Suicidal behaviour and self-harm

Suicide in Australia

Suicide involves not only a tragic loss of a life but also great sadness and soul-searching among the family and friends of the person who has died, and the community at large. More than 2,000 Australians die from suicide every year. For every person who kills themselves, there are at least another 30 people who attempt suicide. The risk is highest for men between 25 and 34 and those over 80. Although suicidal behaviour is more common in women than men, more men die by suicide. The rate for single people is twice that of married people. There is no doubt that depression is a major cause of suicidal behaviour. Of those who do kill themselves, many have experienced major depression, bipolar disorder or schizophrenia.

Suicidal behaviour and mental illness

About 20 per cent of Australians are affected by some form of mental disorder at some time in their lives. Approximately 6 per cent are affected by major depression, and 3 per cent by psychotic illnesses such as bipolar disorder and schizophrenia. Suicide is the main cause of premature death among people with mental illness; more than 10 per cent of those affected kill themselves within the first 10 years of diagnosis. Yet many of those who have attempted or seriously thought about killing themselves will, with medical intervention, social support and time, go on to live full and productive lives.

Why people feel suicidal

For people with a mental illness, the pain and distress of the illness can be so great they may feel an overwhelming desire to end their life. Others say their illness was only recognised or taken seriously after a suicide attempt. An attempt may be an early sign of a mental illness developing, and it is important to get help from a doctor if this is the case.

For someone with a mental illness, the following may contribute to suicidal behaviour.

  • Borderline personality disorder (BPD)

    People with Borderline Personality Disorder may harm themselves or behave in a suicidal way. Some find self-harm brings temporary relief from their distress. This is a symptom of the disorder and requires treatment from a health professional.

  • Depression

    The majority of people with mental illness who suicide will have experienced major depression.

  • Psychotic symptoms

    Some may attempt suicide because they are confused or even directed by their hallucinations, or to bring relief from untreated psychotic symptoms.

  • Drugs and alcohol

    The abuse of drugs (such as marijuana, heroin or amphetamines) and alcohol is closely related to suicidal behaviour.

Why people self-harm

Self-harm means any behaviour which involves the deliberate causing of pain or injury to oneself. This includes cutting, burning or hitting oneself, overdosing on prescription or illegal drugs, or even binge-eating or starvation, abuse of drugs or alcohol or repeatedly putting oneself in dangerous situations.

Self-harm is usually a response to distress — often the distress associated with mental illness. In the short-term, some people find that it provides temporary relief from the psychological distress they are experiencing. While people who self-harm do not necessarily mean to kill themselves, it often becomes a compulsive and dangerous activity, and requires careful professional help.

How to help

The majority of people give warning signs about their suicidal intentions. Some of these warning signs include:

  • expression of hopelessness or helplessness;
  • written or spoken notice of intention, saying goodbye;
  • dramatic change in personality or appearance;
  • irrational, bizarre behaviour;
  • overwhelming sense of guilt, shame or reflection;
  • changed eating or sleeping patterns;
  • severe drop in school or work performance;
  • giving away possessions or putting affairs in order;
  • lack of interest in the future; and
  • self-harming actions, such as overdoses, which can be lethal to the person.

If you think a friend or relative is seriously thinking of harming or killing themselves, do not worry silently. Discuss your concerns openly and non-judgmentally with the person and other relevant professionals such as the treating doctor or the school counsellor, for example. If you or someone you know is seriously at risk, it is important to have a crisis service phone number such as Lifeline (13 1114) or local hospital handy in case of an urgent need for help.

After a suicide attempt

Understanding what has happened can help the person involved and carers to cope with a suicide attempt. Your doctor should know about mental health professionals in your area who can provide education and support. They can also advise how to reduce the risk of further attempts, helping the person to work out strategies to overcome or get through these stages.

It is important to realise that the responsibility for an action ultimately lies with the person who carries it out. It can be hard to accept, but if everything possible has been done and someone is still seriously determined to end their life, it can be difficult to prevent this happening. When someone vows to take their own life, family and friends should receive education and support to get through this very distressing and confusing time.

After self-harm

For the person involved, knowing why you self-harm and ways of stopping yourself is helpful. Your doctor can advise about mental health professionals in your area who can help family and friends as well as the person who is self-harming.

Treatment and further prevention

There is no single therapy or treatment that is always successful in reducing the likelihood of suicide. An important step in preventing suicide is to treat the mental disorders that lead to self-harm or suicidal thoughts and actions. Currently the most effective ways to treat mental illness are medication and psychosocial rehabilitation programs. Talk about these with the professionals concerned and try to encourage a treatment plan which involves cooperation between the professionals, family and person concerned.

National Helplines
If you or someone you know is depressed and/or having suicidal thoughts, see your doctor, or phone one of these helplines.
Lifeline (24 hours) 13 11 14
Kids Helpline (under 18 years of age) 1800 55 1800
Just Ask - rural mental health information 1300 13 11 14
Mensline Australia (24 hours) 1300 78 99 78
SANE Helpline - mental illness information, support and referral 1800 18 SANE (7263)

 

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