Suicide and attempted suicide — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 39 of 2025

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting suicide and attempted suicide or death from suicide and attempted suicide with the circumstances of a person's relevant service:

1. (1)
   being a prisoner of war before clinical onset;
2. (2)
   having one of the following clinically significant disorders of mental health at the time of clinical onset: (a) acute stress disorder; (b) adjustment disorder; (c) alcohol use disorder; (d) anxiety disorder; (e) attention hyperactivity disorder; (f) bipolar disorder; (g) body dysmorphic disorder; (h) brief psychotic disorder; (i) conduct disorder; (j) depressive disorder; (k) eating disorder; (l) gender dysphoria; (m) obsessive-compulsive disorder; (n) oppositional defiant disorder; (o) panic disorder; (p) personality disorder; (q) phobic anxiety; (r) posttraumatic stress disorder; (s) schizoaffective disorder; (t) schizophrenia; (u) substance/medication-induced anxiety disorder; (v) substance/medication-induced psychotic disorder; (w) substance use disorder;

   Note: clinically significant disorder of mental health is defined in the Schedule 1 - Dictionary.

3. (3)
   experiencing a category 1A stressor before clinical onset;

   Note: category 1A stressor is defined in the Schedule 1 - Dictionary.

4. (4)
   experiencing a category 1B stressor before clinical onset;

   Note: category 1B stressor is defined in the Schedule 1 - Dictionary.

5. (5)
   having a person with whom one has a close family bond or a close personal relationship experience a category 1A stressor within the 2 years before clinical onset;

   Note: category 1A stressor is defined in the Schedule 1 - Dictionary.

6. (6)
   experiencing the death of a person with whom one has a close family bond or a close personal relationship, within the 5 years before clinical onset;
7. (7)
   experiencing the death of a parent within the 25 years before clinical onset, where the person was aged 18 years or younger at the time of the parent's death;
8. (8)
   experiencing the attempted suicide of a parent within the 25 years before clinical onset, where the person was aged 18 years or younger at the time of the parent's attempted suicide;
9. (9)
   experiencing the suicide of an individual of a similar age, with whom the person has a personal association such as a classmate, within the 5 years before clinical onset, where the person was aged 18 years or younger at the time of the associate's suicide;
10. (10)
    experiencing the death of a sibling due to suicide within the 15 years before clinical onset;
11. (11)
    experiencing a category 2 stressor within the 10 years before clinical onset;

    Note: A category 2 stressor can arise in a variety of circumstances connected with service. Such circumstances can arise during the course of service, as a result of separation from service and the conditions associated with that separation, and in the transition to civilian life in the years following separation.

    Note: category 2 stressor is defined in the Schedule 1 - Dictionary.

12. (12)
    being a perpetrator of bullying within the 5 years before clinical onset;
13. (13)
    having experienced as a child (under the age of 18) one of the following; (a) serious physical, emotional, or sexual harm; (b) neglect involving a serious failure to provide the necessities for health, physical and emotional development, or wellbeing by adults with obligations to provide such necessities; before clinical onset;
14. (14)
    performing a self-injurious act, within the 10 years before clinical onset;

    Note: Self-injurious acts may include cutting, burning, hitting or poisoning. The injury is done independently, without the aid of another person, and is severe enough for tissue damage (such as scarring) to result.

15. (15)
    having a medical illness or injury which has resulted in a severe level of disability at the time of clinical onset;

    Note: A person with a severe level of disability may need help with some or all activities of daily living (communication, mobility and self-care).

16. (16)
    having epilepsy at the time of clinical onset;
17. (17)
    having persistent pain, which is severe enough to interfere with daily living, for at least the 3 months before clinical onset;
18. (18)
    having failed an academic examination or other academic assessment within the 30 days before clinical onset;
19. (19)
    for persons 25 years of age and younger only, commencing a course of antidepressant therapy, or increasing or reducing the dose of antidepressant therapy, within the 8 weeks before clinical onset;
20. (20)
    taking any of the following medications within the 14 days before clinical onset; (a) angiotensin-receptor antagonists; (b) antiepileptics; (c) antipsychotics; (d) atomoxetine; (e) benzodiazepines; (f) beta-blockers; (g) bupropion; (h) clofazimine; (i) corticosteroids, other than topical steroids; (j) interferons; (k) isotretinoin; (l) montelukast; (m) opioid analgesics; (n) raltegravir; (o) varenicline; (p) zolpidem; (q) zopiclone;
21. (21)
    taking mefloquine or chloroquine within the 6 months before clinical onset;
22. (22)
    taking methylenedioxypyrovalerone (MDPV) or 4-iodo-2,5- dimethoxy-N-(2-methoxybenzyl)-phenylethylamine (25I-NBOMe) within the 12 hours before clinical onset;
23. (23)
    having a moderate to severe traumatic brain injury before clinical onset;
24. (24)
    having a concussion within the 5 years before clinical onset;
25. (25)
    undergoing bariatric surgery within the 10 years before clinical onset;

    Note: Examples of bariatric surgery include gastrojejunostomy, gastric stapling, vertical banded gastroplasty or gastrectomy with Roux-en-Y anastomosis.

26. (26)
    anticipating an imminent and permanent relocation, or the process of relocation, to a residential aged care facility at the time of clinical onset;
27. (27)
    experiencing a potentially morally injurious event within the 10 years before clinical onset;

    Note: potentially morally injurious event is defined in the Schedule 1 - Dictionary.

28. (28)
    experiencing intimate partner violence within the 1 year before clinical onset;

    Note: intimate partner violence is defined in the Schedule 1 - Dictionary.

29. (29)
    inability to obtain appropriate clinical management for suicide and attempted suicide before clinical worsening;

Aggravation-only factors: the factors in subsection 9(29) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.