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Socio-economic differentials in mental disorders and suicide attempts in Australia

School of Public Health, University of Sydney, New South Wales

Greg Carter, MBBS, FRANZCP

Certificate in Child Psychiatry, Newcastle Mater Hospital and Faculty of Health, University of Newcastle, New South Wales

James Harrison, MBBS, MPH, FAFPHM

Research Centre for Injury Studies, Flinders University, Bedford Park, South Australia, Australia

Correspondence: Professor Richard Taylor, School of Public Health, Edward Ford Building, A27, University of Sydney, NSW 2006, Australia. Tel: +61 2 9351 5996, +61 2 9351 7420; e-mail: richardt{at}health.usyd.edu.au

Declaration of interest None.

Funding detailed in Acknowledgement.

Background Responses to mental disorders usually focus on treatment; socio-economic conditions are less likely to be considered.

Aims To examine social determinants of mental disorders and attempted suicide in Australia.

Method Data from the 1997 Australian National Survey of Mental Health and Wellbeing (n=10 641) were used to estimate associations between socio-economic status, mental disorders and attempted suicide. Logistic regression was used to adjust for age, urban/rural residence and country of birth. Socio-economic status differentials in suicide attempts were also adjusted for mental disorders.

Results Significant increasing gradients from high to low levels of education and occupational status (employed) were evident for affective disorders and anxiety disorders in both men and women and for substance use disorders in men. Similar gradients were found for suicide attempts, which decreased after adjusting for mental disorders, but remained significant in the working-age employed.

Conclusions These findings suggest social causation of mental disorders and suicide attempts, and the need for social and economic responses beyond provision of mental health services.

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