Older adults

Older adults are identified as a population disproportionately impacted by suicide in Australia.

Older adults are exposed to a range of risk factors which can increase vulnerability to suicide such as chronic pain, dependence on others and loss of autonomy, loss of a partner or friends and loneliness.

Data indicates that 4.2 million Australians (16% of Australia's population are aged 65 years and older). Older adults and they are exposed to a range of risk factors which may increase vulnerability to suicide.

What does the evidence tell us about suicide for older people?

Statistics released annually by the Australian Bureau of Statistics show that in 2023:

• Males aged over 85 years had an age standardised suicide rate of 26.4 deaths per 100,000 persons). This is higher than the suicide rate for all males, which was 18.0 per 100,000 persons.
• While males aged over 85 years had the highest age-specific suicide rate, they accounted for 2.4% of male suicide deaths.
• Females aged over 85 years had the highest age-specific suicide rate of all female age groups (10.6 per 100,000).
• The most common psychosocial risk factor for suicide in people over 65 was activity limitations due to disability.

According to the World Health Organization, mental health conditions are under-identified and under-reported in older adults. Untreated mental illness can contribute to an increased suicide risk. Low help-seeking or help-offering behaviours for mental health concerns can impact on suicide rates in older adults. The National Suicide Prevention Taskforce reported that older adults, particularly older men, may be less likely to seek or be provided professional help due to stigma, knowledge of or lack of services available and accessibility.

Professor Diego De Leo of Griffith University notes in his research that aging tends to present challenges such as chronic pain and dependence on others, financial insecurity, grief and bereavement, loneliness, and loss of meaning of life that can also contribute to increased vulnerability for mental health distress or thoughts of suicide. Ageism is a barrier that can limit the care provided to older adults, where concerns are dismissed as inevitable aspects of aging.

Factors that may increase risk of suicide

Factors that increase the risk of suicide amongst older adults living in Australia include:

• Grief and bereavement
• Social isolation
• Losing the ability to live independently
• Sensory impairment and losses (particularly with men)
• Financial difficulty
• Poor physical health and or/chronic pain
• Existing mental health conditions
• Loneliness and isolation
• Perceiving oneself to be a burden on others and a loss of independence
• Ageism
• Retirement and losing a sense of purpose or role in life
• Loss and bereavement (loss can include things like losing their licence/mobility/vision/hearing/independence, as well as physical loss of life including losing partners/siblings/friends/pets/children)
• Losing sense of agency – ability to make your own decisions
• Elder abuse.

Factors that protect against risk of suicide

Protective factors that can reduce the likelihood of suicidal behaviour among older adults living in Australia include:

• Strong social networks
• Community participation
• Learning new skills or having a hobby
• Maintaining physical health
• Help seeking behaviours, particularly for women
• Connection to land, spirituality and ancestry, kinship networks and cultural continuity (such as being a role model and educating the young) for older Aboriginal and Torres Strait Islander adults
• Having a purpose and role to play
• Self-efficacy and a sense of control
• Volunteering.

What does this mean for policy and practice?

Suicide prevention in older adults should target the social determinants of health to mitigate risk factors of suicide such as financial insecurity or loneliness, and strengthening protective factors, such as supporting quality social interactions.

There are a lack of suicide prevention programs and services to support older adults or those working and caring for them, which is an area that warrants expansion. Strengthening mental health and wellbeing supports in aged care settings should also be a priority.

Addressing ageist attitudes and discrimination in health care settings and society more broadly is an area everyone can reflect on and help to incorporate into practice.