Pastoral Care in the event of attempted suicide

ABSTRACT

The research assignment looks at the issues and characteristics surrounding suicide and attempted suicide and presents

a pastoral care plan for an individual who has attempted to do so. It begins by speaking of the necessity for pastoral

carer’s to take care of their own well-being, and understanding when they need to refer the individual for professional

counselling, therapy, or medical treatment. The paper also speaks of the importance of the carer in understanding and

researching the issues surrounding suicide that way they are in a better position to offer care. It explains that the

individual, their family and friends and also their communities are affected by suicide, and therefore care must be given

in varying degrees to all affected. The paper addresses the stigma often attached and to offers brief Biblical arguments

and examples which seek to change Christian attitudes toward suicide. The physical, emotional and spiritual aspects of

caring for a person in this situation are addressed and are later incorporated into the pastoral care plan. Often through

the paper, and in particular the first half, references made to the ‘Pastor’ also refers to any person who engages in

pastoral care. An appendix is attached which has statistical information from the Australian Bureau of Statistics

website, other relevant resources and useful information, as well as links to websites intended to help those who are

facing this issue.

Providing pastoral care in the event of an attempted suicide must take into consideration a number of aspects

starting with the relevant pastoral issues attached with offering care, and then also the spiritual, physical and emotional

dimensions of the people involved. In order to be better informed on how to handle the situation relevant scriptures

will be used to attempt to alleviate the stigma attached to suicide, and also to help shape the attitudes of both the

pastoral carer and the people affected.

Firstly, carer’s must be aware of their own well-being when seeking to care for someone who has attempted suicide.1

The situation can easily overcome and swamp the very person who is seeking to bring healing and restoration. The

pastoral carer must realise that they are not the sum total of all the person’s needs, and that they do not have the

ability alone to “fix” them. Care should be offered with the understanding that the final outcome of the situation is

always the decision of the person for whom they are caring. They must be aware of when they are out of their depth as

far as the support they can offer and be quick to refer the person to qualified counsellors, psychologists, physicians etc.,

and, in addition they should be conscious of their own motivations. As a result of their spiritual authority and privileged

access into people’s lives, pastors have a considerable power and influence which could lead to them using the

relationship to serve their own need of value, worth, identity etc.2 For this reason, it is a good idea for the pastoral

carer to regularly meet with a supervising mentor who they can be honest with and to whom they are accountable.

There also needs to be awareness of the difference between Pastoral Care, and Pastoral Counselling. Pastoral care is

generally much broader in focus and in the number of those for whom care is provided, whereas Counselling becomes

much more limited in the scope of people being cared for, and much more focused in the issues being dealt with, (See

Figures A3 and B4 in the Appendix).

1 On The Line, "Supporting Someone after a Suicide Attempt," http://suicideline.org.au/worried-about-someone/supporting-someone-after-a-suicide-attempt., Peter Brain, Going the Distance (Kingsford, NSW: Matthias Media, 2006).258, Wayne Cordeiro, Leading on Empty : Refilling Your Tank and Renewing Your Passion (Minneapolis, Minn.: Bethany House, 2009).183-202 2 Howard John Clinebell and Bridget Clare McKeever, Basic Types of Pastoral Care & Counseling : Resources for the Ministry of Healing and Growth, Updated and rev. / Bridget Clare McKeever. ed. (Nashville: Abingdon Press, 2011).461-77 3 Morling College lecture notes PC403/603 & MCO503 Week 1 Semester 2 – 24.07.2014 Page 7 4 Peter Janetzki, "Clarifying the Roles of Pastoral Care & Counselling within the Care Ministry of the Church.," http://www.peterj.com.au/wp-content/uploads/2013/03/Journal-Article.pdf.

Secondly, it is important that the pastor is informed about the issues surrounding suicide. By doing some research on

the topic, it will give insight into things such as the prevalence of the problem in society, common causes leading to

suicide, the demographic of people most at risk, and the warning indicators that an individual is thinking of taking their

own life. For example a quick look on the Australian Bureau of Statistics will show that the most suicides for men and

women occur in people aged between 35 and 44 years old. This is consistent across all states in Australia with the

exception of two states/territories – one being the Northern Territory whose most suicides occur for those aged

between 15-24 years of age. (See Tables 5.1 and 5.2 in Appendix). Therefore whilst for most states the age group most

at risk is 35 to 44 years old, there seems to be some reason why (for instance things like: drug/alcohol abuse, sexual

abuse, lack of employment etc etc.), in the Northern Territory the trend is different. So whilst not telling us everything

about the situation, these resources do provide valuable information. Closer research will give the carer even further

insight such as the fact that although men have higher rates of suicide, women actually have higher rates of attempted

suicide.5 As Howard Clinebell states, “Pastor’s need to know how to prevent suicide and to have enough information to

make quick evaluations of the likelihood that people in different categories – age, gender, suicidal thinking, life crises, or

levels of depression – will act on their suicidal threats or impulses.”6 Being armed with this kind of information will

assist the pastor to know if a person who has attempted suicide is planning to do so again. It is helpful for the carer to

try and understand the “head space” of the person who is thinking of or has attempted suicide. Psychologist Edwin

Shneidman, a leading authority on suicide, highlights ten characteristics that are commonly associated with suicide.7

(See Apendix Figure C.)8 Being aware of these will give insight into the possible thought patterns of those who are

affected.

Thirdly, the pastor should provide care for the individual directly, and also by providing the support needed to enable

their family, friends and community to assist. Although the main priority is to care for the person who has attempted

suicide, the effects of suicide or attempted suicide extend well beyond the individual. For this reason it is necessary that

pastoral care is provided to the person’s community, friends and family who are likely to be having feelings such as:

anger, shame, guilt, and fear, or who may be avoiding, minimising or simply pretending the problem doesn’t concern

5 D. Geldard and K. Geldard, Basic Personal Counseling: A Training Manual for Counselors, 5th ed. (Frenchs Forest, NSW: Prentice Hall / Pearson Learning Australia, 2005)., Clinebell and McKeever, Basic Types of Pastoral Care & Counseling : Resources for the Ministry of Healing and Growth.148 6 Basic Types of Pastoral Care & Counseling : Resources for the Ministry of Healing and Growth.148 7 Edwin Shneidman, Definition of Suicide (Jason Aronson, Incorporated, 1977).121-49, 8 AIPC (Australian Institute of Professional Counsellors), "Suicide: Statistics, Characteristics and Myths," AIPC Article Library, no. June 14, 2012 (2012).

them.9 In addition, seeing as the suicide of a friend or family member has been recognised as a contributing factor to

further suicides10, creating an environment where people feel safe to talk about it, is of the utmost importance.

Knowing and providing access to government and community resources and services designed to help prevent suicide is

one of the simple ways to initiate the conversation. (See Figure D, in Appendix for some resources).

There has traditionally been, and still exists, stigma attached to suicide in Christian communities.11 Much of this

stems from the 4th century AD when Augustine strongly pronounced against suicide in The City Of God, claiming it was a

type of murder.12 During the 16th and 17th centuries in England people such as, George Abbot, Anthony Anderson,

Thomas Beard, Bishop Lancelot Andrews and John Abernethy spoke so strongly against suicide that they went as far as

saying that those who committed this heinous act would be eternally condemned.13 Others such as James Gustafson,

claim that suicidal thoughts or actions stem from a poor spiritual state. In essence they say that if a person’s spiritual

walk with God is healthy, they would not be tempted to take their own life.14 Unfortunately, these attitudes can

sometimes still be expressed towards the person and the family of a person who has attempted suicide. These attitudes

only serve to further isolate them and thus aggravate the problem instead of bringing healing.

In response to the attitude above, it is worth noting that the Bible clearly says that there is only one unforgivable sin,15

and this is not the taking of one’s own life. Secondly there are examples recorded in scripture of prophets or people

who are regarded as heroes of the faith, who have despaired of life. For instance, the author of Ecclesiastes came to a

point of hating life,16 Jonah, although a prophet sent by God, reached a point where he preferred to die than live.17

Elijah wanting to die, prayed that God would take his life,18 as did Moses who came to a point where he was being

overwhelmed by the burden placed upon him,19 and the Apostle Paul speaks of being subjected to such intense pressure

9 On The Line, "Suicide Call Back Service," https://www.suicidecallbackservice.org.au/concerned-about-someone/supporting-someone-after-a-suicide-attempt. 10 Geldard, Basic Personal Counseling: A Training Manual for Counselors., Jack Wellman, "Suicidal Thoughts: 7 Biblical Tips," Telling Ministries LLC, http://www.whatchristianswanttoknow.com/suicidal-thoughts-7-biblical-tips/. 11 Kathy McKay and Jann E Schlimme, "Making Sense of Suicide," (2011). 12 Elizabeth K. Hunter, "'Between the Bridge and the Brook'," Reformation & Renaissance Review: Journal of the Society for Reformation Studies 15, no. 3 (2013).241 13 Ibid.238 14 Charles W. Stewart, "What Does the Bible Say About Suicide," Journal of Pastoral Care 45, no. 1 (1991).88-9 15 Matthew 12:31-32 16 Ecclesiastes 2:17 17 Jonah 4:3 18 1 Kings 19:4 19 Numbers 11:11-15

that he despaired of life itself.20 What this shows is that as humans we are all subject to times of weakness and intense

suffering which at times seems greater than we can bear, not to mention those who suffer mental illnesses, which come

with all their complexities. All people, given the right circumstances, are potentially susceptible and at risk of self harm.

In contrast, the Bible sympathises with those who suffer and records the cries and complaints of those who endured the

darkest of times. Psalm 69 gives a great example of ongoing suffering – to the point where the Psalmist is weary of

calling for help (vs3), and Psalm 88 ends so bleakly that the final words of the psalmist are ‘darkness is my closest

friend’. When attempting to care for someone who has attempted suicide it helps to remove the stigma by showing

that many others are going through similar struggles and that they are not alone. The scriptures provide some of the

most assuring passages that simply give ‘permission’ for the person to feel the way they are without compounding their

problem by added the further burden of guilt and shame upon them.

Scriptures provide a great spiritual source of strength for someone who has attempted suicide. The Bible affirms that

they have Christ as a mediator who is able to empathize with their weaknesses, and who offers grace and help in their

time of need.21 Through scripture they can be affirmed of their worth, value and position in Christ22, they are assured

that God is close to them23, that God has a plan and a good future for them24, and that they are able to overcome their

struggle through the strength they receive from Christ.25 Care should be used with passages that may often be quoted

with intentions to comfort, such as 1 Corinthians 10:13 because it may cause a person to feel as though they failed

when they should have found the way out, and thus have a negative impact. However, speaking the truth of God in

scriptures is a great way to provide the spiritual care they need. Other ways in which they will need to be cared for

spiritually is through ongoing prayer, through fellowship, through music and meditation on God, and through helping to

redirect their mind on all of God’s blessings in order to rediscover the joy, hope and peace they have in Christ.26

Nurturing a person’s spirit as a means to help recover from attempted suicide is recommended on suicide prevention

20 2 Corinthians 1:8 21 Hebrews 4:14-16 22 Psalm 139, John 3:16, Galatians 3:26, 1 John 3:1-2 23 Psalm 34:11 24 Jeremiah 29:11 25 Philippians 4:12-13 26 Philippians 4:4-9

websites for even those who do not necessarily profess a Christian faith, therefore consider how much more beneficial

it is for those who cry out to the one true God.27

To look after the emotional well-being of someone who has attempted suicide required regular contact in their

presence. They should also always have people who love and care for them around them for support. They will need to

be able to talk honestly and frankly about their thoughts and feelings with someone who they trust, and they will also

need the company, interaction and emotional support of friends and family who are happy just to be a part of their life

and participate in regular fun and light hearted activities with them. The carer should try and understand their

perspective and feelings and to seek the root causes that led to them attempting suicide in order to then put a plan in

place to prevent the same from re-occurring. It is imperative that they immediately seek professional help from a

counsellor or psychiatrist.28 The person should be encouraged to take as much responsibility for their own welfare as

they are capable of at that time, therefore by helping them to write out a safety plan in the event that they feel suicidal

again, or even getting them to sign a ‘Life Contract’29 in the presence of a witness, can assist them to do so.30

The physical ways in which care can be shown to someone who has attempted suicide is firstly to ensure that they

are safe and no longer in danger. They may need hospitalisation or medication that may help with the situation, and

therefore a visit to their General Practitioner may be what they require. The carer should ensure that all the means by

which they could plan to end their life are removed. This may include things like removing pills, razors, rope, poison etc.

Ensuring they are getting proper and regular sleep and that they are not using drugs or alcohol is important as a lack of

sleep or the use of drugs and alcohol can impair their ability to think clearly and logically. Encouraging them to do some

kind of exercise can also help to clear their mind, as well as provide them with a general sense of well-being. Depending

on what physical and emotional state they are in, they may also need assistance in completing everyday regular errands

27 David Horgan, "Body, Mind, Spirit... Tips," http://suicideprevention.com.au/body-mind-spirit-tips-2/. 28 Clinebell and McKeever, Basic Types of Pastoral Care & Counseling : Resources for the Ministry of Healing and Growth.148-51 29 A life contract is a simple form which states something like: “I will agree not to harm myself and if I do have suicidal thoughts, I agree that I will contact one of the following people….family member, friend, doctor, counsellor, help line etc.” 30 Suicide Call Back Service, "Supporting Someone after a Suicide Attempt," https://www.suicidecallbackservice.org.au/concerned-about-someone/supporting-someone-after-a-suicide-attempt.

and duties such as house-keeping, grocery shopping, washing and cooking etc., and they may also not be able to work

and therefore be struggling financially. The carer ought to keep these things into consideration and seek to help in

these areas also, therefore they may be required to organise a few people who can commit to provide meals, or they

may need to contact financial institutions for assistance etc.

Below I have created an example pastoral care plan that could be used for people who have attempted suicide.

Please not that this may not be applicable in all cases, and is intended primarily as a template to be used should the

need arise.

Pastoral Care Plan

Person’s situation: Ali has attempted suicide by jumping off a high bridge. Luckily his fall was broken by a stray

sheep which gave it’s life to save his, however still leaving him with two broken legs, a cracked rib and significant

bruising. He is 37 years old and owns a dairy farm in Tilba Tilba on the south coast of NSW, about a 5 hour drive from

Sydney. He lives on the farm with his wife Fatima and their three children Muhammed – 11 years old, Rasha – 9, and

Christian – 5. Profits have been low due to the farm being affected by a long drought, and they recently had to lay off

several of their employees. Muhammed is about to start high school but the nearest school is very far and would

require him to board. Given their current financial situation, Ali and Fatima cannot afford to send him to boarding

school and were considering studying by correspondence. Meanwhile, Christian is also about to start school. Fatima

wants to return to Sydney to live close to her family, who said they would provide temporary financial support and

housing on the condition that she and her family convert back to Islam. Ali has been disowned by his entire family, who

live in the neighbouring town 20km away, after his conversion to Christianity 8 years ago.

Major needs for the person:

Physical

- Ongoing medical care (doctor’s visits, getting medication etc)

- Mobility (general everyday actions ie. bathroom visits, showering, ‘walking’ around the farm)

- Worker to continue every day running of the farm

- Money

Social/Relational

- Regular Interaction with friends, family and church members

- Non-judgemental support

- Support for his immediate family

- Safety plan

Emotional/Mental

- Counselling/Psychological Therapy

- Self worth

- Love, Acceptance, Hope

- Family counselling

- Accountability Partner (someone he can talk to if he is feeling suicidal again)

Spiritual

- Prayer

- Fellowship/Church Family

- Comfort/Encouragement through scripture

- Faith strengthening support for him and his family

Support Network:

Pastor – Pastoral Care, Emotional Support, Spiritual Guidance, Fellowship, Accountability

Counsellor/Psychologist – Emotional Support, Accountability, Mental Support

Doctor – Physical healing, referral to other professionals

Wife – Physical support (helping him with bathroom visits, mobility, farm work etc), emotional support

Church Community/Friends – Emotional support, ongoing social interaction and visits, spiritual support,

financial support, help with work on the farm, prayer support, non-judgemental acceptance, support for his

family’s emotional and physical needs eg. cooking meals, cleaning house, helping to bathe and dress Ali,

people willing to listen and talk with wife and children.

Major Overall Objectives for Pastoral Care Plan:

- To prevent further suicide attempts by helping Ali to see hope and a realistic positive way forward

- To provide emotional, spiritual, social, and physical support for his immediate family

- To provide emotional and spiritual support for the church community and friends affected

- To create an environment of love and acceptance for him and his family

- To help ease the factors which led to his attempted suicide

Length of Plan and How It Will Be Reviewed:

This plan will last one year with reducing intensity based on how well Ali responds. There is a possibility of extension if

recovery takes longer than anticipated.

The plan will be reviewed after 1 month, 3 months, 7 months, and 12 months of activation. At each interval of the plan

some of the more demanding aspects of caring will be discontinued. For example, after 3 months his legs and rib should

have healed, therefore he may no longer need someone to help him bathe, and after 1 month he may no longer need

constant regular visits. This is designed to slowly and gently allow him to return to his position of self-sufficiency

without becoming disempowered and overly dependent, nor feeling neglected or abandoned.

Assessment in the reviews will be based on: whether there have been additional suicide attempts or ideation,

doctor/counsellor/psychologist recommendation, the needs of Ali and his family as expressed by them directly, and the

ability of church members and friends to continue providing care without them feeling overburdened. The effectiveness

will also be measured by the general well-being and stress levels of Ali and his family.

Specific Steps:

Identified Problem or Issue (Relevant scriptures to help inform care)

Specific Objectives or Goal (indicate whether they are short-term (S) or long-term (L)

Specific Skills or Activities that will be Utilised

Support Providers Specific Resources that will be used

Ali is suicidal John 21:15-17 Job 2:11-13 Philippians 2:19-25 Matthew 18:20 James 5:16 Galatians 6:1-5 Matthew 18:8 Matthew 6:13 1 Thessalonians 5:17 Philippians 4:6

Keep him alive (L) by preventing additional attempts to take his life

Counselling Ministry of presence to provide emotional support and also to lessen the time he is alone, and therefore at risk of repeat attempt Write up Life Contract31 Assist with a safety plan32 Removal of items that may be used to suicide33 (where practical – ie. the bridge is impossible to move) Prayer

Suicide Prevention Line Professional Counsellor Pastoral carer, Church Members, Friends, Family. Counsellor, Pastoral carer Counsellor, Pastoral carer Wife, Friends Pastoral carer, friends, family, church community, prayer team

Australian Suicide Prevention Foundation: 1800 465 366 www.suicideprevention.com.au Phone numbers and list of other trusted people who Ali can call if he needs to. Lifeline: 13 11 14 Safety plan template34 (See appendix Figure E) Guidelines for writing the safety plan35 Australian Bureau of Statistics – Information on methods of Suicide. (Table 11.4 in appendix) Prayer notice board and bulletin Communal prayer time God

Ali is not mobile Galatians 6:1-5 Philippians 2:4 James 2:14-17

Providing care that will overcome his lack of mobility (S)

Organise people who can assist with basic things such as bathroom visits, showers, getting dressed etc. Assisting to bring Ali to doctor or medical appointments. Assist with picking up medicines from pharmacy. Errands around the farm

Close friend or church member Close friend or church Member Church members/Friends

Home visiting carer or nurse Car or adequate means of transport Wheelchair Their knowledge and experience of working on a Dairy Farm

Ali is struggling financially James 2:14-17 1 John 3:17-18 Matthew 5:42 Deuteronomy 15:7-11 Acts 4:32-35

Providing care that will strengthen his financial security (L)

Special collection of funds Contacting a mediating organisation or financial planner to negotiate with creditors and provide ongoing finance management

Church community Pastoral carer, close friend, or church member

Announcing a special offering for Ali on Sunday Christians Against Poverty www.capaust.org Grants and Assistance – Department of Agriculture36

31 Geldard, Basic Personal Counseling: A Training Manual for Counselors. 32 Service, "Supporting Someone after a Suicide Attempt"., Suicide Line, "Self-Help for Suicidal Feelings," http://suicideline.org.au/content/uploads/self-help_for_suicidal_feelings.pdf. 33 Service, "Supporting Someone after a Suicide Attempt". 34 Stanley B Brown G, Department of Veterans Affairs, "Patient Safety Plan Template," WICHE (Western Institute Commission for Higher Education) Mental Health Program and Suicide Prevention Resource Center http://www.sprc.org/library_resources/items/patient-safety-plan-template. 35 http://www.sprc.org/sites/sprc.org/files/SafetyPlanningGuide.pdf 36 http://www.agriculture.gov.au/about/current-grants

http://www.suicideprevention.com.au/

http://www.capaust.org/

Ali has been disowned by his family Ephesians 2:19 Romans 12:5 Matthew 12:48-50 John 19:26-27

Fill the gap that is left by essentially having no extended family (L)

High level of genuine and intimate fellowship, and the formation of closer family-like relationships Active-reflective listening whilst discussing how it affects Ali and his family

Church members Pastoral carer

Unity of the Spirit Adaption into God’s family

Pressure on Ali and family to return to Islam 1 Thessalonians 5:11 Hebrews 10:23-25 Hebrews 4:14-16

Support and encourage Ali and his family in their Christian faith (L)

Active-reflective listening whilst discussing their spiritual doubts and struggles. Use of empathy. Normalise their feelings and doubts. Convey that there is no shame to be feeling the way they are Prayer Bible study and assurance from God’s Word

Pastoral carer Pastoral carer Pastoral carer Pastoral carer

Exploration of God’s providence and care in Ali’s life so far, and also the fact he survived the suicide attempt. Share testimonies of others who have experienced similar. Refer to books written by ex-muslims eg. I Dared to Call Him Father – Bilquis Sheikh Bible, Study Guides

Judgemental attitudes Galatians 6:1-4 James 4:11-12 Romans 2:1-3 Romans 8:1 1 Corinthians 16:14 Hebrews 4:14-16

To minimise negative attitudes and the stigma surrounding suicide (S)(L)

Educating and training the church community about suicide, the myths surrounding it, and giving concrete examples of helpful and unhelpful37 responses. Offering a Biblical perspective. Create an environment of acceptance, love and encouragement and a safe place for others who may feel the same to seek help

Pastor Pastor/pastoral carers Church community

Australian Bureau of Statistics38

www.suicide.org/suicide-myths.html

The effect and added burden on Ali’s family. Galatians 6:2 Romans 12:15

To assist Fatima, and Ali’s children with the emotional and physical effects (L)

Provide family counselling Meeting with each member of the family individually and together to allow them to talk about the issues. Active-reflective listening, empathy, acceptance, love

Counsellor/Therapist Pastoral carer

Ali’s current emotional and mental state of being. Jeremiah 29:11 Romans 5:3-5 2 Corinthians 4:16-18 Philippians 4:13 2 Timothy 1:7

To assist Ali reach a place where he sees hope, an alternative way to solve the problems which led to the suicide attempt, and to help him think logically and rationally. (L)

Ongoing counselling Ongoing pastoral care Consistent and encouraging fellowship, social and relational interaction

Counsellor/Therapist Pastoral carer Church community, Friends

37 https://www.suicidecallbackservice.org.au/concerned-about-someone/supporting-someone-after-a-suicide-attempt 38 http://www.abs.gov.au/ausstats/[email protected]/Products/3309.0~2010~Chapter~Suicide+in+Australia?OpenDocument

http://www.suicide.org/suicide-myths.html

APPENDIX

FIGURE A.

1. GENERAL PASTORAL

CARE

2. PASTORAL

COUNSELLING

3. CLINICAL

COUNSELLING

4. PSYCHIATRIC CARE

Broad Broad focus Focused Focused and intense

Hard to define but is reflected in

the attitude of the carer in all

relationships

Short term and contracted

Problem focused,

Goal/Solution orientated

Short term or long term

conflict, stress or issue

oriented

Provides clinical assessment for

individuals and counsellors

Is an active demonstration of

care and support in all life’s

circumstances.

Short term crisis intervention

and support.

Person or relationship

change oriented. Issues

generally not black and

white. About which shade

of grey is the right one.

Provides

long term psychotherapy and/or

medication

hospitalisation when needed

Relationship & family based

within the church community

Long term support and care.

Often takes place within the

context of a church or

community

Controlled contact i.e. by

appointment only. Fees for

service usually involved.

Deals with major disorders:

Organic - e.g. Delirium,

Dementia

Functional e.g. Schizophrenia

Manic depressive

Need to be aware of

transference and counter

transference

Has potential for transference

and counter transference.

Has therapeutic goal for

person, couple family. Has

potential for transference

and counter transference.

Post partum psychosis

Paranoid states

Eating Disorders

Pastoral care training beneficial Supervision essential.

Supervision essential Legally and Registration

controlled.

Can become complicated when

working with many family

members in the congregation.

Presumes some measure of

training or competence.

Membership of

professional association

essential.

Medical Training required

Can leave members very

vulnerable knowing Pastor

knows their intimate Issues,

details and/or history.

Not advisable for Pastor to

do this with members of his

own congregation – refer

out.

External to Church community –

often in hospital contexts

FIGURE B.

FIGURE C.

Re-interpreted Dr Shneidman’s ten characteristics into a mnemonic to help you remember them.

The acronym is COPPINGOUT, as follows:

Constriction is the cognitive state.

Oblivion is the goal: the cessation of consciousness.

Psychological pain is the stimulus.

Purpose is to seek a solution.

Intention is communicated interpersonally beforehand.

Needs are frustrated. Getting out – escaping – is the desired action.

Overriding emotion is hopelessness-helplessness.

Underlying attitude is ambivalence.

Time-worn coping patterns are again employed.

Let’s unpack those a little bit.

Constriction is the cognitive state: A person thinking of dying by suicide often has a rigid and

narrow pattern of cognition: like tunnel vision. Rather than engaging in problem-solving

behaviours, the person tends to see his or her options in extreme, all-or-nothing terms. The

person’s cognitive state is not conducive to good decision-making.

Oblivion is the goal: the cessation of consciousness: Rather than continue to be obsessed with

hugely distressing thoughts, the person who would die by suicide seeks the end of conscious

experience. Suicide appears to offer oblivion.

Psychological pain is the stimulus: Suicidal people feel intense and excruciating emotions of

guilt, shame, sadness, anger, and fear, often arising from multiple sources, and it is the pain of

these that motivates the desire to suicide.

Purpose is to seek a solution: When people find themselves in an unbearable situation, suicide

may appear to be a preferable solution to continuing in the dire circumstances. Emotional

distress and/or physical disability may be feared by the person more than death. Perpetrators of

criminal acts about to be caught by authorities have sometimes preferred suicide (such as by

jumping in front of a train or shooting themselves) to facing justice and a life behind bars (or

possibly being executed by the death penalty). Whatever the horrific situation, suicide is not a

random or pointless act; it is an answer to a seemingly insolvable problem.

Intention is what is communicated interpersonally: One of the most dangerous misconceptions

about suicide is the idea that people who really want to kill themselves don’t talk about it.

Schneidman estimates that in at least 80 per cent of completed suicides, people have

communicated their lethal intentions to others, usually by telling people about their plans, but

also by behavioural means (more on pre-suicide behaviours later).

Needs are frustrated: Frustrated psychological needs make someone more vulnerable to suicidal

ideation. People who have very high standards and expectations can feel especially disappointed

when progress towards their goals is thwarted. If they attribute the failure or disappointment to

their own shortcomings, they may come to see themselves as worthless, unlovable, or

incompetent: a perfect set-up for suicide. For young people, particularly, career/employment

issues, family conflict, and other interpersonal frustrations can precipitate suicide. Similarly,

studies have found that, in periods of high unemployment, suicide rates go up (Yang, B.,

Motohashi, Y., & Lester, D., 1992).

Getting out – escaping – is the desired action: Suicide seems to provide a way out of painful self-

awareness and/or intolerable circumstances: a definite way out.

Overriding emotion is hopelessness-helplessness: Even more central to predicting suicidal

behaviour than intense negative emotions (such as fear, anger, or sadness), is the pervasive

sense that the future is hopeless, and that no one can do anything to help. Pessimism breeds

suicide.

Underlying attitude is ambivalence: For all the intensity of negative emotion and sincere desire to

die, however, there is simultaneously in most suicides an equally strong wish to find a way out of

the dilemma. Thus, suicide contemplation is about intense ambivalence. The skilled social

support person can tap into this ambivalence, helping the person to swing to the “want to find a

way out of the dilemma” pole.

Time-worn coping patterns are again employed: Not surprisingly, people thinking about killing

themselves generally use the same patterns of thought and ways of coping to deal with the

current crisis as they have always used. If someone is habitually a loner, refusing to ask others

for help or believing that no one can help, that person is likely to act from a stance of isolation in

the lead-up to the suicide as well (Oltmanns & Emery, n.d.).

FIGURE D.

Crisis helplines

Lifeline: 13 11 14

Suicide Call Back Service: 1300 659 467

Kids Helpline (for young people aged 5 to 25 years): 1800 55 1800

Suicide Line: 1300 651 251

Australian Suicide Prevention Foundation: 1800 465 366

Websites

www.suicidecallbackservice.org.au

www.suicideline.org.au

www.kidshelp.com.au

www.lifeline.org.au

www.suicideprevention.com.au

www.suicidepreventionaust.org

www.jigsaw.ontheline.org.au

http://www.suicidecallbackservice.org.au/

http://www.suicideline.org.au/

http://www.kidshelp.com.au/

http://www.lifeline.org.au/

http://www.suicideprevention.com.au/

http://www.suicidepreventionaust.org/

http://www.jigsaw.ontheline.org.au/

FIGURE E.

INFORMATION FROM THE AUSTRALIAN BUREAU OF STATISTICS

OVERVIEW

In 2010, a senate inquiry (The Hidden Toll: Suicide in Australia) highlighted the potential costs of suicide to individuals,

families and communities. Suicide can be defined as the deliberate taking of one's life (Butterworths Concise Australian

Legal Dictionary, 1997, Butterworths Sydney). To be classified as a suicide, a death must be recognised as being due to

other than natural causes. Detailed information on how deaths are classified as suicide by the ABS can be found in

Explanatory Notes 92-94.

This chapter contains summary statistics on suicide deaths registered in Australia, where the underlying cause of death

was determined as Intentional self-harm (suicide (X60-X84, Y87.0)). Further information on suicides is presented in the

data cubes associated with this publication.

External causes of death are required to be examined by the coroner, who investigates both the mechanism by which a

person died, and the intention of the injury (whether accidental, intentional self-harm or assault). For a death to be

determined a suicide, it may be established by coronial inquiry that the death resulted from a deliberate act of the

deceased with the intention of ending his or her own life (intentional self-harm). In addition to coroner-determined

suicides, deaths may also be coded to suicide following further investigation of information on the NCIS. For further

information on how a death may be coded to suicide, see Explanatory Note 94.

KEY CHARACTERISTICS

There were 2,535 deaths from Intentional self-harm (suicide, (X60-X84, Y87.0)) in 2012, resulting in a ranking as the 14th

leading cause of all deaths. Three-quarters (75.0%) of people who died by suicide were male, making suicide the 10th

leading cause of death for males. Deaths due to suicide occurred at a rate of 11.0 per 100,000 population in 2012.

http://www.abs.gov.au/ausstats/[email protected]/Lookup/3303.0Explanatory+Notes12012


AGE

Median age

The median age at death for suicide in 2012 was 44.6 years for males, 42.8 years for females

and 44.1 overall. In comparison, the median age for deaths from all causes in 2012 was 78.6

years for males, 84.6 years for females and 81.7 years overall.

Age-specific rates

Age-specific death rates are the number of deaths during the reference year for specific age

groups per 100,000 of the estimated resident population of the same age group (see Glossary

for further information). The pattern of age-specific rates in 2012 for suicide in males and

females is shown in the graph below.

Footnote(s): a) Includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in

interpreting figures relating to suicide. See Explanatory Notes 92-94. (b) Rate per 100,000

estimated mid-year resident population for each age group and sex. (c) Causes of death data

for 2012 are preliminary and subject to a revisions process. See Explanatory Notes 29-33 and

Technical Notes, Causes of Death Revisions 2006, in Causes of Death, Australia, 2010 (cat.

no. 3303.0) and Causes of Death Revisions 2010 and 2011 in this publication.

Source(s): Causes of Death, Australia

http://www.abs.gov.au/ausstats/[email protected]/Lookup/3303.0Glossary12012

http://www.abs.gov.au/Ausstats/Free.nsf/LookupAttach/0D053D99C811B16DCA257CA5000C946B/$File/AGE-SPECIFIC%20SUICIDE%20RATES,%202012-Age-specific_suicide_rates_2012.csv

The highest age-specific suicide death rate for males in 2012 was observed in the 85 years

and over age group (37.6 per 100,000 males). As a proportion of total male deaths in this age

group, suicide deaths represented 0.3%. The second highest age-specific suicide rate was

observed in the 80-84 year age group, with 28.1 suicide deaths per 100,000 males. Suicide as

a proportion of total male deaths for this age group was 0.4%. Excluding the 0-14 year age

group, the age-specific suicide rate for males was lowest in the 15-19 year age group (9.3

deaths per 100,000), however, this represented over a fifth of all deaths in this age group

(21.9%).

For females the highest age-specific suicide death rate in 2012 was observed in the 80-84

year age group, with 9.5 deaths per 100,000. Outside of the 0-14 year age group, the lowest

age-specific death rate for female deaths was in the 65-69 year age group (4.1 deaths per

100,000).

Age-standardised rates

Age standardisation is used to compare death rates over time, as it accounts for any changes

in the age-structure of a population over time. The age-standardised suicide rate for persons

in 2012 was 11.0 per 100,000. This compares with 11.2 per 100,000 in 2003.

The age-standardised suicide rate in 2012 for males was 16.8 per 100,000 while the

corresponding rate for females was 5.5 per 100,000.

Footnote(s): (a) Age-standardised rate per 100,000. Standardised using direct method and the

Australian estimated resident population (persons) at 30 June 2001 as standard population.

(b) Includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures

relating to suicide. See Explanatory Notes 92-94. (c) All causes of death data from 2006

onward are subject to a revisions process - once data for a reference year are 'final', they are

no longer revised. Affected data in this table are: 2006-2010 (final), 2011 (revised), 2012

(preliminary). See Explanatory Notes 29-33 and Technical Notes, Causes of Death Revisions,

2006 in Causes of Death, Australia, 2010 (cat. 3303.0) and Causes of Death Revisions, 2010

and 2011 in this publication.

Source(s): Causes of Death, Australia

Suicide by year of occurrence

Sections 1-7 (including this section on suicide deaths) of the Causes of Death, Australia

publication are based on year of registration data (e.g. when the death was registered).

Section 8 is based on year of occurrence (e.g. the year the death actually occurred).

For the 2012 reference year, 10.3 of deaths had a year of occurrence prior to 2012. This

compares with the 2011 reference year where 7.0% of deaths occurred prior to 2010, and the

2010 reference year where 9.1% of deaths occurred prior to 2010.

The number of deaths that are registered in any year will be different to the number of deaths

that actually occurred in that year. Counts of specific causes of death (including suicide)

based on year of occurrence are available for 2002-2011 in the Year of Occurrence datacube.

The proportion of suicide deaths that occur in a previous reference period can impact the

overall count of suicide deaths, along with coronial investigations not being finalised and the

revisions process undertaken by the ABS.

Suicide deaths of children and young people under the age of 15

The number of suicide deaths of children and young people under the age of 15 is small, but

is significant in terms of the proportion of all deaths within this age group. The tables

provided below show aggregate data for the 5 year period from 2008-2012. The age group

published is for persons 5 to 14 years of age. This aligns with standards used elsewhere in the

Cause of Death release and with those used by the World Health Organisation (WHO). The

ABS is not aware of any recorded suicide deaths of children under the age of 5.

Deaths of children by suicide is an extremely sensitive issue. The number of deaths of

children attributed to suicide can be influenced by coronial reporting practices. Reporting

practices may lead to differences in counts across jurisdictions and this should be taken into

account when interpreting these data. For more information on issues associated with the

compilation and interpretation of suicide data, see Explanatory Notes 92-94.

The following two tables present the number of deaths from suicide by age group for the

2008-2012 reference period. Table 5.1 shows the number of deaths from suicide and age-

specific death rates by age group and sex. Table 5.2 shows the number of deaths from suicide

by age group and state or territory of usual residence.

It is recognised that the death rate from suicide differs between Aboriginal and Torres Strait

Islanders and non-Indigenous Australians. While not separately tabulated, it should be noted

that of the 57 deaths by suicide of children and young people under the age of 15, 15 deaths

(26.3%) were of Aboriginal and Torres Strait Islander Australians. The remaining deaths

were of non-Indigenous persons or persons for whom Indigenous status was not stated.

http://www.abs.gov.au/Ausstats/Free.nsf/LookupAttach/0D053D99C811B16DCA257CA5000C946B/$File/AGE-STANDARDISED%20DEATH%20RATES(a)%20FOR%20SUICIDE(b),%202003-2012-Age-Standardised%20Death%20Rates%20for%20Suicides,%202003-2012.csv

http://www.abs.gov.au/ausstats/[email protected]/Lookup/3303.0main+features100072012


Table 5.1 Suicide, Number and age-specific rates of death by age group and sex, 2008-

2012(a)(b)

Males Females Persons Males Females Persons Cause of Death and

ICD-10 code no. no. no. rate(c)(d) rate(c)(d) rate(c)(d)

5-14 29 28 57 0.4 0.4 0.4 15-24 1 119 410 1 529 14.2 5.5 10.0 25-34 1 698 469 2 167 21.5 6.1 13.9 35-44 2 021 591 2 612 26.0 7.5 16.6 45-54 1 823 572 2 395 24.4 7.5 15.9 55-64 1 182 374 1 556 19.0 6.0 12.4 65-74 653 183 836 16.4 4.5 10.4 75-84 499 142 641 22.7 5.2 13.0 85 and over 212 67 279 32.2 5.3 14.4 All ages(e) 9 236 2 837 12 073 16.8 5.1 11.0

(a) All causes of death data from 2006 are subject to a revisions process - once data for a reference year are

'final', they are no longer revised. Affected data in this table are: 2008-2010 (final), 2011 (revised), 2012

(preliminary). See Explanatory Notes 29-33 and Technical Notes, Causes of Death Revisions, 2006 in the

Causes of Death, Australia, 2010 publication, and Causes of Death Revisions, 2010 and 2011 in this publication.

(b) Includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to

suicide. See Explanatory Notes 92-94.

(c) Age-specific rates of deaths are the number of deaths per 100,000 population.

(d) The age-specific rates published in this table are calculated for the 2008-2012 reference period. As such,

they may differ from age-specific rates published elsewhere in the Cause of Death which are calculated for a

single year.

(e) Includes deaths of persons whose age was not stated.

Table 5.2 Suicide, Number of deaths by age group and state or territory of usual residence, 2008-2012(a)(b)(c)

New

South

Wales

Victoria Queensland South

Australia Western

Australia Tasmania Northern

Territory Aust.

Capital

Territory

Australia(d)

Age

group

(years) no. no. no. no. no. no. no. no. no.

5-14 12 14 14 2 7 3 4 1 57 15-24 326 330 394 120 237 38 65 19 1 529 25-34 552 491 522 161 298 58 54 31 2 167 35-44 681 579 637 224 340 70 41 40 2 612 45-54 670 559 540 193 299 79 26 28 2 395 55-64 432 354 366 131 190 50 9 24 1 556 65-74 262 182 191 64 93 24 10 10 836 75-84 204 143 132 54 71 23 2 11 641 85 and

over 91 54 67 17 32 15 0 3 279

All

ages(e) 3 230 2 706 2 864 966 1 567 360 212 166 12 073

(a) All causes of death data from 2006 are subject to a revisions process - once data for a reference year are

'final', they are no longer revised. Affected data in this table are: 2008-2010 (final), 2011 (revised), 2012

(preliminary). See Explanatory Notes 29-33 and Technical Notes, Causes of Death Revisions, 2006 in the

Causes of Death, Australia, 2010 publication, and Causes of Death Revisions, 2010 and 2011 in this publication.

(b) Cells with small values have been randomly assigned to protect the confidentiality of individuals. As a

result, some totals will not equal the sum of their components. Cells with a zero value have not been affected by

confidentialisation.

(c) Includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to

suicide. See Explanatory Notes 92-94.


http://www.abs.gov.au/AUSSTATS/[email protected]/Previousproducts/3303.0Technical%20Note12010?opendocument&tabname=Notes&prodno=3303.0&issue=2010&num=&view=

http://www.abs.gov.au/ausstats/[email protected]/Lookup/3303.0Technical+Note12012






(d) Includes 'other territories'.

(e) Includes deaths of persons whose age was not stated.

Crisis helplines

Lifeline: 13 11 14

Suicide Call Back Service - 1300 659 467

Kids Helpline (for young people aged 5 to 25 years): 1800 55 1800

This page last updated 24 March 2014

METHOD OF SUICIDE

In 2012, the most frequent method of suicide was hanging, strangulation and suffocation

(X70), a method used in more than half (54.4%) of all suicide deaths. Poisoning by drugs

(X60-X64) was used in 14.5% of suicide deaths, followed by poisoning by other methods

(X65-X69) including by alcohol and motor vehicle exhaust (8.5%). Methods using firearms

(X72-X74) accounted for 6.8% of suicide deaths. The remaining suicide deaths included

deaths from drowning, jumping from a high place, and other methods.

Mechanism By Intent - Selected Causes

Coronial processes to determine the intent of a death (whether intentional self-harm,

accidental, homicide, undetermined intent) are especially important for statistics on suicide

deaths because information on intent is necessary to complete the coding under ICD-10

coding rules. Coroners' practices to determine the intent of a death may vary across the states

and territories. In general, coroners may be reluctant to determine suicidal intent (particularly

in children and young people). In some cases, no statement of intent will be made by a

coroner. The reasons may include legislative or regulatory barriers, sympathy with the

feelings of the family, or sensitivity to the cultural practices and religious beliefs of the

family. For some mechanisms of death where it may be very difficult to determine suicidal

intent (e.g. single vehicle accidents, drownings), the burden of proof required for the coroner

to establish that the death was suicide may make a finding of suicide less likely.

The table below presents selected external causes of death by mechanism and intent. It is

possible that additional suicide deaths are contained within the Intent categories of Accidental

and Undetermined Intent, particularly for the mechanisms of poisoning and hanging, see

Explanatory Notes 92-94.

http://www.lifeline.org.au/

http://www.suicidecallbackservice.org.au/

http://www.kidshelp.com.au/


5.5 Selected external causes of death, Mechanism by intent - 2012(a)(b)

Accidental death Intentional self-

harm(c) Assault

Undetermined

intent Other

intent(d) Total

Mechanism of death no. no. no. no. no. no.

Poisonings (X40-X90, X60-

X69, X85-X90, Y10-Y19) 935 582 1 135 0 1 653

Hanging (W75-W84, X70,

X91, Y20) 229 1 379 14 37 0 1 659

Drowning and submersion

(W65-W74, X71, X92, Y21) 188 44 2 15 0 249

Firearms (W32-W34, X72-

X74, X93-X95, Y22-Y24) 4 173 40 9 0 226

Contact with sharp object

(W25-W29, X78, X99, Y28) 7 79 97 6 0 189

Falls (W00-W19, X80,

Y01,Y30) 1 997 112 1 7 0 2 117

Other(e) 2 531 166 119 92 273 3 181 Total 5 891 2 535 274 301 273 9 274

(a) Causes of death data for 2012 are preliminary and subject to a revisions process. See Explanatory Notes 29-

33 and Technical Notes, Causes of Death Revisions, 2006 in Causes of Death, Australia, 2010 and Causes of

Death Revisions, 2010 and 2011 in this publication. (b) Data cells with small values have been randomly assigned to protect the confidentiality of individuals. As a

result, some totals will not equal the sum of their components. Cells with a zero value have not been affected by

confidentialisation. (c) Includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to

suicide. See Explanatory Notes 92-94. (d) Includes Complications of medical and surgical care (Y40-Y84), Legal Intervention and operations of war

(Y35-Y36), Sequelae with surgical and medical care as external cause (Y88) and Sequelae of other external

causes (Y89). (e) Includes sequelae, explosives, smoke/fire/flames, blunt object, jumping or lying before moving object,

crashing of motor vehicle, other and unspecified means.

This page last updated 24 March 2014






3303.0 Causes of Death, Australia, 2012Released at 11.30am (Canberra time) 25 March 2014

Table 11.1 Suicide, Number of deaths, 5 year age groups by sex, 2003–2012

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Age group (years) no. no. no. no. no. no. no. no. no. no.

Males

0-14 6 7 7 7 8 8 0 8 7 6

15-19 89 53 67 81 84 73 77 91 81 70

20-24 162 143 166 149 150 155 133 135 160 144

25-29 180 172 156 124 160 165 167 144 175 168

30-34 227 221 207 153 181 189 169 173 168 180

35-39 185 174 167 185 209 207 201 229 171 196

40-44 197 208 204 167 167 212 195 221 185 204

45-49 187 131 177 193 164 198 197 224 196 204

50-54 112 126 138 141 147 148 162 164 149 181

55-59 88 89 93 115 107 130 119 136 130 139

60-64 66 78 68 81 93 88 117 115 101 107

65-69 63 71 47 56 61 82 64 62 82 78

70-74 65 64 49 57 44 57 49 58 52 69

75-79 54 49 38 47 51 48 60 69 49 45

80-84 27 44 40 26 40 40 35 51 48 54

85 and over 28 30 33 41 33 33 40 34 49 56

All ages 1,737 1,661 1,658 1,624 1,699 1,833 1,785 1,914 1,803 1,901

Females

0-14 7 1 3 1 4 3 3 5 9 8

15-19 24 32 24 29 32 25 28 26 36 59

20-24 25 37 33 39 34 35 38 55 57 51

25-29 41 30 43 35 41 37 50 51 41 41

30-34 70 48 36 39 49 53 53 47 44 52

35-39 57 41 51 55 52 63 57 59 59 64

40-44 45 50 43 57 59 52 49 54 65 69

45-49 57 51 46 37 53 56 48 64 57 48

50-54 36 38 39 46 55 60 67 55 48 69

55-59 37 24 25 43 46 39 48 45 51 44

60-64 22 17 25 30 38 21 32 30 26 38

65-69 20 17 20 19 19 16 22 15 17 21

70-74 13 12 18 23 15 21 14 16 22 19

75-79 14 19 20 16 16 14 16 15 12 15

80-84 4 15 11 15 6 4 14 17 11 24

85 and over 5 5 7 10 11 9 13 12 21 12

All ages 477 437 444 494 530 508 552 566 577 634

Persons

0-14 13 8 10 8 12 11 3 13 16 14

15-19 113 85 91 110 116 98 105 117 117 129

20-24 187 180 199 188 184 190 171 190 217 195

25-29 221 202 199 159 201 202 217 195 216 209

30-34 297 269 243 192 230 242 222 220 212 232

35-39 242 215 218 240 261 270 258 288 230 260

40-44 242 258 247 224 226 264 244 275 250 273

45-49 244 182 223 230 217 254 245 288 253 252

50-54 148 164 177 187 202 208 229 219 197 250

55-59 125 113 118 158 153 169 167 181 181 183

60-64 88 95 93 111 131 109 149 145 127 145

65-69 83 88 67 75 80 98 86 77 99 99

70-74 78 76 67 80 59 78 63 74 74 88

75-79 68 68 58 63 67 62 76 84 61 60

80-84 31 59 51 41 46 44 49 68 59 78

85 and over 33 35 40 51 44 42 53 46 70 68

All ages 2,214 2,098 2,102 2,118 2,229 2,341 2,337 2,480 2,380 2,535

© Commonw ealth of Australia 2014

Australian Bureau of Statistics

Reference year

— nil or rounded to zero (including null cells)

np not available for publication but included in totals w here applicable, unless otherw ise indicated.

All causes of death data from 2006 onw ard are subject to a revisions process - once data for a reference year are 'f inal', they are no longer

revised. Affected data in this table are: 2006-2010 (f inal), 2011 (revised) and 2012 (preliminary). See Explanatory Notes 29-33 and Technical

Notes, Causes of Death Revisions, 2006 in Causes of Death, Australia, 2010 (cat. 3303.0) and Causes of Death Revisions, 2010 and 2011 in

this publication.


Table 11.2 Suicide, Age-specific death rates, 5 year age groups by sex, 2003–2012

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Age group (years) Rate Rate Rate Rate Rate Rate Rate Rate Rate Rate

Males

0-14 0.3 0.3 0.3 0.3 0.4 0.4 — 0.4 0.3 0.3

15-19 12.8 7.6 9.5 11.3 11.5 9.8 10.2 12.1 10.8 9.3

20-24 23.6 20.3 23.1 20.2 19.8 19.8 16.3 16.4 19.4 17.4

25-29 26.6 25.5 22.9 17.8 22.1 21.7 20.8 17.4 20.8 19.6

30-34 30.4 29.5 27.8 20.8 24.9 26.0 22.9 23.1 21.8 22.6

35-39 25.7 24.1 22.9 24.7 27.1 26.2 25.2 28.8 21.9 25.3

40-44 26.1 27.4 26.9 22.2 22.4 28.5 26.0 29.0 23.5 25.2

45-49 27.0 18.5 24.6 26.4 21.9 26.0 25.6 29.1 25.6 26.9

50-54 17.3 19.3 20.9 21.0 21.6 21.3 22.8 22.7 20.1 24.0

55-59 15.2 14.9 15.1 18.3 17.1 20.6 18.6 21.0 19.6 20.6

60-64 15.2 17.3 14.5 16.5 17.6 15.7 20.2 19.3 16.5 17.6

65-69 18.0 19.7 12.6 14.7 15.4 20.0 14.9 13.7 17.3 15.3

70-74 21.7 21.5 16.5 19.0 14.3 17.9 14.9 16.9 14.6 18.6

75-79 22.7 20.2 15.4 18.8 20.3 19.1 23.8 27.2 19.0 16.9

80-84 18.8 28.9 25.3 15.8 23.5 22.7 19.3 27.4 25.2 28.1

85 and over 32.1 33.4 34.2 39.7 29.8 28.1 32.3 25.8 35.2 37.6

All ages 17.7 16.8 16.5 16.0 16.4 17.3 16.5 17.5 16.2 16.8

Females

0-14 0.4 np np np np np np 0.2 0.4 0.4

15-19 3.6 4.8 3.6 4.3 4.6 3.6 3.9 3.7 5.1 8.3

20-24 3.8 5.5 4.7 5.5 4.7 4.7 4.9 7.0 7.2 6.4

25-29 6.1 4.5 6.4 5.1 5.8 5.0 6.4 6.4 5.0 4.9

30-34 9.2 6.3 4.8 5.3 6.7 7.3 7.2 6.3 5.7 6.6

35-39 7.8 5.6 6.9 7.2 6.6 7.9 7.1 7.3 7.5 8.2

40-44 5.9 6.5 5.6 7.5 7.8 6.9 6.4 7.0 8.1 8.4

45-49 8.1 7.1 6.3 5.0 7.0 7.2 6.1 8.2 7.3 6.2

50-54 5.5 5.8 5.9 6.8 8.0 8.5 9.3 7.5 6.4 9.0

55-59 6.5 4.1 4.1 6.8 7.3 6.1 7.4 6.8 7.6 6.4

60-64 5.1 3.8 5.4 6.1 7.2 3.8 5.5 5.0 4.2 6.2

65-69 5.5 4.6 5.2 4.9 4.7 3.8 5.1 3.3 3.5 4.1

70-74 4.0 3.7 5.6 7.1 4.5 6.2 4.0 4.4 5.9 4.9

75-79 4.7 6.4 6.7 5.4 5.4 4.7 5.4 5.1 4.0 4.9

80-84 np 6.6 4.7 6.3 2.5 np 5.7 6.8 4.3 9.5

85 and over 2.6 2.5 3.4 4.6 4.9 3.8 5.3 4.7 7.9 4.4

All ages 4.8 4.4 4.4 4.8 5.1 4.8 5.1 5.1 5.1 5.6

Persons

0-14 0.3 0.2 0.3 0.2 0.3 0.3 np 0.3 0.4 0.3

15-19 8.3 6.2 6.6 7.9 8.2 6.8 7.2 8.0 8.0 8.8

20-24 13.9 13.0 14.1 13.0 12.4 12.4 10.8 11.8 13.5 12.0

25-29 16.4 15.0 14.7 11.5 14.0 13.5 13.8 12.0 13.0 12.4

30-34 19.7 17.8 16.2 13.0 15.8 16.6 15.0 14.7 13.8 14.6

35-39 16.7 14.8 14.8 15.9 16.8 17.0 16.1 18.0 14.6 16.7

40-44 15.9 16.9 16.2 14.8 15.0 17.6 16.1 17.9 15.8 16.7

45-49 17.5 12.8 15.4 15.6 14.4 16.5 15.8 18.5 16.4 16.5

50-54 11.4 12.5 13.4 13.9 14.7 14.9 16.0 15.0 13.2 16.4

55-59 10.9 9.5 9.6 12.6 12.2 13.3 13.0 13.8 13.5 13.4

60-64 10.2 10.6 9.9 11.3 12.4 9.8 12.9 12.1 10.4 11.8

65-69 11.7 12.0 8.9 9.7 10.0 11.8 9.9 8.5 10.4 9.7

70-74 12.5 12.2 10.8 12.8 9.2 11.9 9.3 10.5 10.2 11.6

75-79 12.8 12.6 10.7 11.5 12.2 11.3 13.9 15.3 10.9 10.5

80-84 8.5 15.5 13.0 10.2 11.2 10.5 11.4 15.6 13.3 17.5

85 and over 11.8 12.2 13.2 16.0 13.1 11.9 14.4 11.9 17.3 16.0

All ages 11.2 10.5 10.4 10.4 10.7 11.0 10.8 11.3 10.7 11.2




Reference year



revised. Affected data in this table are: 2006-2010 (f inal), 2011 (revised), 2012 (preliminary). See Explanatory Notes 29-33 and Technical


this publication.


Table 11.3 Suicide, Age-specific death rates, 10 year age groups by sex, 2003–2012

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Age group (years) Rate Rate Rate Rate Rate Rate Rate Rate Rate Rate

Males

0-14 0.3 0.3 0.3 0.3 0.4 0.4 — 0.4 0.3 0.3

15-24 18.2 14.0 16.3 15.9 15.7 14.9 13.4 14.4 15.3 13.6

25-34 28.6 27.6 25.5 19.4 23.5 23.8 21.8 20.1 21.3 21.0

35-44 25.9 25.8 24.9 23.4 24.7 27.3 25.6 28.9 22.7 25.2

45-54 22.3 18.9 22.9 23.8 21.8 23.8 24.3 26.0 22.9 25.4

55-64 15.2 15.9 14.8 17.5 17.3 18.3 19.4 20.1 18.1 19.2

65-74 19.7 20.5 14.3 16.6 14.9 19.1 14.9 15.1 16.1 16.7

75-84 21.2 23.5 19.2 17.6 21.6 20.6 21.9 27.3 21.6 21.6

85 and over 32.1 33.4 34.2 39.7 29.8 28.1 32.3 25.8 35.2 37.6

All ages 17.7 16.8 16.5 16.0 16.4 17.3 16.5 17.5 16.2 16.8

Females

0-14 0.4 np np np np np np 0.2 0.4 0.4

15-24 3.7 5.1 4.2 4.9 4.7 4.1 4.5 5.4 6.2 7.3

25-34 7.7 5.5 5.5 5.2 6.3 6.1 6.8 6.3 5.4 5.7

35-44 6.8 6.1 6.2 7.4 7.2 7.4 6.8 7.1 7.8 8.3

45-54 6.9 6.5 6.1 5.8 7.4 7.8 7.6 7.8 6.9 7.6

55-64 5.9 4.0 4.6 6.5 7.3 5.0 6.5 6.0 6.0 6.3

65-74 4.8 4.2 5.4 5.9 4.6 4.9 4.6 3.8 4.6 4.4

75-84 3.5 6.5 5.8 5.8 4.1 3.3 5.5 5.9 4.2 7.0

85 and over 2.6 2.5 3.4 4.6 4.9 3.8 5.3 4.7 7.9 4.4

All ages 4.8 4.4 4.4 4.8 5.1 4.8 5.1 5.1 5.1 5.6

Persons

0-14 0.3 0.2 0.3 0.2 0.3 0.3 np 0.3 0.4 0.3

15-24 11.1 9.6 10.4 10.5 10.3 9.7 9.1 10.0 10.9 10.5

25-34 18.1 16.5 15.5 12.3 14.9 15.0 14.4 13.3 13.4 13.4

35-44 16.3 15.9 15.5 15.3 15.9 17.3 16.1 17.9 15.2 16.7

45-54 14.6 12.7 14.4 14.8 14.5 15.7 15.9 16.8 14.8 16.4

55-64 10.6 10.0 9.8 12.0 12.3 11.7 12.9 13.0 12.0 12.7

65-74 12.0 12.1 9.8 11.1 9.6 11.9 9.6 9.4 10.3 10.5

75-84 11.1 13.8 11.6 11.0 11.8 11.0 12.8 15.4 12.0 13.6

85 and over 11.8 12.2 13.2 16.0 13.1 11.9 14.4 11.9 17.3 16.0

All ages 11.2 10.5 10.4 10.4 10.7 11.0 10.8 11.3 10.7 11.2



Reference year






this publication.


Table 11.4 Suicide by mechanism, Number of deaths by sex, 2003–2012

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

no. no. no. no. no. no. no. no. no. no.

Males

Poisoning by drugs 148 127 128 100 123 158 170 146 167 195

Poisoning by other 340 331 286 248 222 217 226 202 183 172

Hanging 820 822 885 872 934 998 969 1,119 1,048 1,081

Firearms 184 162 136 172 182 171 166 157 136 166

Contact w ith sharp object 38 46 35 37 37 37 50 53 54 64

Drow ning and submersion 31 35 24 23 24 32 29 29 35 26

Falls 56 64 67 61 65 98 72 92 75 79

Other 120 74 97 111 112 122 103 116 105 118

Total 1,737 1,661 1,658 1,624 1,699 1,833 1,785 1,914 1,803 1,901

Females



Hanging 176 176 183 208 216 215 228 256 271 298

Firearms 9 5 11 9 8 12 8 14 6 7



Falls 26 31 25 31 23 40 29 41 32 33

Other 37 27 29 34 38 39 37 34 32 48

Total 477 437 444 494 530 508 552 566 577 634

Persons



Hanging 996 998 1,068 1,080 1,150 1,213 1,197 1,375 1,319 1,379

Firearms 193 167 147 181 190 183 174 171 142 173



Falls 82 95 92 92 88 138 101 133 107 112

Other 157 101 126 145 150 161 140 150 137 166

Total 2,214 2,098 2,102 2,118 2,229 2,341 2,337 2,480 2,380 2,535


Data cells w ith small values have been randomly assigned to protect the confidentiality of individuals. As a result, some totals w ill not equal the sum of

their components. Cells w ith a zero value have not been affected by confidentialisation.


Reference year



All causes of death data from 2006 onw ard are subject to a revisions process - once data for a reference year are 'f inal', they are no longer revised.

Affected data in this table are: 2006-2010 (f inal), 2011 (revised), 2012 (preliminary). See Explanatory Notes 29-33 and Technical Notes, Causes of

Death Revisions, 2006 in Causes of Death, Australia, 2010 (cat. 3303.0) and Causes of Death Revisions, 2009 and 2010 in this publication.


Table 11.5 Suicide, State and territory, Number of deaths, Age-standardised death rate, Rate ratio, Sex, 2003–2012

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

no. no. no. no. no. no. no. no. no. no. Rate Rate

Males

NSW 510 464 438 461 459 477 466 520 457 512 13.7 0.8

Vic. 409 396 394 360 358 429 434 426 400 385 15.1 0.9

Qld 371 371 360 383 397 440 415 441 438 472 20.4 1.2

SA 154 141 182 132 167 129 138 157 167 149 18.3 1.1

WA 168 156 169 182 204 237 218 250 229 269 20.8 1.2

Tas. 54 70 52 55 47 60 59 47 51 56 22.1 1.3

NT 42 44 37 29 45 31 31 39 38 41 29.4 1.8

ACT 29 19 26 22 22 30 23 34 23 17 14.3 0.9

Australia 1,737 1,661 1,658 1,624 1,699 1,833 1,785 1,914 1,803 1,901 16.8 1.0

Females

NSW 130 123 111 116 152 143 157 154 149 195 4.3 0.8

Vic. 131 125 112 125 116 116 142 132 125 117 4.5 0.9

Qld 95 82 99 111 123 113 110 147 139 149 5.9 1.2

SA 39 37 49 48 38 46 47 40 45 48 5.4 1.1

WA 59 38 34 63 62 63 61 63 80 97 6.3 1.2

Tas. 15 18 22 17 19 13 20 17 23 14 6.7 1.3

NT 1 7 8 3 10 7 6 6 6 7 5.4 1.1

ACT 6 7 9 10 10 6 9 7 10 7 4.2 0.8

Australia 477 437 444 494 530 508 552 566 577 634 5.1 1.0

Persons

NSW 640 587 549 577 611 620 623 674 606 707 8.9 0.8

Vic. 540 521 506 485 474 545 576 558 525 502 9.7 0.9

Qld 466 453 459 494 520 553 525 588 577 621 13.0 1.2

SA 193 178 231 180 205 175 185 197 212 197 11.8 1.1

WA 227 194 203 245 266 300 279 313 309 366 13.5 1.3

Tas. 69 88 74 72 66 73 79 64 74 70 14.1 1.3

NT 44 51 45 33 55 38 37 45 44 48 18.1 1.7

ACT 35 26 35 32 32 36 32 41 33 24 9.1 0.8

Australia 2,214 2,098 2,102 2,118 2,229 2,341 2,337 2,480 2,380 2,535 10.8 1.0



Reference year

Data cells w ith small values have been randomly assigned to protect the confidentiality of individuals. As a result, some totals w ill not equal the

sum of their components. Cells w ith a zero value have not been affected by confidentialisation.


revised. Affected data in this table are: 2006-2010 (f inal), 2011 (revised) and 2012 (preliminary). See Explanatory Notes 29-33 and Technical


this publication.



Standardised

Death Rate

2008-2012

Rate Ratio

2008-2012


Table 11.6 Suicide, Proportion of total deaths, 5 year age groups by sex, 2003–2012

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Age group (years) % % % % % % % % % %

Males

0-14 0.6 0.7 0.7 0.7 0.8 0.8 — 0.8 0.8 0.7

15-19 19.9 15.2 19.3 21.8 23.8 20.2 20.4 24.1 26.1 21.9

20-24 26.1 24.2 27.1 25.1 26.1 27.4 25.1 25.7 30.7 28.7

25-29 25.9 26.7 24.2 22.4 25.4 25.8 25.9 24.5 28.0 26.5

30-34 28.4 25.2 25.4 20.6 25.4 25.4 22.8 24.3 23.7 27.5

35-39 19.1 20.5 18.7 20.6 21.5 21.5 20.4 23.9 19.3 23.1

40-44 14.7 16.2 15.5 13.4 14.5 17.1 15.5 18.0 15.9 16.6

45-49 10.4 7.7 10.1 11.0 9.0 10.9 10.9 12.1 11.4 12.5

50-54 5.0 5.3 5.9 6.1 6.0 5.9 6.4 6.6 6.0 7.4

55-59 2.6 2.7 2.7 3.4 3.1 3.9 3.6 4.0 3.7 4.1

60-64 1.6 1.8 1.6 1.9 2.0 1.9 2.4 2.4 2.0 2.3

65-69 1.1 1.3 0.8 1.0 1.1 1.4 1.1 1.1 1.4 1.3

70-74 0.8 0.8 0.7 0.8 0.6 0.8 0.7 0.8 0.7 0.9

75-79 0.5 0.4 0.4 0.4 0.5 0.5 0.6 0.7 0.5 0.5

80-84 0.2 0.4 0.3 0.2 0.3 0.3 0.3 0.4 0.4 0.4

85 and over 0.2 0.2 0.2 0.3 0.2 0.2 0.2 0.2 0.2 0.3

All ages 2.5 2.4 2.5 2.4 2.4 2.5 2.5 2.6 2.4 2.5

Females

0-14 0.9 np np np np np np 0.7 1.3 1.2

15-19 13.1 17.1 16.0 15.7 19.4 14.9 17.8 17.2 21.6 32.6

20-24 11.6 16.6 16.5 17.5 16.4 17.9 19.2 26.2 25.9 25.2

25-29 16.4 12.3 19.5 15.6 16.8 15.7 18.5 20.5 16.6 18.8

30-34 18.4 14.9 11.0 13.1 14.4 16.3 18.5 15.7 13.8 15.9

35-39 11.1 8.8 10.9 11.6 10.5 12.8 10.8 11.9 11.6 14.1

40-44 5.9 6.9 5.8 8.2 8.1 7.5 7.1 7.6 8.9 9.2

45-49 5.2 4.6 4.4 3.3 4.8 5.0 4.0 5.8 5.1 4.7

50-54 2.6 2.7 2.7 3.2 3.6 4.0 4.1 3.5 3.0 4.4

55-59 1.9 1.2 1.3 2.1 2.2 1.9 2.3 2.2 2.5 2.1

60-64 0.9 0.7 1.0 1.2 1.4 0.7 1.1 1.0 0.9 1.3

65-69 0.6 0.5 0.6 0.6 0.6 0.5 0.6 0.4 0.5 0.6

70-74 0.3 0.3 0.4 0.5 0.3 0.4 0.3 0.3 0.4 0.4

75-79 0.2 0.2 0.3 0.2 0.2 0.2 0.2 0.2 0.2 0.2

80-84 np 0.1 0.1 0.1 0.1 np 0.1 0.1 0.1 0.2

85 and over — — — — — — — — 0.1 —

All ages 0.7 0.7 0.7 0.8 0.8 0.7 0.8 0.8 0.8 0.9

Persons

0-14 0.7 0.5 0.5 0.5 0.7 0.6 np 0.7 1.0 0.9

15-19 17.9 15.9 18.3 19.7 22.4 18.5 19.6 22.1 24.5 25.8

20-24 22.3 22.1 24.5 23.0 23.5 25.0 23.5 25.8 29.3 27.7

25-29 23.4 22.7 23.0 20.4 23.0 23.1 23.7 23.3 24.8 24.6

30-34 25.2 22.5 21.3 18.4 21.8 22.7 21.6 21.8 20.6 23.6

35-39 16.4 16.3 16.0 17.5 17.8 18.5 17.1 19.8 16.5 20.0

40-44 11.5 12.8 12.0 11.5 12.0 13.7 12.5 14.2 13.2 13.8

45-49 8.5 6.4 7.9 8.0 7.4 8.7 8.2 9.7 8.9 9.5

50-54 4.1 4.3 4.7 4.9 5.1 5.2 5.5 5.4 4.8 6.2

55-59 2.3 2.1 2.2 2.9 2.8 3.1 3.1 3.3 3.3 3.3

60-64 1.3 1.4 1.4 1.6 1.8 1.4 2.0 1.9 1.6 1.9

65-69 0.9 1.0 0.8 0.9 0.9 1.1 0.9 0.8 1.0 1.0

70-74 0.6 0.6 0.6 0.7 0.5 0.6 0.5 0.6 0.6 0.7

75-79 0.4 0.4 0.3 0.3 0.4 0.3 0.5 0.5 0.4 0.4

80-84 0.1 0.3 0.2 0.2 0.2 0.2 0.2 0.3 0.2 0.3

85 and over 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1

All ages 1.7 1.6 1.6 1.6 1.6 1.6 1.7 1.7 1.6 1.7





Reference year




this publication.


Table 11.7 Selected external causes of death, Mechanism by intent, 2012

Accidental

death

Intentional

self-harm Assault

Undetermined

intent Other intent Total

Mechanism of death no. no. no. no. no. no.

Poisonings 935 582 1 135 1,653

Hanging 229 1,379 14 37 1,659

Drow ning and submersion 188 44 2 15 249

Firearms 4 173 40 9 226

Contact w ith sharp object 7 79 97 6 189

Falls 1,997 112 1 7 2,117

Other 2,531 166 119 92 273 3,181

Total 5,891 2,535 274 301 273 9,274




np not available for publication but included in totals w here applicable, unless otherw ise

indicated.

Causes of death data for 2012 are preliminary and subject to a revisions process. See

Explanatory Notes 29-33 and Technical Notes, Causes of Death Revisions 2006, Causes of

Death, Australia, 2010 (cat. no. 3303.0) and Causes of Death Revisions 2010 and 2011 in this

publication.

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Brain, Peter. Going the Distance. Kingsford, NSW: Matthias Media, 2006. Brown G, Stanley B, Department of Veterans Affairs. "Patient Safety Plan Template." WICHE

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Clinebell, Howard John, and Bridget Clare McKeever. Basic Types of Pastoral Care & Counseling : Resources for the Ministry of Healing and Growth. Updated and rev. / Bridget Clare McKeever. ed. Nashville: Abingdon Press, 2011.

Cordeiro, Wayne. Leading on Empty : Refilling Your Tank and Renewing Your Passion. Minneapolis, Minn.: Bethany House, 2009.

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http://www.whatchristianswanttoknow.com/suicidal-thoughts-7-biblical-tips/

Pastoral Care in the event of attempted suicide

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