Research priorities in suicide prevention: an examination of Australian-based research 2007–11
Jo Robinson A C and Jane Pirkis BA Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Vic. 3052, Australia.
B Jane Pirkis, Centre for Health Policy, Programs and Economics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Vic. 3052, Australia.
C Corresponding author. Email: jr@unimelb.edu.au
Submitted: 21 March 2013 Accepted: 4 September 2013 Published: 22 November 2013
Abstract
Objective Suicide prevention, including among youth, has been a national priority in Australia for some time. Yet despite this, rates of suicide, and related behaviour, remain high. The aim of this study was to review all suicide-prevention research that had been conducted in Australia between January 2007 and December 2011, with a specific emphasis on studies relating to young people, in order to determine whether or not we are prioritising the sort of research that can adequately inform policy development and guide ‘best practice’.
Methods Data were collected from two sources. First, several electronic databases were searched in October 2012 in order to identify published journal articles relating to suicide, written by Australian authors. Second, summary data obtained from the National Health and Medical Research Council, the Australian Rotary Health Research Fund and the Australian Research Council were examined in order to identify currently funded studies that relate to suicide. Studies were then classified according to whether or not they had a focus on youth, and according to research type, type of suicide-related behaviour under investigation and method of suicide.
Results There were 224 articles published and 12 grants funded that specifically focussed on suicide-related behaviour over the period January 2007 to December 2011. Of these, 47 articles (21%) and five funded grants (42%) focussed on young people. Youth studies, in particular those reported in the published articles, tended to be epidemiological in nature and only six of the published articles (13%) and two of the funded grants related to intervention studies.
Conclusions Although the focus on youth is welcome, the lack of intervention studies is disappointing. Given that rates of suicide and related behaviour remain high, there is a clear need for a stronger body of intervention research that can inform national policy, if we are to successfully develop effective approaches to reducing suicide risk.
What is known about the topic? Although the prevention of youth suicide has been a national priority for some time, rates of suicide and suicide-related behaviour remain high among young Australians. Much is known about the epidemiology of suicide; however, relatively little is known about which interventions may be effective in reducing this risk. Previous research suggests that although youth receive a reasonable amount of research attention in Australia, the majority of studies focus on epidemiological as opposed to intervention research.
What does this paper add? This paper reviews all suicide research that has been conducted in Australia between 2007 and 2011 in order to examine how much attention is currently given to studies relating to youth, and the relative priority given to intervention and epidemiological studies. Our findings support those reported previously, which suggest that although a significant proportion of suicide research focuses on youth, relatively little attention continues to be given to intervention studies.
What are the implications for practitioners? This paper argues that further intervention research is needed if we are to build a sufficiently strong evidence base that can effectively inform policy development and guide best practice when it comes to preventing youth suicide in Australia.
References
[1] Australian Bureau of Statistics (ABS). 3303.0 – Causes of death, Australia, 2008. Canberra: ABS; 2010.[2] Patton GC, Coffey C, Sawyer S, Viner RM, Haller DM, Bose K. Global patterns of mortality in young people: a systematic analysis of population health data. Lancet 2009; 374 881–92.
| Global patterns of mortality in young people: a systematic analysis of population health data.Crossref | GoogleScholarGoogle Scholar | 19748397PubMed |
[3] Johnston A, Pirkis J, Burgess P. Suicidal thoughts and behaviours among Australian adults: findings from the 2007 National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2009; 43 635–43.
| Suicidal thoughts and behaviours among Australian adults: findings from the 2007 National Survey of Mental Health and Wellbeing.Crossref | GoogleScholarGoogle Scholar | 19530020PubMed |
[4] Nock MK, Borges G, Bromet EJ, Cha CB, Kessler RC, Lee S. Suicide and suicidal behavior. Epidemiol Rev 2008; 30 133–54.
| Suicide and suicidal behavior.Crossref | GoogleScholarGoogle Scholar | 18653727PubMed |
[5] Mission Australia. National survey of young Australians, key and emerging issues. Sydney: Mission Australia; 2009.
[6] Hawton F. Suicide, and other causes of death, following attempted suicide. British Journal of Psychiatry 1988; 152 359–66.
| Suicide, and other causes of death, following attempted suicide.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL1M%2FgtFOjtA%3D%3D&md5=78e559303b32d3de9a69382f08fcafa2CAS |
[7] Suominen K, Isometsa E, Suokas J, Haukka J, Achte K, Lonnqvist J. Completed suicide after a suicide attempt: a 37-year follow-up study. Am J Psych 2004; 161 562–3.
| Completed suicide after a suicide attempt: a 37-year follow-up study.Crossref | GoogleScholarGoogle Scholar |
[8] Mitchell P. Valuing young lives: evaluation of the National Youth Suicide Prevention Strategy. Melbourne: Australian Institute of Family Studies; 2000.
[9] Department of Health and Ageing. Living is For Everyone (LiFE) Framework. Canberra: Commonwealth of Australia; 2007.
[10] Robinson J, Pirkis J, Krysinska K, Niner S, Jorm AF, Dudley M, et al Research priorities in suicide prevention in Australia: a comparison of current research efforts and stakeholder-identified priorities. Crisis 2008; 29 180–90.
| Research priorities in suicide prevention in Australia: a comparison of current research efforts and stakeholder-identified priorities.Crossref | GoogleScholarGoogle Scholar | 19069610PubMed |
[11] Robinson J, Hetrick S, Martin C. Preventing suicide in young people: systematic review. Aust N Z J Psychiatry 2011; 45 3–26.
| Preventing suicide in young people: systematic review.Crossref | GoogleScholarGoogle Scholar | 21174502PubMed |
[12] Burns J, Dudley M, Hazell P, Patton G. Clinical management of deliberate self-harm in young people: the need for evidence-based approaches to reduce repetition. Aust N Z J Psychiatry 2005; 39 121–8.
| Clinical management of deliberate self-harm in young people: the need for evidence-based approaches to reduce repetition.Crossref | GoogleScholarGoogle Scholar | 15701059PubMed |
[13] Commonwealth Government. Before it’s too late: report on early intervention programs aimed at preventing youth suicide. In House of Representatives Standing Committee on Health and Ageing. Canberra: Commonwealth Government;, 2011.
[14] Hawton K, Zahl D, Weatherall R. Suicide following deliberate self-harm: long-term follow-up of patients who presented to a general hospital. Br J Psychiatry 2003; 182 537–42.
| Suicide following deliberate self-harm: long-term follow-up of patients who presented to a general hospital.Crossref | GoogleScholarGoogle Scholar | 12777346PubMed |
[15] McGorry P. The specialist youth mental health model: strengthening the weakest link in the public mental health system. Med J Aust 2007; 187 S53–S56.
| 17908028PubMed |
[16] Huisman A, Pirkis J. J. R. Intervention studies in suicide prevention research. Crisis 2010; 31 281–4.
| J. R. Intervention studies in suicide prevention research.Crossref | GoogleScholarGoogle Scholar | 21134848PubMed |
[17] Scott A, Gui B. For which strategies of suicide prevention is there evidence of effectiveness? Denmark: World Health Organization; 2012.
[18] Mann J, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, et al Suicide prevention strategies: a systematic review. JAMA 2005; 294 2064–74.
| Suicide prevention strategies: a systematic review.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2MXhtFKgsr%2FO&md5=ea32336dc8ee34d46867f3581c1e2e5aCAS | 16249421PubMed |
[19] Gunnell D, Frankel S.. Prevention of suicide: aspirations and evidence. BMJ 1994; 308 1227–33.
| Prevention of suicide: aspirations and evidence.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2c3js1SltA%3D%3D&md5=7bee5956815f52ccdfefb5792bac7e4aCAS | 8080520PubMed |
[20] Goldney R. Suicide prevention: a pragmatic review of recent studies. Crisis 2005; 26 128–40.
| Suicide prevention: a pragmatic review of recent studies.Crossref | GoogleScholarGoogle Scholar | 16276756PubMed |
[21] Arensman E, Townsend E, Hawton K, Bremner S, Feldman E, Goldney R, et al Psychosocial and pharmacological treatment of patients following deliberate self-harm: the methodological issues involved in evaluating effectiveness. Suicide Life Threat Behav 2001; 31 169–80.
| Psychosocial and pharmacological treatment of patients following deliberate self-harm: the methodological issues involved in evaluating effectiveness.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38%2Fit1Chsg%3D%3D&md5=94afefe78a39158f96c679d4e0e5285bCAS | 11459249PubMed |
[22] Pearson J, Stanley B, King C, Fisher C. Intervention research with persons at high risk for suicidality: safety and ethical considerations. J Clin Psych 2001; 62 17–26.
[23] March J, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, et al Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression – Treatment for adolescents with depression study (TADS): randomized controlled trial. JAMA 2004; 292 807–20.
| Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression – Treatment for adolescents with depression study (TADS): randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2cXmvFCnsLo%3D&md5=957f34accb6d255ec454384bc8da682dCAS | 15315995PubMed |
[24] Titov N. Status of computerized cognitive behavioural therapy for adults. Aust N Z J Psychiatry 2007; 41 95–114.
| Status of computerized cognitive behavioural therapy for adults.Crossref | GoogleScholarGoogle Scholar | 17464688PubMed |
[25] Hawton K, Saunders K, O’Connor R. Self-harm and suicide in adolescents. Lancet 2012; 379 2373–82.
| Self-harm and suicide in adolescents.Crossref | GoogleScholarGoogle Scholar | 22726518PubMed |
[26] Robinson J, Cox G, Malone A, Williamson M, Baldwin G, Fletcher K, et al A Systematic Review of School Based Interventions Aimed at Preventing, Treating, and Responding to, Suicide-Related Behaviour in Young People. Crisis 2012; 34 164–82.
[27] Cox GC, Robinson J, Williamson M, Lockley ACD. J. P. Suicide clusters in young people: Evidence for the effectiveness of postvention strategies. Crisis 2012; 33 208–14.
| J. P. Suicide clusters in young people: Evidence for the effectiveness of postvention strategies.Crossref | GoogleScholarGoogle Scholar |
[28] Commonwealth-Government. The Hidden Toll: Suicide in Australia. Report of the Senate Community affairs Reference Committee. Canberra: Commonwealth of Australia; 2010.
[29] Pringle B, Colpe L, Heinssen R, Schoenbaum M, Sherrill J, Claassen C, et al A Strategic Approach for Prioritizing Research and Action to Prevent Suicide. Psychiatr Serv 2013; 64 71–5.
| A Strategic Approach for Prioritizing Research and Action to Prevent Suicide.Crossref | GoogleScholarGoogle Scholar | 23280458PubMed |
[30] Innvaer S, Vist G, Tromald M, Oxman A. Health policy-makers’ perceptions of their use of evidence: A systematic review. J Health Serv Res Policy 2002; 7 239–44.
| Health policy-makers’ perceptions of their use of evidence: A systematic review.Crossref | GoogleScholarGoogle Scholar | 12425783PubMed |
[31] Clark S, Goldney R. The impact of suicide on relatives and friends. In Hawton K, Van Heeringen K, editors. International Handbook of Suicide and Attempted Suicide. Chichester: Wiley; 2000.
