This annual report - Taranaki District Health Board

SUICIDE AND INTENTIONAL SELF-HARMIntroductionIn New Zealand during 2009, suicide was the second most common cause of death aftermotor vehicle accidents for young people aged 15 to 24 years [489]. Although rates havedeclined since the late 1990s, youth suicide rates remain high compared to other OECDcountries and prevention of youth suicide remains an important focus [490]. For example,in 2009, New Zealand’s suicide rate for those aged 15 to 19 years was 16.7 deaths per100,000 population, as compared to the OECD average of 6.4 per 100,000 population[489,491]. Among those aged 15 to 19 years there were 42 male suicide deaths (25.4 per100,000 population) and 12 female suicide deaths (7.6 per 100,000 population) [489].Suicidal behaviour in young people most often results from an accumulation of risk factorswhich may include childhood and family adversity, individual vulnerabilities, mentaldisorders including depression and substance abuse, non-heterosexual sexual orientation,exposure to suicidal behaviour by others, and exposure to stressors and adversecircumstances [492,493]. Te Rau Hinengaro, The New Zealand Mental Health Surveyfound that the risk of suicidal ideation, a suicide plan, or a suicide attempt were alsosignificantly higher in young people, compared to those aged over 25 years [316]. The riskof suicidal behaviours was also increased in those with low household incomes and thoseliving in deprived areas [316]. Māori ethnicity, socioeconomic disadvantage and childwelfare care are also associated with higher suicide rates among young people in NewZealand [312,494]. A caring parent or other family member and a fair, safe schoolenvironment appear to be protective against suicide attempts [493].Research also suggests that the risk factor profiles for suicide mortality and hospitaladmissions for intentional self-harm differ [489]. In 2009, hospitalisation rates were highestfor young women aged 15 to 19 years (181.1 per 100,000 female population, vs. 78 per100,000 male population [489]). The Youth ’07 survey of 9,107 secondary school studentsin 2007 also found that 26.0% (95% CI 24.4–27.6) of female students and 15.5% (95% CI14.1–16.8) of male students reported deliberately harming themselves in the preceding 12months [314]. Suicidal thoughts, plans and attempts were all more common among femalecompared to male students. Reports of suicidal behaviours were more common amongMāori and Pacific youth compared to NZ Europeans, and those living in moresocioeconomically deprived areas compared to those in less deprived areas.The following section uses information from the National Minimum Dataset and theNational Mortality Collection to review hospital admissions for intentional self-harm andmortality from suicide in young people aged 15–24 years.Data Source and MethodsDefinition1. Hospital admissions for injuries arising from intentional self-harm in young people aged 15–24 years2. Mortality from suicide in young people aged 15–24 yearsData Source1. Hospital AdmissionsNumerator: National Minimum Dataset: Hospital admissions for young people aged 15–24 years with a primarydiagnosis of injury (ICD-10-AM S00–T79) and an external cause code (e-code) of intentional self-harm (ICD-10-AM X60–X84); Admissions with an Emergency Medicine specialty code (M05–M08) on discharge wereexcluded (see Appendix 3).2. MortalityNumerator: National Mortality Collection: Deaths of young people aged 15–24 years with a main underlyingcause of death of intentional self-harm (ICD-10-AM X60–X84)Denominator: Statistics NZ Estimated Resident Population (projected from 2007)Notes on InterpretationThe limitations of the National Minimum Dataset are discussed at length in Appendix 3Suicide and Intentional Self-Harm - 417