a history of self-harm and
suicidal behaviours. Information from 211 healthcare
professionals (152 suicide cases) and 92 healthcare
professionals (81 sudden death cases) was gathered.
However, HCPs were only interviewed if they had
seen the deceased within six months. Considering
the aims of the present report, only information
gathered from NOKs has been analysed.
The PA Study included a question about the
geographical location of the deceased at the time
of their death; this was based on ARIA+ categories.
Consequently, for the present analysis, both cases
and controls were divided into two groups: living in
urban regions (metropolitan and inner regional) and
living in rural regions (outer regional, remote and very
remote). All NSW cases were excluded from the
analysis as these study subjects only lived in urban
areas; this could have presented a possible bias in
the analysis. In total, the study included 50 suicide
cases and 26 sudden-death controls from rural
regions, and 150 suicide cases and 108 suddendeath
controls from urban regions; all were aged 35+
years, in Queensland, and died between 2006 and
2008 (Figure 2).
The study was approved by the Griffi th University
Human Research Ethics Committee and South
Eastern Sydney Human Research Ethics Committee.
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