Australia is forecast to see an increase in suicide deaths of “at least” 13.7% over the next 5 years, according to a new report released by the University of Sydney’s Brain and Mind Centre.
Maintaining employment programs such as JobKeeper, investing in education programs, and doubling the capacity of mental health services could help Australia navigate the “perfect storm” of mental health risk factors and prevent more than 1500 suicide deaths in the next 5 years, say the authors.
The report highlighted the importance of coordinated economic, education, social and mental health measures in safeguarding the mental health of Australians in the wake of the coronavirus disease 2019 (COVID-19) pandemic. The report cautioned that more awareness may not be the answer, forecasting that mental health awareness programs may increase mental health-related emergency department (ED) presentations by 5.2% in the 2020–2025 period.
The authors modelled three scenarios:
- a best-case scenario, which assumes unemployment reaches 11.7% and youth unemployment rises to 19%;
- an extended-duration scenario, which retains the peak unemployment rates of the best-case scenario but extends the duration of high unemployment (ie, unemployment stays above 8.5% and youth unemployment above 15% until August 2022); and
- A worst-case scenario which assumes unemployment reaches 17% and youth unemployment rises to 26.1%.
Each of these scenarios also assumes a 10% reduction in community connectedness resulting from social dislocation unrelated to job loss (eg, working from home, not participating in sports, reduced social gatherings), which will persist for a period of 12 months.
According to the model, under the best-case scenario, Australia was likely to see 19 878 suicide deaths over the period 2020–2025, an increase of at least 13.7%.
The best-case scenario also forecast that there would be 173,123 hospitalisations for self-harm and 1.6 million mental health-related ED presentations.
The authors also modelled the effects of broad strategies and directions for which there is national support or commitment, namely employment programs (eg, JobKeeper), mental health awareness programs, and potential expansion of the Better Access scheme (lifting the cap on the number of sessions with psychiatrists, psychologists and allied professionals that can be claimed on the Medicare Benefits Schedule). They further modelled the impact of education support programs to increase enrolment to post-secondary education and vocational training, and initiatives to increase capacity of mental health services.
The report authors found that the most effective strategy modelled to “bend the mental health curve” was a combination of employment programs extended to March 2022; youth education programs; a doubling of current growth rate in community-based specialist mental health services; coordinating multidisciplinary, measurement-based care enabled through technology; and post-suicide attempt assertive aftercare.
“This combination is projected to prevent 97 030 mental health-related ED presentations, 13 842 self-harm presentations, and 1590 suicide deaths over the period 2020–2025,” the report said.
According to Professor Hickie “this additional demand for mental health care came at a time when Australia’s mental health system was already broken”.
“In my view, unless there is a massive expansion in public mental health, we will not be able to cope. And the only way to do that is for the public sector to purchase capacity from the private sector,” he said. “Just as [federal Health Minister] Greg Hunt bought all the ventilators to ensure access to ventilators in the early days of the pandemic, that’s exactly what we need for mental health.”
Professor Hickie stood by the findings of the complex modelling and simulation, saying that such dynamic modelling played a crucial role in informing suicide prevention measures because they accounted for the interaction between factors.
“Our models do not just look at employment on its own, as simple regression models do,” he said. “Dynamic models tell you potentially which sorts of programs – JobKeeper, education support, mental health programs – will achieve the biggest effects and how to best frame this support.”
If you are experiencing issues around suicide please contact your GP or your EAP Assist counsellor immediately.