Gibson M, Leske S, Ward R, Weir B, Russell K, Kolves K
Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.
Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia; UQ Poche Centre for Indigenous Health, The University of Queensland, Toowong, Queensland, Australia.
J Affect Disord. 2024 Jun 1;354:55-61. doi: 10.1016/j.jad.2024.03.013. Epub 2024 Mar 13.
The current study aimed to compare current suicide rates, trends, previous treatment, suicidality and mental health diagnoses for First Nations and non-Indigenous young people who died by suicide.
Age-specific suicide rates (ASSRs) were calculated per 100,000 persons/year using suicides aged 10-19 years in the Queensland Suicide Register. Rate Ratios (RRs) and 95 % CIs compared ASSRs for First Nations and non-Indigenous youth dying by suicide in Queensland, Australia, from 2001 to 2018. Risk ratios (RiskR) with 95 % CIs compared characteristics between First Nations and non-Indigenous youth suicides. Joinpoint regression was used to identify any changes in trends and annual percentage change (APC) in suicides with 95 % CIs.
The First Nations youth ASSR was 24.71 deaths per 100,000 persons/year, 4.5 times the non-Indigenous ASSR (95 % CI = 3.74-5.38, p < 0.001). Both non-Indigenous and First Nations suicide trends were stable with no joinpoints (APC: 0.3 %, 95 % CI: -1.6-2.2, p = 0.78; APC: 0.9 %, 95 % CI: -0.2-2.1, p = 0.11). Less than a quarter (23.9 %) of First Nations young people had ever received mental health treatment, significantly fewer than non-Indigenous youth (RiskR = 0.80, 95 % CI = 0.71-0.90, p < 0.001). Similarly, in the three months preceding their death, only 14.5 % of First Nations young people had received mental health treatment (RiskR = 0.89, 95 % CI = 0.83-97, p = 0.015).
Reported mental illness, suicidality and help-seeking could be underreported due to concealment from family or police.
The current study finds no change in the gap between the First Nations and Non-Indigenous youth suicide rates nor evidence of decrease in the First Nations youth suicide rate. There is a need for alternative approaches to Indigenous youth suicide prevention, such as assertive outreach models outside of traditional triage and mental health systems to proactively build trusting relationships with young people in communities to identify young people needing support.
本研究旨在比较自杀身亡的原住民和非原住民青年的当前自杀率、趋势、既往治疗情况、自杀倾向及心理健康诊断情况。
利用昆士兰自杀登记册中10至19岁的自杀者数据，计算每10万人/年的年龄别自杀率（ASSR）。采用率比（RR）和95%置信区间（CI）比较2001年至2018年澳大利亚昆士兰自杀身亡的原住民和非原住民青年的年龄别自杀率。采用风险比（RiskR）和95%置信区间比较原住民和非原住民青年自杀者的特征。采用Joinpoint回归分析确定自杀趋势的任何变化以及自杀的年度百分比变化（APC）及其95%置信区间。
原住民青年的年龄别自杀率为每10万人/年24.71例死亡，是非原住民年龄别自杀率的4.5倍（95%CI = 3.74 - 5.38，p < 0.001）。非原住民和原住民的自杀趋势均稳定，无Joinpoint（APC：0.3%，95%CI：-1.6 - 2.2，p = 0.78；APC：0.9%，95%CI：-0.2 - 2.1，p = 0.11）。不到四分之一（23.9%）的原住民青年曾接受过心理健康治疗，显著少于非原住民青年（RiskR = 0.80，95%CI = 0.71 - 0.90，p < 0.001）。同样，在死亡前三个月，只有14.5%的原住民青年接受过心理健康治疗（RiskR = 0.89，95%CI = 0.83 - 97，p = 0.015）。
由于向家人或警方隐瞒，所报告的精神疾病、自杀倾向及寻求帮助情况可能存在漏报。
本研究发现，原住民和非原住民青年自杀率之间的差距没有变化，也没有证据表明原住民青年自杀率有所下降。需要采取替代方法预防原住民青年自杀，例如在传统分诊和心理健康系统之外采用积极的外展模式，主动与社区中的年轻人建立信任关系，以识别需要支持的年轻人。
