Child Suicide in Australia; however does this happen?

Child deaths from suicide (9-14 years) appear to be a hidden problem, which may well be increasing in Australia. A ‘Trends and Issues’ Paper (No 19, Commission for Children and Young People and Child Guardian (CCYPCG), January 2014), reported on a total 169 suicide deaths of children and young people registered in Queensland between 1 July 2004 and 30 June 2013 (9 yrs) and drawn from the Queensland Child Death Register (2004–13). Unfortunately, the CCYPCG ceased operation on 30 June 2014, and its functions moved elsewhere (http://www.ccypcg.qld.gov.au) as part of the implementation of far-reaching recommendations from the Queensland Child Protection Commission of Inquiry (Carmody Review). (http://www.childprotectioninquiry.qld.gov.au/__data/assets/pdf_file/0017/202625/QCPCI-FINAL-REPORT-web-version.pdf) As a result, the ‘Trends and Issues’ Paper No 19, is complex to find on government sites, but is available for download elsewhere. (http://www.iasp.info/pdf/web_resources/child_deaths_prevalence_of_youth_suicide_in_queensland.pdf)

Of the 169 suicides, 124 (73.4%) were aged 15–17 years (average 13.8 suicides per year). However, 44 suicides (26.0%) were of children aged 10–14 years (average 4.9 suicides per year), and one was a child aged 9 years (2011). For the most recent year (2012-13), for young people aged 15–17 years (10 deaths), suicide was the second-leading external cause of death (5.5 per 100,000). However, suicide was the leading external cause of death for children aged 10–14 years (12 deaths, 4.1 per 100,000 children), and the rate was the highest since 2004. Of these 22 suicides, 15 (68%) were male and 7 female. Only 6 suicides (27%) were from an indigenous background (17.1 per 100,000), but this rate was 5.5 times higher than the non-Indigenous (3.1 per 100,000). Only 1 of the 22 was from a remote background, with 7 from regional Queensland, and the rest (14) from metropolitan backgrounds. Eleven were from low to very low socioeconomic backgrounds, with 5 from moderate, and 6 from high or very high. Eleven (50%) were known to the child protection system, (7.1 per 100,000) a rate 3.9 times more than expected. There were 18 hangings, 1 gunshot, 1 jumping from height and 1 in front of a train, and 1 poisoning. The number of hangings seems surprising, and challenges our thinking; our expectation might have been that children would take medication in an extreme moment of frustration or emotional pain. But to organise a hanging perhaps suggests the more deliberate nature of these deaths.

Do the Queensland rates differ from the national rate or from other states and territories?
It is complicated. Queensland figures are from 1^st July to the following end of June, while ABS figures are specific to a given year. The latest report from the Australian Bureau of Statistics (http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0~2012~Main%20Features~Age~10010) is from beginning 2008 to the end of 2012 (5 years), for ages 5-14 years, with a total of 57 suicides from all states and territories, 14 from Queensland. The equivalent number for the same 5 years in the CCYPCG report could be up to 26 deaths, so there may be a disparity.

For New South Wales (http://www.ombo.nsw.gov.au/__data/assets/pdf_file/0005/12389/CDRT_Annual_Report_2012_web.pdf), nine children under 15 are reported as suicides, whereas the ABS report suggests 12.

Northern Territory

A thorough report from the Northern Territory demonstrates marked increases in child and youth suicide, but covers the period 2006-1010, and does not overlap the ABS period reporting (http://www.childrenscommissioner.nt.gov.au/pdfs/other_reports/nt_youth_suicide_public_release_final_with_ISBN.pdf).

After an extensive online search, I cannot find parallel figures for Victoria, Western Australia, Tasmania or the ACT. If anyone can point me in the right direction, I would be very grateful.

The National Children’s Commissioner, Ms Megan Mitchell, has recently completed a national consultation on how children and young people under 18 years can be better protected from intentional self-harm and suicidal behaviour.(https://www.humanrights.gov.au/about/commissioners/ms-megan-mitchell-national-childrens-commissioner) Findings are scheduled be reported in her 2014 Statutory Report to Parliament. One can only hope that she has access to exact figures from all states and territories to compare with ABS data.

One real issue for child suicide is perhaps not the numbers, as much as the human tragedy. The Queensland Commissioner, in noting that half the children were known to the child protection system, suggested these children often “live in circumstances characterised by substance misuse, mental health problems, lack of attachment to significant others, behavioural and disciplinary issues or a history of abuse or violence”. This harks back to many comprehensive reports on how a child can get to the point of suicide. In one of the earliest, David Shaffer (1974) found the most common precipitants were conflict or a ‘disciplinary crisis’ with parents, teachers or police, fights with peers or friends. Annette Beautrais (2001) reports somewhat more complexity, while Dervic and colleagues (2008) note that precipitants may be less easy to identify and child suicide seems to have a brief stress-suicide interval.

If this latter point is true, then more or better services may not solve the problem; we may not get to see the child in time to assist change. We need to focus our prevention efforts more broadly on assisting parents to understand the consequences of trauma, and make changes. We also must assist schools to improve their efforts toward adopting more social and emotional learning programs aimed at helping children toward better mental health, with strategies like mindfulness to work through conflict and trauma.

References

Beautrais, A.L. (2001) Child and young adolescent suicide in New Zealand.

Australian and New Zealand Journal of Psychiatry 35(5): 647-53.

Dervic, K., Brent, D.A. and Oquendo, M.A. (2008) Completed Suicide in Childhood. Psychiatric Clinics of North America 31(2): 271-91.

Shaffer, D. (1974) Suicide in Childhood and Early Adolescence. Journal of Child Psychology and Psychiatry 15(4): 275-91.