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Suicide among Aboriginal and Torres Strait Islander people may be higher than reported
We may be underestimating the number of Aboriginal and Torres Strait Islander people who have committed suicide because the data doesn't include people whose Indigenous status is uncertain, according to Australian experts.
Researcher Dr Gregory Armstrong says Aboriginal and Torres Strait Islander people older than 45 may be at increased risk of suicide.
Suicide rates among middle- and older-aged Aboriginal and Torres Strait Islander people could be a third more than previously believed, according to a new study.
Dr Gregory Armstrong, Melbourne School of Population and Global Health, University of Melbourne, told newsGP that while the instance of death by suicide is still alarming among young Aboriginal and Torres Strait Islander people, analysis of National Coronial Information data shows the older group may also be at a higher risk.
‘In Australia, suicide is a leading cause of mortality for Aboriginal and Torres Strait Islander people,’ Dr Armstrong said.
‘In the period 2012 to 2016, the suicide rate for Indigenous Australians was estimated to be 23.7 per 100,000, twice the rate [11.6 per 100,000] for non-Indigenous Australians.’
Dr Armstrong said the official data shows a severe disparity between the suicide rates of Aboriginal and Torres Strait Islander people and non-Indigenous Australians in the 15–44 age group. But, he said, the rates are similar for all Australians aged 45 and older.
‘This data typically compares those deaths where the deceased have been recorded as Indigenous against those recorded as non-Indigenous,’ he said.
The Indigenous status of nearly 5000 people who died by suicide was classified as ‘unknown’ between 2000 and 2013.
‘We observed that there were higher proportions of “unknowns” in middle and older age groups, which we thought may result in underestimates of Indigenous suicide rates in these age groups,’ he said.
‘To explore this we generated some simple conservative hypothetical scenarios, whereby we reclassified small percentages of “unknowns” as being Indigenous. The effect was quite dramatic.
‘If 5% of “unknowns” were reclassified as Indigenous, there would be only a small increase in the Indigenous suicide rate among younger age groups, but we would see the Indigenous suicide death rate for those aged 41–50 years increase by 33%.’
Dr Armstrong said if such a scenario is true, the story of parity in suicide rates between Aboriginal and Torres Strait Islander people and non-Indigenous Australians at middle and older age groups may be incorrect.
‘Clearly, there is an imperative to fill the gaps in our data with regards to Indigenous status, to help inform suicide prevention and other public health interventions,’ Dr Armstrong said.
‘The Australian Institute of Health and Welfare has published the ‘National best practice guidelines for collecting Indigenous status in health data sets’.
‘This document identifies that more GPs need to routinely collect the Indigenous status of their patients, without making judgements based on appearance. Our analysis provides a clear example as to why this is important.’
Professor Pat Dudgeon, University of Western Australia, Poche Centre for Indigenous Health, who is from the Bardi people of the Kimberley in Western Australia, told newsGP social reality shows that more young Aboriginal and Torres Strait Islander people are at risk of dying by suicide.
However, Professor Dudgeon, who was part of the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project, said the number of suicides in the Aboriginal and Torres Strait Islander community is much more than is being reported.
‘I think that data [about unknowns] needs to be investigated further … we do need to get a true picture,’ she said.
‘Things are pretty bad … there needs to be attention across the lifespan from the beginning to the end.’
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