Colin Tate: What is the general claims experience?

Simon Swanson: One in 13 claims is suicide… But we have a 13 month exclusion… So, the insured population is not the same as the general population… We don’t do experience investigations any more but we’re about to bring them back because we believe the insured population is going to have quite a different signature, so to speak, from the general population in this area.

Helen Hewett: We have to remember that not all suicide deaths are likely to be called suicide… I see lots of certificates where it says whether or not it’s suicide, and it will say ‘unknown’, even though it was a gun-shot wound to the head. I don’t think it would take Einstein to work out what it was.

But some of those claims, depending on the coroner, do not say suicide. The other important thing is, and I know this from a friend’s personal experience, that where it is most likely that the child took a deliberate overdose of drugs for example, but it’s not absolutely conclusive, for of the parents or the family they do not write suicide. So the claims are understated.

Greg Bright: How do drugs, alcohol and mental health relate? Are there causal relationships and, if so, in which direction?

Dr Alex Wodak: I think most people working in the alcohol and drug field and even psychiatry would conclude that there are obviously cases where both theories can be demonstrated. That is where a primary alcohol and drug problem causes the secondary mental health problem. And where a primary mental health problem causes a secondary alcohol and drug problem.

In other words someone has a drinking problem and then gets depressed. Or alternatively someone’s depressed and then starts drinking out of control. So both exist. But I think most people would argue that what is much more common is for alcohol and drug problems to be the primary event and mental health problems to be the secondary event.

I’ll just deal with suicide and alcohol and drugs problems quickly… There’s a very high correlation between alcohol consumption and suicide. And it’s particularly high in young males, in rural areas. Alcohol is often present at the time of suicide. And often contributes to the suicide.

In terms of illicit drugs though, just the broad parameters for elicit drugs and death, in the late 1990s (drugs) were causing up to 10 per cent of deaths in certain young age groups, particularly in males in their late 20s to early 30s. So it was a substantial public health problem. This was when heroin availability was very high. There was a glut of heroin. And deaths from heroin reached over 1,000 in 1999 (in Australia). They’re now down to about 350 because of the shortage of heroin.

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