Proportion of Emergency Department presentations for deliberate self-harm in children and young people

Mental health disorders are the most common chronic conditions experienced by young people in the developed world and are a significant burden to public health in Australia^1,2. In recent years, the number of young people presenting to emergency departments with mental health conditions has steadily increased³. The most common nature of presentation is for deliberate self-harm³. 

Deliberate self-harm refers to an intentional act of causing physical injury to oneself, without the intention for the injury to cause death⁴. However, deliberate self-harm can lead to accidental fatality⁴. Presentations to Emergency Departments for deliberate self-harm may indicate more life-threatening forms of self-injury. There is also an increased risk of completed suicide following presentation to hospital for deliberate self-harm⁵.

Understanding the proportion of paediatric presentations to ED that are because of deliberate self-harm has important implications for policy and service delivery³. Geographic statistics can provide insight into where outpatient mental health services may need to focus prevention and intervention efforts to meet the needs of individuals experiencing acute mental illness, particularly around the prevention of suicide.

Understanding the prevalence of deliberate self-harm emergency department presentations in young people is therefore useful for informing effective policy to improve the outcomes of young people across the state.

REFERENCES

1. Erskine H, Moffitt T, Copeland W, Costello E, Ferrari A, Patton G et al. A heavy burden on young minds: The global burden of mental and substance use disorders in children and youth. Psychological Medicine, 2015; 45(7):1551-63. https://doi.org/10.1017/S0033291714002888 
2. Lawrence D, Hafekost J, Johnson S, Saw S, Buckingham W, Sawyer M et al. Key findings from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Australian & New Zealand Journal of Psychiatry, 2016; 50(9):876-86. https://doi.org/10.1177/0004867415617836     
3. Hiscock H, Neely R, Lei S, Freed G. Paediatric mental and physical health presentations to emergency departments, Victoria, 2008-15. Medical Journal of Australia, 2018. Available from: https://doi.org/10.5694/mja17.00434 
4. Lauw M, How CH, Loh C. Deliberate self-harm in adolescents. Singapore Medical Journal. 2015;56(6):306-309. https://doi.org/10.11622/smedj.2015087
5. Hawton K, Zahl D, & Weatherall R. Suicide following deliberate self-harm: Long-term follow-up of patients who presented to a general hospital. British Journal of Psychiatry. 2003; 182(6), 537-542. https://doi.org/10.1192/bjp.182.6.537

Data Source 

Emergency Department Data Collection 

Numerator

Number of presentations to public and private Emergency Departments with a primary presenting self-inflicted injury, from population aged 10-18

Denominator 

Number of Emergency Department presentations from population aged 10-18 years

Unit of Measure 

Per cent (%)

Geography

SA2, SA3, LGA

Data Confidentiality

Areas with a numerator less than 5 have been supressed

Notes 

Presentations classed as deliberate self-harm if any of the following ICD codes were recorded: