INTENTIONAL SELF-HARM

Mental illness is a key risk factor for intentional self-harm [1], highlighting the importance of effective mental health-related treatments for persons with poor mental health. The following analysis considers deaths of persons from intentional self-harm in 2011-12 (between 10 August 2011 and 27 September 2012 inclusive), including whether they had accessed MBS and/or PBS subsidised mental health-related services or prescription medications (‘mental health-related treatments’). Readers whose main interest is deaths due to intentional self-harm without reference to persons accessing mental health-related treatments should refer to Causes of Death, Australia (cat. no. 3303.0).

In 2011-12 there were 2,295 deaths from Intentional self-harm, accounting for 1.5% of all deaths in Australia. Males accounted for around three-quarters (76.0%) of all deaths from Intentional self-harm (1,744 deaths of males compared with 552 deaths of females), and more than four in five deaths (82.6% or 1,896 deaths) from Intentional self-harm were of persons aged 15-64 years.

The standardised death rate for Intentional self-harm was 10.5 deaths per 100,000 population, with the rate for males being more than three times that of females (16.4 deaths per 100,000 population compared with 5.0 deaths per 100,000 population respectively).

While Intentional self-harm accounts for a relatively small proportion (1.5%) of all deaths in Australia, it accounts for a higher proportion of deaths amongst younger persons. In 2011-12, Intentional self-harm accounted for more than one quarter of deaths (27.7%) of persons aged 15-24 years and a similar proportion (23.2%) amongst persons aged 25-34 years. For persons aged 35-44 years, 13.4% of deaths were due to Intentional self-harm.

DEATHS FROM INTENTIONAL SELF-HARM AMONGST PERSONS WHO ACCESSED MENTAL HEALTH-RELATED TREATMENTS

Of the 2,295 deaths of persons from Intentional self-harm in Australia in 2011-12, just over half (52.9% or 1,214 persons) had accessed mental health-related treatments in 2011. The age structure of these deaths was similar to that of deaths due to Intentional self-harm amongst the total Australian population overall, with 81.0% of deaths from Intentional self-harm amongst persons who accessed mental health-related treatments being persons aged 15-64 years.

The standardised death rate for deaths due to Intentional self-harm for persons who accessed mental health-related treatments in 2011 was 34.4 deaths per 100,000 population, almost three and a half times (3.3) that of the total Australian population (10.5 deaths per 100,000 population).

TYPES OF TREATMENT

Amongst males with Intentional self-harm as a cause of death, almost half (46.7% or 814 males) had accessed mental health-related treatments in 2011, while amongst females with Intentional self-harm as a cause of death almost three-quarters (72.5% or 400 females) had accessed mental health-related treatments. Almost nine in ten (89.7%) females aged 55-64 years with Intentional self-harm as a cause of death had accessed mental health-related treatments in 2011.



Of the 2,295 deaths of persons due to Intentional self-harm in Australia in 2011-12, around one-third (31.0% or 712 persons) had accessed MBS subsidised mental health-related services. This proportion was considerably higher than the proportion of deaths of persons from all causes who had accessed MBS subsidised mental health-related services (6.0%). Almost half (46.1% or 1,059 persons) of all persons with Intentional self-harm as a cause of death had accessed PBS subsidised mental health-related prescription medications.
 
In relation to particular mental health-related services, almost one-quarter (24.2%) of persons with Intentional self-harm as a cause of death had mental health-related consultation(s) with a general practitioner in 2011, while 12.2% had accessed a psychiatrist and 11.7% had accessed a psychologist or other allied health professional. These proportions were considerably higher than for persons who died from other leading causes of death.



Of persons with Intentional self-harm as a cause of death, the proportions who accessed different types of mental health-related services varied across age. Amongst persons aged 35-44 years with Intentional self-harm as a cause of death, 30.0% had accessed a general practitioner for mental health-related consultations in 2011, compared with 11.0% of persons aged 75 years and over.





Almost half (46.1%) of persons with Intentional self-harm as a cause of death accessed mental health-related medications in 2011, similar to the proportion of persons who accessed mental health-related medications who died from all causes (48.1%).

In relation to particular mental health-related medications, around one-third (35.6%) of persons with Intentional self-harm as a cause of death had accessed antidepressants in 2011. A further 18.1% had accessed antipsychotics while 14.9% had accessed anxiolytics.



Of persons with Intentional self-harm as a cause of death, the proportions who accessed different types of mental health-related medications varied across age. Almost half (46.5%) of persons aged 55-64 years with Intentional self-harm as a cause of death had accessed antidepressants in 2011 while almost one quarter (22.5%) of persons aged 35-44 years had accessed antipsychotics.



ENDNOTES

1 SANE Australia website, viewed 24 August 2017, <https://www.sane.org/images/PDFs/1002-rb11.pdf>