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Suicide, self-harm and mental health

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Key points What are suicide and intentional self-harm? Mental health and suicide Mental and behavioural disorders as an associated cause of deaths by suicide Mental health and self-harm Where can I find more information?

Key points

Mental illness is a risk factor for both suicide and intentional self-harm.

The majority of people who die with mental illness do not die by suicide.

Of the people who died by suicide in Australia in 2023, 64% had a mental and behavioural disorder recorded as an associated cause of death.

The AIHW respectfully acknowledges those who have died or have been affected by suicide or intentional self-harm. We are committed to ensuring our work continues to inform improvements in both community awareness and prevention of suicide and self-harm

The National Suicide and Self-harm Monitoring System has been established as part of the national effort to address suicide and self-harm in Australia. The system will improve the quality, accessibility and timeliness of data on deaths by suicide, self-harm and suicidal behaviours. It aims to provide a better understanding of suicide and self-harm in Australia. For more information, refer to Suicide & self-harm monitoring.

What are suicide and intentional self-harm?

Suicide is an action taken to deliberately end one’s own life, while intentional self-harm is deliberately causing physical harm to oneself with or without the intention of dying.

In 2023, there were 3,214 deaths by suicide in Australia – an average of about 9 per day. The age standardised rate was 11.8 deaths per 100,000 population, down from 13.2 in 2019 (AIHW 2024c).

In 2024, Suicide and self-inflicted injuries was the second leading cause of fatal burden among all Australians, with an estimated 159,800 years of life lost (AIHW 2024a).

In Australia, there were close to 24,800 intentional self-harm hospitalisations in 2022–23 (AIHW 2024b). For further information and data, refer to Suicide & Self-harm monitoring.

Mental health and suicide

Mental illness is a risk factor for suicide – people who have a current or previous diagnosis of mental illness are at greater risk of suicide than those without such a diagnosis (Too et al. 2019; Moitra et al. 2021). In particular, psychotic disorders, mood disorders and personality disorders produce a higher risk of suicide (Too et al. 2019).

While mental illness is a risk factor, it is one of many factors associated with suicide risk and is not a sufficient cause of suicide (Mishara and Chagnon 2011). Most people who die with mental illness do not die by suicide. Even when considering shortened life expectancy among people with severe mental illness, suicide accounts for a minority of premature deaths (14%), the bulk of premature deaths being attributed to comorbid physical health conditions (78%; Lawrence et al. 2013).

Suicide is not a direct consequence of mental illness; rather, suicide is a complex multi-causal behaviour that can involve personality characteristics, cultural components and – importantly – stressful life events and circumstances (Rihmer 2011). Among patients with depressive disorders, for example, early negative life events (such as parental loss, emotional, physical or sexual abuse), permanent adverse situations (such as unemployment, isolation, separation) and acute psychological stressors (such as the death of a loved one or a financial disaster) are among the most clinically useful indicators of suicide risk (Rihmer 2011). These historical life factors – sometimes termed psychosocial risk factors – are important in trying to understand the complex determinants of suicide. For more information on psychosocial risk factors and other risk factors for suicide, refer to Suicide & self-harm monitoring.

The National Study of Mental Health and Wellbeing (NSMHW) 2020–2022 collected data on the lived experience of suicide. It found that among people aged 16–85 years:

  • an estimated 17% (3.3 million people) had experienced suicidal thoughts or behaviours in their life
  • an estimated 3% (644,600 people) had experienced suicidal thoughts and behaviours in the previous 12 months. Of these people, 75% had a 12-month mental disorder (meaning they had met the diagnostic criteria for having a mental disorder in their lifetime and had sufficient symptoms of that disorder in the 12 months prior to the study) (ABS 2023).

Psychological distress

There is an established link between suicidality and psychological distress (Rainbow et al. 2021; Junus and Yip 2023). Psychological distress describes a state of emotional anguish associated with stressors that are difficult to cope with in daily life (Arvisdotter et al. 2016). It includes nervousness, agitation, psychological fatigue, hopelessness and depression. Among Australians aged 16–85 years, 17% experienced high or very high levels of psychological distress according to the NSMHW 2020–2022 (ABS 2023).

Importantly, someone experiencing psychological distress will not necessarily be experiencing mental illness, although high scores on the Kessler 10 Psychological Distress Scale (commonly used to measure psychological distress in both research and clinical settings) are correlated with the presence of depressive or anxiety disorders (Andrews and Slade 2001).

For more information on psychological distress, refer to Suicide & self-harm monitoring. Further information and data on psychological distress can also be found at Prevalence and impact of mental illness.

Mental and behavioural disorders as an associated cause of deaths by suicide

In Australia, of those people who died by suicide in 2023, 64% had a Mental and behavioural disorder recorded as an associated cause of death (ABS 2024). More specifically, 38% had Mood [affective] disorders listed as an associated cause of death, making this the most common risk factor that investigative processes listed as present in the lives of people who died by suicide that year (see below for more information). Anxiety and stress-related disorders were found to be the 5th most common risk factor, and substance use disorders were also found to be amongst the most common risk factors (Figure SSHM.1).

The Australian Bureau of Statistics (ABS) codes causes of death from information contained on the National Coronial Information System (NCIS), including police, pathology, toxicology and coroner reports. As part of the investigation for a suicide, risk factors are often mentioned in these reports. For suicide, risk factors can include mental health conditions, lifestyle factors and/or chronic diseases that can interact and increase the 'risk' of suicide.

Circumstances relating to a suicide are multifaceted and complex. It is often a combination of multiple factors rather than a single factor that contribute to a person dying by suicide. Risk factors should not be considered in isolation. While a risk factor may have been present for a person who died by suicide, it may not have been a direct cause. For further information and data on suicide risk factors as a cause of death, refer to Australian Bureau of Statistics – Risk factors for intentional self-harm (Suicide) in Australia.

Figure SSHM.1 Most common risk factors listed as an associated cause of death for people who died by suicide in 2023

Top risk factors listed for people who died by suicide in Australia in 2023, by proportion

Note that multiple risk factors can be listed for each person who died by suicide. In 2023, the average number of risk factors listed per person who died by suicide was 4.

Source: ABS (2024) external link | Data source overview

Mental health and self-harm

The 2020–2022 NSMHW estimated that 9% of Australians (1.7 million people) aged 16–85 years had self-harmed in their lifetime and 2% (342,100) had self-harmed in the previous 12 months (ABS 2023).

Mental illnesses, particularly depression, anxiety and substance use disorders, commonly co-occur with self-harm (Hawton et al. 2013; Kiekens et al. 2018). A systematic review of mental illness in patients presenting to hospital following self-harm found that more than 80% of adolescents and adults who intentionally self-harm have a mental illness (Hawton et al. 2013). Many people who intentionally self-harm do not go on to die by suicide. At the same time, self-harm is a strong predictor of future self-harm and suicide (Townsend et al. 2016). For more information and data on self-harm, refer to Suicide & self-harm monitoring: Intentional self-harm hospitalisations.

Where can I find more information?

More information and data – including specific population and demographic data in relation to suicide and intentional self-harm – can be found at Suicide & self-harm monitoring.

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Content advisory

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Caution: Some people may find parts of this content confronting or distressing.

Please carefully consider your needs when reading the following information about suicide and self-harm. If this material raises concerns for you contact Lifeline on 13 11 14, or see other ways you can seek help.

The information included here places an emphasis on data, and as such, can appear to depersonalise the pain and loss behind the statistics. The AIHW acknowledges the individuals, families and communities affected by suicide each year in Australia.

The AIHW supports the use of the Mindframe guidelines on responsible, accurate and safe suicide and self-harm reporting. Please consider these guidelines when reporting on statistics of suicide and self-harm.