Ambulance attendances, self-harm behaviours and mental health

The complete extent of non-fatal suicidal and self-harming behaviours in the community is unknown in Australia. Although, data on hospitalisations due to intentional self-harm provide an indication of the incidence of these behaviours in the community, only those with serious physical or mental health issues admitted for further treatment are included. In addition, clinical data from emergency departments (EDs) or primary health care services cannot currently capture those presenting with intentional self-harm or suicidal ideation in most jurisdictions. Many others will not seek medical treatment. An additional difficulty in determining the incidence of suicidal and self-harming behaviours in the community is that ICD-10 codes, used to classify morbidity in health datasets, cannot distinguish between different types of intentional self-harm (see Technical notes).

Clinical data from ambulance attendances have the potential to provide a more complete picture of suicidal and self-harming behaviours in Australia, and to identify opportunities for improved intervention or postvention—importantly—at a stage when further harm may be prevented.

The National Ambulance Surveillance System (NASS) is a world-first public health monitoring system providing timely and comprehensive data on ambulance attendances in Australia. The NASS is a partnership between Turning Point, Monash University and jurisdictional ambulance services across Australia. Through funding by the AIHW as a component of the National Suicide and Self-harm Monitoring Project, the NASS will collate and code monthly ambulance attendances data for participating states and territories for self-harm behaviours (suicidal ideation, suicide attempt, death by suicide, self-injury) and mental health.