28 May 2019
SUICIDAL behaviour among men could be up to three times higher than some estimates, according to ground-breaking research backed by Beyond Blue and Movember.
Beyond the Emergency, a world-first study by Turning Point and Monash University in partnership with ambulance services, investigated the scale and nature of ambulance call outs to men presenting with acute mental health issues, self-harm or suicidal behaviour.
The three-year research program found that every day, ambulances around the country made on average 82 attendances to men who had either tried to take their lives or were having serious thoughts about doing so.
National suicide figures show on average, six men take their lives in Australia each day.
The new data paints a more detailed picture of suicidality among Australian men.
The research found there were 30,197 ambulance attendances for men who had thoughts of suicide or had attempted suicide between July 2015 and June 2016.
Yet existing data, based on presentations to hospital emergency departments, identify around 10,000 male cases annually.
This is because hospital emergency department data is typically only able to record one reason for presentation, which may not be related to mental health. For example, physical injury following a suicide attempt may only be captured in the data as a physical injury.
“This research tells us that suicide-related presentations to our health services by men triple when measured by ambulance data rather than hospital data alone. It tells us that what we know about male suicide is just the tip of the iceberg,” Beyond Blue Chair Julia Gillard said.
Beyond Blue CEO Georgie Harman added: “As well, it draws out the complex nature of the challenges that confront our paramedics and their patients,
“And it illustrates the urgent need for system reform. In particular, we must stop the revolving door of acute presentations to hospital emergency departments by valuing and investing more in community-based supports and alternative pathways to deal with immediate crisis.”
Turning Point and Monash University Professor Dan Lubman, who led the research project, agreed.
“We need better options for men who are in suicidal crisis,” Prof Lubman said.
“If they don’t have life-threatening injuries, they shouldn’t be at emergency departments yet paramedics feel they have too few alternatives. Our paramedics need more support and people with acute mental health issues or who feel suicidal need better models of care.”
The Movember Foundation’s Global Director of Mental Health, Suicide Prevention Brendan Maher said: “On average, we lose six men to suicide in Australia every single day – a figure that is both devastating and unacceptable.”
“For the first time, ground-breaking research projects like Beyond the Emergency help to paint a picture of the full extent of the men’s mental health crisis, which will prove invaluable to the sector as we continue to identify service gaps and fight for better treatments that will ultimately save the lives of Aussie men,” he said.
Researchers analysed paramedic clinical records from New South Wales, Victoria, Queensland, Australian Capital Territory, Northern Territory and Tasmania.
They also conducted an online survey of 1,230 paramedics, in-depth interviews with 73 paramedics from city and country areas, and interviewed 30 men who had used ambulance services for mental health and suicide-related issues.
Researchers discovered that between July 2015 and June 2016, there were 112,637 ambulance attendances for men experiencing acute mental health issues. Of those:
·         15 percent were for those experiencing suicidal thoughts;
·         8 percent were for suicide attempts;
·         42 percent had already presented to the ambulance service at least once;
·         20 percent were for more than one mental health issue;
·         10 percent were for anxiety, 9 percent were for depression, 8 percent were for psychosis;
·         78 percent were transported to hospital;
·         60 percent of attendances occurred after-hours.
According to the research, only 14 percent of paramedics reported comprehensive training for mental health presentations and two out of three paramedics felt under-prepared to talk to patients about their needs. 
In two out of three attendances, alcohol and or drugs were also involved. Yet many paramedics said they found it hard to spot signs of mental health issues and suicide risk when the patients were also affected by alcohol or drugs.
The report recommends better training for paramedics, sustained use of coded ambulance records to identify and monitor community health needs and a sweeping overhaul of the current service system.
“This report provides an important insight into the magnitude and complexity of male suicide risk and mental ill health attended to by our committed paramedics,” said Ambulance Victoria CEO Associate Professor Tony Walker.
“In recent years we have significantly increased training on how to care for patients in these situations, but acknowledge we have more to do, in both training of staff but also in exploring the best care models for people,” Mr Walker said.
Prof Lubman added that ambulance data should be used more widely.
“This world-first study demonstrates the utility of using coded ambulance data as a reliable national surveillance and early warning system for mental health and self-harm, and supports the Commonwealth’s call for timely, accurate collection of data about suicide and community health,” Prof Lubman said.
The Movember Foundation is committed to supporting men to take action early when times get tough – contributing more than $3.1 million in funding over the past three years in support of Beyond the Emergency. It is the leading global funder of gender-based mental health tools, resources and interventions.
Full Beyond the Emergency report: