3303.0 - Causes of Death, Australia, 2018 Quality Declaration 
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 25/09/2019   
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Intentional self-harm, key characteristics

There were 3,046 registered deaths of people who died due to intentional self-harm (suicide) in Australia in 2018. Suicide is the leading cause of death among people aged 15-44 in Australia, and is a focal point of government from a policy and prevention perspective. The fifth National Mental Health and Suicide Prevention Plan provides details of strategies aimed at reducing the impact of suicide in Australia.

The standardised death rate in 2018 was 12.1 deaths per 100,000 people. Death rates recorded over the five years from 2014 to 2018 have been between 11.9 (2016) and 12.9 (2015) deaths per 100,000 people. This contrasts with rates of between 10.5 (2011) and 11.2 (2010 and 2012) in the five years from 2009 to 2013.

Intentional self-harm was the 14th ranked leading cause of death in 2018.

Intentional self-harm deaths by sex

Suicide rates for males and females differ considerably with males consistently accounting for approximately three-quarters of suicide deaths. Of the 3,046 registered suicide deaths, 2,320 were of males and 726 were of females with standardised death rates of 18.6 and 5.7 respectively.

The graph below shows the standardised death rates for suicide over the last decade for males, females and persons. To help interpret changes in rates over time, the graph includes upper and lower bounds for data points. These bounds provide an insight into the variability associated with the recorded suicide rates and help to show whether differences in recorded rates are statistically significant.

The suicide rate for both males and females in 2018 decreased slightly compared to 2017 (0.5 deaths per 100,000 for both sexes), but for both sexes rates have remained comparable over the past five years (2014 to 2018).

Suicide is the tenth leading cause of death for males and the 23rd leading cause for females. While the death rate between sexes is notably different, the median age of death due to suicide is similar at 44.3 years of age for males and 44.7 years of age for females.


Standardised death rates for intentional self-harm, 2009-2018 (a)(b)(c)(d)(e)(f)

Graph: Standardised death rates for intentional self-harm, 2009-2018
Footnote(s):
(a) Standardised death rate. Death rate per 100,000 estimated resident population as at 30 June (mid year). See Explanatory Notes 46-49 for further information.
(b) The data presented for intentional self-harm includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 41 and 91-100 in this publication.
(c) 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: 2014 and 2015 (final), 2016 (revised), 2017 and 2018 (preliminary). See Explanatory Notes 59-62 in this publication and Causes of Death Revisions, 2015 Final Data (Technical Note) and 2016 Revised Data (Technical Note) in Causes of Death, Australia, 2017 (cat. no. 3303.0).
(d) See Explanatory Notes 77-108 for further information on specific issues related to interpreting time-series and 2018 data
(e) Care needs to be taken when interpreting data derived from Victorian coroner-referred deaths including suicide, see Explanatory Note 111 in this publication.
(f) Changes in coding processes have been applied to 2018 data. See Technical Note Updates to Iris coding software: Implementing WHO updates and improvements in coding processes in this publication.

Intentional self-harm deaths by states and territories

All states and territories except New South Wales recorded small decreases in the number of registered deaths due to intentional self-harm from 2017 to 2018 (see table below). The three most populous states of New South Wales, Victoria and Queensland accounted for close to three quarters of those deaths.

When considering changes in counts or rates of suicide deaths it is important to understand the range of administrative factors which can influence data for a particular reference year. Factors such as changes in processing rates for death registrations can influence the count of deaths, while the flow of information between Coroners courts, Registries, the National Coronial Information System and the ABS can influence what information is available to specify a particular cause of death. For further information on an emerging administrative issue relating to Victorian data, see Explanatory Note 111.

Number of suicide deaths, by state or territory of usual residence, 2009-2018 (a)(b)(c)(d)(e)



2009

No.
2010

No.
2011

No.
2012

No.
2013

No.
2014

No.
2015

No.
2016

No.
2017

No.
2018

No.

NSW
623
674
617
727
718
832
839
818
880
899
Vic(d)
576
558
526
514
533
658
678
639
621
593
Qld
525
588
578
631
676
658
761
689
804
786
SA
185
197
212
198
203
243
234
225
224
212
WA
279
313
309
367
336
367
402
370
409
383
Tas.
79
64
74
71
74
69
84
94
80
78
NT
37
45
44
48
33
56
48
47
51
47
ACT
32
41
33
24
37
38
46
28
58
47
Australia(f)
2,337
2,480
2,393
2,580
2,610
2,922
3,093
2,911
3,128
3,046


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: 2014 and 2015 (final), 2016 (revised), 2017 and 2018 (preliminary). See Explanatory Notes 59-62 in this publication and Causes of Death Revisions, 2015 Final Data (Technical Note) and 2016 Revised Data (Technical Note) in Causes of Death, Australia, 2017 (cat. no. 3303.0).
(b) The data presented for intentional self-harm includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 41 and 91-100 in this publication.
(c) See Explanatory Notes 77-108 for further information on specific issues related to interpreting time-series and 2018 data
(d) Care needs to be taken when interpreting data derived from Victorian coroner-referred deaths including suicide, see Explanatory Note 111 in this publication.
(e) Changes in coding processes have been applied to 2018 data. See Technical Note Updates to Iris coding software: Implementing WHO updates and improvements in coding processes in this publication.
(f) Includes Other territories. See Explanatory Notes 12-15 for more information.

Intentional self-harm deaths by states and territories: Standardised death rates

The table below presents a ten year time series of standardised death rates for Australian states and territories. Standardised death rates enable better comparisons both between states and territories and over time.

Death rates for most states and territories decreased from 2017 to 2018 with the exception of New South Wales which recorded a death rate of 11.1 per 100,000 people in 2018, compared with 10.9 in 2017.

In 2018, the Northern Territory recorded the highest suicide death rate at 19.5 suicide deaths per 100,000 population.

Standardised death rates for suicide, by state or territory of usual residence, 2009-2018 (a)(b)(c)(d)(e)(f)(g)



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)
2018

Rate(c)

NSW
8.7
9.3
8.4
9.8
9.5
10.8
10.9
10.4
10.9
11.1
Vic(d)
10.5
10.1
9.2
9.0
8.9
10.9
11.1
10.1
9.6
9.1
Qld
12.1
13.4
12.9
13.9
14.6
14.0
16.0
14.2
16.3
15.8
SA
11.5
11.8
12.9
11.7
11.9
14.4
13.3
13.3
12.8
12.0
WA
12.3
13.6
12.9
15.0
13.5
14.5
15.6
14.4
15.8
14.7
Tas.
15.4
13.0
14.1
13.7
14.2
12.8
16.2
17.3
15.6
14.5
NT
17.4
18.8
18.5
19.1
14.2
21.8
20.3
19.6
20.3
19.5
ACT
8.9
11.3
9.3
6.2
9.6
9.8
11.4
7.2
14.1
11.0
Australia(f)
10.7
11.2
10.5
11.2
11.1
12.3
12.9
11.9
12.6
12.1

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: 2014 and 2015 (final), 2016 (revised), 2017 and 2018 (preliminary). See Explanatory Notes 59-62 in this publication and Causes of Death Revisions, 2015 Final Data (Technical Note) and 2016 Revised Data (Technical Note) in Causes of Death, Australia, 2017 (cat. no. 3303.0).
(b) The data presented for intentional self-harm includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 41 and 91-100 in this publication.
(c) Standardised death rate. Death rate per 100,000 estimated resident population as at 30 June (mid year). See Explanatory Notes 46-49 for further information.
(d) Care needs to be taken when interpreting data derived from Victorian coroner-referred deaths including suicide, see Explanatory Note 111 in this publication.
(e) Changes in coding processes have been applied to 2018 data. See Technical Note Updates to Iris coding software: Implementing WHO updates and improvements in coding processes in this publication.
(f) Includes Other territories. See Explanatory Notes 12-15 for more information.
(g) See Explanatory Notes 77-108 for further information on specific issues related to interpreting time-series and 2018 data.


Intentional self-harm by age and sex

The following sections cover various age and sex breakdowns of suicide deaths. Suicide can impact different demographics in different ways and understanding those differences can assist in targeting policies and prevention activities.

Intentional self-harm by age and sex: Age distribution

The graph below shows the age distribution of suicide deaths and provides an insight into the proportion of those deaths that occurred within each age cohort. The age distribution of suicide deaths for both males and females is very similar despite there being considerable difference in the number of suicide deaths for each sex.

The highest proportion of suicide deaths occur among young and middle aged people, while the proportion decreases in progressively older age cohorts. More than half of all suicide deaths in 2018 (54.8%) occurred between the ages 30 and 59. The median age at death for suicide was 44.4 years of age, compared to 81.7 years of age for all deaths.


Suicide deaths by age and sex as a proportion of total suicide deaths, 2018 (a)(b)(c)(d)(e)
Graph: Suicide deaths by age and sex as a proportion of total suicide deaths, 2018
Footnote(s):
(a) Causes of death data for 2018 are preliminary and subject to a revisions process. See Explanatory Notes 59-62.
(b) See Explanatory Notes 77-108 for further information on specific issues related to interpreting time-series and 2018 data.
(c) The data presented for intentional self-harm includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 41 and 91-100 in this publication.
(d) Care needs to be taken when interpreting data derived from Victorian coroner-referred deaths including suicide, see Explanatory Note 111 in this publication.
(e) Changes in coding processes have been applied to 2018 data. See Technical Note Updates to Iris coding software: Implementing WHO updates and improvements in coding processes in this publication.


Intentional self-harm by age and sex: Age-specific death rates

Age-specific death rates show how suicide manifests across age cohorts by relating the number of deaths to the size and structure of the underlying population. The graph below shows that age-specific death rates for males are consistently higher than those for females. This is due to the high proportion of suicide deaths that occur among males.

Age-specific death rates are high between the ages of 35 and 59 for both males and females. For males in 2018, the highest rate (32.9 deaths per 100,000 males) is for those aged 85 years and older, in part reflecting a smaller underlying population in this age cohort. Males aged 85 and over accounted for 2.7% of male suicide deaths, while males aged 45-49 (the second highest age-specific rate) accounted for 9.9%.

Age-specific death rates for intentional self-harm by sex, 2018 (a)(b)(c)(d)(e)(f)(g)


Graph: Age-specific death rates for intentional self-harm by sex, 2018
Footnote(s):
(a) Age-specific death rates reflect the number of deaths for a specific age group, expressed per 100,000 of the estimated resident population as at 30 June (mid year) of that same age group (see the Glossary in this publication for further information).
(b) Suicide deaths in the 0-14 year age group have been excluded because of the small number of deaths that occur within this age group.
(c) Causes of death data for 2018 are preliminary and subject to a revisions process. See Explanatory Notes 59-62.
(d) See Explanatory Notes 77-108 for further information on specific issues related to interpreting time-series and 2018 data.
(e) The data presented for intentional self-harm includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 41 and 91-100 in this publication.
(f) Care needs to be taken when interpreting data derived from Victorian coroner-referred deaths including suicide, see Explanatory Note 111 in this publication.
(g) Changes in coding processes have been applied to 2018 data. See Technical Note Updates to Iris coding software: Implementing WHO updates and improvements in coding processes in this publication.

Intentional self-harm by age and sex: Premature mortality

Intentional self-harm is a significant cause of premature mortality in Australia. It is the leading cause of death for people aged between 15-44 and the second leading cause of death for those aged between 45-54. One measure of premature mortality is years of potential life lost, which weights age at death to gain an estimate of how many years a person would have lived had they not died prematurely (see Explanatory Notes 42 to 45). Suicide accounts for the highest number of years of potential life lost among leading cause groups of conditions. Other conditions such as heart disease account for more premature deaths, but less years of potential life lost. In 2018, suicide accounted for over one-third of deaths (38.4%) among people 15-24 years of age and 29.4% of deaths among people 25-34 years of age. In 2018, there were 105,730 years of life lost to suicide. On average, a person who died by suicide in 2018 lost 36.7 years of life.

Intentional self-harm by age and sex: Suicide deaths of children

Deaths of children from 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 data. For more information on issues associated with the compilation and interpretation of suicide data, see Explanatory Notes 91 to 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.

The table below provides information on suicide deaths among children over the last five years. In 2018, there were 100 recorded child suicide deaths and suicide remained the leading cause of death among Australian children. The suicide rate among children 5-17 years of age in 2018 was 2.5 deaths per 100,000 children.

Similar to suicide in other age groups, the suicide count and rate in male children is substantially higher than for females. In 2018, the death rate among male children was 3.0 per 100,000 people (61 deaths), while for females it was 2.0 per 100,000 (39 deaths).

More than three-quarters of child suicides in 2018 were between the ages 15 to 17 (78.0%). When all child suicide deaths are combined for years 2014 to 2018, the Northern Territory reported the highest jurisdictional rate of child deaths due to suicide, with 12.5 deaths per 100,000.


Intentional self-harm in children aged 5-17 years, 2014-2018 (a)(b)(c)(d)(e)(f)(g)(h)(i)


Age group (years)
2014

No./proportion
2014

Rate(d)
2015

No./proportion
2015

Rate(d)
2016

No./proportion
2016

Rate(d)
2017

No./proportion
2017

Rate(d)
2018

No./proportion
2018

Rate(d)

5-17 years
Males
Suicide
51
2.6
49
2.5
63
3.2
63
3.1
61
3.0
All causes
244
12.7
298
15.2
280
14.1
270
13.4
262
12.8
Proportion(f)
20.9
na
16.4
na
22.5
na
23.3
na
23.3
na
Females
Suicide
38
2.1
40
2.2
28
1.5
35
1.8
39
2.0
All causes
195
10.7
217
11.7
161
8.6
197
10.3
186
9.6
Proportion(f)
19.5
na
18.4
na
17.4
na
17.8
na
21.0
na
Persons
Suicide
89
2.4
89
2.3
91
2.4
98
2.5
100
2.5
All causes
439
11.7
515
13.5
441
11.4
467
11.9
448
11.2
Proportion(f)
20.3
na
17.3
na
20.6
na
21.0
na
22.3
na
All ages(e)
2,922
12.3
3,093
12.9
2,911
11.9
3,128
12.6
3,046
12.1

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: 2014 and 2015 (final), 2016 (revised), 2017 and 2018 (preliminary). See Explanatory Notes 59-62 in this publication and Causes of Death Revisions, 2015 Final Data (Technical Note) and 2016 Revised Data (Technical Note) in Causes of Death, Australia, 2017 (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) The data presented for intentional self-harm includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 41 and 91-100 in this publication.
(d) Child rates are expressed as age-specific death rates. The number of deaths for a specific age group, expressed per 100,000 of the estimated resident population as at 30 June (mid year) of that same age group (see the Glossary in this publication for further information).
(e) All ages rates are expressed as age-standardised rates. Death rate per 100,000 estimated resident population as at 30 June (mid year). See Explanatory Notes 46-49 for further information.
(f) Intentional self-harm deaths as a proportion of all deaths in the 5-17 year age group.
(g) See Explanatory Notes 77-108 for further information on specific issues related to interpreting time-series and 2018 data.
(h) Care needs to be taken when interpreting data derived from Victorian coroner-referred deaths including suicide, see Explanatory Note 111 in this publication.
(i) Changes in coding processes have been applied to 2018 data. See Technical Note Updates to Iris coding software: Implementing WHO updates and improvements in coding processes in this publication.


The sex ratio for suicide deaths, defined as the number of male suicide deaths per female suicide death, are provided in the graph below for child suicide deaths and all suicide deaths from 2009 to 2018. The sex ratio is consistently lower for child suicide deaths showing there is less difference in the number of male and female deaths among children. In 2018, the sex ratio for child suicide was 1.6 male deaths for every female death, while for all ages combined it was 3.2 male deaths for every female suicide death.

Sex ratio differences for child suicide (5-17 years) and all suicide, 2009-2018 (a)(b)(c)(d)(e)

Graph: Sex ratio differences for child suicide (5-17 years) and all suicide, 2009-2018
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: 2014 and 2015 (final), 2016 (revised), 2017 and 2018 (preliminary). See Explanatory Notes 59-62 in this publication and Causes of Death Revisions, 2015 Final Data (Technical Note) and 2016 Revised Data (Technical Note) in Causes of Death, Australia, 2017 (cat. no. 3303.0).
(b) The data presented for intentional self-harm includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 41 and 91-100 in this publication.
(c) See Explanatory Notes 77-108 for further information on specific issues related to interpreting time-series and 2018 data.
(d) Care needs to be taken when interpreting data derived from Victorian coroner-referred deaths including suicide, see Explanatory Note 111 in this publication.
(e) Changes in coding processes have been applied to 2018 data. See Technical Note Updates to Iris coding software: Implementing WHO updates and improvements in coding processes in this publication.

Age-related multiple causes and intentional self-harm

It is well documented that the circumstances relating to suicide deaths are complex. Co-morbidities like mental health conditions, chronic diseases and/or drug addiction can provide critical contextual information regarding these circumstances. Mood disorders, including depression, were the most commonly mentioned co-morbidity across all 3,046 suicide deaths (mood disorders were present in 43.9% of these deaths). This was followed by problems related to substance use, which includes abuse of alcohol and drugs (like heroin and methamphetamine), but also intoxication due to excessive use of a given substance at the time of death. Problems related to substance use were present in over one quarter of suicide deaths (29.4%).

The profile of common co-morbidities in suicide deaths varies in critical ways when examined by age group (see tabulation below). Chronic diseases and complex health conditions are more likely to be identified as co-morbidities among older age groups. For instance, cancer was mentioned in 13.4% of suicide deaths among those aged 65 to 84, and 11.5% among those aged 85 and over. Substance use is more commonly identified as a co-morbidity among younger people, as is the related finding of drugs and other substances in the blood.

It is recognised that many antecedent factors related to a suicide death are not diagnosable health conditions. These factors have not been traditionally captured in ABS cause of death coding within the scope of the International Classification of Diseases. The ABS recently released the results of a pilot study based on 2017 coroner-referred deaths which captured information on certain psychosocial factors alongside other associated causes. This pilot highlighted key factors such as past history of self-harm, relationship issues, legal and financial concerns and disability as being most commonly associated with suicide deaths, while also highlighting the strengths and limitations of this work. Information on psychosocial factors are not part of this publication, but findings from the pilot study can be found in the Research Paper: Psychosocial risk factors as they relate to coroner-referred deaths in Australia, 2017. The ABS is working towards embedding these additional factors in future mortality datasets in collaboration with key stakeholders.

Intentional self-harm top ten multiple causes, proportion of total suicides, by age group, 2018 (a)(b)(c)(d)(e)(f)(g)


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)
37.1
47.5
46.3
39.5
23.1
43.9
Mental and behavioural disorders due to psychoactive substance use (F10-F19)
29.3
39.9
26.8
11.8
np
29.4
Other symptoms and signs involving emotional state (R458) (c)
21.4
24.2
19.8
19.6
23.1
21.7
Findings of alcohol, drugs and other substances in blood (R78)
26.9
28.5
17.9
8.9
np
21.5
Anxiety and stress-related disorders (F40-F48)
15.5
20.1
18.5
12.8
np
17.6
Schizophrenia, schizotypal and delusional disorders (F20-F29)
3.3
9.2
6.5
3.4
np
6.5
Unspecified mental disorder (F99)
4.8
6.6
4.3
3.4
5.0
Diseases of the musculoskeletal system (M00-M99)
np
1.5
4.7
8.9
6.4
3.4
Malignant neoplasms (C00-C97, D45-D46, D47.1, D47.3-D47.5)
np
3.2
13.4
11.5
3.2
Chronic pain (R522)
np
2.0
3.5
5.5
6.4
2.8
Personality disorders (F60-F69)
3.5
3.9
2.0
np
2.8
Ischaemic heart diseases (I20-I25)
np
0.6
2.1
8.4
14.1
2.4
Diabetes (E10-E14)
0.6
2.7
5.5
np
1.9
Hypertensive diseases (I10-I15)
np
1.8
6.5
np
1.6
Cerebrovascular diseases (I60-I69)
1.1
1.2
0.6
3.1
np
1.3
Chronic lower respiratory diseases (J40-J47)
np
0.8
4.7
6.4
1.1
Behavioural disorders usually occurring in childhood and adolescence (F90-F98)
1.3
2.2
np
1.0
Dementia, including Alzheimer disease (F01, F03, G30)
np
4.2
7.7
0.8
Disorders of psychological development (F80-F89)
4.1
np
np
np
0.8
Behavioural syndromes associated with physiological and physical factors (F50-F59)
1.3
0.9
np
0.6

np not available for publication but included in totals where applicable, unless otherwise indicated.
— nil or rounded to zero (including null cells)
Footnote(s):
(a) Causes of death data for 2018 are preliminary and subject to a revisions process. See Explanatory Notes 59-62.
(b) See Explanatory Notes 77-108 for further information on specific issues related to interpreting time-series and 2018 data.
(c) Includes 'suicide ideation'
(d) The data presented for intentional self-harm includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 41 and 91-100 in this publication.
(e) Care needs to be taken when interpreting data derived from Victorian coroner-referred deaths including suicide, see Explanatory Note 111 in this publication.
(f) Changes in coding processes have been applied to 2018 data. See Technical Note Updates to Iris coding software: Implementing WHO updates and improvements in coding processes in this publication.
(g) The top ten multiple causes were captured for each age group then combined into one list, therefore the number of causes listed in the table is higher than 10.

Crisis helplines


Lifeline: 13 11 14

Suicide Call Back Service - 1300 659 467

Kids Helpline (for young people aged 5 to 25 years): 1800 55 1800