Objective: The aim of this paper is to explore the conceptual basis of limiting access to potential methods of suicide as a public health measure.
Method: A review of the literature was conducted.
Results: Both physical availability and sociocultural acceptability are important determinants of choice. There is considerable evidence of an association between method availability and method specific suicide rates. There is also evidence that restriction of method availability is often associated with a reduction in method specific suicide rates. There is some evidence that restrictions on method availability under certain conditions may reduce overall suicide rates.
Conclusions: Suicide methods employed by young Australians are changing, with a disturbing rise in frequency of hanging and car exhaust suicides slightly offset by a decline in firearm suicides. Opportunities exist for further reducing firearm suicides and addressing exhaust suicides by practical measures. There are also obvious options for changing prescribing practices with respect to more lethal medications (e.g. tricyclic antidepressants). However, the rise in hanging seems problematic from this perspective and in need of ecological study.
CantorCHTurrellGBaumeP.Access to means of suicide by young Australians. A background report to the Commonwealth Department of Health and Family Services Youth Suicide Prevention Advisory Group. Canberra: Commonwealth Department of Health and Family Services, 1996.
2.
AdityanjeeDRSuicide attempts and suicides in India: cross-cultural aspects. International Journal of Social Psychiatry1986; 32:64–73.
3.
SomasundarumDJRajaduraiS.War and suicide in northern Sri Lanka. Acta Psychiatrica Scandinavica1995; 91:1–4.
4.
PounderDJChanging patterns of male suicide in Scotland. Forensic Science International1991; 51:79–87.
5.
Bille-BraheUJessenG.Suicide in Denmark, 1922–1991: the choice of method. Acta Psychiatrica Scandinavica1994; 90:91–96.
6.
BurvillPWChanging patterns of suicide in Australia, 1910–1977. Acta Psychiatrica Scandinavica1980; 62:258–268.
7.
CurranPSLesterD.Trends and methods used for suicide in Northern Ireland. Ulster Medical Journal1991; 60:58–62.
8.
FarmerRRhodeJ.Effect of availability and acceptability of lethal weapons on suicide mortality: an analysis of some international data. Acta Psychiatrica Scandinavica1984; 62:436–466.
9.
SnyderMLMethods of suicide used by Irish and Japanese samples: a cross-cultural study from 1964 to 1979. Psychological Reports1994; 74:127–130.
10.
ClarkeRVLesterD.Suicide: closing the exits. New York: Springer-Verlag, 1989.
11.
HassanR.Suicide explained: the Australian experience. Melbourne: Melbourne University Press, 1995.
12.
BoorM.Methods of suicide and implications for suicide prevention. Journal of Clinical Psychology1981; 37:70–75.
13.
FisherEPComstockGWMonkMASencerDJCharacteristics of completed suicides: implications of differences among methods. Suicide and Life-Threatening Behavior1993; 23:91–100.
14.
McIntoshJLMethods of suicide. In: MarisRWBermanALMaltsbergerJTYufitRI, eds. Assessment and prediction of suicide. New York: Guilford Press, 1992:381–397.
15.
CardJJLethality of suicidal methods and suicide risk: two distinct concepts. Omega1974; 5:37–45.
16.
KleckG.Point blank: guns and violence in America. New York: Aldine de Gruyter, 1992.
17.
BuckleyNAWhyteIMDawsonAHMcManusPRFergusonNWCorrelations between prescriptions and drugs taken in self-poisoning: implications for prescribers and drug regulation. Medical Journal of Australia1995; 162:194–197.
18.
ClarkeRVPoynerB.Preventing suicide on the London underground. Social Science and Medicine1994; 38:443–446.
19.
HawtonKWareCMistryHParacetamol self-poisoning: characteristics, prevention and harm reduction. British Journal of Psychiatry1996; 168:43–48.
20.
MauriceSPommereauXPueyoSEpidemiological surveillance of suicides and attempted suicides in Aquitaine, south-west France, using an original computer network of Sentinel General Practitioners. Journal of Epidemiology and Community Health1989; 43:290–292.
21.
FarmerRDTSuicide by different methods. Postgraduate Medical Journal1979; 55:775–779.
22.
MarzukPMLeonACTardiffKMorganEBStajicMMannJJThe effect of access to lethal methods of injury on suicide rates. Archives of General Psychiatry1992; 49:451–458.
23.
OliverGHetzelBSAn analysis of recent trends in suicide rates in Australia. International Journal of Epidemiology1973; 2:91–101.
24.
WhitlockFASuicide in Brisbane, 1956–1973: the drug-death epidemic. Medical Journal of Australia1975; 1:737–743.
25.
HardwickeCHoltLJamesRSmithA.Trends in self-poisoning with drugs in Newcastle NSW. Medical Journal of Australia1986; 144:453–454.
26.
MyersJBSmithAJElliotRLMacAskillP.Self-poisoning with drugs. A 3-year study in Newcastle NSW. Medical Journal of Australia1981; 2:402–405.
27.
CantorCHSubstances involved in fatal drug overdoses in Brisbane, 1979–1987. Acta Psychiatrica Scandinavica1989; 80:69–71.
28.
ColeridgeJCameronPADrummerOHMcNeilJJSurvey of drug-related deaths in Victoria. Medical Journal of Australia1992; 157:459–462.
29.
CromeP.The toxicity of drugs used for suicide. Acta Psychiatrica Scandinavica1993; 371:33–37.
30.
EkebergOJacobsonDFlaatenBHackA.Effect of regulatory withdrawal of drugs and prescription recommendations on the pattern of self-poisonings in Oslo. Acta Psychiatrica Scandinavica1987; 221:483–487.
31.
RetterstolN.Death due to overdose of antidepressants: experiences from Norway. Acta Psychiatrica Scandinavica1993; 371:28–32.
32.
LesterDKazuhikoA.The effects of controls on sedatives and hypnotics on their use for suicide. Clinical Toxicology1989; 27:299–303.
33.
MurrayD.Handguns, gun control laws and firearm violence. Social Problems1975; 23:81–92.
34.
LesterD.Gun control, gun ownership and suicide prevention. Suicide and Life-Threatening Behavior1988; 18:176–180.
35.
LesterDMurrellMEThe preventive effect of strict gun control laws on suicide and homicide. Suicide and Life-Threatening Behavior1982; 12:131–140.
36.
NicholsonRGarnerA.The analysis of the Firearms Control Act of 1975. Washington, DC: United States Conference of Mayors, 1980.
37.
BoorMBairJHSuicide rates, handgun control laws and sociodemographic variables. Psychological Reports1990; 66:923–930.
38.
DudleyMCantorCHde MooreG.Jumping the gun: firearms and the mental health of Australians. Australian and New Zealand Journal of Psychiatry1996; 30:370–381.
39.
CantorCHSlaterPJThe impact of firearm legislation on suicide in Queensland: preliminary findings. Medical Journal of Australia1995; 162:583–585.
40.
BeautraisALJoycePRMulderRTAccess to firearms and the risk of suicide: a case control study. Australian and New Zealand Journal of Psychiatry1996; 30:741–748.
41.
BeautraisALJoycePRMulderRTResponse to Cantor's comment on Access to firearms and the risk of suicide: a case control study [letter]. Australian and New Zealand Journal of Psychiatry1997; 31:608–609.
42.
KreitmanN.The coal gas story. British Journal of Preventative and Social Medicine1976; 30:86–93.
43.
World Health Organization.Changing patterns in suicide behavior. European Reports and Studies no. 74. Copenhagen: WHO Regional Office for Europe, 1982.
44.
LesterD.The availability of firearms and the use of firearms for suicide: a study of 20 countries. Acta Psychiatrica Scandinavica1990; 81:146–147.
45.
LesterD.Use of firearms for suicide in Canada. Perceptual Motor Skills1994; 79:962.
46.
McClureGMGSuicide in children and adolescents in England and Wales 1960–1990. British Journal of Psychiatry1994; 165:510–514.
47.
PounderDJWhy are the British hanging themselves?American Journal of Forensic Medical Pathology1993; 14:135–140.
48.
TeicherMHGlodCColeJOEmergence of intense suicidal preoccupation during fluoxetine treatment. American Journal of Psychiatry1990; 147:207–210.
49.
PappLAGormanJMResponse to Teicher and associates’ Emergence of intense suicidal preoccupation during fluoxetine treatment. American Journal of Psychiatry1990; 147:1380–1381.
50.
CantorCHHillMAMcLachlanEKSuicide and related behaviour from river bridges: a clinical perspective. British Journal of Psychiatry1989; 155:829–835.
51.
EmmersonBCantorCHTrain suicides in Brisbane, Australia. Crisis1993; 14:90–94.