Suicide prevention

About this topic

Every life lost to suicide is a tragedy for family, friends, kin and communities. Although suicide and intentional self-harm are complex issues, they can be prevented. The Australian Institute of Health and Welfare respectfully acknowledges those who have died or have been affected by suicide or intentional self-harm.

Suicide and intentional self-harm behaviours arise from a complex web of personal, social and historical factors (Dudgeon et al. 2017). Experiencing the sorrow and loss of family and community members in short succession can mean being in a constant state of grief and mourning (Silburn et al. 2014).

Suicidal behaviour can appear in clusters—this is a rapid increase in the number of suicides in a few months or years, or within a certain geographical area. Exposure to suicidal behaviour may be a factor contributing to increased suicides.

Historical factors may also contribute to suicide. Suicide among First Nations people is considered a post-colonisation phenomenon that markedly increased in prevalence from the 1960s (Hunter & Milroy 2006; Silburn et al. 2014). Understanding the ongoing effects of colonisation and the importance of culture is important for individual and communal healing (Silburn et al. 2014).

Effective suicide prevention requires a multi-sector approach that includes health, education, employment, welfare agencies, law-enforcement agencies, housing providers and non-government organisations (AIHW 2020). Programs and care can be delivered to:

• a whole community (regardless of their level of suicide risk)
• those at imminent risk of suicide
• those who need follow-up after a suicide attempt (AIHW 2018).

In 2020, all Australian governments and the Coalition of Aboriginal and Torres Strait Islander Peak Organisations worked in partnership to develop the National Agreement on Closing the Gap- external site opens in new window (the National Agreement), built around 4 Priority Reforms. The National Agreement also identifies 19 targets across 17 socioeconomic outcome areas. One of these targets directly relates to suicide prevention, monitored annually by the Productivity Commission.

Postvention services support people who have been exposed to or bereaved by suicide. These services aim to help reduce distress and the risk of suicide (AHA 2014).

The Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention (CBPATSISP) develops evidence for effective suicide prevention strategies for First Nations people and communities (Dudgeon et al. 2019). The CBPATSISP research shows that effective suicide response is multi-layered. It includes prevention for individuals, tailored responses for high-risk groups, and multi-level suicide prevention activities for individuals, families and communities. These activities include:

• raising community awareness of mental health and suicide
• addressing substance use and employment issues
• promoting healing in families by strengthening social and emotional wellbeing.

Suicide prevention strategies are more likely to succeed if they are co-designed and implemented with First Nations community leadership. Communities understand the lived experience of community members at risk of suicide and are best placed to design suicide responses (Dudgeon et al. 2019).

Key statistics

The following data are from New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. Data from these jurisdictions were considered to have adequate levels of Indigenous identification in mortality data at the time the data were released by the Australian Bureau of Statistics (ABS). Data from 2020, 2021 and 2022 are not final and may be subject to revision.

In 2022, 212 First Nations people died by suicide (an age-standardised rate of 29.9 per 100,000 population). Suicide was the fifth leading cause of death among First Nations people, and the 17th leading cause of death for non-Indigenous Australians (ABS 2023a). It was the leading cause of death for First Nations people aged 15–44 years and third leading cause of death for First Nations people aged 1–14 (ABS 2023a).

In 2022, suicide accounted for 4.6% of all deaths of First Nations people while the comparable proportion for non-Indigenous Australians was 1.6% (AIHW 2023) (Table SP.1).

From 2010 to 2021, the age-standardised rate of suicide among First Nations people fluctuated, from a low of 18.9 per 100,000 population in 2012 to a high of 27.9 per 100,000 population in 2020. There was a break in the series in 2022 due to improvements in deriving Indigenous status in New South Wales (see Figure 1 Notes). The rate for 2022 was 29.9 per 100,000. There was no break in series for non-Indigenous Australians (AIHW 2023) (Figure 1; Table SP.1).

1. All rates are presented per 100,000 population and are directly age-standardised.
2. Deaths are counted according to year of registration of death, not necessarily the year in which the death occurred.
3. Data by Indigenous status is reported by usual residence for NSW, Qld, WA, SA and NT only (including totals). Data for Vic, Tas and ACT is excluded in line with national reporting guidelines.
4. A 2022 increase in Aboriginal and Torres Strait Islander deaths is influenced by the use of information from the Medical Certificate of Cause of Death (MCCD) for the first time for deriving the indigenous status of deaths registered in New South Wales. For more information, see Technical Note: The impact of using two sources for deriving the Indigenous status of deaths in NSW in 2022 in Causes of Death, Australia 2022 Methodology.
5. Rates for Aboriginal and Torres Strait Islander people have been calculated using population estimates and projections for the relevant year based on the 2016 Census. Non-Indigenous estimates for the relevant years have been derived by subtracting Aboriginal and Torres Strait Islander population estimates based on the 2016 Census from the total Australian estimated resident population (ERP) based on the 2021 Census.
6. Prior to 2017 data are presented by reference year for some jurisdictions and there may be minor differences to other sources.

In 2022, the age-standardised rate for First Nations males was 3.3 times that of First Nations females (46.3 per 100,000 and 14.0, respectively) (Table SP.2). When looking at aggregated data for the period 2018–2022, the age-standardised rate for First Nations males was 2.9 times that of First Nations females (41.5 per 100,000 and 14.1, respectively) (Figure 2; Table SP.3).

For 2018–2022, the suicide rate for First Nations males was 2.2 times that of non-Indigenous males. The rate for First Nations females was 2.4 times that of non-Indigenous females (ABS 2023a) (Figure 2; Table SP.3).

1. Data are presented for all ages
2. Data reported are compiled by jurisdiction of usual residence for NSW, Qld, WA, SA and NT only. Data for Victoria, Tasmania and Australian Capital Territory have been excluded in line with national reporting guidelines. For information on issues with Aboriginal and Torres Strait Islander identification, see the Deaths of Aboriginal and Torres Strait Islander people section of the methodology on the ABS website.
3. Deaths are counted according to year of registration of death, not necessarily the year in which the death occurred.
4. Rates are per 100,000 population and are directly age-standardised using the Australian 2001 standard population.
5. Rates presented in this table have been calculated using Aboriginal and Torres Strait Islander population estimates and projections based on the 2016 Census. Non-Indigenous estimates have been derived by subtracting the 2016-census-based Aboriginal and Torres Strait Island population from the total 2021-census-based Estimated Resident Population (ERP). See the Age-standardised death rates (SDRs) section of the Methodology in Causes of Death, Australia, 2021 for further information.
6. Although most deaths of Aboriginal and Torres Strait Islander people are registered, it is likely that some deceased are not accurately identified as Aboriginal and Torres Strait Islander. Therefore, these data are likely to underestimate the Aboriginal and Torres Strait Islander mortality rate. For further information see the Deaths of Aboriginal and Torres Strait Islander people section in the methodology on the ABS website.
7. Data cells with small values have been randomly assigned to protect the confidentiality of individuals. As a result, some totals will not equal the sum of their components. Cells with a zero value have not been affected by confidentialisation.

Data from 2018–2022 show that the suicide rate was highest among First Nations people aged 35–44 years (52.3 per 100,000 population), 25–34 years (48.4 per 100,000) and 15–24 years (41.0 per 100,000) (ABS 2023a) (Figure 3; Table SP.3).

1. Data reported are compiled by jurisdiction of usual residence for NSW, Qld, WA, SA and NT only. Data for Victoria, Tasmania and Australian Capital Territory have been excluded in line with national reporting guidelines. For information on issues with Aboriginal and Torres Strait Islander identification, see the Deaths of Aboriginal and Torres Strait Islander people section of the methodology on the ABS website.
2. Deaths are counted according to year of registration of death, not necessarily the year in which the death occurred.
3. Rates by age group are age-specific death rates presented per 100,000 population.
4. Rates presented in this table have been calculated using Aboriginal and Torres Strait Islander population estimates and projections based on the 2016 Census. Non-Indigenous estimates have been derived by subtracting the 2016-census-based Aboriginal and Torres Strait Island population from the total 2021-census-based Estimated Resident Population (ERP). See the Age-standardised death rates (SDRs) section of the Methodology in Causes of Death, Australia, 2021 for further information.
5. Although most deaths of Aboriginal and Torres Strait Islander people are registered, it is likely that some deceased are not accurately identified as Aboriginal and Torres Strait Islander. Therefore, these data are likely to underestimate the Aboriginal and Torres Strait Islander mortality rate. For further information see the Deaths of Aboriginal and Torres Strait Islander people section in the methodology on the ABS website.
6. Data cells with small values have been randomly assigned to protect the confidentiality of individuals. As a result, some totals will not equal the sum of their components. Cells with a zero value have not been affected by confidentialisation.

Data from 2018–2022 by state or territory show the annual age-standardised suicide rate was highest in Western Australia (38.1 per 100,000) and lowest in New South Wales (22.8 per 100,000). For non-Indigenous Australians, suicide rates were lower than for First Nations people in all 5 states and territories (ABS 2023a) (Figure 4; Table SP.4).

1. Deaths registered between 2018 and 2022.
2. Data are reported by jurisdiction of usual residence for NSW, Qld, WA, SA and the NT only. Data for Victoria, Tasmania and the Australian Capital Territory have been excluded in line with national reporting guidelines. For information on issues with Aboriginal and Torres Strait Islander identification, see the Deaths of Aboriginal and Torres Strait Islander people section of the methodology.
3. All causes of death data from 2006 onward are subject to a revisions process - once data for a reference year are 'final', they are no longer revised. Affected data in this table are: 2018–2019 (final), 2020 (revised), 2021 (preliminary revised) and 2022 (preliminary). See the Data quality section of the Causes of Death, Australia, 2022 methodology and Causes of Death Revisions, 2019 Final Data (Technical Note) and 2020 Revised Data (Technical Note) in Causes of Death, Australia, 2022 on the ABS website.
4. Rates presented in this table have been calculated using Aboriginal and Torres Strait Islander population estimates and projections based on the 2016 Census. Non-Indigenous estimates have been derived by subtracting the 2016-census-based Aboriginal and Torres Strait Island population from the total 2021-census-based Estimated Resident Population (ERP). See the Age-standardised death rates (SDRs) section of the Methodology in Causes of Death, Australia, 2022 for further information.
5. See the Data quality section of the methodology on the ABS website for further information on specific issues related to interpreting time-series and 2022 data.

The following data refer to the annual crude suicide rates among First Nations people, in areas defined as Indigenous Regions (IREG), covering New South Wales, Queensland, Western Australia, South Australia and the Northern Territory.

Note:

• IREGs are a lower level of geography, resulting in numbers that are too small for the use of age-standardisation. As there is little age-structure variation between IREGs, crude rates have been used in this section instead.
• crude rates are not comparable with age-standardised rates
• certain IREGs in WA, NT and SA have been combined to avoid suppressing data.

Data from 2013–2022 combined show that the rate of suicide among First Nations people varied greatly between IREGs. Kununurra in Western Australia had the highest rate of suicide, with 64.3 per 100,000 persons. The lowest suicide rate was recorded in Torres Strait, with 6.7 per 100,000 (Figure 5; Table SP.5).

The rate of suicide among First Nations males was higher than the rate among First Nations females in all IREGs covered here. The IREG with the highest suicide rate among First Nations males was Kununurra (79.1 per 100,000), and the IREG with the lowest reportable suicide rate among First Nations males was Dubbo (20.8 per 100,000 males) (Figure 5; Table SP.5).

Among First Nations females, Kununurra was the IREG with the highest rate of suicide (51.3 per 100,000), and Dubbo and New South Wales Central and North Coast were the IREGs with the lowest reportable rate (both 6.1 per 100,000 females) (Figure 5; Table SP.5).

The male and female rates are not shown for the Torres Strait IREG and the combined Port Augusta | Port Lincoln – Ceduna IREGS because of confidentiality concerns related to the small numbers of recorded suicides (Figure 5; Table SP.5).

1. IREGs based on Australian Statistical Geography Standard (ASGS) 2016 (second edition) boundaries.
2. Certain IREGs in WA, NT and SA have been combined to avoid suppressing data.
3. Analysis is based on deaths registered from 2013 to 2022. Deaths registered in 2019 or earlier are based on the final version of cause of death data; deaths registered in 2020 are based on the revised version; and deaths registered in 2021 and 2022 are based on the preliminary version. Revised and preliminary versions are subject to further revision by the Australian Bureau of Statistics (ABS).
4. Numbers and rates are reported for 5 jurisdictions – New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. These jurisdictions are considered to have adequate levels of First Nations identification in mortality data. Numbers of deaths are also reported for Victoria, Tasmania, and the Australian Capital Territory, however these data should be interpreted with caution due to concerns around the quality of First Nations identification in those 3 jurisdictions.
5. The crude rates in this table are presented on a per 100,000 population basis, using AIHW-derived estimates of the mid-year population from 2013 to 2022 (2016 Census-based). As is standard practice, all age groups are included in the denominator even though suicides are not normally recorded in very young children. Crude rates are not directly comparable with age-standardised rates presented elsewhere. Some rates can be volatile due to the small numbers of deaths over the reference period.
6. Data are likely to underestimate the Aboriginal and Torres Strait Islander mortality rate. See the Deaths of Aboriginal and Torres Strait Islander people section of the Causes of Death methodology on the ABS website for further information.
7. Deaths were concorded from SA2 of usual residence to IREG based on First Nations-weighted correspondence files. Deaths that could not be concorded to IREG were not included in this table.

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