Suicide is a major health problem worldwide. According to the World Health Organisation (WHO, 1992), every year almost one million people die from suicide in the world – this roughly corresponds to one death every 40 seconds. Further, for every completed suicide there are an estimated 20 more suicide attempts. Suicide is now in the three leading causes of death for individuals’ age between 15 and 44 years (Australian Bureau of Statistics, ABS, 2013). Suicide has a complex interplay of biological, psychological and environmental factors underlying it, and has a devastating effect on families and friends.
Suicide is defined as any self-injurious act which results in intentionally killing oneself (WHO, 1992). For a death to be classified as suicide in Australia, a coronial enquiry must establish that the death resulted from a deliberate act by the individual with intention to end his or her life (ABS, 2013). Attempted suicide refers to a self-inflicted harmful act with intention to die, but the act is not fatal. Suicidal thoughts refer to thoughts about harming or killing oneself, which may or may not lead to an attempt of suicide. The term ‘suicidality’ encompasses suicidal thoughts and behaviours, including completing or attempting suicide.
Differences with Self Injury
Self-injury refers to any behaviour that intentionally and directly causes pain or injury to oneself without the intention to die (SANE Australia, 2010). It can include cutting, burning or hitting oneself, the abuse of alcohol or drugs, overdosing on drugs (over the counter, prescription or illegal), hair pulling, punching walls or other objects or scratching or picking the skin resulting in bleeding. See the Self-injury module for more details.
Suicide and self-injury are interconnected issues. However, the underlying mindset between the two is different. The main difference between suicidality and self-injury is intent. A person who is suicidal is contemplating ending his or her life. They see no other way but suicide to end their pain and suffering. Self-injury, on the other hand, is a coping strategy that provides temporary relief from the emotional distress they are experiencing and continue living.
Although young people who do self-injure do not mean to kill themselves, it is often dangerous and can inadvertently result in serious injury or death. Self-injury behaviour is an important risk factor for suicide.
The highest (documented) rates of suicide are found in Eastern European countries and Russia, with the lowest rates in Latin America (WHO, 2009). Australia, New Zealand, the USA, western European countries and Asia fall in the middle of the range. The most common methods of suicide vary between countries, and are partly related to availability of means (Ajdacic-Gross et. al., 2008). For example, pesticide poisoning is common in the Pacific region, India, China and Latin America, while firearms are common in the United States. Hanging is the most common method across many countries (Ajdacic-Gross et. al.). It must be noted that the recording and reporting of suicide varies across individual countries, with under-reporting often occurring and statistics unavailable for many countries in Africa and South East Asia. Thus caution is needed when interpreting statistics.