Factors influencing suicide in older rural males: a review of Australian studies.

INTRODUCTION: Suicide remains an important public health issue in Australia, responsible for around 2500 deaths each year. Although suicide only accounts for around 1.7% of total mortality in Australia per year, 75% of suicide deaths are in males. This article reviews the factors contributing to suicide in older rural males in Australia and then categorises the papers into themes for ease of explanation. Living with experiences of drought, dramatic weather change, lower employment opportunities, out-migration, changing family dynamics, ageism in the community, economic change and competitive labour markets, all add to the diverse experience for an older person who is ageing in a rural setting.

METHODS: A literature search was conducted in March 2015, using the terms 'elderly' and 'older males' and then combined with 'rural', 'suicide' and 'Australia', to investigate the amount of research that has been conducted on the factors relating to suicide in older rural Australian males.

RESULTS: Reviewed articles consisted of research using either quantitative or qualitative approaches, which investigated suicide in older Australians published between 1950 and 2014. With strict adherence to the selection criteria, articles (21 in total) were removed because they were a literature review; a narrative review; they focused predominantly on youth or suicide risk, suicidal ideation or suicide attempts; or they discussed reasons for living. This article discusses the researcher's recommendations for further research into employment transitions for older Australian males, and the need to review policy change for further intervention in the future.

CONCLUSIONS: This article highlights factors that may cause older rural Australians to be placed at a higher risk of suicide than their urban-dwelling counterparts. With the impact of the changing economy, unpredictable climatic conditions and dynamic changes in rural Australian families, there is a need to highlight research that has been conducted in this area. Future research should focus on identification of misclassification of suicide deaths, investigation of the possible effect that retirement pathways may have on older Australian males, suicide prevention strategies, mental wellbeing and the risk of suicidal behaviour. This will ascertain any compounding or protective factors that could influence this current trend.