Adolescents 3.4 times more likely to self-harm than adults: AIHW

Every year, more than 6000 young people are hospitalised from intentional self-harm injuries, leading GPs to call for a systemic rethink of mental health services in Australia.
 
According to new Australian Institute of Health and Welfare (AIHW) data, children aged 13–18 are 3.4 times more likely than adults to be hospitalised from self-harm. Young girls are particularly at risk, representing four in five of these cases.
 
This alarming new insight has led GPs to plead for urgent mental health funding, training, and support, especially as current psychologist and psychiatric waitlists are leaving patients without care for months on end.
 
Dr Andrew Leech, a GP with a special interest in paediatric and mental health, described the data as a ‘tragedy’.
 
‘These children have their lives ahead of them and they get caught up in complex or difficult situations and see no other way than to self-harm or injure themselves and unfortunately, they may not be able to access support or help when they need it,’ he told newsGP.
 
‘One of the tricky things is unless you ask, you usually don’t know about it, so it’s a really important thing for GPs to be asking about self-harm in adolescent consultations.
 
‘A lot of teenagers won’t talk about it, or shy away from it, or are ashamed of it, or there’s a parent in the room and they don’t want the parent to know, so we need to carefully navigate these situations with them.’
 
The AIHW data, released this month, examines all hospital and emergency department presentations for young people, revealing between 2021–22, 1098 boys and 5244 girls self-harmed – 6342 in total.
 
These numbers represent a 38% increase in cases compared to just four years ago, with 4572 self-harm hospitalisations reported in the same age group in 2017–18.
 
Dr Leech said the spike comes as teens continue to navigate the complex world of social media, with some negatively impacted by it, while others use it as a positive avenue of escape.
 
According to headspace, one in three young people currently experience problematic social media use, and 55% say not enough is being done in terms of media regulation and laws.
 
However, 41% of young people say the amount of information on social media is empowering, and 40% believe it is a good place to meet new friends.
 
‘Young people compare themselves to other idealistic characters online and there’s a pressure to be perfect,’ Dr Leech said.
 
‘It can become very confusing as they navigate social media, and they fall in traps, and think, “well I’m never going to be like that”.
 
‘But on the flip side, a lot of teenagers tell me they use it as an escape when they do feel like self-harming, so it’s very tricky to say, “we’ll just get rid of it” because for some of them it’s their only portal for support and communication to others when they’re feeling vulnerable.’
 
Dr Leech is calling for additional funding for mental health appointments, saying a standard 20-minute consultation is inadequate for discussing an individual’s mental wellbeing.
 
‘GPs need to be able to sensitively ask about self-harm with their adolescent patients, and if it’s not something you’re comfortable asking the teenager with the parent in the room, it may be important to ask the parent to step outside and then to ask,’ he said.
 
‘There are a number of teenagers self-harming without disclosing it as part of their routine consultations, so we can’t be judgmental towards them, we need to build rapport through being approachable and understanding.
 
‘Even if we don’t always understand why they’re doing it, because it’s very easy to jump to say, “don’t do it”, we need to dig deeper and work out where it’s coming from, what’s causing it, and how can we support that issue that’s going on for them.’
 
More broadly, the data found boys make up 58% of all emergency department presentations and 61% of hospitalisations.
 
Children younger than four years old are most likely to have an emergency presentation, while First Nations children and those living in remote Australia experience disproportionately higher rates of childhood injury.
 
Falls and contact with objects were the top causes of injury hospitalisation, with 36% of these being for fractures.
 
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