Suicide and intentional self-harm hospitalisations among regional and remote communities

Suicide by remoteness areas

About 28% of the Australian population live in regional and remote areas – areas outside Australia’s major cities. There are many positive aspects about living in regional and remote areas, including higher levels of life satisfaction compared with those in urban areas (Wilkins 2015), increased community interconnectedness and social cohesion, and higher levels of community participation, volunteering and informal support from their communities (Ziersch et al. 2009). However, Australians living in these areas face unique challenges due to their geographic isolation, and often have poorer health and welfare outcomes than those living in major cities.

For further information on how the statistics reported here were calculated see Technical notes.

Are people in regional and remote areas at greater risk of deaths by suicide?

From 2001 to 2023:

• The numbers of deaths by suicide were highest in Major Cities and fell as remoteness increased, while age-standardised suicide rates tended to increase with the increasing remoteness.
• Suicide rates for residents of Major Cities were the lowest of all 5 remoteness areas each year and remained relatively stable over the period (ranging from 9.2 deaths per 100,000 population in 2006 to 11.7 in 2001 and 2017).
• Suicide rates in Very Remote areas fluctuated between 2001 and 2023, with the lowest rate recorded in 2003 (17.6 deaths per 100,000 population) and the highest in 2007 and 2016 (29.1). The rate of suicide in Very Remote areas was 27.3 in 2001 and 21.0 in 2023. Fluctuations in rates are due largely to the small population and small numbers of deaths by suicide in these areas.
• Suicide rates for residents of Remote areas also fluctuated over the period, ranging from 10.6 deaths per 100,000 population in 2009 to 23.7 in 2022.
• Suicide rates in Inner Regional and Outer Regional areas were generally higher in the second half of the period, with lows of 11.4 and 12.1 deaths per 100,000 population, respectively, in 2006 and highs of 17.1 and 20.1, respectively, in 2019.
• The greatest proportion of deaths by suicide occurred in Major Cities and remained relatively stable at 61.3–66.7% over the period.

In 2023:

• The age-standardised suicide rate for residents of Major Cities (10.0 deaths per 100,000 population) was lower than the national rate of 11.8.
• Suicide rates for residents of all other remoteness areas were above the national rate.
• The rate for residents of Very Remote areas (21.0 deaths per 100,000 population) was 2.1 times that of the rate for residents of Major Cities (10.0); however, numbers of deaths were relatively small (40 deaths in Very Remote areas vs 1,985 in Major Cities).
• The proportion of deaths by suicide occurring in Major Cities in 2023 was 62.5%.

Intentional self-harm hospitalisations by remoteness areas

Understanding the geographical distribution of hospitalisations due to intentional self-harm based on patients’ area of usual residence (see Technical notes for more information) can help target suicide prevention activities to areas in need.

Do people in regional and remote areas experience higher rates of intentional self-harm hospitalisations?

In 2023–24:

• Residents of Very remote areas recorded a rate of 144 hospitalisations per 100,000 population, around 70% higher than that of residents of Major cities, which recorded the lowest rate (84 hospitalisations per 100,000 population).
• Over two-thirds of intentional self-harm hospitalisations were residents of Major cities (68%).
• Young people aged 15–19 had the highest rates of intentional self-harm hospitalisations in each remoteness area, with the exception of Remote for which 15–19 and 20–24-year-olds had equally high rates.
• The highest rate of intentional self-harm hospitalisations overall was in the 15–19 age group in Very remote areas (437 hospitalisations per 100,000 population), followed by 20–24-year-olds in Very Remote areas (345).

A similar pattern was seen with deaths by suicide as age-standardised suicide rates tended to increase with remoteness of place of residence.

How have rates of intentional self-harm hospitalisations changed for remoteness areas?

Between 2012–13 and 2023–24:

• Overall rates of intentional self-harm hospitalisations increased in Very remote areas from 2012–13 to 2021–22 (from 172 to 193 hospitalisations per 100,000 population) before declining to 144 in 2023–24.
• Rates fell in Inner regional areas (from 125 to 87, hospitalisations per 100,000 population) and Major cities (111 to 84) over this period.
• Rates initially increased in Outer regional areas from 136 hospitalisations per 100,000 population in 2012–13 to 170 in 2016–17, and then steadily decreased to 104 in 2023–24.
• The highest increases in rates of intentional self-harm hospitalisations occurred in those aged 25–29 in Very remote areas (191 hospitalisations per 100,000 population in 2012–13 to 257 in 2023–24.
• The largest decrease in rates of intentional self-harm hospitalisations was among the 35–39-year-old age group in Outer regional areas (from 256 hospitalisations per 100,000 population in 2012–13 to 132 in 2023–24).

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Supplementary tables

• Deaths due to suicide 2023 – National Mortality Database
• Hospitalisations for intentional self-harm 2023–24 – National Hospital Morbidity Database
  
  

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