Conference Agenda

Background: Youth suicide is a major public health problem and, despite significant effort and investment, rates remain high. A contemporary understanding of the social determinants of suicide is required to optimise preventative efforts. The Right Here, Right Now study aims to investigate the broad social and structural determinants driving mental ill-health and suicide risk in young Australians.

Methods: A cross-sectional national survey of 2948 young Australians aged 12-25 (M = 20.2 years, SD = 3.7, 54.2% female) was conducted. Participants were recruited from 2 research panels and boosted by convenience sampling with population-based quotas applied. An online questionnaire was administered examining mental ill-health, suicide and self-harm, and potential contributing factors such as climate anxiety, childhood trauma and intimate partner violence, plus online experiences including social media use.

Results: Preliminary analysis indicates that 67.9% participants reported experiencing mild symptoms of depression, with 14.9% experiencing moderately severe and 9.1% severe depressive symptoms respectively. One third (33.6%) reported ever being diagnosed with a mental illness, behavioural disorder, or a neurodevelopmental condition. Lifetime serious suicidal thoughts were reported by 35.5% of participants, with 15.3% reporting suicidal thoughts in the past 12 months; 8.9% reported at least one lifetime suicide attempt.

The most common contributors reported by participants were cost of living (87.2%), followed by housing affordability (84.6%), physical appearance (81.0%), climate change (78.8%), global conflicts (77.7%), mental health (75.2%), and physical health (75.1%). 60.4% expressed concern about social media use, with most only being slightly (26.5%) or somewhat (17.2%) concerned.

Conclusion: This study has provided up-to-date data on rates of, and risk factors for, mental ill-health and suicide risk among young Australians. It is hoped this will lead to increased, more contemporary, understanding of how to tackle suicide risk in young people plus recommendations for clinical services, policymakers and researchers, in and beyond Australia.

Background: Over 500 people die by suicide annually in Ireland. Among males aged under 25, suicide is the leading cause of death, while for females suicide is the third highest cause of death. There are stark socio-demographic differences in adolescent mental health difficulties, with consequences for widening inequalities. National studies of youth suicide are needed, including a focus on social determinants.

Method: A national retrospective study of a complete cohort of youth suicides in Ireland (2015-2020) was carried out. Data on probable suicides were obtained from the Irish Probable Suicide Death Study (IPSDS). National population statistics were obtained from the Central Statistics Office. Key variables examined included age, sex, socio-economic status (SES), living situation and employment.Poisson regression with population offset, adjusted by sex and age, was used to examine suicide rates in groups of interest.

Results: There were 735 cases of probable suicide recorded nationally among those aged 10-30 in the 6-year study period, with 74% of suicides in males. The overall annual rate of probable suicide was 9.77 per 100,000 (95% CI: 9.07-10.5). Highest rates in males and females were in the 25-29 year-old and 20-24 year-old age groups respectively. Homelessness was associated with high suicide risk, with an annual rate of 104.9 per 100,000. Compared with the reference group (high SES employed individuals), the unemployed group had an elevated suicide rate (IRR: 21.42; 95% CI: 14.23-33.89). Middle SES and lower SES employed individuals also had higher suicide rates than the reference group (IRR: 4.87; CI: 3.16-7.84 and IRR: 4.61; CI: 2.85-7.69 respectively). Students had significantly higher rates of suicide than the high SES reference group (IRR: 9.87; CI: 6.52-15.69).

Conclusion: Interventions to reduce social inequalities may be effective in reducing rates of suicide. Targeted support is needed for high-risk groups including those experiencing unemployment or homelessness and students.

Background

Self-harm is one of the leading causes of death among young people worldwide. Age of onset of hospital-presenting self-harm is older than what is generally reported. The evidence is mixed regarding the relationship between age of onset and repeat self-harm. This study explores the relationship between age of first presentation (onset) and repeat self-harm.

Methods

Data between 2010-2023 were included from the National Self-Harm Registry Ireland. Young people aged 10-20 years who first presented to hospital emergency departments with self-harm between 2010-2018 were followed for a maximum of 5 years. Cox regression provides estimates on repetition risk over time in males and females with age of onset as a predictor and method(s) of self-harm, alcohol involvement, and admission information as covariates.

Results

Between 2010-2018,16,310 individuals presented to emergency departments for the first time, 62.1% were made by females and 37.9% by males. Approximately 26% repeated over the 5 year follow up. The gender proportions for first and repeat presentations were similar. Repeat presentations made by males who had an onset age of 10-13 years were minimal but sharply increased with increasing age of onset. Repeat presentations made by females sharply increased from those with an onset age of 12 years and then declined after reaching its peak at 15 years.

Conclusions

Descriptive results suggest repetition is associated with a younger age of onset among females compared to males. The findings of the cox regression analysis will be presented and will add nuance to the descriptive findings. The age groups and clinical characteristics where risk is highest and intervention might be most appropriately directed will be presented.

Background: Patients presenting to the hospital after a suicide attempt have a higher risk of subsequent suicide, especially in the months following their visit. In the Netherlands, approximately 40% of visits involve a re-attempt, although recent data are scarce. Young people aged 15-29 years are the highest risk group for emergency department (ED) visits after a suicide attempt. This study aims to inform suicide prevention strategies for young people by analysing time trends in suicide attempts, re-attempts, and receipt of aftercare.

Methods: Data were obtained from the Dutch Injury Surveillance System (DISS), which collects registration data from a representative sample of Dutch hospitals. Observed numbers of suicide attempts and non-suicidal self-injuries were extrapolated to estimate total self-harm events. Prevalence rates per 100,000 inhabitants were calculated for 2020-2024 and compared with rates from 2015-2019. Analyses were stratified by gender and 10-year age groups. To reduce participation burden for hospitals, re-attempts were assessed using 2024 data, with duplicated cases identified in the dataset through 2023.

Results: Preliminary findings showed that between 2020 and 2024, 42% of ED visits for suicide attempts involved young people aged 10–29 years. The increase in suicide attempts was significant among young females (73%), whereas the increase among young males did not reach statistical significance. Females aged 10–19 years and 20–29 years remained high-risk groups, with 200 and 220 ED visits per 100,000 inhabitants, respectively. Re-attempts were more common among females. Additional results on age-specific patterns, methods for self-harm and aftercare will be presented.

Conclusions: Our preliminary findings indicate that suicide attempts have increased among young people, particularly young females. This trend might be partly attributable to re-attempts within this group. These findings highlight the importance of ensuring high-quality care in hospitals to help prevent worsening of mental health among young people.