The decline in Australian young male suicide.

Since the late 1990s there has been a sharp downward trend in Australian young male suicide. It is possible that a major government youth suicide prevention initiative, the National Youth Suicide Prevention Strategy (NYSPS), implemented during 1995-1999 may have influenced the decline. In this article, we examine time trends in age- and means-specific male and female Australian suicide rates in relation to unemployment rates and the NYSPS. Based on Australian suicide data over the period 1966-2003, we assess secular changes in the 20-24 year male suicide to total (crude) male suicide rate ratio in relation to the NYSPS, using interrupted time series analysis (ARIMA), since this was previously found to be significantly associated with the 20-24 year male unemployment to total employment ratio. Results show that a dramatic reduction in Australian young male (aged 20-34 years) suicide has occurred since 1997-1998, declining from approximately 40 per 100,000 in 1997-1998 to approximately 20 per 100,000 in 2003. Most of the decline is due to a decrease in suicide by hanging and to a lesser extent from motor vehicle carbon monoxide and other gases. Further, the previously established strong secular association (lasting over 3 decades from 1966) between the rate ratio of 20-24 year male suicide to total (crude) male suicide, and the rate ratio of 20-24 year male unemployment to total unemployment, appears to have been disrupted. ARIMA modelling of the suicide ratio against the initiative indicates a highly significant statistical association between the NYSPS and the suicide ratio reduction but not between the NYSPS and the unemployment indicator trend, suggesting a break in the link between young male suicide and unemployment. The recent sudden turnaround in Australian young male suicide trends and its extent appears to preclude explanations centring on slow-moving social indices traditionally associated with suicide, or on possible cohort effects. This sudden decrease has occurred mainly in non-impulsive means, and at the same time has broken a long-standing secular link between 20 and 24-year-male suicide and unemployment, lending plausibility to the case for the NYSPS having had an impact on young male suicide in Australia.