Ambulance attendances for suicidal and self-harm behaviours

Last update released by AIHW on Monday, 9 December 2024

The following summary is based on data released by the Australian Institute of Health and Welfare (AIHW) from the National Suicide and Self-Harm Monitoring System (the System): Ambulance attendances: Suicidal ideation, and suicidal and self-harm behaviours.

The System was established as part of the national effort to address suicide and self-harm in Australia by improving the quality, accessibility and timeliness of data on deaths by suicide and on self-harming and suicidal behaviours.

For guidance on reporting on suicide and self-harm data, please refer to the Mindframe quick reference guide.
What is included in the release?

The data released by AIHW includes ambulance data for NSW, Qld, Tas, ACT and the NT to September 2023. It includes ambulance attendance data for:

  • Suicidal ideation (suicidal thoughts)
  • Suicide attempts
  • Self-harm (self-injury without suicidal intent).

Technical notes provided by AIHW give more detailed information about the National Ambulance Surveillance System (NASS).

What are the key findings?

Between March 2018 and September 2023:

  • In NSW, Vic and Qld, ambulance attendance rates were highest for suicidal thoughts, followed by suicide attempts and self-harm. In Tas, ACT and the NT, differences in rates by attendance types were less clear due to smaller numbers.
  • Overall, females had a higher number of ambulance attendances for suicide attempts and self-harm in NSW, Vic and Qld. Though, males and females had similar ambulance attendance rates for suicidal thoughts in these states.
  • Smaller numbers in Tas, ACT and the NT make it difficult to see gender differences for suicidal thoughts, suicide attempts or self-harm.
What does this mean for policy and practice?

The AIHW's update on ambulance attendances for suicidal thoughts, and suicidal and self-harm behaviours helps us better understand how people experience suicidal distress. Whilst not everyone experiencing suicidal distress needs or receives support from ambulance services, these data complement other national datasets to improve suicide prevention efforts.

Suicide deaths are just the tip of the iceberg when it comes to suicide surveillance. Monitoring suicide attempts, self-harm and suicidal thoughts is crucial, but is challenging to do so comprehensively. Hospital data provide insight into the prevalence of intentional self-harm behaviours.1 However, the codes used (e.g. ICD-10) to record this behaviour in these systems don't distinguish between self-harm with and without suicidal intent, limiting our overall understanding of self-harm and suicidal distress.

Analysing data from ambulance attendances reveals a deeper layer of the iceberg - providing more information about self-harm without suicidal intent, and experiences of suicidal thoughts in cases where people aren’t hospitalised. These data supports suicide prevention policy and practice by:

  • Increasing understanding of age and gender differences in ambulance service use for suicidal distress, helping to target specific interventions.
  • Offering information to support developing suicide prevention interventions like aftercare or postvention.
  • Developing effective safety plans that include family and friends.
  • Developing targeted policies or interventions for specific types of self-harm, such as regulating access to means.
  • Supporting ambulance services to deliver mental health interventions, as well as training for paramedics.
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Notes

1

Lubman DI, Heilbronn C, Ogeil RP, Killian JJ, Matthews S, Smith K, et al. National Ambulance Surveillance System: A novel method using coded Australian ambulance clinical records to monitor self-harm and mental health-related morbidity. PLoS ONE. 2020;15(7). https://doi.org/10.1371/journal.pone.0236344