Differences in Characteristics and Exposure to Stressors Between Persons With and Without Diagnosed Mental Illness Who Died by Suicide in Victoria, Australia

Patterns of Suicide in the Context of COVID-19: Evidence From Three Australian States

Aims: We aimed to determine whether there has been a change in the number of suicides occurring in three Australian states overall, and in age and sex subgroups, since the COVID-19 pandemic began, and to see if certain risk factors for suicide have become more prominent as likely underlying contributing factors for suicide. Method: Using real-time data from three state-based suicide registers, we ran multiple unadjusted and adjusted interrupted time series analyses to see if trends in monthly suicide counts changed after the pandemic began and whether there had been an increase in suicides where relationship breakdown, financial stressors, unemployment and homelessness were recorded. Results: Compared with the period before COVID-19, during the COVID-19 period there was no change in the number of suicides overall, or in any stratum-specific estimates except one. The exception was an increase in the number of young males who died by suicide in the COVID-19 period (adjusted RR 1.89 [95% CI 1.11-3.23]). The unadjusted analysis showed significant differences in suicide in the context of unemployment and relationship breakdown during the COVID-19 compared to the pre-COVID-19 period. Analysis showed an increase in the number of suicides occurring in the context of unemployment in the COVID-19 period (unadjusted RR 1.53 [95% CI 1.18-1.96]). In contrast, there was a decrease in the number of suicides occurring in the context of relationship breakdown in the COVID-19 period (unadjusted RR 0.82 [95% CI 0.67-0.99]). However, no significant changes were identified when the models were adjusted for possible over-dispersion, seasonality and non-linear trend. Conclusion: Although our analysis found no evidence of an overall increase in suicides after the pandemic began, the picture is complex. The identified increase in suicide in young men indicates that the impact of the pandemic is likely unevenly distributed across populations. The increase in suicides in the context of unemployment reinforces the vital need for mitigation measures during COVID-19, and for ongoing monitoring of suicide as the pandemic continues.

Maternal deaths by suicide in Queensland, Australia, 2004-2017: an analysis of maternal demographic, psychosocial and clinical characteristics

To characterise the demographic and clinical characteristics of women who died by suicide in the perinatal period to inform and improve suicide prevention strategies. Retrospective analysis of maternal suicides during and within 1 year after the end of pregnancy in Queensland between January 2004 and December 2017. Outcomes measured included timing of death in relation to pregnancy, sociodemographic and clinical characteristics and health service use prior to death. There were 65 deaths by suicide in the study period; six occurred during pregnancy, 30 occurred after a live birth, 22 occurred after a termination of pregnancy and seven followed a miscarriage or stillbirth. Most suicides were late maternal deaths. Women were younger, and more likely to identify as Aboriginal or Torres Strait Islander, when compared to all women giving birth for the same time period. Most women had a prior mental health diagnosis, most commonly depression. Over half of women had recent relationship separation or conflict prior to death. Perinatal women had higher rates of death by violent means than all women in Queensland who died by suicide during the same time period. The demographic, psychosocial and clinical characteristics of a group of women who died by suicide have been described, and this shows a high proportion of women with a prior mental health diagnosis. To reduce maternal mortality, psychosocial screening must be implemented broadly and continued until the end of the first year postpartum. Similar screening attention is needed for women who had a termination of pregnancy, miscarriage or stillbirth.