|
Abstract
|
In a recent issue of the journal, I presented a graph of the suicide rate in Australia from 1991 to 2016 on which I marked the introduction of various interventions which might have been expected to reduce the suicide rate (Jorm, 2019). These interventions included various new plans, strategies, reforms, organizations and treatments. The graph appeared to indicate that these interventions had not had any sustained impact. Readers of the journal were invited to explain this apparent lack of effect.
Since then, the journal has published two contributions proposing an explanation. Bastiampillai et al. (2020) argued that the interventions were ineffective because they did not influence the underlying sociological determinants of suicide. They drew on the perspective of Durkheim to argue that Australia has had a relatively stable suicide rate over the past century, but with periods when the trend deviated due to major social upheavals. They pointed out that the male suicide rate had increased during the Great Depression and decreased during World War II. They also identified another increase in both male and female suicide during the 1960s, which they attributed to availability of barbiturates. In a response to Bastiampillai et al. (2020), Pridmore (2020) agreed with them about the importance of sociological factors. However, he disputed their interpretation of the rise during the 1960s, attributing it to the considerable social change that occurred during this period, rather than availability of barbiturates.
Based on these responses and other discussions I have had with suicide experts, I now want to propose an explanation for the lack of impact of interventions. My explanation has three components.
Suicide is influenced by social factors that are outside the domain of mental health services
I agree with Bastiampillai et al. (2020) and Pridmore (2020) that there are major social factors affecting the suicide rate. These include loss of employment, financial crisis, relationship breakdown and trouble with the law. The availability of alcohol and other substances is also important. Mental health interventions are not likely to have a major impact on these social factors ...
Language: en |