Australia's rural localities face an increasing burden of death due to suicide (Hirsch, 2006). Those groups most vulnerable to suicide appear to be males, youth, farmers and Indigenous people. Data from the Queensland Suicide Register showed that, between 2005 and 2007, male suicide rates in remote areas (36.32 per 100,000) were significantly higher than male suicide rates in non-remote areas (18.25 per 100,000). Further research has also shown that the relative rate of male suicide in rural Queensland was 1.99 compared to rates in metropolitan locations (Kõlves et al, 2009). While the gap is widest between metropolitan and remote suicide rates and the rates highest among rural males, regional suicide rates are still higher and metropolitan rates and the rural female suicide rate is higher than the urban female suicide rate. The present report aimed to present a holistic examination of suicide in regional and remote Australia. It predominantly focused on the Queensland experience and has investigated a wide range of psychological, environmental and cultural factors, within this bound geographical context.

The ways in which suicide prevention initiatives can target different stages of the suicidal process have been described by Mann et al. (2005). These authors argue that suicidal ideation may stem from stressful life events and/or psychiatric disorders. These factors can be influenced through education and awareness programs, screening of individuals at risk, and various treatments. However, it must be noted that while the impacts of environmental factors, such as stressful life events, can sometimes be reduced, the events themselves may be unavoidable. Aspects of suicide prevention can focus on building resilience as a way to combat the impacts of these inevitable events. Once suicidal ideation is present, it can be detected by screening individuals at risk. Before ideation leads to a suicidal act, it can be targeted through treating issues such as underlying disorders and impulsivity, hopelessness and/or pessimism. Other suicide prevention initiatives may also limit access to suicide means and exposure to negative or harmful examples in the media. Australia was the one of the first countries to reflect upon the national and global evidence which recognised the devastating consequences of suicidal behaviours (Jenkins and Kovess, 2002; Department of Health and Ageing, 2008). Since the early 1990s, the Department of Health and Ageing has led the national approach for suicide prevention. The National Youth Suicide Prevention Strategy 1995-1999 was further expanded into the National Suicide Prevention Strategy (NSPS); a strategic plan to prevent suicide across the whole lifespan. In 2000, the Living Is For Everyone: A Framework for Prevention of Suicide and Self-harm in Australia (LIFE Framework) was launched. This was later evaluated and further development led to the release of the Living is For Everyone (LIFE) Framework (2007).

Indigenous populations have been recognised to have elevated rates of suicide in many countries around the world, including Australia. However, to date, comprehensive understanding of the complexities of suicides among persons of Aboriginal and/or Torres Strait Islander origin (in the report referred to as Indigenous populations or Indigenous Australians) has been limited due to scarce epidemiological evidence about its prevalence and specific factors that distinguish Indigenous suicides from those among non-Indigenous populations. This report aims to fill in this gap by providing an analysis of the incidence of suicide among the Indigenous population in Queensland, thereby increasing the understanding and awareness of the distinctive aspects of Indigenous suicide.

In 1973, A. Alvarez published the seminal and evocative work 'The Savage God: A Study of Suicide'. Inspired by his personal experiences of suicide, Alvarez sought to deconstruct the myriad myths which shrouded suicide at the time and delve into the reasons behind different suicidal performances. By looking at the act through various lenses, Alvarez sought to make sense of suicide; how something so destructive, so taboo, could also be something spoken about just like any other conversation topic, depending upon to whom you were speaking. Similarly inspired, in November 2010, the first Inter-Disciplinary.Net Global Conference on Suicide was held in Prague, Czech Republic. In an intimate conference arena, a group of people from various countries around the world, from many different backgrounds and possessing myriad lived experiences, tried to make sense of suicide.

A review of Aboriginal suicide prevention programs were conducted to highlight promising projects and strategies. A content analysis of gray literature was conducted to identify interventions reported to have an impact in reducing suicidal rates and behaviors. Most programs targeted the whole community and were delivered through workshops, cultural activities, or creative outlets. Curriculums included suicide risk and protective factors, warning signs, and mental health. Many programs were poorly documented and evaluations did not include suicidal outcomes. Most evaluations considered process variables. Results from available outcome evaluations suggest that employing a whole of community approach and focusing on connectedness, belongingness and cultural heritage may be of benefit. Despite the challenges, there is a clear need to evaluate outcomes if prevention is to be progressed.

Traditionally, suicides performed for reasons of love have been largely romanticised and more likely forgiven. This chapter compares the ways in which love, sex and suicide have been inscribed on female bodies in historical and modern times. Love suicides have predominantly concerned heterosexual love; the woman inspires the emotions, the man acts upon his desires. Consequently, religious and social theorists have warned about the dangers of love and the corresponding dangers of women. Without love, men were strong and certain, society ran smoothly. If men were made vulnerable when they loved a woman, women needed to be chaste and distant so as to become unlovable. They could not tempt men into desire; they could not positively react to male desire. This interplay between desire and denial has become a dangerous game for young women in the modern world illustrated by two teenage suicides in America. Love has been replaced with sex in meaning and in action. These suicides are not romanticised. Women have become vulnerable in a balance between shame and honour, reputation and reality. Socially-perceived goodness is considered to protect women from suicide - it appears that to lose one's goodness is to lose one's claim on life.

The grief following a suicide death has long been considered different to other forms of bereavement. One key feature of this difference is stigma which, in many societies and cultures, can leave the suicide bereaved isolated and disconnected from their community. Previous research examining the experiences of the suicide bereaved report feelings of being silenced-left both without a voice to articulate grief and without an audience to hear their stories. Facebook has occupied a somewhat dichotomous role within suicide research. Initially such social media was viewed with uncertainty, particularly as it remains difficult to ensure the safety of vulnerable people who disclose suicidal feelings in such open fora. This may be exacerbated by the fact that a person's number of Facebook 'friends' may advertise popularity but may not be indicative of their true connectedness to individuals or a community. However, the positive role Facebook can play in giving the suicide bereaved a voice in their grief-allowing them to tell their story-has been little examined. In remote communities, where access to traditional modes of help seeking can be limited by distance and lack of services, Facebook can be used positively to not only remain connected to others but also access information on services which can provide professional counselling and support. A case study in a remote Australian Aboriginal community demonstrates the ways in which Facebook has provided an accessible and valuable tool for an individual recently bereaved by suicide. By analysing the trajectory of the language used over time, and the way the story of grief was told, it can be seen that the use of Facebook facilitated healing and (re)connection to the community. This discourse opens up new ideas to the ways in which Facebook and other social media may be employed to better assist those experiencing grief, identify vulnerabilities and ensure greater connection to services at appropriate times for those who require them.

As examined previously, suicide in rural areas is affected by myriad factors, some of which are unique from the experience of suicide in urban areas. Chapter Two presented an analysis of contextual factors on an aggregated level. This is crucial when we assess suicide risk at an individual level, especially considering that suicide risk and protective factors differ depending on wider social, cultural and economic environments. Consequently, Chapter Three will continue with individual-level analyses, comparing risk factors in rural and urban areas of Queensland. It will also illustrate statistical analyses with four rural case studies. The aims of the quantitative analyses were: • To assess suicide predictors in rural and urban regions by comparing rural suicide to rural sudden-death, and urban suicide to urban sudden-death; and, • To compare the differences between rural suicide and urban suicide. This chapter will use information collected within the frames of the Australian Research Council Linkage Project (LP0562078) "Preventing suicide: A psychological autopsy study of the last contact with a health professional before suicide". This study used a case-control psychological autopsy study approach. The Psychological Autopsy (PA) method was applied when investigating completed suicides (study group) and sudden deaths (control group), aged 35+ years in QLD and NSW. The sudden death group included heart attacks, road traffic accidents (RTA) and other accidents, but excluded accidental overdoses, homicides and single vehicle RTAs. The PA obtained information from interviews with next-of-kin (NOK) and healthcare professionals about the deceased for both suicides and sudden deaths.

Australian social identity was traditionally grounded within its agricultural heritage. The 'farmer', be he primarily concerned with crops or livestock, not only provided the lynchpin of Australia's economy but his lifestyle also framed the ideals of masculinity which consequently became entrenched within Australia's culture. However, Australia's social identity has changed along with its economic reliance upon the farming industry and rural sector. The rural lifestyle, so idealised within Australian popular culture, is now increasingly marginalised in a country where the three-quarters of the population live in metropolitan areas (Australian Bureau of Statistics, 2006a), even though the majority of land is considered to be 'rural' (see also Alston, 2010). The once idealised rural lifestyle is also proving to be less ideal for those actually living it.

Suicide has long been constructed as a monstrous death within many societies. Its very existence challenges the social norms the majority of people presume to be acceptable; it leaves behind people questioning the reasons behind the choice. In this way, those who choose suicide have also been branded monsters - the most common of which is the belief that ghosts can arise from these deaths. Traditional Chinese stories of female suicide-related ghosts seemed to follow a distinct narrative trope involving rational, heroic men and irrational, villainous women. The ways in which stories of hungry ghosts were told speaks to the ways in which female suicide was understood and rationalised within traditional Chinese society. It also provides a demonstration of suicide prevention based within supernatural encounters. While the seriousness in which these stories were held is uncertain, they remain a colourful and potent source of suicide story-telling. By seeking to understand this mythology, we also begin to better understand the stigma and stereotypes that continue to attach to female suicide in modern rural China.