While there has been increasing acknowledgement of Indigenous Australian disadvantage over the last two decades, and subsequent attempts by the government to attend to these inequities, Indigenous Australian people are still disadvantaged in comparison to non-Indigenous Australians. The quality of life, life expectancy and level of opportunity continue to be considerably lower for Indigenous people (Vicary & Westerman, 2004). The historical degradation and demarcation of Indigenous peoples has led to their disconnection from country and cultural traditions (Sveticic et al., 2012). Indigenous populations have poorer health than non-Indigenous populations, inequalities which are larger in Australian than on other developed countries (Durey & Thompson, 2012). Until 30 years ago, suicide among the Indigenous Australian population was a rather uncommon phenomenon. It is now the primary external cause of death Indigenous Australian males and the second most prominent cause of death for females (De Leo, Milner & Sveticic, 2012). Suicide rates are twice as high for Indigenous Australians than non-Indigenous (Australian Bureau of Statistics, 2016). This paper will discuss some of the factors that contribute to the inequality of Indigenous suicide in Australia. Limitations in access to health services, mental health, substance abuse, differences in cultural beliefs, and historical factors will be considered.
A report by the Australian Bureau of Statistics (2016), which focussed on Indigenous and deaths from people who lived in New South Wales, Queensland, South Australia, Western Australia, and the Northern territory, showed that in 2015, 152 Aboriginal and Torres strait islander people died by cause of suicide. The suicide rate for Aboriginal and Torres Strait islander people was25.5 deaths per 100,000. In comparison to 12.5 deaths per 100,000 for non-Indigenous. 5.2% of all Indigenous deaths were suicide compared with suicide deaths of non-Indigenous Australians, which was 1.8%. In the 5 years between 2011 and 2015, deliberate self-harm was the primary cause of death for Indigenous and Torres Strait Islander peoples from 15 to 34 years of age, and was the second most prominent cause of death for persons aged 35 to 44. The median age at death from suicide was 28.5 years in comparison to 45 years for non-Indigenous people. The Indigenous suicide rates for persons aged 15 to 44 were two to four times higher than those of non-indigenous Australians (Australian Bureau of Statistics, 2016). While men show higher rates of suicide deaths, women show higher rates of suicide attempts. It is thought that in reality, the Indigenous rate of suicide may even be two to three times higher than numbers demonstrate, due to the possibility of un-reported cases, and the common shortage of data on suicide attempts and self-harming behaviour (Elliot-Farelly, 2004). Indigenous people in remote communities appear to be extremely affected by suicide (Rajkumar & Hoolahan, 2004). For instance, men in remote areas are 2.6 times more likely to commit suicide than men in urban areas. Suicide rates form remote areas have been rising over time (Kolves, Milner, Mckay & De Leo, 2012).
Suicide among Aboriginal Australians has been generally interpreted as connected to social factors arising from the oppression and racism imposed on Australian Indigenous peoples across the past 200 years. These historical issues are considered to contribute to ongoing intergenerational trauma and psychological and social instabilities in Indigenous people (De Leo, Milner & Sveticic, 2012). From the 1970’s onwards, rapid social change cooccurred for Indigenous people, with a possible critical juncture characterised by the new introduction to welfare and cash economy bringing with it unlimited access to alcohol. These shifts weer intensified by social and economic disadvantages, as demonstrated in over-crowded accommodation and housing, insufficient nutrition, low levels of school attendance, and high rates of unemployment, issues that still prevail today. Also, significant was the higher predominance of crime, violence and imprisonment in Aboriginal communities, possibly heightening other circumstantial stressors (De Leo, Milner & Sveticic, 2012). Past policies still have an effect on generations of Aboriginal people following the time of policy introduction. This is especially significant for victims of the Stolen Generation. Impacts upon victims and the families of the Stolen Generation are extensive and continuing. Children who were removed, and families who had people taken from them remain severely influenced by the experience and exhibit a vast array of psychological manifestations because of this procedure (Vicary & Westerman, 2004). Victims and subsequent generations show psychological responses such as inconsolable grief and loss, post-traumatic stress disorders, low self-regard and confidence, helplessness, depression, anger, disconnection from culture and lineage connections, personality and adjustment disorders, poor parenting abilities, disorganised attachment, insufficient relationship skills, problems with cultural identity, substance abuse, violence, guilt, and suicide (Vicary & Westerman, 2004).
The presence of psychological distress combined with high levels of alcohol and substance use ha has been a suggested contributing factor to the inequality in Indigenous suicide (Rajkumar & Hoolahan, 2004). In the year 2012 to 2013, nearly one-third of Indigenous people aged 18 and over experienced high or very high levels of psychological distress in the month before they were questioned (Australian Bureau of Statistics, 2012-2013). In remote communities, comorbidity of anxiety and depression combined with alcohol misuse can cause great distress for the individual and community, and pose significant challenges for inclusive care. In some Aboriginal communities the use of inhalants is a concern and the inhalation of petrol is a dangerous recreational activity for indigenous youth (Rajkumar & Hoolahan, 2004). Indigenous suicide is can be impulsive and commonly occurs in the circumstances off, or situation following intoxication. There are often no behaviours of or signs warning family members of approaching suicidal behaviour. Suicide notes are very rare in Indigenous cases which suggests a lack of intention or premeditation, this impulsivity is assumed to be connected with alcohol use (Elliot-Farelly, 2004). Alcohol is said to have contributed to up to 77 percent of deaths by suicide in the Indigenous population. Illicit substances such as marijuana and petrol inhalation have also been discovered as present in numerous suicide cases (De Leo, Milner & Sveticic, 2012).
However, some cases are not just as a result of alcohol use and may be a result of other long-term affects on well-being and opportunities.