Centre for Rural and Remote Mental Health, University of Newcastle, Orange, Australia.
School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia.
PLoS One. 2021 Jul 21;16(7):e0245271. doi: 10.1371/journal.pone.0245271. eCollection 2021.
Suicide rates are higher in rural Australia than in major cities, although the factors contributing to this are not well understood. This study highlights trends in suicide and examines the prevalence of mental health problems and service utilisation of non-Indigenous Australians by geographic remoteness in rural Australia.
A retrospective study of National Coronial Information System data of intentional self-harm deaths in rural New South Wales, Queensland, South Australia and Tasmania for 2010-2015 from the National Coronial Information System.
There were 3163 closed cases of intentional self-harm deaths by non-Indigenous Australians for the period 2010-2015. The suicide rate of 12.7 deaths per 100,000 persons was 11% higher than the national Australian rate and increased with remoteness. Among people who died by suicide, up to 56% had a diagnosed mental illness, and a further 24% had undiagnosed symptoms. Reported diagnoses of mental illness decreased with remoteness, as did treatment for mental illness, particularly in men. The most reported diagnoses were mood disorders (70%), psychotic disorders (9%) and anxiety disorders (8%). In the six weeks before suicide, 22% of cases had visited any type of health service at least once, and 6% had visited two or more services. Medication alone accounted for 76% of all cases treated.
Higher suicide rates in rural areas, which increase with remoteness, may be attributable to decreasing diagnosis and treatment of mental disorders, particularly in men. Less availability of mental health specialists coupled with socio-demographic factors within more remote areas may contribute to lower mental health diagnoses and treatment. Despite an emphasis on improving health-seeking and service accessibility in rural Australia, research is needed to determine factors related to the under-utilisation of services and treatment by specific groups vulnerable to death by suicide.
澳大利亚农村地区的自杀率高于主要城市，但导致这种情况的因素尚不清楚。本研究强调了自杀趋势，并检查了澳大利亚农村地区的地理偏远程度对非土著澳大利亚人的心理健康问题和服务利用的影响。
这是一项对 2010-2015 年期间国家尸检信息系统中来自新南威尔士州、昆士兰州、南澳大利亚州和塔斯马尼亚州的农村地区非土著澳大利亚人故意自残死亡的全国尸检信息系统数据的回顾性研究。
2010-2015 年期间，有 3163 例非土著澳大利亚人故意自残死亡的封闭案例。自杀率为每 10 万人 12.7 人，比澳大利亚全国自杀率高 11%，且随距离偏远而增加。在自杀死亡者中，多达 56%的人被诊断患有精神疾病，另有 24%的人有未被诊断出的症状。报告的精神疾病诊断随着距离的增加而减少，精神疾病的治疗也是如此，特别是在男性中。最常见的诊断是情绪障碍（70%）、精神病性障碍（9%）和焦虑障碍（8%）。在自杀前的六周内，22%的病例至少去过一次任何类型的卫生服务机构，6%的病例去过两次或两次以上的服务机构。单独使用药物治疗占所有治疗病例的 76%。
农村地区自杀率较高，且随距离偏远而增加，这可能归因于精神障碍的诊断和治疗率下降，尤其是在男性中。在偏远地区，精神科专家的可用性较低，加上社会人口因素，可能导致心理健康诊断和治疗率降低。尽管澳大利亚农村地区强调了改善卫生服务的获取和服务的可及性，但需要研究确定与特定群体自杀风险相关的服务利用不足和治疗不足的因素。
