Suicidal ideation and non-fatal deliberate self-harm presentations in the Kimberley from an enhanced police-mental health service notification database

Abstract

Objectives: To determine the rate of presentations for suicidal ideation and deliberate self-harm in the Kimberley region of Western Australia, characterized in terms of age, gender, rates of repetition and engagement with community mental health services. Methods: An observational study of health service presentations over 12 months. Setting: 10 sites across the region with police services were included, capturing the overwhelming majority of self-harm presentations in the region. Participants: all Indigenous presentations were analyzed. Of the 433 individuals who presented, 361 were Indigenous. Main outcome measures: suicidal phenomena, including suicidal ideation and any type of deliberate self-harm regardless of intent. Results: Analysis suggests a broadly similar age and sex stratification of self-harm in this population compared with international reports. The rates, however, are 5-20 times higher than those reported in non-Indigenous populations in Australia and abroad, depending on whether the comparison rate is calculated from population surveys or hospital presentations. Conclusions: Prevalence of suicidal phenomena is very high and is likely to be much higher than estimated by this hospital based study. Such high prevalence suggests that a population level intervention is required in addition to interventions involving clinical services.