Onie Sandersan, Usman Yuslely, Widyastuti Retno, Lusiana Merry, Angkasawati Tri Juni, Musadad Dede Anwar, Nilam Jessica, Vina Ashra, Kamsurya Rizal, Batterham Philip, Arya Vikas, Pirkis Jane, Larsen Mark
Black Dog Institute, University of New South Wales (UNSW Sydney), Sydney, Australia.
Universitas Airlangga, Surabaya, Indonesia.
Lancet Reg Health Southeast Asia. 2024 Feb 26;22:100368. doi: 10.1016/j.lansea.2024.100368. eCollection 2024 Mar.
Timely and accurate data are critical for effective suicide prevention. Indonesia-the fourth most populous country in the world-has limited data availability and thus, limited data-driven interventions. Through a national government partnership, we obtained critical non-public data for attempts and suicides that could be analysed for the first time in Indonesia's history.
We obtained and analysed data from five sources from 2016 to 2021: police data, death registry data, a provincial survey, a sample registry system, and the WHO's Global Health Observatory (WHO GHO) data. Using these data, we estimated underreporting, identified provinces with the highest suicide and suicide attempt rates, assessed gender ratios, identified methods used, and compared urban and rural suicides.
The analysis yielded an underreporting rate of 859.10% for suicides, while verbal autopsies and increased quality control only increased coverage from 12.80% to 51.40%. Provinces with the highest rates of suicide were Bali, Riau Islands, Special Region of Yogyakarta, Central Java, and Central Kalimantan. Gender analysis revealed a ratio of 1: 2.11 for female to male suicides. Suicide methods analysis revealed that hanging and self-poisoning were the most used method, and rural suicides occurred at a rate 4.47 times higher than urban suicides.
The analysis revealed the highest underreporting rate in the literature from a national sample and vast heterogeneity among provinces with high suicide rates-including provinces with strong mystic beliefs, suggesting the need for a culturally sensitive sub-national tailored approach. Through our study, we provide critical information which will allow for data-driven suicide prevention.
The data collection for this was part of a project funded by the Australian Department of Foreign Affairs and Trade, Australian-Indonesian Institute (AII2020322).
及时且准确的数据对于有效的自杀预防至关重要。印度尼西亚是世界上人口第四多的国家，其数据可得性有限，因此基于数据的干预措施也有限。通过与国家政府合作，我们获取了关键的非公开自杀未遂和自杀数据，这些数据在印度尼西亚历史上首次得以分析。
我们获取并分析了2016年至2021年五个来源的数据：警方数据、死亡登记数据、省级调查、样本登记系统以及世界卫生组织全球卫生观测站（WHO GHO）数据。利用这些数据，我们估算了漏报情况，确定了自杀率和自杀未遂率最高的省份，评估了性别比例，确定了所使用的方法，并比较了城乡自杀情况。
分析得出自杀漏报率为859.10%，而死因推断和加强质量控制仅使覆盖率从12.80%提高到51.40%。自杀率最高的省份是巴厘岛、廖内群岛、日惹特区、中爪哇省和中加里曼丹省。性别分析显示女性与男性自杀比例为1:2.11。自杀方法分析表明上吊和自我中毒是最常用的方法，农村地区的自杀发生率比城市地区高4.47倍。
该分析揭示了来自全国样本的文献中最高的漏报率，以及自杀率高的省份之间存在巨大差异，包括一些有着浓厚神秘信仰的省份，这表明需要采取针对次国家层面且考虑文化因素的量身定制方法。通过我们的研究，我们提供了关键信息，这将有助于开展基于数据的自杀预防工作。
此次数据收集是由澳大利亚外交与贸易部、澳大利亚 - 印度尼西亚研究所资助项目（AII2020322）的一部分。
