Epidemiology of Emergency Department Visits for Suicide Attempts in the South Pacific: New Zealand 1997-2006

Background: Increasing rates of emergency department (ED) visits for self-harm have been reported in the US. It is not clear if these trends are generalizable to other nations. Study objectives: To determine national trends in ED visits for self-harm in New Zealand (NZ) from 1997-2006. Methods: Annual national hospitalisation admission data were obtained from the NZ Ministry of Health. Serious self-harm visits were defined by ICD9 E950-959 and ICD10 X60-X84 codes among all admitted ED patients from 1997-2006. Results: Serious self-harm ED visits in NZ increased significantly from 1997 to 2006 (95.7 to 152.7 per 100 000; ptrend<.01). ED suicide visit and hospitalization rates were persistently higher for females, increasingly significantly from 1997 to 2006 (108.9 to 203.7 per 100 000; ptrend<.01). Young females (15-19 years) had the highest hospitalisation rate, increasing significantly from 1997 to 2006 (296.7 to 492.2 per 100 000) (ptrend<.01). Serious self-harm rates were higher amongst indigenous Maori than non-Maori throughout the decade, increasing over two-fold from 1997 to 2006 (90.1 to 209.6 per 100 000; ptrend<.01). In 2006 the Maori hospitalisation rate was 1.5 times the non-Maori rate (p<.01). ED self-harm rates in 2006 were 181.7 v. 102.8 per 100 000 in the most deprived v. least deprived population quintiles (p<.01). Conclusions: ED visits for serious self-harm in NZ show similar trends to those in the US, increasing during the last decade and continuing to increase as national suicide rates decline. These trends imply that self-harm presentations constitute an increasing workload for emergency departments internationally.