Suicide in Australia: meta-analysis of rates and methods of suicide between 1988 and 2007

To the Editor: We read with interest the recent meta-analysis of rates and methods of suicide in Australia by Large and Nielssen.1 Previous research has shown a marked increase in hanging suicides in women in South Australia over the 15-year period 1986 to 2000,2 which concurs with the findings of Large and Nielssen at a national level between 1988 and 2007.1

One of the features of this increase in hanging suicides, which was not specifically addressed in their excellent overview, relates to trends in specific age groups such as the young. A previous analysis of suicides in individuals aged 16 years and under and for whom autopsies were performed at the Forensic Science Centre (now Forensic Science South Australia; FSSA), in Adelaide,3 included a total of 19 cases of suicide for the 5 years 1985 to 1989, of which seven deaths (37%) were from hanging. The age range of the hanging victims was 14–16 years (mean age, 15 years), with a male to female ratio of 6:1. This compares with a total of 10 suicides among young people, recorded in FSSA files for the 5 years 2005 to 2009, of which nine (90%) were by hanging. The age range of the hanging victims in this group was 10–16 years (mean age, 14.7 years), with a male to female ratio of 4:5. The difference between these two periods was statistically significant (P < 0.005).3

Thus, although suicide in those aged 16 years and under remains an uncommon event,3 developments in deliberate self-harm among the general population may also be reflected in the young. While there was a fall in the total number of young suicide victims, from 19 to 10, between the two periods in the SA study, this has not been matched by a decline in hanging suicides (ie, a significantly greater percentage of suicides in the young in SA now involve self-suspension).3 This finding may be of use to those studying specific issues and trends in youth suicide.