Examining the chronicity of suicidal thoughts and behaviors among Australian males

PURPOSE: Research on chronic suicidal thoughts and behaviors (STB) in Australia is limited. This study aimed to determine the prevalence and identify predictors of chronic STB among Australian males. METHODS: A nine-year retrospective cohort study was conducted, analysing data from the first four waves of the Ten to Men Study. The study included 3,070 males who reported lifetime STB at Wave 1. Chronic STB was defined as the presence suicidal thoughts, plans, or attempts over subsequent waves. Modified Poisson and mixed-effects Poisson regression models were used to identify predictors. RESULTS: The prevalence of chronic suicidal thoughts and attempts were 34.5% and 13.6%, respectively, with an overall chronic STB prevalence of 37.2%. At Wave 2, depression (IRR = 1.59; 95% CI [1.28, 1.98]; P < 0.001), homosexuality (IRR = 1.50; 95% CI [1.06, 2.14]; P = 0.023), and alcohol use disorder (IRR = 1.21; 95% CI [1.01, 1.46]; P = 0.044) were significantly associated with chronic STB. Over nine years, depression (IRR = 2.57; 95% CI [2.05, 3.22]; P < 0.001), alcohol use disorder (IRR = 1.53; 95% CI [1.27, 1.85]; P < 0.001), disability (IRR = 1.43; 95% CI [1.12, 1.82]; P = 0.004), and marijuana use (IRR = 1.33; 95% CI [1.05, 1.67]; P = 0.016) were key predictors. CONCLUSION: Among Australian men who report lifetime STB, more than one in three experience chronic STB over a nine-year period. Depression, alcohol use disorder, disability, illicit substance use, and socioeconomic factors emerged as primary predictors. Further research is needed to explore intervention strategies addressing these factors.