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: