Suicide & self-harm monitoring
Intentional self-harm hospitalisations
What is intentional self-harm?
Intentional self-harm is often defined as deliberately injuring or hurting oneself, with or without the intention of dying. Intentional self-harm comes in many forms, and affects people from different backgrounds, ages and lifestyles. The reasons for self-harm are different for each person and are often complex.
The term ‘intentional self-harm’ in the National Hospital Morbidity Database (NHMD) provides information on patients admitted to hospital for self-poisoning or self-injury, with or without suicidal intent – and therefore includes both suicide attempts and non-suicidal self-harming behaviours.
Most people who self-harm do not go on to end their lives – but previous self-harm is a strong risk factor for suicide. Therefore, monitoring of intentional self-harm is key to suicide prevention.
Understanding the scale of the problem of intentional self-harm in Australia is difficult because many cases of self-harm are unreported unless medical treatment is required.
- Only those patients admitted to hospital for intentional self-harm are currently routinely reported in national data sets.
- Presentations to hospital emergency departments relating to suicide attempts or intentional self-harm cannot be easily identified in the current national emergency department data collection.
- Data collections from general practitioners or mental health services do not routinely capture patients treated for intentional self-harm.
- Data are available from ambulance attendance records and national population surveys (see below).
Hospitalisations data for patients with intentional self-harm injuries includes those with and without suicidal intent. For further information see Technical notes.
The NHMD is the national source of hospitalisation data in Australia. Data on the patient’s diagnosis, interventions and ‘external cause’ (including intentional self-harm) are reported to the NHMD by all states and territories using the International statistical classification of diseases and related health problems, 10th revision, Australian modification (ICD-10-AM) and the Australian Classification of Health Interventions (ACHI). The World Health Organization’s Eleventh revision of the International Classification of Diseases (ICD-11) – yet to be adopted in Australia – has the capability to classify the intent of the external cause of an injury.
In recognition of the need for better data around suicide and self-harm, the AIHW is currently working with key stakeholders, including the Mental Health and Suicide Prevention Data Governance Forum and Emergency Department data custodians to develop a nationally consistent method to identify and collect data on suicide-related ED presentations.
A range of national surveys are conducted to provide information on intentional self-harm. These include, but are not limited to:
- The 2020–21 and 2021–22 National Study of Mental Health and Wellbeing provides lifetime prevalence estimates of mental disorders for Australians aged 16–85. The study collects information on suicidal thoughts and behaviours and self-harm (without suicidal intent).
- The Australian Child and Adolescent Survey of Mental Health and Wellbeing collects data on suicidal thoughts and behaviours and self-harm (without suicidal intent) for adolescents aged 12–17.
Hospitalisations data for patients with intentional self-harm injuries includes those with and without suicidal intent. For further information see Technical notes.
Intentional self-harm hospitalisations by sex
Rates of hospitalisations for intentional self-harm are higher for females
In 2023–24:
- two thirds of people hospitalised for intentional self-harm injuries were female (64%, or 15,409 hospitalisations)
- the rate of intentional self-harm hospitalisations was higher for females than males (115 compared with 65 per 100,000 population)
- the rate for females aged 0–14 years increased from 41 in 2019–20 to 71 per 100,000 population in 2021–22 and 2022–23, before decreasing to 56 per 100,000 population in 2023–24
- the rate for males aged 14 years and under has increased overall from 4.8 in 2008–09 to 7.2 per 100,000 population in 2023–24. However, out of all intentional self-harm hospitalisations among children 14 years and under (males and females), the proportion for males has decreased from 21% to 12%.
A higher rate of intentional self-harm among females is the opposite of what is seen in deaths by suicide, where rates are higher for males than for females (see Deaths by suicide over time). This may, in part, be due to differences between methods used by males and females – with males tending to use more lethal methods than females. In addition, females generally access more health services than males. For more details, see Patterns of health service use in the last year of life among those who died by suicide.
The bar chart shows the age-specific rates of intentional self-harm hospitalisations for males and females for specific age groups and all ages combined by year. Users can also view age-specific rates, numbers and the proportions of hospitalisations for intentional self-harm by sex for each age group and year from 2008–09 to 2023–24.
Intentional self-harm hospitalisations by age
Rates of hospitalisations for intentional self-harm are higher for young people
Between 2008–09 and 2023–24, the rates of intentional self-harm hospitalisations were consistently high for young people. The highest rates in 2023–24 were recorded for:
- females aged 15–19 years (405 per 100,000 population), followed by females aged 20–24 years (253 per 100,000 population).
The highest rates for males also occurred in these younger age groups but rates were at least 2-fold lower than those of females. For example, in 2023–24:
- the highest rates of self-harm hospitalisations were 114 per 100,000 population for males aged 15–19 and 20–24 years.
During 2008–09 to 2016–17, there was a steady increase in the rates for both males and females aged 15–19. Rates peaked again in 2020–21 and have since declined (see Suicide and intentional self-harm hospitalisations among young people).
Download data tables
Supplementary tables
Hospitalisations for intentional self-harm 2023–24 – National Hospital Morbidity Database