Suicide & self-harm monitoring: Intentional self-harm hospitalisations

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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.

What are the sources of data on intentional self-harm?

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).

Improving self-harm data

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.

National survey data

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.