Intentional self-harm and suicide

< causes of Injury

Suicide is the leading cause of death for Australians aged 15–44 (AIHW 2022). Males have a higher rate of death by suicide than females, while females have a higher rate of hospitalisation due to intentional self-harm. Along with falls, intentional self-harm is one of the two major causes of hospitalisation for injury where females outnumber males.

Intentional self-harm and suicide resulted in:

This represents 5.1% of injury hospitalisations and 24% of injury deaths.

Determining if an injury was intentional is not always straightforward, especially when children are involved (see the technical notes). For this reason, statistics about hospitalisations due to intentional self-harm are presented here for children aged 14 and under as a group, and statistics about suicide are not presented for children aged under 10.

Causes of injury in hospitalisations for intentional self-harm

In 2020–21, 77% of intentional self-harm hospitalisations involved pharmaceutical drugs (Table 1).

Notes

1. Rates are crude per 100,000 population.
2. Percentages may not total 100 due to rounding.
3. Codes in brackets refer to the ICD-10-AM (11th edition) external cause codes (ACCD 2019).

Source: AIHW National Hospital Morbidity Database.

For more detail, see Data tables B27–28.

Causes of injury in deaths by suicides

In 2019–20, the most common cause of injury in deaths by suicide was hanging, strangulation and suffocation (Table 2).

Notes

1. Rates are crude per 100,000 population.
2. Percentages may not total 100 due to rounding.
3. Codes in brackets refer to the ICD-10 external cause codes (WHO 2011).

Source: AIHW National Mortality Database.

For more detail, see Data tables E39–41.

Seasonal differences

Hospitalisations due to intentional self-harm show some seasonal patterns. There are two peaks per year, around November and February/March.

The interactive display illustrates other seasonal variations in injury hospitalisations.

Figure 1: Seasonal differences in hospitalisations for intentional self-harm, 2018–19 to 2020–21

Notes

1. Admission counts have been standardised into two 15-day periods per month.

2. A scale up factor has been applied to June admissions to account for cases not yet separated.

Source: AIHW National Hospital Morbidity Database.

Trends over time

The age-standardised rate of hospitalisations due to intentional self-harm in 2020–21 was 4.4% higher than a year earlier.

Over the period from 2011–12 to 2016–17 there was an average annual increase of 2.6%. There is a break in the time series for hospitalisations between 2016–17 and 2017–18 due to a change in data collection methods (see the technical notes for details).

For deaths by suicide, the average annual increase in rate between 2010–11 and 2019–20 was 1.9% (Figure 2).

Figure 2: Hospitalisations for intentional self-harm and deaths by suicide, by sex, by year

For more detail, see Data tables C1–3 and F1–4.

Age and sex differences

Rates of hospitalisation and death from intentional self-harm injuries differed for males and females and across age groups (Figure 3). While rates of death by suicide are higher for males than females, intentional self-harm is one of the few causes of injury where rates of hospitalisation are higher for females than males.

For hospitalisations from intentional self-harm injuries in 2020–21:

• 2 in 3 were for females (66%)
• the age-standardised rates were:
  • 163 per 100,000 females and
  • 80 per 100,000 males
• females aged 15–24 (and those aged 15–19 in particular), had the highest rates.

For deaths by suicide in 2019–20:

• 3 in 4 were for males (76%)
• the age-standardised rates were:
  • 19 per 100,000 males and
  • 6.0 per 100,000 females
• people aged 45–64 had the highest rates, followed by people aged 25–44, compared with other age groups.

Figure 3: Hospitalisations for intentional self-harm and deaths by suicide, by age group and sex

For more detail, see Data tables A1–3 and D1–3.

Severity

There are many ways that the severity, or seriousness, of an injury can be assessed. Four measures of the severity of hospitalised injuries are:

• number of days in hospital
• time in an intensive care unit (ICU)
• time on a ventilator
• in-hospital deaths.

The average number of days in hospital for intentional self-harm was lower than that for all hospitalised injuries, but the percentages of self-harm cases that included time in an ICU or on continuous ventilatory support were the highest of all the main causes of hospitalised injuries. The rate of in-hospital deaths was higher than for all injuries (Table 3).

Note: Average number of days in hospital (length of stay) includes admissions that are transfers from 1 hospital to another or transfers from 1 admitted care type to another within the same hospital, except where care involves rehabilitation procedures.

Source: AIHW National Hospital Morbidity Database.

For more detail, see Data tables A13–15.

Aboriginal and Torres Strait Islander people

Among Aboriginal and Torres Strait Islander people:

• there were 2,800 hospitalisations due to intentional self-harm in 2020–21 (Table 4)
• females were 1.5 times as likely as males to be hospitalised due to intentional self-harm
• intentional self-harm hospitalisation rates were highest in the 15–24 age group (Figure 3)
• there were 211 deaths by suicide in 2019–20 (Table 5)
• males were 2.5 times as likely as females to die by suicide.

Note: Rates are crude per 100,000 population.
Source: AIHW National Hospital Morbidity Database.

Notes:

1. Rates are crude per 100,000 population.
2. Deaths data only includes data for New South Wales, Queensland, Western Australia, South Australia, and the Northern Territory.

Source: AIHW National Mortality Database.

Indigenous and non-Indigenous Australians

Indigenous Australians, compared with non-Indigenous Australians (after adjusting for the difference in population age structure), were:

• 2.9 times as likely to be hospitalised due to intentional self-harm in 2020–21 (Table 6 and Figure 3)
• 2.5 times as likely to die by suicide in 2019–20 (Table 7).

Notes

1. Rates are age-standardised to the 2001 Australian population (per 100,000).
2. ‘Non-Indigenous Australians’ excludes cases where Indigenous status is missing or not stated.

Source: AIHW National Hospital Morbidity Database.

Notes

1. Rates are age-standardised to the 2001 Australian population (per 100,000).
2. ‘Non-Indigenous Australians’ excludes cases where Indigenous status is missing or not stated.
3. Deaths data only includes data for New South Wales, Queensland, Western Australia, South Australia, and the Northern Territory.

Source: AIHW National Mortality Database.

The rate of hospitalisations for intentional-self harm was highest among the 15–24 life-stage age group for both Indigenous and non-Indigenous Australians (Figure 4). Deaths data are not presented because of small numbers.

Figure 4: Hospitalisations due to intentional self-harm by Indigenous status, by age group and sex, 2020–21

For more detailed data, see Data tables A4–6 and D4–6.

Remoteness

Compared to those living in other areas, people in Remote areas had the highest age-standardised rate of hospitalisation for intentional self-harm in 2020–21 (Table 8). People in Remote areas were 1.8 times as likely as people living in Major cities to be hospitalised due to intentional self-harm. People living in Very remote areas were 2.6 times as likely as people living in Major cities to die by suicide in 2019–20 (age-standardised) (Table 9).

Note: Rates are age-standardised per 100,000 population.
Source: AIHW National Hospital Morbidity Database.

n.p. Not publishable because of small numbers, confidentiality or other concerns about the quality of the data.
Note: Rates are age-standardised per 100,000 population.
Source: AIHW National Mortality Database.

The highest rate of intentional self-harm hospitalisations was among the 15–24 life-stage age group living in Remote areas of Australia. (Figure 5).

Deaths data are not presented because of small numbers.

Figure 5: Hospitalisations due to intentional self-harm by remoteness, by age group and sex, 2020–21

For more detail, see Data tables A7–9 and D9–10.

For information on how statistics are calculated by remoteness, see the technical notes.

Data details

Technical notes: how the data were calculated

Data tables: download full data tables

Glossary

< causes of Injury