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Intentional self-harm, key characteristics

In 2017, in Australia, 3,128 people died from intentional self-harm (X60-X84, Y87.0) rising 9.1% from 2,866 in 2016. The preliminary standardised death rate for 2017 was 12.6 deaths per 100,000 persons (see graph below) and was equal with 2015 as the highest recorded preliminary rate in the past 10 years. This compares with a final rate of 10.9 suicide deaths per 100,000 persons in 2008. Intentional self-harm was ranked the 13th leading cause of death in 2017, moving up from 15th position in 2016.



Deaths from intentional self-harm occur among males at a rate more than three times greater than that for females. In 2017, the standardised death rate for males was 19.1 deaths per 100,000 males and represented 75.1% of all intentional-self harm deaths, while for females it was 6.2 deaths per 100,000 females (24.9%). Intentional self-harm is the 10th ranked leading cause of death for males, while suicide does not appear in the top 20 leading causes of death for females. However, the age-standardised suicide rate for females is the highest recorded preliminary rate in 10 years.



Suicide deaths by states and territories All states except for Tasmania, Victoria and South Australia recorded an increase in deaths due to intentional self-harm in 2017. Queensland reported the largest increase in suicide deaths (804 deaths in 2017 compared with 674 deaths in 2016). The Australian Capital Territory recorded the largest percentage increase (107.1%), with 58 intentional self-harm deaths registered in 2017 compared with 28 in 2016. New South Wales and Western Australia also recorded increases in deaths due to suicide. The table below displays a ten year times series of the number of intentional self-harm deaths by Australian jurisdictions.



Number of suicide deaths, State/Territory of usual residence, 2008-2017 (a)(b) 2008



No. 2009



No. 2010



No. 2011



No. 2012



No. 2013



No. 2014



No. 2015



No. 2016



No. 2017



No. NSW 620 623 674 617 727 718 832 829 805 880 Vic 545 576 558 526 514 533 658 668 624 621 Qld 553 525 588 578 631 676 658 757 674 804 SA 175 185 197 212 198 203 243 232 225 224 WA 300 279 313 309 367 336 367 400 371 409 Tas. 73 79 64 74 71 74 69 83 92 80 NT 38 37 45 44 48 33 56 49 46 51 ACT 36 32 41 33 24 37 38 46 28 58 Australia 2,341 2,337 2,480 2,393 2,580 2,610 2,922 3,065 2,866 3,128

Footnote(s):

(a) All causes of death data from 2006 onward are subject to a revisions process - once data for a reference year are 'final', they are no longer revised. Affected data in this table are: 2008-2014 (final), 2015 (revised), 2016-2017 (preliminary). See Explanatory Notes 57-60 in this publication. See also Causes of Death Revisions, 2014 and 2015 (Technical Note) in Causes of Death, Australia, 2016 (cat. no. 3303.0).

(b) Includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to suicide. See Explanatory Notes 91-100.



The table below presents a ten year time series of standardised death rates for states and territories. The Northern Territory recorded the highest rate of suicide per capita in 2017, at 20.3 deaths per 100,000 persons. Queensland accounted for 49.6% (130 deaths) of the overall increase in suicide deaths from 2016 to 2017, with rates increasing from 13.9 to 16.3 deaths per 100,000 persons. The rate of intentional self-harm deaths also increased in New South Wales and Western Australia with 10.9 and 15.8 deaths per 100,000 persons, respectively. The Australian Capital Territory represented the largest rate increase in intentional self-harm deaths, from 7.2 deaths to 14.1 deaths per 100,000, yet accounted for a smaller proportion of the total increase in suicide deaths at 11.5% (30 deaths) of the total increase in this period. Slight decreases in suicides rates were recorded for Victoria, South Australia and Tasmania (Please see data cube 11 on intentional-self harm in this publication for further information on suicide deaths by jurisdiction, including counts of suicide deaths).



Standardised death rates for suicide, State/Territory of usual residence, 2008-2017 (a)(b)(c) 2008



Rate(c) 2009



Rate(c) 2010



Rate(c) 2011



Rate(c) 2012



Rate(c) 2013



Rate(c) 2014



Rate(c) 2015



Rate(c) 2016



Rate(c) 2017



Rate(c) NSW 8.8 8.7 9.3 8.4 9.8 9.5 10.8 10.8 10.3 10.9 Vic 10.2 10.5 10.1 9.2 9 8.9 10.9 10.9 9.9 9.6 Qld 13.2 12.1 13.4 12.9 13.9 14.6 14 15.9 13.9 16.3 SA 11 11.5 11.8 12.9 11.7 11.9 14.4 13.2 13.3 12.8 WA 13.8 12.3 13.6 12.9 15 13.5 14.5 15.6 14.4 15.8 Tas. 15 15.4 13 14.1 13.7 14.2 12.8 16 17 15.6 NT 17.5 17.4 18.8 18.5 19.1 14.2 21.8 20.6 19.3 20.3 ACT 10.1 8.9 11.3 9.3 6.2 9.6 9.8 11.4 7.2 14.1 Australia 10.9 10.7 11.2 10.5 11.2 11.1 12.3 12.7 11.7 12.6 Footnote(s): (a) All causes of death data from 2006 onward are subject to a revisions process - once data for a reference year are 'final', they are no longer revised. Affected data in this table are: 2008-2014 (final), 2015 (revised), 2016-2017 (preliminary). See Explanatory Notes 57-60 in this publication. See also Causes of Death Revisions, 2014 and 2015 (Technical Note) in Causes of Death, Australia, 2016 (cat. no. 3303.0).

(b) Includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to suicide. See Explanatory Notes 91-100.

(c) Standardised death rate. Death rate per 100,000 estimated resident population as at 30 June. See Explanatory Notes 44-47 for further information Age distribution of deaths due to intentional self-harm

In 2017, suicide was the leading cause of death among people aged between 15-44 years, and the second leading cause of death among those 45-54 years of age. The median age at death for suicide was 44.5 years. This compares to a median age of 81.9 years for all deaths. The median age for males was 44.0, compared to a median age of 45.7 for females.



The graph below shows the proportion of all suicide deaths that occurred within each 5 year age group. While the number and rate of suicide deaths differs significantly for males and females, the age distribution of these deaths is very similar. The highest proportion of suicide deaths occurs in the 45-49 year age group among both males and females. The proportion of suicide deaths decreases among those over 55 years of age for males and females. While the number of males who die by suicide exceeds the number of females for every age group, of the females who do die by suicide, the highest proportion are aged between 45 and 49 (12.1%), followed by those aged 50-54 (10.4%). For males, the peak is also in the 45-49 age group (11.0%), but the next most prevalent age groups are 40-44 and 30-34 (both 10.3%). The 50-54 years age group had the largest proportional difference between males and females, with 7.0% of male suicides occurring in this age group compared to 10.4% of female suicides.

Suicide and premature mortality



In 2017 intentional self-harm was a leading cause of premature mortality in Australia. While intentional self-harm accounts for a relatively small proportion (1.9%) of all deaths in Australia, it accounts for a high proportion of deaths among younger people. Suicide accounted for over one-third of deaths (36%) among people aged 15-24 years of age, and over a quarter of deaths (30.9%) among those aged 25-34 years. There were 108,081 years of life lost to intentional self-harm in 2017 (see explanatory notes 40-43). On average, a person who died by suicide in 2017 lost 34.5 years from their life.

Age-specific death rates for intentional self-harm



Age-specific death rates reflect the number of deaths for a specific age group, expressed per 100,000 of the estimated resident population of that same age group, for a given period (see the Glossary in this publication for further information). Age-specific suicide death rates for 2017 are shown in the graph below. The 0-14 year age group has been excluded from this graph because of the small number of deaths that occur within that age group.

In 2017 the highest age-specific suicide rate was highest among males aged 85 years and older, recording 32.8 deaths per 100,000 persons. It should be noted that the number of suicides in this age group accounted for 2.6% of all male intentional self harm deaths in 2017. The second highest age-specific suicide rate for males was in the 45-49 year age group. For females, the highest age-specific suicide rate is in the 45-49 year age group, while the over 85 year age group has the lowest rate in sharp contrast to males. The largest decrease in age-specific suicide rates for males was in the 75-79 year age group, falling from 21.4 deaths per 100,000 persons in 2016 to 15.5 in 2017. This age group also saw the equal largest decline for females, along with the 20-24 year age group, falling 1.4 percentage points (from 7.3 to 5.9, and from 7.7 to 6.3 respectively). Not taking into account gender, those aged 45-49 showed the highest age-specific death rate for intentional self-harm in 2017, as well as the highest rate increase from 2016. Excluding males aged 85 years and over, the age-specific deaths rates were the highest in middle-aged males aged between 40-44 years and 45-49 years, both greater than 30 deaths per 100,000 males. Suicide accounted for 19.5% of all male deaths for 40-44 years and 14.0% of all male deaths for 45-49 years. The age-specific suicide rate for males was lowest in the 15-19 year age group (13.9 deaths per 100,000 males), yet suicide accounted for 36.4% of all deaths in that age group.

Age-related associated causes In 2017, approximately 80.0% of intentional self-harm deaths had co-morbidities mentioned as contributing factors to death. Co-morbidities can be significant etiological factors, providing contextual information regarding circumstances surrounding an intentional self-harm death. Mood disorders, including depression , were the most common mentioned condition with intentional self-harm in 2017, being present in 43.0% of deaths . This is followed by drug and alcohol disorders, which include drug misuse, but also acute intoxication, where one's judgement may be impaired by the drug or alcohol present in the system. There are important variations with associated conditions when age disaggregations are applied. People aged over 65 years are more likely to have a chronic health condition present at death than younger cohorts. Notably, cancer was present in approximately 25.0% of suicides of persons aged over 85 years. Younger cohorts had higher reference to drug and alcohol use disorders and acute intoxication, with 41.6% of suicides in the 25-44 year age group having these conditions mentioned. The table below shows the proportion of the ten most common grouped conditions mentioned with suicide deaths in 2017 by selected age groups. It is recognised that many antecedent factors related to a suicide death are not a diagnosable health condition, and may include issues such as financial difficulty or relationship distress. These factors have not been traditionally captured in ABS cause of death coding within the scope of the International Classification of Diseases. The ABS have completed a pilot study with 2017 suicide data where certain psychosocial factors have been coded in as associated factors to the death. This additional data is not part of this release, but instead will be released at a later date, as part of an information paper.

Intentional self-harm top 10 multiple causes, proportion of total suicides , by age group, 2017 (a)(b)(c) Cause of death and ICD code 5-24 years 25-44 years 45-64 years 65-84 years 85 years + All ages Mood disorders (F30-F39) 34.3 43.0 49.0 40.3 26.0 43.0 Mental and behavioural disorders due to psychoactive substance use (F10-F19) 25.9 41.6 26.7 10.1 2.6 29.5 Other symptoms and signs involving emotional state (R458) (c) 20.6 16.9 19.5 16.4 11.7 18.1 Anxiety and stress-related disorders (F40-49) 15.2 19.7 17.9 13.6 9.1 17.5 Findings of alcohol, drugs and other substances in blood (R78) 18.5 17.0 13.7 9.6 7.8 14.9 Schizophrenia, schizotypal and delusional disorders (F20-F29) 3.5 7.9 5.2 2.3 — 5.5 Unspecified mental disorder (F99) 7.2 5.0 4.3 1.8 — 4.5 Malignant neoplasms (C00-C97, D45-D46, D47.1, D47.3-D47.5) 0.5 0.9 1.9 16.1 24.7 3.7 Diseases of the musculoskeletal system (M00-M99) 0.2 1.7 3.3 11.1 15.6 3.6 Personality disorders (F60-F69) 5.4 5.0 2.0 1.3 — 3.5 Chronic pain (R522) 0.5 1.3 3.7 5.3 5.2 2.6 Ischaemic heart diseases (I20-I25) 0.2 0.7 1.8 7.8 16.9 2.3 Chronic lower respiratory diseases (J40-J47) 0.2 0.5 2.0 6.0 9.1 1.9 Diabetes (E10-E14) 0.5 0.6 2.0 5.0 9.1 1.8 Heart failure (I50-I51) 0.2 0.2 1.0 5.0 7.8 1.2 Behavioural disorders usually occurring in childhood and adolescence (F90-F98) 3.7 1.1 0.6 — — 1.1 Disorders of psychological development (F80-F89) 2.1 0.5 0.1 — — 0.5 — nil or rounded to zero (including null cells)

Footnote(s):

(a) Includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to suicide. See Explanatory Notes 91-100.

(b) Causes of death data for 2017 are preliminary and subject to a revisions process. See Explanatory Notes 57-60.

(c) Includes suicide ideation

Suicide deaths of children



Deaths of children by suicide is an extremely sensitive issue. The number of deaths of children attributed to suicide can be influenced by coronial reporting practices. Reporting practices may lead to differences in counts across jurisdictions and this should be taken into account when interpreting this data. For more information on issues associated with the compilation and interpretation of suicide data, see Explanatory Notes 91-100.



For the purposes of the following analysis, children are defined as those aged between 5 and 17 years of age. The ABS is not aware of any recorded suicide deaths of children under the age of 5 years. In 2017, suicide remained the leading cause of death of children between 5 and 17 years of age, with 98 deaths occurring in this age group. This represents a 10.1% increase in deaths from 2016. The age-specific rate of suicide in this age group was 2.4 per 100,000 in 2017, with the male rate of 2.9 substantially higher than the female rate of 1.9. Nearly 80% of the child suicides were aged between 15 and 17 (78.8%), leading to an age specific death rate of 8.4 compared to a rate of 0.7 for 5-14 year olds.



When all child suicide deaths are combined for years 2013 to 2017, the Northern Territory reported the highest jurisdictional rate of child deaths due to suicide, with 13.9 deaths per 100,000 persons. All other states and territories reported rates ranging from 1.7 to 3.6 deaths per 100,000 (Victoria and Tasmania, respectively). Intentional self-harm in children aged 5-17 years, Australia, 2013-2017 (a)(b)(c)(d)(e) Age group (years) 2013



No./proportion 2013



Rate(d) 2014



No./proportion 2014



Rate(d) 2015



No./proportion 2015



Rate(d) 2016



No./proportion 2016



Rate(d) 2017



No./proportion 2017



Rate(d) 5-17 years Males Suicide 60 3.1 51 2.6 47 2.4 62 3.1 63 3.1 All causes 283 14.9 244 12.7 298 15.2 280 14.1 270 13.4 Proportion(e) 21.2 na 20.9 na 15.8 na 22.1 na 23.3 na Females Suicide 35 1.9 38 2.1 40 2.2 27 1.4 35 1.8 All causes 204 11.3 195 10.7 217 11.7 161 8.6 197 10.3 Proportion(e) 17.2 na 19.5 na 18.4 na 16.8 na 17.8 na Persons Suicide 95 2.6 89 2.4 87 2.3 89 2.3 98 2.4 All causes 487 13.1 439 11.7 515 13.5 441 11.4 467 11.9 Proportion(e) 19.5 na 20.3 na 16.9 na 20.2 na 21 na All ages(d) 2,610 11.3 2,891 12.4 3,065 12.9 2,866 11.8 3,128 12.7 na Not applicable

Footnote(s):

(a) All causes of death data from 2006 onward are subject to a revisions process - once data for a reference year are 'final', they are no longer revised. Affected data in this table are: 2013-2014 (final), 2015 (revised), 2016-2017 (preliminary). See Explanatory Notes 57-60 in this publication. See also Causes of Death Revisions, 2014 and 2015 (Technical Note) in Causes of Death, Australia, 2016 (cat. no. 3303.0).

(b) Cells with small values have been randomly assigned to protect the confidentiality of individuals. Cells with a zero value have not been affected by confidentialisation.

(c) Includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to suicide. See Explanatory Notes 91-100.

(d) Crude death rate per 100,000 estimated resident population as at 30 June.

(e) Intentional self-harm deaths as a proportion of all deaths in the 5-17 year age group.





Intentional self-harm sex difference trends occur consistently across all age groups except for those aged 5-17 years of age. While the age-specific rate for males remains higher than for females in the 5-17 year age group, the ratio of male to female intentional self-harm deaths is smaller, with more variability occurring year to year. With the exception of 2016, sex differences have decreased to less than 2 male deaths per every female death from intentional self-harm in the past 5 year period. This compares to more than 3 male deaths for every female death in all other age groups. For the years 2013-2017 combined, the crude rate difference between male and females aged 5-17 was 1.0, compared to the rest of the population, where the recorded crude rate difference was 12.5. Intentional self-harm sex difference trends occur consistently across all age groups except for those aged 5-17 years of age. While the age-specific rate for males remains higher than for females in the 5-17 year age group, the ratio of male to female intentional self-harm deaths is smaller, with more variability occurring year to year. With the exception of 2016, sex differences have decreased to less than 2 male deaths per every female death from intentional self-harm in the past 5 year period. This compares to more than 3 male deaths for every female death in all other age groups. For the years 2013-2017 combined, the crude rate difference between male and females aged 5-17 was 1.0, compared to the rest of the population, where the recorded crude rate difference was 12.5.





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