Every 40 seconds someone commits suicide in the world.1 In Australia suicide accounts for the highest number of premature deaths, equivalent to the combined loss from cancer of the breast, skin, colon and prostate and is the leading cause of death in the younger age groups–15-24 and 25-44 years.
Suicide may be sudden but it is often the result of a complex interaction between several risk and self-protective factors that may stretch back to childhood. Poor problem-solving skills or perfectionism can aggravate the effects of risk factors.
Family history, past or current mental problems, low coping skill potential and aggression are common individual risk factors. In Australia the risk factors include indigenous status, isolation, remoteness and ready access to lethal means of suicide.  An individual’s societal domain adds another dimension to the propensity for suicidal ideation.
The number of Australians who contemplate suicide dwarfs the numbers who go through with it. A National survey of Mental Health and Wellbeing found up to 150 times more people with in a 12-month history of suicidal thoughts, and even attempts, than the number of actual suicides. Suicidal prevalence, in contrast to actual suicides, is significantly higher in women than men (about 500:100), whereas one quarter of the 2,522 actual suicides in Australia were among women. Australian hospitalisation rates for intentional self-harm somewhat mirror this trend, with rates for females at least 40% higher than for mails.
Some self-harm may be attention-seeking, which suggests that analysis of suicide methods could shed more light on why rates of actual suicide are higher for men. More than half of suicides in Australia result from hanging, which is lethal 70% of the time.
Poisoning (except with gas) accounts for almost one-third of deaths and ranks second as a cause of premature death. It is the preferred method amongst women but is lethal 1.5% of the time. Exposure to poisoning accounted for over 80% of hospitalisation for intentional self-harm. That poisoning is the preferred method of self-harm among females - especially younger ones - could suggest that this method of attempting suicide is responsible for significantly lower suicide rates among women than males.
Australian suicide rates for men differ by birth cohort. For the under-30 age group, Generation X (born 1966-1975) had the highest rates, followed by Baby Boomers (born 1946-1965) and Generation Y (born 1976-1985). The rates for those born from 1986 to 1994 are closer to the generations born before 1946 and are thus below the rates of the three previous generations.
Socioeconomic status is also a contributor; the male suicide rate is about 50% higher for the most disadvantaged quintile compared to the least disadvantaged quintile. For females, the pattern was less clear. Remote areas of Australia experience almost twice as high a suicide rate as major cities.
Suicide is the last resort for those with fragile mental health and who cannot cope. Much like in other countries, Australia’s life insurance industry suffers from worsening morbidity experience because of mental health problems.
As a society - as we have more and more public conversations around this issue; and the traditional stigma associated with mental health slowly but surely fades away; it is perhaps likely that we have in fact underestimated just how many of us are affected by mental health challenges.
What is the missing link in the conversation is it the interrelation of religion and/or spirituality with our mental health and how we can harness this resource to positively influence our mental health and emotional wellbeing.
Religion and/or spirituality is an important source of strength for many people who experience life challenges, including mental health issues.
The 2016 Australian Census showed that 52% of the population reported Christian religion affiliations. Non-Christian religions represented about 8% of the population. The 2016 Australian census also recorded that the combined number of people who self-identified as Muslim in Australia, from all forms of Islam, constituted 2.6% of the total Australian population. About 39% of the population stated they had no religion or did not state their religion. 
Religion or faith-based affiliation is a significant expression for over 60% of Australians, therefore a conversation about religion and/or spirituality and its associated outcomes for mental health are overdue. Religion and/or spirituality provide an individual with a sense of connection to something bigger than self and how one fits in with the world. It also creates a sense of community and connectedness, and gives the individual a sense of purpose and hope. These are protective factors for mental health and have positive affects on the individual’s wellbeing.
Although there are many documented positive affects of religion and/or spirituality on the overall health and wellbeing of an individual, there is no denying that the religion and/spirituality is expressed differently depending on the individual belief system which is influenced by many factors including cultural factors. This differing belief system can also be detrimental to people’s own health and wellbeing. For example, people who believe that prayer and/or meditation alone will cure their mental health issues are not likely to present voluntarily at a mental health service for care and support. Some individuals would choose different forms of spiritual cleansing, such as exorcism over cognitive behaviour therapy and other evidence-based therapies any day.
There is also an increasing stigmatisation of mental health issues in the faith-based communities, including the belief lack of prayer and faith or sin causes that mental illness; sometimes it is the belief that the evil spirit has influence on the individual experiencing a mental health crisis. This belief system is likely to lead to people being disconnected from communities of support and service providers, resulting in a decline in people’s mental health.
Religion and/or spiritual interventions and mental health care and support are not supposed to be mutually exclusive but must interface and align to enable the flourishing of the whole of the person and challenge understanding on perceptions of mental health issues.
My belief is that as long as the mental health sector; and the messaging around mental health and suicide prevention miss this; I fear many people will simply choose to continue to just “pray about it” rather than a combination of prayer or meditation and professional mental health care. Similarly, in cases of individuals faced with severe illnesses such as cancer; We can observe this in evidence of increased mortality where individuals embrace alternative therapies at the exclusion of conventional medicine when often the best outcomes are seen by those who incorporate both in combination.
There is no doubt that religion and/or spirituality forms a part of the individual’s core understanding of the world they live in and how they interact with it and others. Most poignant with this is the application of religion and or/spirituality as a coping mechanism for people from ethnic communities, which bring enormous implications in relation to explanatory models of mental health issues, service access and treatment.
Mental Health is such a challenging issue, we must identify and utilise every possible tool at our disposal in a collaborative sense so that no one is left behind, no one feels isolated and no one ever feels the need to choose faith and/or spirituality over professional mental health care and support. As unlikely bedfellows as it seems, they are not meant to be mutually exclusive.