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suicide

suicide

see also:

  • Victorian resources:
    • HOPE = Hospital Outreach Post-suicidal Engagement
      • “The aim of the HOPE initiative is to provide an assertive outreach approach to people who would not usually receive follow up by a clinical mental health service. It is a different cohort of consumer with a greater emphasis on non-clinical, psycho social support in the approach. HOPE aims to address a service gap and provide additional resources to people who would generally be referred to primary care services.”

introduction

  • suicide is often enacted as an impulsive reaction to an acute crisis situation such as a relationship breakdown or family disputes, and thus is more likely to be carried out if there is ready access to a modality at the scene of the acute crisis, such as a firearm, a long pointed kitchen knife, potentially lethal medications, tall structures such as bridges without safety barriers, etc.
  • acute crisis intervention can be very successful in preventing such impulsive suicide deaths.
  • suicidality associated with chronic depression or psychiatric illnesses can be much more difficult to prevent.
  • in a pilot study, low blood activity levels of the gene SKA2 (a gene which is important in the function of the prefrontal cortex), or epigenetic methylation of that gene appeared to be 80% sensitive for detecting suicidal ideation, and 90% sensitive for detecting high suicide risk.

epidemiology

  • there is an apparent decline in Australian suicide rates since 1997 according to ABS data, however, this data may be erroneous due to possible under-reporting due to mis-classification (Coroners often make no reference to intent) or delays in closure of cases 1)
  • in 2000, an electronic register of coroner cases, the National Coroners Information System (NCIS) commenced, and this began to be used by ABS officers from 2003 to supplement visits to coroners offices, and then replaced these visits in 2006.
  • unfortunately, deaths may not be completed on NCIS for some years after the death until the case is closed by the coroner.
  • ABS changed its system for coroner-certified deaths registered after 2006.
  • Large and Nielssen reported the apparent decline in Australian suicide rates and the changing modality of suicide with reduced access to firearms since the 1990's2)
    • reported Australian annual suicide rates:
      • 1988:
        • males: 21 per 100,000 of which, firearms (5.93), hanging (5.14), gassing (4.43), poisoning (2.56) and jumping from a height (0.84) were the main methods
        • females: 5.6 per 100,000 of which poisoning (2.25), hanging (1.09), gassing (0.83), firearms (0.38). drowning (0.35) and jumping (0.30) were the main modalities.
      • 1998:
        • males: apparently peaked at 28.3 per 100,000 due to a doubling of hangings which offset the 60% decline in firearm deaths
        • females: apparent slight peak as hangings rose to 1.93 but other methods declined.
      • 2007:
        • males: apparent decline to 13.9 per 100,000
        • females: apparent decline to 3.96 per 100,000
1)
MJA 19 April 2010 vol 192(8): p428
2)
Large and Nielssen. MJA 19 April 2010 vol 192(8): p432-437
suicide.txt · Last modified: 2019/05/13 03:40 by wh