Suicide and intentional self-harm hospitalisations among First Nations people

Background

Reducing deaths by suicide and suicidal behaviour among Aboriginal and Torres Strait Islander (First Nations) people is an issue of major concern for many First Nations communities and a public health priority for all Australian governments (Australian Government 2022). By using data about suicide deaths and intentional self-harm among First Nations people, prevention strategies can be better targeted to reduce suicide deaths.

Understanding the complexity and interrelationship between protective and risk factors for suicide among First Nations communities is important in designing culturally appropriate and relevant suicide prevention programs and policies. This is because concepts of wellbeing among First Nations people are shaped by factors such as historical events, community values and cultural beliefs, all of which interact and protect from or increase the risk of suicide. See Protective and risk factors for suicide among Indigenous Australians for more information.

Suicide among First Nations people

Suicide data on this page are reported for New South Wales, Victoria, Queensland, Western Australia, South Australia and the Northern Territory (6 jurisdictions) unless otherwise stated. First Nations people living in these 6 jurisdictions make up 96% of the First Nations population in Australia (ABS 2023). Data for Tasmania and the Australian Capital Territory have been excluded (see Technical notes on the Australian Bureau of Statistics (ABS) website for further information).

In 2023:

• suicide accounted for 5.2% of all deaths among First Nations people, representing 7.1% of all male deaths and 3% of all female deaths.
• after adjusting for age, First Nations males experienced 3.5 times the rate of suicide deaths compared with First Nations females (48.5 and 13.8 suicide deaths per 100,000 population, respectively).
• both First Nations males and females experienced suicide deaths at a higher rate than non-Indigenous Australians. After adjusting for age, the rate of death by suicide for First Nations males was 2.9 times that of non-Indigenous males and 2.6 times for First Nations females compared with non-Indigenous females.

Longer-term trends

Between 2011 and 2021, age-standardised rates of suicide among First Nations people ranged from a low of 16.9 deaths per 100,000 population in 2012 to a high of 25.7 per 100,000 in 2020.

Overall, the rate of suicide among First Nations people has been trending upwards. This increase reflects both improvements in the identification of First Nations people in deaths data, which the ABS has been implementing since 2015 (ABS 2024), as well as an actual increase in suicide rates in the community.

Death by suicide across age groups among First Nations people

Suicide contributes to premature mortality in First Nations people, especially in younger age groups. Between 2019 and 2023:

• among First Nations people, the percentage of all deaths that were deaths by suicide was highest for younger age groups. For those aged 0–24 years and 25–44 years, 1 in 5 deaths (20.7% and 20.4%, respectively) were by suicide. For 45–64 year olds, it was 2.9% and for those aged 65 years and older, 0.2% of deaths were by suicide
• the rate of suicide deaths per 100,000 population among First Nations people was highest among 25–44 year olds (49.3 deaths per 100,000 population). This was followed by 45–64 year olds (26.3), 0–24 year olds (13.9) and those aged 65 and over (7.9)
• among First Nations people aged 0–24 and 25–44, suicide rates were around 3 times as high (2.8 and 3.2, respectively) compared to non-Indigenous Australians of the same age
• non-Indigenous Australians aged 65 years and over experienced a higher suicide rate compared to First Nations people of the same age (12.7 and 7.9 deaths per 100,000 population, respectively)
• the proportion of all deaths that were deaths by suicide was higher among First Nations people aged 0–24 years compared to non-Indigenous Australians aged 0–24 years (20.7% and 16.4% respectively). However, in all other age groups, suicide accounted for a higher proportion of total deaths among non-Indigenous Australians compared to First Nations people.

State and territory suicide rates among First Nations people

Suicide rates for First Nations males were higher than for First Nations females in all 6 jurisdictions. Between 2019–2023, within each state and territory, the suicide rate for First Nations males was 2.4 to 3.4 times that of First Nations females.

Between 2019–2023, across the 6 jurisdictions, the highest suicide rate among First Nations males was for those living in Western Australia (53.6 per 100,000), followed by the Northern Territory and Victoria (48.4 and 48.3 respectively). First Nations males living in New South Wales had the lowest suicide rate for males (34.0 per 100,000) out of all 6 jurisdictions.

The highest suicide rate among First Nations females was for those living in the Northern Territory (20.3 per 100,000). This was followed by females living in Victoria (18.9). Like First Nations males, the lowest suicide rate among First Nations females was for those living in New South Wales (9.9 per 100,000).

Intentional self-harm hospitalisations among First Nations people

During 2023–24:

• There were 2,648 hospitalisations for intentional self-harm among First Nations people, which was a rate of 259 per 100,000 population.
• The highest rate of hospitalised intentional self-harm among First Nations people was for females aged 15–19 years (748 hospitalisations per 100,000 population), followed by First Nations females aged 25–29 years (638 hospitalisations per 100,000 population).
• The highest rate of hospitalised intentional self-harm among First Nations males was in the 40–44 year old age group (412 hospitalisations per 100,000 population), followed by 30–34 years (379 per 100,000 population) and 25–29 years (371 per 100,000 population).

How have rates of intentional self-harm hospitalisations changed for First Nations people?

From 2016–17 to 2023–24:

• the rate of hospitalisations for intentional self-harm among First Nations people decreased overall from 314.0 to 259.4 hospitalisations per 100,000 population (from 2,849 to 2,648 hospitalisations).

Rates of hospitalisation for intentional self-harm decreased from 2016–17 to 2023–24 for both females and males.

From 2016–17 to 2023–24:

• Rates of intentional self-harm hospitalisations among First Nations females decreased from 383.4 to 325.2 hospitalisations per 100,000 population (from 1,736 to 1,654 hospitalisations).
• Rates for First Nations males decreased from 244.9 to 193.8 hospitalisations per 100,000 population (from 1,113 to 993 hospitalisations).
• The largest change in rate of intentional self-harm hospitalisations was among First Nations females aged 15–19 years. For this group, the rate of hospitalisations declined overall from 1,093.9 to 747.6 hospitalisations per 100,000 population (from 467 to 380 hospitalisations).
• Rates of intentional self-harm hospitalisations also decreased overall among First Nations females aged 30–34 years (634.3 to 381.5 hospitalisations per 100,000 population) and First Nations females aged 35–39 years (576.8 to 420.3 hospitalisations per 100,000 population) (from 186 to 137 and from 149 to 126 hospitalisations, respectively).
• The largest overall change in rate among First Nations males was among those aged 45–49 years (460.1 to 272.6 hospitalisations per 100,000 population) (from 111 to 63 hospitalisations).

Impact on health and life expectancy for First Nations people

The following is an overview of the estimated impact of suicide among First Nations people, from AIHW’s Australian Burden of Disease study (see Australian Burden of Disease Study: impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2018).

Suicide and self-inflicted injuries were the second highest cause of total years of life lost (YLL) among First Nations people, second to coronary heart disease across all three data years. In 2018, there was approximately 10,800 YLL for suicide and self-inflicted injuries, an increase of around 2,400 years since 2011 (8,400 YLL) and 4,100 years since 2003 (6,700 YLL).

Among First Nations men, suicide and self-inflicted injuries were the second highest cause of YLL, after coronary heart disease. Approximately 8,000 years of life were lost to suicide and self-inflicted injuries in 2018, compared to around 5,900 YLL in 2011 and 5,400 YLL in 2003.

In 2018, approximately 2,800 years of life were lost due to suicide and self-inflicted injuries among First Nations women. Though suicide and self-inflicted injuries were the second leading cause of YLL in both 2018 and 2011, they were the sixth leading cause of YLL among First Nations women in 2003.

Among all First Nations people who died by suicide and self-inflicted injuries, an average of around 55 years of life were lost in 2018, 2011, and 2003.

Among First Nations men, the average YLL per death by suicide and self-inflicted injuries was 55 in 2018 and 2011 and 56 in 2003. Among First Nations women, the average YLL per death by suicide and self-inflicted injuries was 57 in 2018 and 2011 and 58 in 2003.

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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
• Illness and injury – Behavioural risk factor burden for suicide and self-inflicted injuries – Australian burden of disease study 2022
  
  

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