Adolescent Suicidal Behaviors During the COVID-19 Pandemic in Australia: Analysis of Acute Harms Assessed via Ambulance Data

Debbie Scott, Michael McGrath, Naomi Beard, Sarah Chislett, Ryan Baldwin, Ziad Nehme, Dan I. Lubman, Rowan P. Ogeil

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Purpose: This study investigated changes in suicidal ideation, attempts, and nonsuicidal self-injury (NSSI)-related ambulance attendances among adolescents during the COVID-19 pandemic. Methods: An interrupted time series analysis using data from the National Ambulance Surveillance System, a globally unique mental health and suicide surveillance system. Patients aged 12–17 years from the state of Victoria, Australia who were attended by ambulance for suicide attempts, suicide ideation, and NSSI between January 2016 and October 2021 were included. Monthly ambulance attendances during the pre-COVID period (January 2016–March 2020) were compared to those in the peak period of COVID-19 (April 2020–October 2021). Results: There were 20,125 ambulance attendances for suicide ideation, suicide attempt, and NSSI in adolescents over the study period. During the pre-COVID period, the number of suicide ideation, attempts, and NSSI attendances was increasing by 1.1% per month (incidence rate ratio [IRR]:1.011; 95% confidence interval [1.009–1.013], p < .001). There was no change in the rate of all suicide ideation, attempt, and NSSI for all adolescents during the period of COVID-19. However, when disaggregated by gender, there was a 0.7% increase in the monthly rate of attendances for females (IRR: 1.007 [1.001–1.013], p = .029), and a 3.0% decrease for males (IRR: 0.970 [0.964–0.975], p < .001). Discussion: Adolescent female suicide ideation, attempt, and NSSI attendances increased during the COVID-19 period, compared with males in the same time period. These findings suggest tailored intervention strategies may be needed to address the increasing trends of self-harm among young people.

Original languageEnglish
Pages (from-to)908-915
Number of pages8
JournalJournal of Adolescent Health
Issue number5
Publication statusPublished - 2024


  • Adolescent health
  • Ambulance
  • COVID-19
  • Public health
  • Self-harm
  • Suicide

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