Child abuse and neglect identified as a leading risk factor for self-harm and suicide

The report provides new insights into potentially-modifiable risk factors, which also include misuse of drugs and alcohol, and domestic violence.

The study estimates that almost half (48 per cent) of the burden of suicide and self-inflicted injuries is due to those four risk factors.

Child abuse and neglect during childhood, however, was consistently the leading behavioural risk factor contributing one third of the total burden of disease due to suicide and self-harm in females, and 24 per cent in males in 2019.

In 2019, Australians lost 145,703 years of healthy life due to suicide and self-harm, representing around 23 per cent of the total burden of disease and injury in Australia, and 10 per cent of total burden among those aged 15 to 24 years.

There were 3300 deaths by suicide in 2019, and more than 28,600 hospitalisations due to intentional self-harm in 2019-20 in Australia, the report reveals. Males were three times more likely to take their lives than females, but females were more likely than males to be hospitalised for intentional self-harm.

Alcohol use in people over the age of 15 was the second leading risk factor among males, while, for females, intimate partner violence contributed almost 20 per cent of the burden among those aged 15 years and over.

Suicide was the third leading cause of fatal burden in Australia in 2018 (second for males) and the leading cause of fatal burden for males and females aged 15-44, data linked to the report says.

After adjusting for population increase and ageing, there was a 13 per cent increase in total burden due to suicide and self-inflicted injuries between 2003 and 2019.

Opposition Family and Community Services spokeswoman and Port Stephens MP Kate Washington said the report revealed some of the most tragic consequences of a failing child protection system.

"Right now in NSW, two out of three children reported to the Department as being at risk of significant harm are never even seen by a caseworker," Ms Washington said.

"The government says that creating safer homes for vulnerable children is a priority, but by their own measure, they are failing dreadfully, and it's getting worse.

"If we are going to prevent the tragic loss of more young lives due to child abuse and neglect, the NSW government must step up and start taking its job seriously."

More than 50 "at risk" kids are being reported every day across the Hunter New England region a total of 19, 245 children in the 12 months to the end of December, 2020. That is an increase of more than 42 per cent since 2014, according to statistics produced by the NSW Department of Communities and Justice.

Less than one third of those children are being seen by caseworkers who are grappling with the sheer volume of cases - 55 at-risk kids per full-time funded position. That leaves more 13,000 children identified as being at risk of serious harm to fend for themselves.

To become the subject of a 'risk of significant harm' report, a child must be the suspected victim of sexual physical or emotional abuse, domestic violence, or neglect.

Statistics produced by the Department of Communities and Justice on a quarterly basis show the number of children at risk but not assessed by a caseworker has risen by 44 per cent in the six years to 2020.

Another report, the biennial report of the deaths of children in NSW, produced by the NSW Ombudsman's office, reveals that the proportion of children who died as a result of abuse and neglect with a child protection history, has more than doubled over the past ten years, from 44 per cent to 89 per cent.

A spokesman for the AIHW, Richard Juckes, said the inclusion of child abuse and neglect into burden of disease analysis as a risk factor involved meta-analysis of data from around the world.

"So it's not so much being discovered in this report as being quantified," he said.

There was often a huge lag, he pointed out, saying the statistics revealed more about the long term effects on adults of being abused or neglected as children, that the immediate impacts of child abuse and neglect.

And while intervention could mean different things to different people, and some aspects of it may be politically charged, the message was clear, Mr Juckes said.

"Reducing childhood abuse and neglect will lead to less suicide burden later on."

The AIHW report also found that the Northern Territory was home to the greatest burden due to suicide and self-inflicted injuries, where the rate was 1.6 times as high as the national rate, and that the rate generally increased with increasing remoteness, with the highest rates of burden among people living in remote and very remote areas, where the rates were 2.3 times those for major cities.

It found the rate of suicide and self harm increased with increasing socioeconomic disadvantage, with the rate of burden among people in the lowest socioeconomic areas (most disadvantaged areas) being twice as high as that of those in the highest (least disadvantaged) socioeconomic areas.

On average, people lost 42 years of life due to dying from suicide in 2019. This was much higher than leading causes of death such as coronary heart disease (12), dementia (7) and lung cancer (17); and similar to road transport injuries (43) and drug use disorders (41).

That puts suicide among the top 5 causes with the highest average years of life lost each year.

The report, The health impact of suicide and self-inflicted injuries in Australia, 2019, updates and extends data from the Australian Burden of Disease Study 2018 to calculate the combined impact on individuals of dying prematurely from suicide (fatal burden) and of injury and illness from self-harm (the non-fatal burden)

In other AIHW research linked to the report on Social factors and deaths by suicide, available on the AIHW Suicide and self-harm monitoring website, there were also strong associations established between suicide and being widowed, divorced or separated; being in a lone person household, and being unemployed or not in the labour force.

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