Eight years ago, Duty of Care, the pioneering West Australian study of the fate of mental health patients in the wake of de-institutionalisation, revealed that their suicide rate had doubled. Academic studies here and overseas have verified this tragic rise among people with a chronic mental illness. Now the Herald (’Revealed: Australia’s suicide epidemic’, August 21) has confirmed that this appalling reality persists in NSW.

Four years ago the NSW Sentinel Events Review Committee, chaired by Peter Baume, examined this tragedy and concluded that a third, and possibly more, of these deaths were preventable. One of the measures needed was more mental health hospital beds (still well below the 1993 numbers in NSW). As the Herald report notes, many of the deaths were the result of premature discharge or even denial of admission by a hospital. This is more often than not the result of a bed shortage.

Those who object to an expansion of bed numbers as return to the past and as no solution, let me add two points. For every suicide in a hospital (and one is too many) there are 15-20 deaths within seven days of a premature discharge or denial of admission. And that community support services also need to be vastly improved, although the close observation available in a hospital is not achievable by even the best community support service.

As has been demonstrated on a number of occasions, the community around Callan Park (along with Barry O’Farrell and the Greens) supports the re-opening of Rozelle Psychiatric Hospital formerly located in its beautiful grounds. In the circumstances this would an act of simple humanity.

Hall Greenland

SMH, August 21, 2009

AUSTRALIA has dangerously miscalculated its suicide statistics - by as much as 30 per cent in NSW and Queensland - leaving a silent and growing epidemic of mounting deaths.

The figures are in stark contrast to years of backslapping by state and federal governments, congratulating themselves for reducing suicide rates from a peak of 2700 in 1997.

The Herald can reveal the suicide toll is as high now as it was in the 1990s - if not higher - with experts predicting a further rise as the impact of rising unemployment and other economic factors bite.

Ten people each month take their lives either inside a state health facility or within a week of having contact with one.

Discharged too soon from emergency departments, left unobserved in psychiatric wards or denied admission to overcrowded inpatient facilities, their deaths reveal a pattern of repeated systemic failures that demands urgent reform.

The dangerous combination of government under-investment, shutting families out of hospital and police processes, a lack of training and a general community malaise about how to prevent suicide means so many are falling through the cracks.

In the 18 months to June 2008, at least 175 people died from suicide within seven days of contact with the health system, figures from the NSW Clinical Excellence Commission show.

A coroner’s inquest into a man who shot himself within hours of being discharged from hospital concluded last week, with police and health departments questioned over their protocols for dealing with people at risk.

In another death, in which a woman set fire to herself after being denied help by a public hospital, the coroner noted: ”This death was preventable and is probably the most tragic example of NSW Health’s inability and/or failure to deal with individual cases in an appropriate manner.”

John Mendoza, an adjunct associate professor at the University of Sydney faculty of medicine, said the real rate of suicide was about 2500-2700. ”With this economic downturn we can expect that to increase by around 10 per cent, so we are looking at approximately 3000 people each year,” he said. ”None of this takes into account suicides by way of single vehicle accidents - these are the only aspect of road accident deaths rising as a percentage of total deaths.”

These figures indicate a major health problem and are much higher than the Bureau of Statistics count of 1800 suicide deaths a year, said Professor Mendoza, who is chairman of the Federal Government’s National Advisory Council on Mental Health.

”It is a hidden epidemic and yet the Federal Government only invests $1 per person per year on suicide prevention.”

The director of health and vital statistics at the Australian Bureau of Statistics, Tara Pritchard, confirmed the bureau would release updated figures in March to correct the undercounting.

”What that revision of ABS data will show us is that really we have gone nowhere in terms of overall reductions from the peaks in suicide rates in the early 1990s, and we have certainly gone nowhere among reducing suicide in indigenous populations. They remain four times higher overall,” Professor Mendoza said.

Governments had done little more than the bare minimum to prevent deaths, said Dawn O’Neil, chief executive officer of Lifeline.

”Once we got confirmation the rates were not coming down … the Government didn’t want to know, politically they wanted to believe that the suicide rates were falling.”