ATTEMPTED-SUICIDE IN ADELAIDE AND PERTH - CHANGING RATES FOR MALES AND FEMALES, 1971-1987

Objective: Official rates of attempted suicide in Perth, in 1971-1972 and 1986-1987, were examined, with the aim of documenting changes in the age and sex distribution of persons who attempted suicide over the 15-year period. In addition a survey of all patients presenting to the Royal Adelaide Hospital between 1986 and 1988 aimed to determine whether or not the official figures accurately reflect the number of presentations for attempted suicide. Design and setting: Rates of attempted suicide were calculated from the Hospital Morbidity Data for hospitals in the Perth Statistical Division and from the Inpatient Separations Information System (ISIS) for hospitals in the Adelaide Statistical Division. Rates were expressed for each sex as annual age-specific rates per 100 000 population. The data were age-standardised by the direct method. A survey was completed of all patients presenting to the Royal Adelaide Hospital between 1986 and 1988 after attempted suicide. The findings were compared with the official figures for the Royal Adelaide Hospital and were used to estimate the actual rate of attempted suicide in the Adelaide Statistical Division. Results: In Perth the rate of attempted suicide for males increased from 93 per 100 000 in 1971-1972 to 137 per 100 000 in 1986-1987. The increase was most striking in the age groups 15-19 and 40-44 years. The rate for females decreased from 214 per 100 000 to 195 per 100 000. In Adelaide, from 1986 to 1987, between one-fifth and one-third of persons who attempted suicide and presented to the Royal Adelaide Hospital were not recorded in the ISIS. In 1988, two-thirds were not recorded. We estimated that the real rate of attempted suicide for males in Adelaide was about 180 per 100 000 and for females was about 250 per 100 000. Conclusions: Our understanding of the epidemiology of attempted suicide is largely based on data which are now out of date. The Perth findings of a 47% rise in rate among males and a 9% fall among females suggest that attempted suicide is no longer a behaviour more associated with females than males. The Adelaide survey data demonstrate that official rates for attempted suicide underestimate the extent of the phenomenon in the community by a significant margin. An attempted suicide register is suggested as a method of overcoming this problem.