Is there a relationship between mental health reforms and general population suicide rates in Australia?

The relationship between mental health reforms and general population suicide rates in Australia over the past three and a half decades: 1987–2021

by Samantha Sijing Wang, Valsamma Eapen and Ping-I Lin

Published May 2024

What's the issue?

In Australia, suicide remains a devastating public health crisis. There is an ongoing need for effective interventions to address this complex issue. National Mental Health Plans (NMHPs) aim to improve mental health and reduce suicide rates in Australia. The plans include various strategies to address issues impacting on mental health and suicide including service delivery, public perception, economic impacts, and rights-based approaches.

Over time, these plans have evolved and shifted from a focus on clinical interventions to community-driven approaches. In more recent times, the plans have also considered not just the biological and psychological aspects of mental health, but also societal and economic influences, such as housing, employment and community involvement.

However, the extent to which these plans have specifically impacted suicide rates remains unclear. This research aims to fill this gap by examining the association between NMHPs and suicide rates across Australia over 35 years (1987–2021).

What was done?

The researchers of this study used datasets that accurately represent the Australian population, primarily from AIHW National Mortality Database Suicide and the Australian Bureau of Statistics (ABS). From these datasets, a new dataset was generated that compiled the age-standardised rates of suicide per 100,000 population as well as the number of suicides within particular areas of Australia from 1987 to 2021.

The researchers of this study looked at the five NMHPs spanning from 1993 to 2022. Changes in the NMHPs over time were quantitatively represented using specific indicators associated with each NMHP phase, including policy introductions, amendments and other significant shifts.

The researchers then used Kendall’s Tau correlation test for statistical analysis of the data to show how suicide rates fluctuated alongside the implementation of different NMHPs.

What was found?

This study demonstrated that age-standardised suicide rates in Australia exhibited a modest decline from 14.3 deaths per 100,000 population in 1987 to 12.1 deaths per 100,000 population in 2021. However, the overall trend reveals a pattern of relative stability in suicide rates across the 34-year period.

The findings from the study indicate that the NMHPs have not had a significant effect on suicide rates. While some NMHPs coincided with national declines in suicide rates, definitively attributing these reductions solely to the plans is not possible. The researchers identify that decreases in suicides could be influenced by a myriad of factors and that the relationship between suicide rates and NMHPs in Australia are complex. Further research is needed to isolate the specific impact of individual plan elements and account for the multifaceted nature of suicide risk.

Why are the findings important?

There are challenges in examining suicide trends within the context of NMHPs due to the complex nature of suicide risk in Australia and inconsistencies in policy implementation. However, understanding the association between state-based suicide rates and the NMHPs is vital for future policy development and interventions. Comprehensive evaluations of Australia’s NMHPs are crucial moving forward to measure their effectiveness.

By incorporating a focus on data collection, workforce development, service integration, and ongoing evaluation following each plan reform, further steps can be taken within Australia towards a more effective mental healthcare system and a reduction in suicide rates.