Suicide prevention strategies need to address role of alcohol

Turning Point experts are calling for an increased focus on the role of alcohol in national and state suicide prevention efforts.

In an article published in this month’s Australian & New Zealand Journal of Psychiatry, Turning Point researcher Dr Katrina Witt and Turning Point Director Prof Dan Lubman said that there has been limited discussion regarding the importance of reducing alcohol consumption in Australia, despite robust evidence demonstrating a link between suicide and population levels of drinking.

“At the population level, rates and patterns of alcohol consumption have been consistently associated with suicide rates across a number of countries, particularly for males. Data suggest increasing per capita alcohol consumption is associated with an increase in overall suicide rates, with the proportion of suicides attributable to alcohol as high as 66.4% in countries that predominately consume spirits and 34.5% in countries that predominately consume non-spirits-based alcoholic beverages.”

According to Dr Witt and Prof Lubman, one concern is that individuals with alcohol and other drug use problems are typically excluded from randomised controlled trials of novel interventions for the prevention of self-harm and suicide, despite between one-quarter to one-third of suicide decedents meeting diagnostic criteria for an alcohol use disorder.

“Individuals with alcohol are infrequently identified as an important ‘at risk’ group, despite the fact that alcohol dependence in particular has been consistently identified as the second most common psychiatric diagnosis behind depression as precipitating factor for suicide.”

Dr Witt and Prof Lubman said the issue was of particular concern for men, given they are less likely to seek help for suicidal ideation and behaviours until they reach crisis point.

“Males with depression, for example, are more likely to report problems with alcohol use, whereas females are more likely to report ‘classical’ symptoms of depression. Therefore, when males do seek help, they are more likely to be referred for alcohol and drug treatment in the first instance.

“It is therefore important that alcohol and other drug services are adequately skilled to identify individuals at risk of suicide, appropriate prevention and intervention strategies are sufficiently resourced within these settings, and effective partnerships are in place with local mental health providers to provide support and referral pathways.”

Dr Witt and Prof Lubman propose that future suicide prevention strategies must also advocate for policies that effectively reduce alcohol consumption, such as increasing the price of alcohol through taxation and limiting marketing and promotion.

Furthermore, they said it was important to reduce society’s stigma towards alcohol and mental health – and reduce a prevailing community view that because both alcohol and drug use and suicidal behaviour are self-inflicted, they are less worthy of appropriate treatment and management than physical health complaints.

“If meaningful reductions in Australia’s suicide rate remain a national priority, this can only be achieved when initiatives acknowledge the role of alcohol of suicidal behaviour, and all relevant at risk populations are targeted.”

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