Suicide risk factors: Statistics on populations and occupations affected

 

Suicide is the worst outcome for those with mental ill health. It’s important to remember that these statistics and numbers represent real people and their loved ones.

Unfortunately, thoughts of suicide (aka passive or active suicidal ideation) are more common than many realise. According to the Australian Institute of Health and Welfare (AIHW), in 2021, 16.7% of Australians aged 16–85 had seriously contemplated ending their lives at some time. That’s nearly 1 in 5 adults. Each year, there are approximately 65,000 attempts.

Although suicidal ideation is quite common, completed suicide itself is thankfully a much rarer occurrence in Australia.

Research has identified suicide risk factors, and that particular groups and occupations are disproportionately affected compared to the general population. This article provides data, mostly drawn from the Australian context, on suicide among broad demographic groups before looking at occupational groups affected and job-related risk factors.

Psychosocial Risk Factors

Most people who die by suicide have diagnosable psychological conditions, such as a depressive or substance use disorder. However, about half have no known history of mental ill health (which could be for many reasons, e.g., they were never diagnosed, kept their mental health issues to themselves, feared prejudice and discrimination, or experienced shame and self-stigma).

In addition to psychological disorders, certain psychosocial and life history factors are associated with an increased likelihood of suicide. Identifying these circumstances is important for suicide prevention efforts. But we should also remember that the vast majority of individuals with these factors do not attempt suicide.

Deriving their findings from 2017–2021 data, the AIHW writes that 2/3 of those who died by suicide had at least one psychosocial risk, such as (listed from most prevalent):

• Personal history of self-harm
• Problems in spouse/partner relationship
• Family disruption by divorce/separation
• Death or disappearance of family member (bereavement)
• Limitation of activities due to disability
• Other problems related to primary supporters
• Family member absence
• Legal problems
• Housing and/or economic problems (e.g., unemployment, homelessness)
• History of medical treatment non-compliance

The CDC and NAMI in the US include these suicide risk factors: past or upcoming crises, a recent tragedy or loss, problematic substance use/intoxication, physical health problems, a family history of suicide, a trauma or abuse history, and prolonged stress.

And the AIHW also informs us that – relative to other reference groups and when controlling for other variables – the greatest associations with suicide include:

• Being male
• Being widowed, divorced, or separated
• Living in a one-person household
• Being unemployed/not in the labour force

Sex/Gender

Data from the Australian Bureau of Statistics (ABS) reveals that males represented 3/4 of Australians who died by suicide in 2020. In that year, it was the 10th and 22nd leading cause of death for males and females respectively.

Although women in Western countries are more likely than men to express suicidal ideation and attempt suicide non-fatally, men are at greater risk for completed suicide. The term for this is the “gender paradox in suicide.” One explanation could be that males often choose more dangerous methods than females. Or that women are more culturally conditioned to display help-seeking behaviour.

Age

The previously referenced ABS statistics from 2020 highlight that, due to constituting a larger proportion of the total population, the young and middle-aged (15–64) represent greater proportions who die by suicide than the elderly (65+). About 84% of Australians are under 65, and 83.6% of Australian suicides in 2020 fell in the 15–64 age range.

The AIHW provides the following data for deaths by suicide in 2021:

• 53% were aged 30–59
• 24% were aged 60+
• 22% were aged 15–29

In 2021, the leading cause of death for Australians between 15 and 44 was suicide, according to the AIHW. And for youth aged 15–24, suicide represented 1/3 of all deaths (as this group is less likely to die from other causes such as physical health conditions).

But in terms of the highest suicide rates (per 100,000 people), they were found in:

• Males aged 85+: 36.4 deaths per 100,000
• Males aged 80–84: 31.2
• Males aged 50–54: 26.9

Ethnic and Cultural Background

Beyond Blue writes that First Nations individuals have nearly twice the suicide risk as non-First Nations Australians. Similar to other cultural groups, more males die by suicide than females: 70.3% in 2019. Moreover, roughly 1/3 of the First Peoples population experiences high or very high psychological distress, compared to 1/8 of the rest of the population. In 2018, suicide and self-inflicted harm were the second leading cause of years of life lost (YLL) for First Nations peoples.

Regarding culturally and linguistically diverse (CALD) peoples, the not-for-profit also states that: “research from both Australia and overseas has consistently highlighted that immigrant and refugee populations are at higher risk of severe mental illness.” Individuals from these communities more often first access help through emergency services during a crisis (with severe symptoms), and they are more likely to be diagnosed with psychosis than non-CALD people.

Both First Nations and CALD individuals are impacted by racism, with greater incidents resulting in worsened mental health.

LGBTIQ+

LGBTIQ+ Health Australia states that people belonging to the LGBTIQ+ community are at far greater risk of attempting suicide. Their report from 2021 indicates that, compared to the general population, LGBTIQ+ individuals aged 16–17 were about five times more likely to have ever attempted suicide, and nearly three times likelier to have done so in the past 12 months.

48.1% of transgender and gender-diverse individuals aged 14–25 reported ever trying to take their own life. This rate is 15 times higher than the average. 27.8% of bisexual people aged 18+ had attempted suicide at some point.

Socioeconomic and Employment Status

Regarding socioeconomic status, those in the lowest income areas have been found to have the highest (age-standardised) suicide rates. The rate for residents in the most disadvantaged regions is over twice that of those in the highest socioeconomic locations – 18.4 and 8.1 deaths per 100,000, respectively. Rates correspondingly decrease as economic advantage increases.

As previously mentioned, unemployment/being out of the labour force is another significant psychosocial risk factor for suicidality, as are economic problems more broadly.

Region/Geography

According again to the AIHW, about 28% of the Australian population lives outside of major metropolitan areas – in rural or regional regions. Because of their relative isolation and reduced access to healthcare services, compared to those in large urban cores, rural and remote populations may face worse overall health outcomes and greater suicide risk.

Data shows that, in 2021, although 61% of suicides occurred in major cities, this may be accounted for by their larger population sizes. For instance, the suicide rates for those in Very Remote areas and Major Cities were 23.9 and 10.0 deaths per 100,000, respectively. As the national average was 12.0 in 2021, urban centres had a lower rate than average. However, every other remoteness region had a rate higher than 12.0.

Occupations

A 2020 study from Monash University reveals that those employed in certain occupations – and those whose jobs had particular characteristics – are at heightened risk of suicidal ideation, attempts, and completed suicide. Examining over 60 international studies, the researchers identified several career-related factors that increased the probability:

• High job demand
• Physical danger
• Shift work
• Low control or autonomy
• Access to lethal means

In terms of which occupational groups are disproportionately impacted, the review lists the following:

• Farming and agriculture
• Veterinarians
• Medical practitioners
• Nursing and midwifery
• Paramedics
• Firefighters
• Law enforcement
• Construction
• Creative industries

We can see that particular roles in these industries may expose people to the job-related risk factors, e.g., access to lethal means, physical danger/trauma (including witnessing death and suicide, which is another risk), low autonomy, high stress and responsibility, etc.

In addition, another Australian study finds that men in male-dominated fields had a "significantly higher suicide rate compared to males in female-dominated" ones. On the other hand, women in female-dominated careers had a "slightly elevated" risk in relation to those in male-dominated fields.

Suicide Reduction Among Employees

The CDC in the US offers recommendations as to how to improve mental wellbeing and therefore lower suicide amongst employees, such as:

• Changing organisational culture, practices, policies, and programs to prevent mental ill-health from occurring in the first place
• Encouraging prosocial behaviour and help-seeking if necessary
• Referring employees to appropriate services and supports (such as counselling, drug and alcohol treatment, etc.)

The United Project is committed to fostering psychologically safe team workplaces through early detection programs, so nobody has to suffer alone at work.