Self harm

• Overview of Aboriginal and Torres Strait Islander peoples cases
• Key risks
• Overview of non-Aboriginal cases
• Comparative patterns of injury

Definition of self harm

Self harm injury hospitalisations include injuries in suicide and attempted suicide, and self-inflicted injuries specified as intentional. These are divided into six subsets of ICD9 External Causes Codes. These subsets are assigned the following E-codes: E-code 950 (attempted suicide and self-inflicted poisoning by solid or liquid substances), E952 /.0 (attempted suicide and self-inflicted poisoning by motor vehicle exhaust gas), E953 /.0 (attempted suicide and self-inflicted injury by hanging), E955 /.0-.4 (attempted suicide and self-inflicted injury by firearms), E956 (attempted suicide and self-inflicted injury by cutting and piercing instrument) and E951, E952 /.1-.9, E953 /.1-.9, E954, E955 /.5-.9, E957-E959 (attempted suicide and self-inflicted injury by other/unspecified means).Criteria for assigning injuries to self harm categories vary from state to state and therefore the figures presented here should be considered as only an approximation of the level of self harm hospitalisation.

Overview of Aboriginal and Torres Strait Islander peoples cases

The principal methods of self harm leading to hospitalisation of Aboriginal and Torres Strait Islander peoples are presented in Figure 26.

Figure 26: Principal methods of self harm leading to hospitalisation in Aboriginal and Torres Strait Islander peoples, Australia (except NT), 1991/92.

Key risks

• Amongst Aboriginal and Torres Strait Islander peoples, those aged 15 to 39 have the highest rates of hospitalisation from self-inflicted injuries.
• The majority of cases of self-inflicted injury hospitalisation are females, accounting for 57 percent of cases.
• Aboriginal and Torres Strait Islander adults aged 15 to 44 have relatively high rates of self-inflicted injury hospitalisation from poison ingestion (191 per 100,000) and from cutting or piercing injuries (95 per 100,000).
• Aboriginal and Torres Strait Islander males are twice as likely to be hospitalised as a result of self-inflicted cutting or piercing injuries (60 per 100,000) than females (33 per 100,000).
• Aboriginal and Torres Strait Islander females aged between 15 and 44 are two and a-half times more likely to harm themselves by ingesting poison (271 per 100,000) than are Aboriginal and Torres Strait Islander males of the same age (106 per 100,000).

Overview of non-Aboriginal cases

The principal methods of self harm leading to hospitalisation of non-Aboriginals are presented in Figure 27.

Figure 27: Principal methods of self harm leading to hospitalisation in non-Aboriginal populations, Australia (except NT), 1991/92.

Comparative patterns of injury

Figure 28: Rate of self harm injury hospitalisation in Aboriginal and Torres Strait Islander peoples and non-Aboriginal populations, by age, Australia (except NT), 1991/92.

The proportion of self harm injuries inflicted by cutting and piercing in Aboriginal and Torres Strait Islander peoples (29 percent of cases) is about three times that in non-Aboriginals (10 percent of cases).

The overall age-adjusted rate (hospitalisations per 100,000 population) of hospitalisation as a result of self-inflicted cutting and piercing in Aboriginal and Torres Strait Islander peoples (46) was about six times the rate of the non-Aboriginal population (7).

Over the ages 15 to 44, the hospitalisation rate from cutting or piercing self-inflicted injuries in Aboriginal and Torres Strait Islander peoples was about seven to eight times that of non-Aboriginals.

In Aboriginal and Torres Strait Islander peoples, ingestion of poison as a means of causing self harm is less common (62 percent of cases) than in the non-Aboriginal population (81 percent of cases).

The age-adjusted rate (hospitalisations per 100,000 population) of hospitalisation as a result of self-inflicted poison ingestion in Aboriginal and Torres Strait Islander peoples (105) was almost twice the rate in the non-Aboriginal population (60).

Other methods of self harm resulting in hospitalisation (such as by firearms or hanging) were uncommon in both populations. This is because suicide attempts using these methods are more likely to lead to death rather than hospitalisation. Over the period 1990-92, suicide by hanging or by firearm accounted for 93 percent of all suicide deaths in Aboriginal and Torres Strait Islander peoples, more than double the corresponding percentage in the case of non-Aboriginal suicide deaths (Harrison and Moller, 1994).