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Suicide among emergency service workers: a retrospective mortality study of national coronial data, 2001–2017

Published online by Cambridge University Press:  08 September 2022

Katherine Petrie*
Black Dog Institute, School of Medicine, University of New South Wales, Randwick, NSW, 2031, Australia School of Psychiatry, University of New South Wales, Sydney, NSW, 2000, Australia
Matthew Spittal
Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
Stephanie Zeritis
Black Dog Institute, School of Medicine, University of New South Wales, Randwick, NSW, 2031, Australia
Matthew Phillips
Black Dog Institute, School of Medicine, University of New South Wales, Randwick, NSW, 2031, Australia
Mark Deady
Black Dog Institute, School of Medicine, University of New South Wales, Randwick, NSW, 2031, Australia
David Forbes
Department of Psychiatry, Phoenix Australia Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne, VIC, 3010, Australia
Richard Bryant
School of Psychology, University of New South Wales, Sydney, NSW, 2000, Australia
Fiona Shand
Black Dog Institute, School of Medicine, University of New South Wales, Randwick, NSW, 2031, Australia
Samuel B. Harvey
Black Dog Institute, School of Medicine, University of New South Wales, Randwick, NSW, 2031, Australia
Author for correspondence: Katherine Petrie, E-mail:



Emergency service workers (ESW) are known to be at increased risk of mental disorders but population-level and longitudinal data regarding their risk of suicide are lacking.


Suicide data for 2001–2017 were extracted from the Australian National Coronial Information Service (NCIS) for two occupational groups: ESW (ambulance personnel, fire-fighters and emergency workers, police officers) and individuals employed in all other occupations. Age-standardised suicide rates were calculated and risk of suicide compared using negative binomial regression modelling.


13 800 suicide cases were identified among employed adults (20–69 years) over the study period. The age-standardised suicide rate across all ESW was 14.3 per 100 000 (95% CI 11.0–17.7) compared to 9.8 per 100 000 (95% CI 9.6–9.9) for other occupations. Significant occupational differences in the method of suicide were identified (p < 0.001). There was no evidence for increased risk of suicide among ESW compared to other occupations once age, gender and year of death were accounted for (RR = 0.99, 95% CI 0.84–1.17; p = 0.95). In contrast, there was a trend for ambulance personnel to be at elevated risk of suicide (RR = 1.41, 95% CI 1.00–2.00, p = 0.053).


Whilst age-standardised suicide rates among ESW are higher than other occupations, emergency service work was not independently associated with an increased risk of suicide, with the exception of an observed trend in ambulance personnel. Despite an increased focus on ESW mental health and wellbeing over the last two decades, there was no evidence that rates of suicide among ESW are changing over time.

Original Article
Copyright © The Author(s), 2022. Published by Cambridge University Press

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