GROWTH IN EMERGENCY SELF-HARM PRESENTATIONS IN YOUNG PEOPLE IN NSW: COMPARING TRENDS BEFORE AND SINCE THE COVID-19 FIRST WAVE

ABSTRACT

Background: Self-harm presentations in young people have increased internationally over the last decade. The COVID-19 pandemic has the potential to worsen these trends. Objectives: To describe trends in Emergency Department (ED) self-harm presentation for young people in New South Wales (NSW) before and since the COVID-19 pandemic. Methods: We studied presentations to NSW EDs by 10- to 24-year-olds for self-harm or suicidal ideation. Interrupted time series compared annualised growth before COVID-19 (2015-20) and since (March 2020-June 2021). Subgroup analyses compared age group, gender, triage category, rurality and disadvantage. Time series decomposition identified long-term, seasonal and shortterm trends. Findings: Self-harm presentations by young people in NSW increased by 8.9% per annum (pa) pre-COVID. Growth accelerated to 19.9% pa post-COVID, specifically due to increased presentations by females aged 13-17 (up 47.1% pa, from 290 per 10,000 in 2019 to 466 per 10,000 in 2021). Self-harm presentations in males aged 10-24 did not increase post-COVID (105.4 per 10,000 in 2019, 109.8 per 10,000 in 2021) despite growing 9.9% pa before COVID. Presentation rates accelerated significantly in socially advantaged areas and in non-aboriginal youth. Conclusion: ED self-harm presentations by NSW young people grew steadily before COVID. Growth has increased since COVID specifically for adolescent girls, but not among adolescent males. Surprisingly, the largest post-COVID increases in annual growth occurred in socio-economically advantaged and urban regions and non- Aboriginal young people. The COVID-19 pandemic appears to have added new challenges, particularly in females in the developmentally critical early adolescent and teenage years.