Aotearoa Self-harm Hospital Study: Sentinel surveillance of paediatric self-harm in New Zealand

New Zealand has one of the highest rates of youth suicide in the world. In addition, around 10 children (10-14 years) die by suicide in New Zealand each year with Māori females particularly vulnerable. Suicide is tragic because it is preventable. Despite high public interest little progress has been made in reducing suicide, partly due to lack of good quality data to inform interventions.

One startling fact with important implications for prevention, is that children and adolescents who attend hospital following an act of self-harm (SH) are fifty times more likely to die by suicide, so are an important way to inform suicide prevention activities. One in four will re-present with a further episode of SH within six months. Hospital presentation for SH is one of strongest predictors of death by suicide, so a comprehensive understanding of this high risk population is essential for suicide prevention. Self-harm is defined as any form of intentional self-poisoning or self-injury regardless of motivation or the degree of intention to die. Current data reporting practices in NZ undercount SH presentations by 50 – 60%.

Children and adolescents under 15 years who harm themselves are at particularly increased risk of suicide but, due to the greater number of deaths in older age groups their needs have been neglected to date. This study will pilot a surveillance system of hospital presenting self-harm among those under 15 years at Middlemore Hospital, for two years and a monthly national survey of paediatric presentations for SH.