A novel population-level national surveillance system of self-harm, Australia
Suicidality and non-suicidal self-injury (NSSI) are major public health issues. Self-harm is a policy and intervention priority area for governments and health services, yet there is a paucity of timely and robust data to monitor suicidality and NSSI at a population level. This study presents the findings and audit from the first 15 months of a national self-harm surveillance system that uses unique methodology.
METHODS:
Ambulance records potentially related to self-harm were extracted, reviewed and coded by trained project staff. This coded data was audited to identify false negative and false positive self-harm cases within the raw dataset. Data from July 2012 to September 2013 for Victoria, Australia are reported, representing a service population of approximately 5.5 million residents.
RESULTS:
173 suicides, 8099 suicide attempts, 8690 suicidal ideation only and 2733 NSSI cases were identified. Strikingly, prior to coding, 78% of suicidal ideation and 89% of suicide attempt cases were missed. Also, substantial numbers of false positives occurred within the raw ambulance dataset, with 41% of suicidal ideation and 16% of suicidal attempt cases incorrectly recorded by paramedics as self-harm cases.
CONCLUSIONS:
This surveillance system provides a robust contribution to public health policy and service delivery. Importantly, as data are available within three months of acute incidents, this represents an internationally unique system for ongoing and timely population-level monitoring of self-harm.