Self-harm in 5-to-24 year olds: Retrospective examination of hospital presentations to emergency departments in New South Wales, Australia, 2012 to 2020

• Published in: PloS one Vol. 18; no. 8; p. e0289877
• Main Authors: Torok, Michelle, Burnett, Alexander C R, McGillivray, Lauren, Qian, Jiahui, Gan, Daniel Z Q, Baffsky, Rachel, Wong, Quincy
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 10.08.2023
• Subjects: Adolescent; Age; Analysis; Australia; Behavior; Causes of; Child; Child development; Codes; Country of birth; Demographic aspects; Emergency medical care; Emergency medical services; Emergency service; Emergency Service, Hospital; Female; Females; Health aspects; Health risks; Hospitals; Humans; Male; Males; Management of crises; Medicine and Health Sciences; Mental disorders; Mental health; New South Wales - epidemiology; Pandemics; People and Places; Poisoning; Psychological aspects; Retrospective Studies; Self destructive behavior; Self-Injurious Behavior - epidemiology; Self-injury; Sex; Statistical analysis; Suicide; Suicides & suicide attempts; Teenagers; Trends; Young adults; Youth; Australia; New South Wales; United Kingdom; New South Wales Australia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0289877

There is some evidence that self-harm presentations in children and young people have increased over the past decade, yet there are few up-to-date studies examining these trends. This study aims to describe trends in the rates and severity of emergency department self-harm presentations for youth aged 5-24 years in New South Wales, Australia between 1 January 2012 and 31 December 2020. We analysed self-harm hospital presentations using join point analysis to compare quarterly growth in rates and urgency of presentation since 2012 by age group and sex. Binomial logistic modelling was used to identify risks for re-presentation for self-harm, including age group, sex, country of birth, mode of arrival, inpatient status, triage category, rurality, and socio-economic disadvantage. In total, 83,111 self-harm presentations for 51,181 persons were analysed. Overall rates of self-harm among those aged 5-24 years increased by 2.4% (p < .001) per quarter in females and 1.6% (p < .001) per quarter in males, with statistically significant average quarterly increases observed across all age groups. Overall and age-specific self-harm triage urgency rates increased statistically significantly for potentially serious, and potentially- and immediately life-threatening categories. A higher likelihood of re-presentation to any emergency department for self-harm was associated with younger age, female, residing in a regional area, arriving by ambulance, admitted as an in-patient, and a more severe index self-harm presentation. Hospital self-harm presentations have been growing steadily over the past decade, with the greatest growth in the youngest people. Understanding the reasons for these sustained upward trends is a priority for suicide prevention.