title: Suicidal ideation and non-fatal deliberate self-harm presentations in the Kimberley from an enhanced police-mental health service notification database.
abstract: OBJECTIVE
  To determine the rate of presentations for suicidal ideation and deliberate self-harm in the Kimberley region of Western Australia, characterized in terms of age, gender, rates of repetition and engagement with community mental health services.
  
  
  METHODS
  An observational study of health service presentations over 12 months.
  
  
  METHODS
  10 sites across the region with police services were included, capturing the overwhelming majority of self-harm presentations in the region.
  
  
  METHODS
  all Indigenous presentations were analyzed. Of the 433 individuals who presented, 361 were Indigenous.
  
  
  METHODS
  suicidal phenomena, including suicidal ideation and any type of deliberate self-harm regardless of intent.
  
  
  RESULTS
  Analysis suggests a broadly similar age and sex stratification of self-harm in this population compared with international reports. The rates, however, are 5-20 times higher than those reported in non-Indigenous populations in Australia and abroad, depending on whether the comparison rate is calculated from population surveys or hospital presentations.
  
  
  CONCLUSIONS
  Prevalence of suicidal phenomena is very high and is likely to be much higher than estimated by this hospital based study. Such high prevalence suggests that a population level intervention is required in addition to interventions involving clinical services.
authors.affiliation: Psychiatry Registrar, Kimberley Population Health Unit, Australia; Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.
authors.forename: Cate
authors.initials: C
authors.lastname: McHugh
authors.affiliation: Consultant Psychiatrist, Kimberley Mental Health, Drug and Alcohol Service, Broome, WA, and; University of Western Australia, Perth, WA, Australia.
authors.forename: Sivasankaran
authors.initials: S
authors.lastname: Balaratnasingam
authors.affiliation: General practice Registrar, Kimberley Aboriginal Medical Service, Broome, WA, Australia.
authors.forename: Anita
authors.initials: A
authors.lastname: Campbell
authors.affiliation: Consultant Psychiatrist, Kimberley Mental Health, Drug and Alcohol Service, Broome, WA, and; University of Western Australia, Perth, WA, Australia.
authors.forename: Murray
authors.initials: M
authors.lastname: Chapman
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D044382:Population Groups / Q000706:statistics & numerical data*; D012307:Risk Factors; D012621:Seasons; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D017678:Sex Distribution; D059020:Suicidal Ideation; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult
keywords: Indigenous; deliberate self-harm; remote mental health; suicidal ideation; young people