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Self-poisoning by older Australians

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Improving mental care for people over 65 must be a priority

In this issue of the MJA, important data on self-poisoning by older people presenting to the Hunter Area Toxicology Service (HATS) over a 26-year period are reported.1 It is firstly to be recognised that these data are the result of the enormous effort involved in maintaining a database over a period of that length. They are clearly of interest to specialists in the field of toxicology, but the data will also attract much broader interest. Suicide rates among men in Australia aged 85 or more were the highest for any age group throughout the period of study.2 Further, self-poisoning remains one of the most common methods employed. This report is therefore very interesting, and may provide clues about how to respond to this major, but often hidden, public health challenge.

The study by Pillans and co-authors found that only 3.6% of all toxicology presentations to HATS were by people over 65.1 However, the importance of this group of patients lies in the fact that overdoses in older people were associated with longer admission times, and greater likelihood of admission to an intensive care unit, need for artificial ventilation, and death (3.8% of older patients died, compared with 0.6% of those under 65). These findings are consistent with long term experience that…