Suicides in Aboriginal and non-Aboriginal people following hospital admission for suicidal ideation and self-harm: A retrospective cohort data linkage study from the Northern Territory

Bernard Leckning, Rohan Borschmann, Steven Guthridge, Sven R Silburn, Tanja Hirvonen, Gary W Robinson

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Abstract

Purpose:
This study aimed to explore risk factors for suicide in Aboriginal and non-Aboriginal people following hospital admission for suicidal ideation and self-harm in the Northern Territory, Australia to help clarify opportunities for improved care and intervention for these population groups.

Methods:
Individuals with at least one hospital admission involving suicidal ideation and/or self-harm between 1 July 2001 and 31 December 2013 were retrospectively recruited and followed up using linked mortality records to 31 December 2014. Survival analyses stratified by Indigenous status identified socio-demographic and clinical characteristics from index hospital admissions associated with suicide.

Results:
Just over half of the 4391 cohort members identified as Aboriginal (n = 2304; 52.4%). By 2014, 281 deaths were observed comprising 68 suicides, representing a 2.6% and 2.0% probability of suicide for Aboriginal and non-Aboriginal people, respectively. After adjusting for other characteristics, a higher risk of suicide was associated with male sex (Aboriginal adjusted hazard ratio: 4.14; 95% confidence interval: [1.76, 9.75]; non-Aboriginal adjusted hazard ratio: 5.96; 95% confidence interval: [1.98, 17.88]) and repeat hospital admissions involving self-harm (Aboriginal adjusted hazard ratio: 1.37; 95% confidence interval: [1.21, 1.55]; non-Aboriginal adjusted hazard ratio: 1.29; 95% confidence interval: [1.10, 1.51]). Severe mental disorders were associated with a four times higher risk of suicide (adjusted hazard ratio: 4.23; 95% confidence interval: [1.93, 9.27]) in Aboriginal people only.

Conclusion:
The findings highlight non-clinical risk factors for suicide that suggest the need for comprehensive psychosocial assessment tailored to Aboriginal and non-Aboriginal people hospitalised with suicidal ideation or self-harm. Implementing appropriate management and aftercare within a broader public health framework is needed to support recovery and reduce long-term suicide risk in the community, especially for Aboriginal people and males.
Original languageEnglish
Pages (from-to)391-400
Number of pages10
JournalAustralian and New Zealand Journal of Psychiatry
Volume57
Issue number3
Early online dateJun 2022
DOIs
Publication statusPublished - Mar 2023

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: B.L. is supported by a research scholarship from the National Suicide Prevention Research Fund administered by Suicide Prevention Australia. R.B. is funded by a National Health and Medical Research Council (NHMRC) Emerging Leadership-2 Investigator Grant (GNT2008073).

Funding Information:
We would like to acknowledge people who have had direct experience of suicide, including those who have attempted suicide and those bereaved by suicide. We would like to thank the advisory group to this study comprising Aboriginal and non-Aboriginal experts with clinical and lived experience for their generous insight and feedback. We thank the NT Department of Health for their support in obtaining and understanding the data for this study. The views expressed in this publication are those of the authors and not necessarily those of the funding body and partners to this study. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: B.L. is supported by a research scholarship from the National Suicide Prevention Research Fund administered by Suicide Prevention Australia. R.B. is funded by a National Health and Medical Research Council (NHMRC) Emerging Leadership-2 Investigator Grant (GNT2008073).

Publisher Copyright:
© The Royal Australian and New Zealand College of Psychiatrists 2022.

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