Suicide and self-harm

Introduction

On average, more than 3,000 Australians lose their lives by suicide each year.¹ In 2021, 813 people in Queensland died from suspected suicide.² Each suicide is devastating to family, friends and the community—it is estimated that an additional 135 people are affected by each death.³

The Queensland Suicide Prevention Plan 2019­–2029,⁴ along with Better Care Together,⁵ focus on strengthening services to ensure that everyone can access the support they need, achieve positive mental health and wellbeing and live their lives with meaning and purpose. This will be achieved under four action areas:

1.    Building resilience. Improve wellbeing in our people and communities
2.    Reducing vulnerability. Strengthen support to vulnerable people
3.    Enhancing responsiveness. Enhance responses to suicidality
4.    Working together. Achieve more by working together.⁴

Suicide and self-harm burden

In 2022, 160,365 years of healthy life were lost due to suicide and self-harm injuries, making it the 7th leading cause of overall health burden in Australia. The age-standardised rate (ASR or standardised rate) of healthy life lost was 6.4 per 1,000 persons.⁶ The disease expenditure for suicide and self-harm injuries in 2019–20 in Australia was $259.7 million.⁷

Measurement

Information for suicide deaths was sourced from the Australian Institute of Health and Welfare (AIHW)¹ and the Suicide in Queensland annual report.² The AIHW describes suicide as “an action taken to deliberately end one’s own life, while intentional self-harm is deliberately causing physical harm to oneself but not necessarily with the intention of dying”.¹ Hospitalisation data from AIHW were used to describe intentional self-harm.¹

Suicide

Queensland Suicide Register

Information included in this section is from the Suicide in Queensland annual report developed by the Australian Institute for Suicide Research and Prevention at Griffith University. The annual report provides a summary of characteristics of Queensland residents who have died by suicide.² Results from the Queensland Suicide Register may differ to those reported by AIHW (see Technical notes).

In 2021, there were 813 suicide deaths (standardised rate 15.5 deaths per 100,000 persons) in Queensland.²

Demographic differences

In 2021, the Queensland standardised suicide death rate was 3.1 times higher in males (23.7 per 100,000 in males and 7.6 per 100,000 in females) (Figure 1).²

In 2021, standardised suicide death rates differed by age group. Suicide rates in adults 65 to 69 years were 4.6 times higher for males than females (20.6 per 100,000 persons for males and 4.5 per 100,000 persons for females). Standardised death rates were highest in the following age groups:

• Males: 20 to 24 (34.8 per 100,000 persons), 25 to 29 (33.2 per 100,000 persons) and 50 to 54 (39.0 per 100,000 persons).
• Females: 35 to 39 (10.8 per 100,000 persons), 45 to 49 (11.5 per 100,000 persons) and 50 to 54 (12.8 per 100,000 persons).²

Suicide rates in the younger age groups for males and females have varied over time with male rates showing higher variability.

Remoteness differences

In this report, Queensland’s geographic diversity is measured by remoteness.⁸

The suicide rates were highest for people living in very remote regions compared to major cities. In the 3-year period 2019–2021, the standardised rate of suicide deaths was (Figure 1):

• 27.4 and 24.4 per 100,000 persons in very remote regions and remote regions, respectively, compared to 12.8 per 100,000 persons in major cities
• Males: 1.6 times higher in remote regions compared to major cities (32.3 and 19.6 per 100,000 persons, respectively)
• Females: 2.4 times higher than women living in remote regions compared to major cities (15.5 and 6.4 per 100,000 persons, respectively).²

Results should be interpreted with caution due to small numbers.

Trends

While there has been some variability in standardised rates between years, trends in suicide deaths have been largely stable.

National suicide deaths

Information in this section was sourced from the AIHW National Mortality Database for suicide.¹

In 2021, there were 3,144 suicide deaths in Australia translating to a standardised rate of 12.0 per 100,000 persons.¹

Demographic differences

While national standardised rates of suicide deaths varied little from 2009 to 2021, rates were consistently higher among males than females. In 2021, suicide deaths were 3.0 times higher in males (18.2 per 100,000 in males compared to 6.1 per 100,000 in females).¹ This is consistent with the sex difference reported by the Queensland Suicide Register.

Remoteness and socioeconomic differences

Two measures that classify Australia’s geographic diversity are remoteness⁸ and the area-based index of relative socioeconomic advantage and disadvantage.⁹

The standardised suicide death rate was highest for people living in very remote regions compared to major cities, and those in the most disadvantaged area compared to least disadvantaged. Nationally in 2021, standardised suicide death rates were:

• 23.9 and 21.2 per 100,000 persons in very remote regions and remote regions, respectively, compared to 10.0 per 100,000 persons in major cities.¹ The difference between remote and very remote areas compared to major cities nationally was similar to the findings from the Queensland Suicide Register.
• 2.3 times higher in the most disadvantaged areas than in the least disadvantaged areas (18.4 compared to 8.1 per 100,000 persons, respectively).¹

Trends

While there has been some variability in standardised rates between years, trends in suicide deaths have been largely stable.

Figure 3: Suicide deaths, by age and sex, Australia, 2021

Note: This dashboard is developed and maintained by the Australian Institute of Health and Welfare.

Intentional self-harm

Data for this section were sourced from the AIHW National Hospital Morbidity Database for monitoring suicide and self-harm.¹

In 2020–21, the crude rate of hospitalisations for intentional self-harm in Australia was 116.3 per 100,000 persons. The rate for Queensland was 183.1 per 100,000 persons (Figure 4). While rates of intentional self-harm hospitalisation from 2008–09 to 2020–21 in Queensland were consistently higher than the national rate, AIHW do not report a significant difference.¹⁰

Demographic differences

Nationally, trends in hospitalisations for intentional self-harm have been consistently higher among females. In 2020–21, the crude hospitalisation rate per 100,000 persons was 1.9 times higher in females (152.5 hospitalisations in females compared to 79.0 in males) (Figure 4).¹

Hospitalisations for self-harm injuries were most common among the younger age groups. Intentional self-harm hospitalisation rates were highest in both the 0 to 24 and 25 to 44 age groups. Among males, rates were consistently highest among those in the 25 to 44 age group.

The crude hospitalisation rate in 2020-21 was:

• 0 to 24 years: 160.1 per 100,000 persons. It was 3.4 times higher in females than males (250.3 and 73.7 per 100,000 persons, respectively).
• 25 to 44 years: 136.8 per 100,000 persons. It was 40.7% higher in females than males (159.5 and 113.4 per 100,000 persons, respectively).¹

Hospitalisations for self-harm injuries have increased over time among younger females. From 2008–09 to 2020–21 (data not included in figure):

• females age 0 to 14 years: the rate of hospitalisations more than tripled (19.1 per 100,000 persons in 2008–09 and 70.5 per 100,000 persons in 2020–21).
• females age 15 to 19 years: the rate of hospitalisations nearly doubled (373.6 per 100,000 persons in 2008–09 and 697.7 per 100,000 persons in 2020–21).¹

Note: For children, especially those aged under 10, it is difficult to determine whether a self-inflicted injury was done with intent to self-harm.

Remoteness and socioeconomic differences

The crude rate of hospitalisations for intentional self-harm injury was highest in remote and very remote regions of Australia and in people living in the most disadvantaged areas.¹

Nationally in 2020–21, the crude rate of intentional self-harm hospitalisations was (Figure 4):

• 66.4% higher in very remote regions than major cities (177.5 and 106.7 per 100,000 persons, respectively)
• 50.6% higher in the most disadvantaged areas than in the least disadvantaged areas (134.8 and 89.5 per 100,000 persons, respectively).¹

Trends

The national rate of hospitalisations for self-harm injuries has been stable over time with a similar pattern for males and females.

Figure 5: Self-harm injuries, by age and sex, Australia, 2021

Note: This dashboard is developed and maintained by the Australian Institute of Health and Welfare.

Comparison of self-harm and suicide

While suicide deaths are more common among males, hospitalisations for intentional self-harm occur more frequently among females. Similar to Queensland, suicides deaths in Australia are 3.0 times higher in males compared to females. For intentional self-harm, females were hospitalised almost twice as often males (Figure 6).¹

When interpreting this figure please note difference on y-axis.

Additional information

Data and statistics

Additional suicide and self-harm information is available from:

• AIHW: Suicide and self-harm monitoring
• AIHW: Interactive data on disease burden from the Australian burden of disease study
• ABS: National Study of Mental Health and Wellbeing
• The Queensland Suicide Register: The Queensland Suicide Register (QSR).

Strategies and general information

• Everyday life: The Queensland Suicide Prevention Plan 2019-2029
• Better Care Together: A plan for Queensland’s state-funded mental health, alcohol and other drug services to 2027
• National Mental Health and Suicide Prevention Agreement
• Bilateral Schedule on Mental Health and Suicide Prevention: Queensland
• The Australian Government’s National Mental Health and Suicide Prevention Plan.

Section technical notes

Where presented, ratios were calculated using higher precision estimates than in text. Ratios calculated using estimates in text may differ.

Queensland Suicide Register includes suspected suicide deaths in years 2019 to 2021 which are routinely updated with coronial findings.² AIHW determine suicide deaths from the AIHW National Mortality Database and from the Australian Bureau of Statistics for cause of death. Unit records are provided to the Registries of Births, Deaths and Marriages and to the National Coronial Information System and include a cause of death coded by the Australian Bureau of Statistics.¹

Caution is advised when comparing suicide death rates between states and territories. This is because rates fluctuate over time, there are a small number of suicide deaths registered each year, and differences in the coronial process and data processing exist between the states and territories.¹

Different measures are reported for suicide and self-harm.

Please see the AIHW admitted patient care data quality statement provides additional information.

References

1. Australian Institute of Health and Welfare. 2023. Suicide and self-harm monitoring.
2. Leske S., Adam G., Catakovic A., Weir B. & Kolves K. 2022. Suicide in Queensland: annual report 2022. Australian Institute for Suicide Research and Prevention, World Health Organisation Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.
3. Cerel J., Brown M.M., Maple M., Singleton M., van de Venne J., Moore M. & Flaherty C. 2019. How many people are exposed to suicide? Not six. Suicide and Life-Threatening Behaviour. 49(2): 529–534. doi: 10.1111/sltb.12450.
4. Queensland Mental Health Commission. 2019. Every life. The Queensland suicide prevention lan 2019 - 2029.
5. Queensland Government. 2022. Better care together: a plan for Queensland’s state-funded mental health, alcohol and other drug services to 2027.
6. Australian Institute of Health and Welfare. 2022. Australian burden of disease study 2022. doi: 10.25816/E2V0-GP02
7. Australian Institute of Health and Welfafre. 2022. Disease expenditure in Australia 2019-20.
8. Hugo Centre for Migration and Population Research. 2018. Accessibility/remoteness index of Australia (ARIA). Accessibility/Remoteness Index of Australia (ARIA). Accessed: 1 October 2022.
9. Australian Bureau of Statistics. 2018. Socio-economic indexes for areas (SEIFA) 2016. 2033.0.55.001 - Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2016. Accessed: 1 October 2022.
10. Australian Institute of Health and Welfare. 2022. Suicide and self-harm monitoring. Intentional self-harm hospitalisations by states and territories.