Centre for Suicide Prevention Research

AGE-STANDARDIZED SUICIDE RATES (PER 100 000 POPULATION)

SITUATION

According to the World Health Organisation, there were an estimated 804 000 suicide deaths worldwide in 2012.

This indicates an annual global age-standardized suicide rate of 11.4 per 100 000 population (15.0 for males and 8.0 for females).

Interactive global data and map:

World Health Organisation Interactive Chart – Mental Health and Suicide Rates

LIST BY THE WORLD HEALTH ORGANIZATION (2012)

Suicides per 100,000 people per year (age standardized)
Both sexes rank	Country	Both sexes	Male rank	Male	Female rank	Female
1	Guyana	44.2	1	70.8	1	22.1
2	South Korea	28.9	5	41.7	5	18.0
3	Sri Lanka	28.8	3	46.4	7	12.8
4	Lithuania	28.2	2	51.0	29	8.4
5	Suriname	27.8	4	44.5	11	11.9
6	Mozambique	27.4	8	34.2	2	21.1
7	Tanzania	24.9	13	31.6	4	18.3
7	Nepal	24.9	17	30.1	3	20.0
9	Kazakhstan	23.8	6	40.6	21	9.3
10	Burundi	23.1	9	34.1	9	12.5
11	India	21.1	22	25.8	6	16.4
12	South Sudan	19.8	19	27.1	7	12.8
13	Turkmenistan	19.6	11	32.5	32	7.5
14	Russia	19.5	7	35.1	46	6.2
14	Uganda	19.5	20	26.9	10	12.3
16	Hungary	19.1	12	32.4	34	7.4
17	Japan	18.5	20	26.9	17	10.1
18	Belarus	18.3	10	32.7	44	6.4
19	Zimbabwe	18.1	18	27.2	18	9.7
20	Bhutan	17.8	32	23.1	13	11.2
21	Sudan	17.2	33	23.0	12	11.5
22	Comoros	16.9	29	24.0	15	10.3
23	Ukraine	16.8	16	30.3	55	5.3
24	Poland	16.6	15	30.5	98	3.8
24	Equatorial Guinea	16.6	27	24.1	27	8.6
26	Eritrea	16.3	22	25.8	24	8.7
27	Latvia	16.2	14	30.7	86	4.3
27	Kenya	16.2	26	24.4	29	8.4
29	Malawi	16.0	30	23.9	23	8.9
30	Zambia	15.7	39	20.8	14	10.8
31	Montenegro	15.3	25	24.7	44	6.4
32	Djibouti	15.1	38	20.9	20	9.5
33	Finland	14.8	34	22.2	32	7.5
34	Belgium	14.2	36	21.0	31	7.7
35	Iceland	14.0	36	21.0	40	6.7
36	Angola	13.8	41	20.7	35	7.3
37	Moldova	13.7	27	24.1	73	4.8
38	Estonia	13.6	24	24.9	98	3.8
38	El Salvador	13.6	31	23.5	53	5.7
40	Myanmar	13.1	60	16.5	15	10.3
41	Trinidad and Tobago	13.0	42	20.4	46	6.2
42	Czech Republic	12.5	35	21.5	97	3.9
43	Slovenia	12.4	39	20.8	84	4.4
	Serbia	12.4	44	19.9	50	5.8
	Somalia	12.4	54	18.1	39	6.8
	Papua New Guinea	12.4	66	15.9	22	9.1
47	France	12.3	47	19.3	49	6.0
48	Chile	12.2	49	19.0	50	5.8
48	Bolivia	12.2	63	16.2	28	8.5
50	Uruguay	12.1	43	20.0	61	5.2
50	United States	12.1	46	19.4	61	5.2
52	Rwanda	11.9	57	17.1	36	7.2
53	Croatia	11.6	45	19.8	78	4.5
54	Austria	11.5	53	18.2	54	5.4
54	Ethiopia	11.5	60	16.5	40	6.7
56	Thailand	11.4	48	19.1	78	4.5
56	Cuba	11.4	50	18.5	78	4.5
58	Sweden	11.1	63	16.2	48	6.1
59	Ireland	11.0	58	16.9	61	5.2
59	Madagascar	11.0	69	15.2	38	6.9
61	Bosnia and Herzegovina	10.8	55	18.0	89	4.1
61	Bulgaria	10.8	59	16.6	55	5.3
63	Australia	10.6	65	16.1	61	5.2
63	Solomon Islands	10.6	76	13.9	36	7.2
65	Romania	10.5	52	18.4	109	2.9
66	Argentina	10.3	56	17.2	89	4.1
67	Slovakia	10.1	50	18.5	121	2.5
67	Democratic Republic of the Congo	10.1	67	15.8	73	4.8
69	Nicaragua	10.0	68	15.4	70	4.9
70	Mongolia	9.8	62	16.3	100	3.7
70	Canada	9.8	70	14.9	73	4.8
72	Congo	9.6	71	14.7	77	4.6
72	New Zealand	9.6	73	14.4	69	5.0
74	Central African Republic	9.5	75	14.1	55	5.3
75	Cambodia	9.4	86	12.6	43	6.5
76	Pakistan	9.3	106	9.1	19	9.6
77	Germany	9.2	72	14.5	89	4.1
	Kyrgyzstan	9.2	74	14.2	78	4.5
	Switzerland	9.2	78	13.6	68	5.1
	Ecuador	9.2	81	13.2	55	5.3
81	Norway	9.1	84	13.0	61	5.2
82	Denmark	8.8	78	13.6	89	4.1
82	Laos	8.8	91	11.2	42	6.6
84	Guatemala	8.7	77	13.7	86	4.3
84	Luxembourg	8.7	84	13.0	84	4.4
86	Uzbekistan	8.5	81	13.2	89	4.1
87	Portugal	8.2	78	13.6	102	3.5
	Gabon	8.2	87	12.1	78	4.5
	Netherlands	8.2	89	11.7	73	4.8
90	Bahrain	8.1	90	11.6	109	2.9
91	Mauritius	8.0	81	13.2	109	2.9
91	Timor-Leste	8.0	99	10.2	50	5.8
93	Turkey	7.9	88	11.8	88	4.2
94	China	7.8	128	7.1	24	8.7
94	Bangladesh	7.8	131	6.8	24	8.7
96	Sierra Leone	7.7	94	11.0	78	4.5
97	Cote d’Ivoire	7.4	96	10.6	89	4.1
97	Singapore	7.4	101	9.8	55	5.3
99	Fiji	7.3	96	10.6	89	4.1
100	Cameroon	7.0	95	10.9	103	3.4
101	Costa Rica	6.7	91	11.2	129	2.2
102	Nigeria	6.5	98	10.3	109	2.9
103	Maldives	6.4	118	7.8	70	4.9
103	Brunei	6.4	119	7.7	61	5.2
105	United Kingdom	6.2	101	9.8	119	2.6
105	Swaziland	6.2	111	8.6	89	4.1
107	Lesotho	6.1	105	9.2	103	3.4
107	Paraguay	6.1	106	9.1	105	3.2
109	Malta	6.0	93	11.1	164	0.7
110	Israel	5.9	101	9.8	127	2.3
110	Albania	5.9	134	6.6	61	5.2
112	Brazil	5.8	104	9.4	121	2.5
113	Benin	5.7	110	8.8	107	3.1
113	Afghanistan	5.7	136	6.2	55	5.3
115	Togo	5.5	113	8.5	113	2.8
115	Honduras	5.5	114	8.3	113	2.8
117	Colombia	5.4	106	9.1	137	1.9
117	Senegal	5.4	111	8.6	113	2.8
119	Morocco	5.3	100	9.9	154	1.2
120	Republic of Macedonia	5.2	124	7.3	105	3.2
120	Iran	5.2	133	6.7	101	3.6
122	Spain	5.1	115	8.2	129	2.2
123	Vietnam	5.0	117	8.0	123	2.4
123	Gambia	5.0	121	7.6	119	2.6
125	Cabo Verde	4.8	106	9.1	143	1.6
	Burkina Faso	4.8	124	7.3	113	2.8
	Mali	4.8	126	7.2	118	2.7
128	Panama	4.7	116	8.1	151	1.3
	Cyprus	4.7	119	7.7	144	1.5
	Italy	4.7	121	7.6	137	1.9
	Chad	4.7	123	7.4	127	2.3
	Guinea-Bissau	4.7	126	7.2	123	2.4
	Guinea	4.7	128	7.1	123	2.4
134	Qatar	4.6	138	5.7	154	1.2
135	Liberia	4.3	131	6.8	135	2.0
135	Indonesia	4.3	156	3.7	70	4.9
137	Mexico	4.2	128	7.1	141	1.7
137	Tajikistan	4.2	138	5.7	113	2.8
139	Dominican Republic	4.1	137	6.1	132	2.1
140	Greece	3.8	135	6.3	151	1.3
140	Botswana	3.8	138	5.7	135	2.0
142	Yemen	3.7	151	4.3	108	3.0
143	Niger	3.5	143	5.3	137	1.9
144	Georgia	3.2	138	5.7	159	1.0
	Peru	3.2	149	4.4	132	2.1
	United Arab Emirates	3.2	155	3.9	141	1.7
147	Ghana	3.1	153	4.2	129	2.2
148	South Africa	3.0	142	5.5	158	1.1
148	Malaysia	3.0	147	4.7	144	1.5
150	Armenia	2.9	144	5.0	162	0.9
	Philippines	2.9	146	4.8	154	1.2
	Mauritania	2.9	148	4.5	144	1.5
153	Haiti	2.8	159	3.3	123	2.4
154	Namibia	2.7	149	4.4	148	1.4
155	Belize	2.6	145	4.9	169	0.5
155	Venezuela	2.6	151	4.3	159	1.0
157	Tunisia	2.4	158	3.4	148	1.4
158	Barbados	2.3	154	4.1	166	0.6
158	Bahamas	2.3	157	3.6	151	1.3
160	Jordan	2.0	163	2.2	137	1.9
161	Algeria	1.9	162	2.3	144	1.5
162	Libya	1.8	163	2.2	148	1.4
163	Egypt	1.7	160	2.4	154	1.2
	Azerbaijan	1.7	160	2.4	159	1.0
	Iraq	1.7	166	1.2	132	2.1
166	Jamaica	1.2	165	1.8	164	0.7
167	Oman	1.0	166	1.2	166	0.6
168	Lebanon	0.9	166	1.2	166	0.6
168	Kuwait	0.9	169	1.0	163	0.8
170	Syria	0.4	170	0.7	170	0.2
170	Saudi Arabia	0.4	171	0.6	170	0.2

UNDERSTANDING DIFFERENCE AND UNFAIRNESS IS A FIRST STEP IN SUICIDE PREVENTION

By Gerry Georgatos
March 4th, 2015

Globally, the majority of violent deaths are by suicide – nearly 60 per cent of all violent deaths. On average, annually, more people will die by suicide than will die due to war and civil strife. This statement will shock many people, especially because this has rarely been reported in the media. We hear of the violent deaths because of domestic disputes, of the violent deaths in the course of burglaries, of violent deaths as a s result of gun-related offences, and we hear of the huge loss of human life because of wars and civil strife but yet all up suicide claims more lives than all these unnatural deaths combined. The majority of humanity is oblivious to the fact that the majority of violent deaths are by suicide.

According to the World Health Organisation, in 2012, it is estimated that 56 per cent of all reported violent deaths globally were by suicide. Death by suicide occurs at higher rates in middle and high income nations than in poorer nations. Death by suicide occurs at disproportionately horrific higher rates among the descendants of First Peoples in middle and high income nations which have relatively recent colonial oppressor histories. In these nations the descendants of the First Peoples have been transformed into discriminated minorities – with many of these people, especially those who reject assimilative influences, marginalised.

The more recent the dispossession of a people from their historical conditions the higher their resistance to assimilative imposts and expectations. The more recent such contact and confrontation between cultural settings, the more likely those cultures which have been dispossessed for instance of land rights and of true self-determination, that their identities are intertwined with their historical self, and that they openly distrust their oppressor.

Suicide rates among the descendants of First Peoples within middle and high income nations with colonial oppressor histories are the world’s highest. Therefore the suicides are obviously about identity, resistance to assimilation, racialisation, racism, powerlessness, hopelessness, chronic pain and trauma. One of the strongest indicators for an individual or family for future suicide risk is the fact of a prior suicide attempt(s). Equally, this applies to groups of people, many through a racialised lens, such as the descendants of First Peoples. They can be disaggregated demographically to a region or community. Where for instance the community has a history of reported depressions and self-harms, of suicidal behaviour and suicides, then there is a future risk of self-destructive and suicidal behaviour within that community.

Suicidal behaviour is often the culmination of a set of experiences, events and of an underlay of feelings – how one feels about themselves contextually in light of the experiences and events. Self-destructive and suicidal behaviours can increase in a community that experiences trauma collectively – sharing around the trauma and the sense of hopelessness. Where Governments continue to fail communities, especially those populated by minorities, with disparity and inequalities in social wealth and health that should have been equivalent to the rest of the nation’s social wealth and health, then often it is up to communities to tap into their trusted leaders to look out for one another and educate others to empowerment of the self, to a sense of self and place, and similarly so communally.

People need people, especially in these communities that are deprived and discriminated by Governments. Many communities have third rate services, while some communities are effectively starved of some of the most basic services. In these discriminated communities, the residents cannot continue to cry out to Governments, because it is the very Government they cry out to who is their oppressor, who discriminates against them. Often if they cry out loud enough for long enough, the community is meted out punitive measures and controls which are more about blaming the community than helping them. With some communities, Governments have gone as far as shutting them down. Therefore the social and emotional wellbeing of the community is resigned to by its residents.

Hopelessness is a strong indicator of heightened vulnerability to self-destructive behaviour. Hopelessness has to do with the culmination of overwhelming feelings or beliefs that the future is bleak. Hopelessness exhausts motivation. Where hopelessness is engrained as a whole of family or whole of community approach, the despair and self-destruction begins from a younger age. “It’s our lot”. “It’s the burden of our people.” “Things will never get better.”

The sense of hopelessness is chronic and for some becomes unbearable. Losing someone close to you is a devastating experience. Dealing with their distress in the lead up to their loss is a devastating experience. Having to deal with familial distresses, as if recurring, with other family members is destructive – the objects and functions of the family take a toll, a real beating. For some they are psychologically and emotionally battered, and the damage takes an overwhelmingly feeling of the irreparable. Having to deal with ongoing destructive behaviours, with a communal sense of hopelessness, with the overwhelming backdrop of a deprived and discriminated community, is tortuously exhausting and simply heartbreaking. Community distress and breakdowns occur just like a family can breakdown – indeed, a whole community can breakdown. Hopelessness and despair can be effected as if normalised.

Suicide prevention must be understood in terms of who it is we are responding to: an individual overwhelmed by expectations, an individual overwhelmed by a sense of failure, an individual overwhelmed by a sense of hopelessness, an individual overwhelmed by trauma, an individual overwhelmed by a sense that their identity is a liability, a family overwhelmed by trauma and grief, a community overwhelmed by most of the above: hopelessness, trauma, discrimination, deprivation, racism – the sense the future is ‘bleak’ and ‘unfair’.

A couple of years ago I wrote:

– Suicides are nearly always the culmination of a sense of hopelessness and eventual loss of resilience in enduring unbearable conditions or from the result of intolerable failure(s) whether these failures are associated to low or high expectations. Suicide takes more lives of Australian teenagers aged 14 to 18 years than does any disease. Suicide has to do with the psychosocial identity – in a nutshell, to do with empowerment verse disempowerment.

– The journey to suicide is a psychosocial one – the eroding of identity or the stalling of its development; for First Peoples that can mean their historical and contemporary identities are both eroded and manufactured as a liability – and knowing this, living this, can lead directly to suicide. The suicides crisis is rising year by year and the median age getting younger each year.

– Social and economic development must arise in the dustbowl communities, in the shanty towns, which are the horrible work of Governments rushing people off Country, or which because of the outrageous neglect by Governments lack equivalency of social wealth to the rest of Australia’s communities. But this social and economic development will at best only somewhat reduce the suicides crisis and the whole spectrum of issues that culminate in self-destruction, displaced anger, disassociated behaviours, self-harms and suicides, but it will not abate the crisis. We have two distinct cultures in this nation – Western-based cultures and First Peoples cultures, and they do confront each other, especially in the remote but also in urban centres, and they do clash. To reject this premise will translate in more failed policies or the setting up of more failure and of wasted expenditure. Failure adds up and there reaches a point where it becomes systemic, ruination and despair, genocidal.

– Far too many commentators, far too many politicians have been pushing the line that the suicides crises afflicting First Peoples communities are extremely complex and that the solutions are not easily identifiable, but ironically they then try to push on us simplistic solutions – they say we need to get people into education and jobs. Indeed it is somewhat the opposite, the causes are obvious and the solutions are a little more complex than ‘education and jobs’.

I also suggested:

– The management of ones place within society is critical, and we must be solid in our thinking so as to do everything possible to allow them to navigate their way through society and to their right to empowerment. The majority of First Peoples have taken generational hits to their identity and therefore into the engine room that is self-esteem. These hits have crippled far too many, and these hits distinguish First Peoples from the rest of the Australian population – First Peoples have experiences that non-First Peoples cannot fathom. For many First Peoples their identity is often a liability, historically, culturally and contemporarily. To compound this layered trauma is the fact that a fifth of all First Peoples live in third-world-akin conditions. And far too many are now broken by the crushed hopes they once pegged everything on. There was a huge investiture of faith in the freedom struggles of the 60s, 70s, 80s, in the land rights struggle, in the Black Power movement, in the striving for Treaty, in native title expectations – but for all the good that has come for many there are also far too many who have had their hopes dashed, their expectations betrayed.

– In remote communities, where there is a disproportionate spike in the spates of suicides, particularly youth suicides, impoverishment quantifiably makes difficult the satisfactory navigation of ones identity through society. Children and youth in communities such as Beagle Bay, One Mile Community, Kennedy Hill, Mowanjum, Balgo for example watch their parents and the majority of their community languish in impoverishment. It gets worse for them – salt poured into the wounds – when they watch their families patronised by the sporadic visits of outsiders, by non-Aboriginal bureaucrats, by the affluent locals who come into the communities for a limited exchange of food, song, dance and ‘reconciliation’ events. Then they go, but their parents and community continue on in impoverishment and in hopelessness. These confrontational experiences wrought negative psychosocial effects on the children, driving in messages of inescapable inequality.

– I have met a great many community leaders in my travels, and interviewed many of these leaders. The themes are the same, and the impacts are the same – suffering. Assimilation is only well and good for those who want it but wholesale assimilation is indeed a crime against humanity. Assimilation is no longer a silent killer – we see day in day out the tragedy and extensiveness of the suicides crises. Humanity works best by carrying all people, and by unfolding through an engagement of one another, and certainly never by a majority trying to outmuscle a minority. Humanity must unfold ways forward, and exert endless patience, and never bully others. Assimilation demands the extinguishment of a cultural normative. The humiliation that those children feel in the communities I named offends the psyche and permits anger to arise; this anger can run amok.

– Anger is displaced to the parent, back on to the self, displaced to extended family, back on to the self, displaced on to community, this can lead to violence, the anger always comes back to the self, displaced on to authority, often leading to confrontation and arrest, to incarceration where self-destruction is at a premium, and for those who do degenerate into confrontations with community and authority, and who do not have solid support to turn to, the anger accumulates, becomes unbearable and to find relief it culminates in self-harm, in substance abuses, and tragically for some, in suicide.

In being honest about suicide prevention we must understand the person, family or community we are responding to. We must respond to who they are and therefore to how they should be treated. It is not an equitably fair world. To act as if it is or that it should be is to dangerously dismiss the stresses unique to some but not to others. To act as if life should be fair to people living in deprivation and discrimination when life will not be fair to people living in deprivation and discrimination is to pass the buck to an argument that redress is the solution, when in fact this will be the least likely outcome. To quote Professor Taiaiakei Alfred, the ‘chattering classes’ can carry on all they like about ‘reconciliation’, and I’ll add in, ‘closing the gap’ on inequalities, but life/society, the products of dominant cultures, of the ruling classes and of their Governments, are unfair.

In order to deal with the narrative of those in the now, rather than deal with a body politic, we have to accept that life is shit for far too many and acknowledge their anguish, pain, discrimination and suffering as real and longstanding. Our immediate aim must be to help them to develop and understand resilience and help them with a context of a meaningful life from which they can beat a path away from or around the effects of of the unfairness. We cannot dictate to everyone who is discriminated while they are suffering that we must strive for a ‘fair’ or ‘fairer’ world. This will come at the cost of their own wellbeing and that of those to follow them. Let us work with people first, and worry about changing the world second. To understand people in terms of their discrimination, whether this discrimination is dished out inadvertently or intentionally by Governments, and by some of the ‘chattering classes’, is a step in the right direction.

When I say or write that “People need people”, I mean this in that we must focus on each other, not pass the buck to blaming someone for their lot. We can see the poor and marginalised are victims, blaming others will still not help anyone. We must understand, that racism, and other imposts, are the landscape for many. To pass the buck here by blaming racists for racism, is a waste of time. The end to racism has quite a journey to go.

In understanding this rather than denying this by getting angry at the unfairness of the racism, of the discrimination, by saying merely it should not be this way, is a step in the right direction. We should not posit the crap that the answer to someone’s suffering is to change the landscape, because in doing so we leave behind the victims for longer journey. Each person, each family, each community in distress needs our undivided attention – this constitutes the biggest first step in helping those who are victim day in day out to discrimination, unfairness and so on.

Lifeline’s 24-hour hotline, 13 11 14 Crisis Support and Suicide Prevention

Beyond Blue – 1300 22 4636

PEOPLE STRENGTHENING PEOPLE – FOCUS ON SUICIDE PREVENTION

By Gerry Georgatos
March 9th, 2015

Suicidal behaviour does not mean that someone wants to die, this is another dangerous myth. Suicidal behaviour is a scream for help – people need people. It is a fallacy to presume ‘self-responsibility’ as a way forward for someone in a dark place. People need people to strengthen their resolve to the ways forward. Suicidal behaviour is destructive behaviour that can lead to impulsive actions such as a suicide attempt.

Access to emotional support can save lives. It may never be realised this was the case but person to person support is a huge factor in the improving and saving of lives. Resilience and empowerment are gradually accumulated over time, to the point there comes a time that there is no looking back. It is not true that once someone has exhibited suicidal behaviour that they are forever trapped in the heightened vulnerability to recurring suicidal behaviour.

It is true that a powerful indicator to future risk of suicide is a prior suicide attempt however this does not mean that the heightened risk shall be there for life. Indeed, with the coming together of emotional wellbeing and meaningful contexts, there develops resilience within the individual that can make one stronger than ever before. With the right sort of support, protective factors can guard people against the risk of suicide.

Suicide prevention should not be focused alone on reducing risk factors but just as focused, if not more so, on increasing protective factors. The most powerful protective factors include building a connectedness with other people – they do not need to be about direct and targeted support. This connectedness with other people should include the types of engagements that allow the individual to directly and indirectly draw information about wellbeing, about navigating ones journey through society, and therefore predominately focus on self-worth, identity and conflict management.

Most importantly, healthy relationships will contextualize a meaningful life, an honest life, and this in itself is a relief from the conflict and discord that arise from unhealthy levels of expectations. Personal relationships are important, where the support person can understand that they are about support and not about any particular targeted responsibility to the individual. More research needs to be disaggregated on suicidal behavior and mental disorders, but it appears the majority of suicidal behavior is not linked to mental disorders and rather to a sense of deep unhappiness. Therefore families and communities can contribute significantly to the improving of the life understandings of a troubled person.

The risk of suicidal behavior increases when individuals suffer various discord – such as relationship conflict or from a sense of loss or from a sense of failure. People need people. Isolation is dangerous. The best support comes from ones closest social circle. Protective factors, support comes from the development of ones context of meanings but these too are contributed to by ones social circle.

Where whole of communities are at heightened risk of community distress, the greatest success found in reducing the levels of communal distress is when the social circle that is the community comes together to support one another – therefore inherently highlighting the context of their meanings. Inherently rather than troubled individuals isolated and effectively judged, they are understood and supported. This type of coming together by families, friends and/or communities to a troubled and isolated individual is about wellbeing.

There may have been childhood trauma, interrupted childhood development – a series of emotional instabilities and turmoil’s that have affected personality traits which have given rise to unhappiness and suicidal risk factors. But good self-esteem and protective wellbeing factors will come from people coming together with the troubled individual at whatever point in time. These developmental interruptions, life stresses and unhappiness are not mental disorders that require specialist health practitioner support.

Rather this is all about people coming together to secure healthy and positive relationship building, to patiently assist one with their self-esteem, to contextualize the path to positive self-identity and the pathway to positive outlooks. Attitude is imperative but it is something shaped by the individual and by those around the individual. People do listen; they listen to the negative and to the positive. Positive adaptive outcomes must be patiently but relentless educated and shaped, and the familial and community support self-evident and generous. Once positive attitudes and positive coping understandings settle in as personality traits, the formerly troubled individual is effectively ‘safe’.

There needs to be in society greater onus on shared understandings of contextual meanings of what it takes to shape positive coping strategies in overcoming childhood adversity – abuse, maltreatment, of exposure to domestic violence, of parent mental disorder. There should be less focus and judgment on the fact of any difficult past, it should not be the focal point but if you read newspapers it is the focus. This bent for the past is damaging because it is a trapping. The discourse needs to be focused on the ways forward and in not holding oneself hostage to any past, or in holding any person or any set of events as responsible for any ongoing damage. Positive meanings and positive attitudes will lead to an understanding and forgiveness of the past and that the present and future can be shaped.

Destructive and self-destructive behaviours should be understood as situational and that individual, familial and community attitudes determine the length of these behaviours. Governments investing their attention in helping resource communities for instance to support others is imperative.

Globally, on average, suicide is the leading cause of violent deaths. Self-destructive and suicidal behaviours are responsible for more hospitalisation and for the descent into more social ills than by any other behaviours. Most suicidal behaviours are linked, and usually exclusively, to unhappiness. Therefore suicidal behaviour is preventable. I would argue that suicide and suicidal behaviour are the major health problems society face but of all our major health problems suicidal behaviour is the most preventable. Yet adequate suicide prevention is not prioritised by Governments.

Where causality is limited to relationship and social factors and to vulnerable individuals sense or feelings of hopelessness, the descent into a sense of entrapment and the responsive trait of impulsivity, then this behaviour can be addressed by positive mentoring.

Unhappiness is something that can be addressed holistically rather than it being compartmentalised as some sort of mental disorder manifestation and as of a runaway train risk factor to mental disorders.

Unhappiness is a manifestation. The prevalence of suicide and suicidal behaviour is higher in high and middle income nations as opposed in low income nations. Similarly, rates of reported depressions and of hospitalisations from self-harm are higher in high and middle income nations. Life stresses that lead to suicidal behaviour in some cultures do not lead to suicidal behaviour in other cultures. Therefore the context of our meanings and our support groups are pivotal.

The outlier in the above are discriminated minorities and peoples. In nations, especially high and middle income nations, with relatively recent colonial oppressor histories, the descendants of First Peoples have been degenerated to discriminated minorities. Unless the descendants of First Peoples accept homogeneity and hard edged assimilation they consequently experience a deep sense of discrimination. This goes to the heart of identity, to self-worth and esteem and their historical and contemporary identities become a liability. These disaggregated groups have the world’s highest rates of depressions, unhappiness, self-harms, suicidal behaviour and suicides. It is all about identity, whether for a vulnerable child, young adult, cultural group – the answers lay in respecting one another, being there for the other, empowering each other through meanings, relationships, freedoms and attitudinally.

Suicide prevention is about the positive self and any comprehensive response includes everyone. A comprehensive national response for suicide prevention requires understanding the above. Loose understandings will tighten if we begin to understand that the majority of suicidal behaviours are directly linked to trauma and unhappiness – to situational events. Contexts and understandings can be changed before dangerous reliefs from substance abusing are sought or before serious mental disorders set in.

The point is that suicides, our leading cause of violent deaths, which receive relative little mention in the news, are the most preventable violence. Self-destructive behaviours that can culminate in suicidal behaviours and distress families and communities are in fact a leading cause of familial breakdowns and of community distress. Once again, the point is that this behaviour is the most preventable of the various destructive behaviours that impact families and communities. These need to be prioritised in national conversations, by the media, by our Governments.

There are many ways forward. More to come.

Lifeline’s 24-hour hotline, 13 11 14 Crisis Support and Suicide Prevention
Beyond Blue – 1300 22 4636