Are you okay?

By Yasmin Noone

Aged care staff should all be aware of what they can do to support a depressed or socially isolated older person who might be contemplating suicide, an expert said.

According to psychologist and deputy chair of the Suicide Prevention Australia board, Caroline Aebersold, older men in the 75 and above category are considered a high suicide risk group.

This is despite the fact that there is little awareness about suicide rates within and prevention programs targeting this senior cohort.

“What we seeing [in this age group] are some of the common themes for people facing suicide, like disconnectedness and social isolation,” Ms Aebersold said.

“…There could be a change in life circumstances due to retirement, a person could be in poor health because of the ageing process, or their poor health restricts their ability to do things they would previously do, which could also increase loneliness and social isolation.

“They might also be dealing with loss and grief from the death of people around them or a loss of lifestyle.”

The Australian Bureau of Statistics (ABS) Causes of Death, Australia report states that the highest age-specific suicide death rate for males in 2010 was observed in the 40-44 age group (27.7 people per 100,000 in the population). However, it is closely followed by the 80-84 (25.9 per 100,000 population) and 75-79 year old age groups (25.7 per 100,000 population).

Females aged 65-69 had the lowest age-specific suicide rate (3.3 per 100,000) in 2010.

Ms Aebersold said the rates for death by suicide are also higher for men, in general, than for women, although female attempt rates exceed that of the male population.

This, she added, is typically the case in the older male age groups because more older men maintain “traditionally ‘male values’, have a stoic approach [to facing negative life issues] and are reluctant to seek help from those around them”.

“Certainly, we think that men in this age group probably face issues around retirement, particularly where an older man’s career has been a very strong part of their identity, self-esteem and self-worth.

“While we might begrudge our work lives at times, it is something that gives us purpose in life and social connectedness.”

Advice for aged care staff

Suicide Prevention Australia urges people who are in regular contact with older Australians – especially aged and community care staff – to reach out and offer help if they believe someone is at risk.

“One of the things we talk about is making suicide everybody’s business,” Ms Aebersold said.

“Certainly, we know number one risk factor around suicide is disconnectedness and social isolation, so the most important thing you can do to help someone is to provide support.

“But we need to ensure that everyone feels like they are able to lend a hand and provide support to someone they believe might be at risk.

“You don’t have to be a mental health professional to give someone the support they might desperately need.

“Take time to talk to them and ask them ‘how are you going?’. If you do have some concerns, ask them [directly] what you can do to help them get the support they need.

“And if you hear someone talking about their life not being worth living, it’s important to ask them if they really think that and if they want to take their own life.

“People are often afraid of asking that but it can’t do any harm. If the answer is no, then great. If not, do something to get them support.”

Ms Aebersold advises aged care staff who feel uncomfortable about ‘the question’ should tell the person from the outset they are unsure if they are the best person to provide support, but would like to assist them to get help.

“It’s really important to be real with people. If you are not sure what to say or do, just say you are really upset to hear that [they are contemplating], that you are concerned for them, would like to help them and would like to know what they need.

“Just being real with people and offering support is a huge step in the right direction.

“Suggest a telephone helpline, which is just a phone call away. They will have people who are trained [to deal with the issue] and can have a targeting conversation with them.

“Lifeline [13 11 14] is a good number to have on hand to give out to people.”

Ms Aebersold also believes that aged care staff should be provided with suicide risk awareness and prevention training as part of their professional development, as they work with a high risk group on a day-to-day basis.

“It’s great for staff to feel empowered to identify the risk signs and to know what to do when they think someone is at risk.”

Suicide Prevention Australia quotes suicide as the leading external cause of death in Australia. The figures, which exceed 2,000 deaths per year, are greater than the national road toll.

What the Senate said

The Senate Community Affairs References Committee looked into the nationwide issue in 2010 with The Hidden Toll: Suicide in Australia inquiry.

“Despite a reduction in overall suicide rates, RANZCP [Royal Australian and New Zealand College of Psychiatrists] expected the number of suicides among older men to rise given they constitute a fast growing segment of the population,” the report states.

“…Contributing factors in old age suicide may include physical or economic dependency, mental and/or physical health problems, chronic pain, grief, loneliness, alcoholism or carer stress.

“The Salvation Army also saw an increasing need to target resilience programs and suicide prevention programs to elderly people.

“Similarly Professor Brian Draper considered suicide in old age remained a neglected topic…“He noted: Suicide is likely to be under-reported in the elderly with GPs and other doctors being more likely to record deaths in frail elderly as being due to natural causes to avoid stigma for families and possibly in some circumstances to cover up assisted suicides.”

The Annual National Suicide Prevention Conference, Innovation in Suicide Prevention: Bringing It Together, from 10-12 October in Sydney will feature a presentation and workshop on suicide, men and older people.

For more information about the Annual National Suicide Prevention Conference, visit https://suicidepreventionaust.org/conference/program-2/

**Readers seeking support and information about suicide prevention or depression can contact beyondblue on 1300 22 4636 or www.beyondblue.org.au or talk to their GP, local health professional or someone they trust.

For immediate assistance, call Lifeline on 13 11 14 (24 hour crisis hotline) www.lifeline.org.au

Other useful contacts:

SANE Helpline: 1800 18 SANE (7263)
www.sane.org/helpline

Mensline: 1300 78 9978
www.menslineaus.org.au

Veterans and Veterans Families Counselling Service: 1800 011 046

Kids Help Line: 1800 551 800
www.kidshelpline.com.au