COMPLETED AND ATTEMPTED YOUTH SUICIDE IN VICTORIA

Objective. To examine the biopsychosocial background of persons aged 1 5-24 years who had committed suicide in Victoria, compared with young people who presented to hospital after attempting suicide and who were either hospitalized or given outpatient treatment. From these data it was hoped to develop a screening instrument to delineate attempters a t high risk to suicide. Design. A prospective study was undertaken usi ng a standardized youth suicide interview schedule of all suicides in the 15-24-year age group in Victoria, compared with a sample of those presenting to public hospital emergency departments following attempte d suicide. Data on completed suicides were collected by the staff of t he Coroner's Office and Victoria Police, while psychiatric staff of Vi ctorian hospitals assisted the collection of data on suicide attempter s.Main outcome measures. Data comprised demographic features, method o f suicide or attempt, reasons for the event, social and personal histo ry, psychiatric background and life stressors. Results. One hundred an d forty-eight completed suicides were compared with 105 hospitalized s uicide attempters and 101 non-hospitalized suicide attempters. The maj ority of those completing suicide were male (86 percent), while those attempting suicide were predominantly female (64 percent in both group s). Those completing suicide typically used violent methods, while att empted suicides were mainly from overdose. The most common reported re asons for suicide were psychiatric problems and generalized feelings o f worthlessness. Relationship problems and family conflict were the do minant reasons in both groups of suicide attempters. The data suggest that completed suicide was not related to specific events. Unemploymen t was cited as a reason for suicide in less than 5 percent of cases. S ignificantly, those who attempted suicide were more likely to have sou ght help prior to the attempt (hospitalized 64 percent and non-hospita lized 66 percent) compared with those who successfully suicided (12 pe rcent). Conclusions. These data did not support common assumptions abo ut suicide. Suicide threats or attempts do not discriminate between su bsequent attempts and completed suicide. Approximately 88 percent of t hose who completed suicide displayed no discernible help-seeking behav iour. No specific events were related to completed suicide, indeed, th ose who completed suicide appeared to have experienced fewer stressful life events than those who attempted suicide. Over half the subjects lived at home. For attempters, there was a history of physical abuse, not reported for those who completed suicide. The majority of subjects were not heavy drug or alcohol users. These data suggest: (1) researc h needs to address the antecedents of suicidal behaviour, not the beha viour itself; (2) we need to explore the role of such causal factors a s feelings of worthlessness and interpersonal skills, rather than home lessness and unemployment; and (3) suicide completers and attempters a re heterogeneous groups, to be helped separately. (C) 1998 John Wiley si Sons, Ltd.