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Journal Article

Citation

O'Hare K, Watkeys O, Harris F, Dean K, Carr VJ, Green MJ. Med. J. Aust. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Australian Medical Association, Publisher Australasian Medical Publishing)

DOI

10.5694/mja2.51898

PMID

36970987

Abstract

Self-harm and suicide by young people are major problems,1 and they are more frequent among people known to child protection services,2, 3 especially those placed in out-of-home care.4 We used record linkage to quantify the cumulative incidence of self-harm and suicidal ideation in a population sample of New South Wales children and adolescents aged 0-17 years with differing levels of child protection contact during 2003-21.

We analysed data for the 91 597 participants in wave 3 of the New South Wales Child Development Study5 (http://nsw-cds.com.au). First incidents of self-harm (International Classification of Diseases, tenth revision, Australian modification [ICD-10-AM] codes X60-X84, T14.91, Y87.0) or suicidal ideation (ICD-10-AM codes R45.81, R45.851) during 1 January 2000 - 31 March 2021 were identified in linked health records in the NSW and Australian Capital Territory emergency department, admitted patient, and mental health ambulatory data collections. Record linkage was conducted by the Centre for Health Record Linkage (http://www.cherel.org.au), with an estimated false positive linkage rate of 0.5%. Young people with records of both self-harm and suicidal ideation were included in the self-harm group.

Child protection contact was identified in the NSW Department of Communities and Justice ChildStory database6 (1 July 1998 - 31 July 2021). Each participant was assigned to one of four categories of child protection contact according to the highest level: out-of-home care, substantiated report of child abuse or neglect non-substantiated/non-threshold report of child abuse or neglect, and no child protection contact. The cumulative incidence of first incidents of self-harm and suicidal ideation was calculated for each child protection level, based on the cumulative number of people at each year of age in the study sample (further details: Supporting Information). The NSW Population and Health Services, ACT Health, and Calvary Public Hospital human research ethics committees approved the study (HREC/18/CIPHS/49).


Language: en

Keywords

Suicide; Longitudinal studies; Self-injurious behavior; Child protective services; Child psychiatry

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