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Suicide and self-harm among older Australians

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Older Australians are identified as a priority population under the National Mental Health and Suicide Prevention Agreement (the Agreement) (Commonwealth of Australia 2022). Under the Agreement, Commonwealth and state and territory governments have a shared responsibility to support priority populations who are at higher risk of mental health concerns and suicide due to vulnerabilities caused by social, economic, and environmental circumstances.

Older Australians are a diverse group, with different cultural and socioeconomic backgrounds, life experiences, and lifestyles. They generally include those aged 65 years and over, unless otherwise specified (AIHW 2023). Older people also make up a considerable proportion of Australia’s population – on 30 June 2022, almost 1 in 6 people (17%) were aged 65 years and over (ABS 2023). Due to small numbers, this report does not disaggregate by First Nations status but may be included in future updates where possible.

As people get older, they may become more vulnerable to certain risk factors for suicide and self-harm. For instance, suicidality is associated with loneliness, social isolation, and perceived burdensomeness in older people (Klein et al. 2023). In contrast, strong social support, community engagement and maintaining physical health are protective factors against suicide and self-harm (Klein et al. 2023).

This article provides monitoring data on suicide, intentional self-harm hospitalisations and ambulance attendances for suicidal behaviours among older Australians. For more information on the health and welfare of older Australians, see the GEN Aged Care or the Aged Care webpages. For more information about the mental health needs of individuals at the time of assessment for aged care services and about deaths due to suicide while accessing aged care, see the Mental health in aged care report.

Measuring suicide and intentional-self harm over time

Monitoring data on this page use both age-standardised and age-specific rates to measure suicide and intentional self-harm over time. 

Age-standardised rates adjust for age differences across populations, allowing for comparisons over time. This ensures that observed differences in suicide rates over time are not due to varying age structures but reflect true differences in rates.

Age-specific rates refer to the rate of an event within a specific age group. This is useful for providing information about a particular age group at a given time.

Presenting both age-standardised and age-specific rates provides a comprehensive overview of monitoring data. Age-specific rates identify which age groups are most affected, while age-standardised rates allow for fair comparisons and a broader understanding of trends.

For more definitions please see the Glossary.

Death by suicide among older Australians

The data visualisation below provides an overview of suicide trends among older Australians over time, highlights variations by sex, and compares these trends to younger people and people of all ages.

The interactive timeseries visualisation shows deaths by suicide from 1921 to 2022, by those aged ‘65 years and over’, ‘under 65 years’ and ‘all ages’. Age-standardised rates (per 100,000), age specific rates (per 100,000) and number can be chosen. Data may also be viewed by females, males and persons. 

Older Australians suicide rate has decreased over time

After adjusting for differences in age structures over the years, the overall suicide rate among older Australians (aged 65 year and over) has declined.

  • 1920s to 1960s: Generally, older Australians had higher aged-standardised rates of suicide deaths compared to those aged under 65 years. These peaks often coincided with major social and economic events, see Impact of social and economic events.
  • 1970 to early 1990s: The age-standardised suicide rate among older Australians fell to similar rates, albeit slightly higher overall, of those aged under 65 years.  
  • Early 1990s onwards: Suicide rates among older Australians continued to fall and remained lower than those of people aged under 65 years. In 2022, the age-standardised suicide rate for those aged 65 and over was 13.3 per 100,000 people, compared to 15.7 for those aged under 65 years.
  • Until around the 1990s, males over the age of 65 years had higher rates of suicide compared to those under 65. Since then, the suicide rate of males over 65 years have been slightly lower than those for younger males, with some variation.
  • While the age-standardised and age-specific rate of suicide among older Australians has decreased over time, the total number of suicides has steadily increased, reflecting the overall increase in the Australian population.

Intentional self-harm hospitalisations among older Australians

The data visualisation below provides an overview of intentional self-harm hospitalisations among older Australians, from 2008–09 to 2022–23. Note ‘intentional self-harm’ includes both suicide attempts and non-suicidal self-harming behaviours. For more information on intentional self-harm hospitalisations data, see Suicide & self-harm monitoring: Intentional self-harm hospitalisations and Data sources.

The interactive timeseries visualisation shows intentional self-harm hospitalisations  from 2008–2009 to 2022–2023, by those aged ‘65 years and over’, ‘under 65 years’ and ‘all ages’. Age-standardised rates (per 100,000), age specific rates (per 100,000) and number can be chosen. Data may also be viewed by females, males and persons. 

Intentional self-harm hospitalisations among older Australians is lower than younger Australians

Between 2008–09 and 2022–23:

  • the age-standardised rate of intentional self-harm hospitalisations among older Australians has remained steady, ranging from 36.1 per 100,000 people in 2008–09 to 37.4 in 2022–23, reaching a peak of 44.0 in 2016–17.
  • On average, the age-standardised rate of intentional self-harm hospitalisations was 3.5 times higher among those aged under 65 years compared to older Australians aged 65 and over, reflecting the overall higher rates among younger age groups (AIHW, 2024).
  • The age-standardised rate of intentional self-harm hospitalisations among older Australians was similar for males and females, yet on average the rate was almost twice as high (1.9 times) among younger females compared to younger males.

Ambulance attendances for suicidal ideation, and suicidal and self-harm behaviours among older Australians

The data visualisations below provide an overview of ambulance attendances for suicidal ideation, suicide attempts, and self-injury among older Australians, in states and territories where data are available. This includes people who needed an ambulance and self-harmed during the ambulance attendance or in the preceding 24 hours. For more information on definitions and inclusions, see Ambulance attendances: Suicidal ideation, and suicidal and self-harm behaviours and Data sources - National Ambulance Surveillance System (NASS).

The following time series visualisation contain monthly data from January 2021 until December 2022 among the selected jurisdictions. Data prior to 2021 are based on 1-month per quarter snapshots between March 2018 and December 2020. 

Caution is advised when making month to month comparisons, particularly for the 1-month per quarter snapshot data (pre-2021 data). It is advised to compare the same months over a few years to allow for any seasonal effects and variations at different times of year. When comparing changes to estimates over time it is advised to ‘Show error bars’ on the visualisation. These show the 95% confidence interval for the age-specific rate which can vary widely in the case of small populations. This means that we are confident that the true number would fall within the interval range 95% of the time.

In addition, the following factors should be considered when interpreting ambulance data:

  • Industrial action occurred in New South Wales (NSW) in April 2022, with a minimal impact on ambulance services and demand. 
  • A small decrease in the number of NSW ambulance attendances was observed in July and August 2022 due to technical issues.
  • Industrial action in NSW during early February 2023, which could have resulted in lower numbers. 
  • A computer-aided dispatch outage in Queensland on 10 March 2023 resulted in no cases being recorded for that date.

The interactive timeseries visualisation shows ambulance attendances, from January 2018 to June 2023. Prior to January 2021, data are quarterly monthly snapshots, with data series breaks in between snapshot months. From January 2021, data are shown as monthly snapshots with no data breaks. Data are show by those aged ‘65 years and over’, ‘under 65 years’ and ‘all ages’. Age-specific rates (per 100,000) and number can be chosen. Data may also be viewed by females, males and persons. The user may also view data with 95% confidence interval error bars, by selecting ‘show error bars’.

Ambulance attendances for self-harm are lower among older Australians compared to younger Australians

Between March 2018 and June 2023 in New South Wales (NSW), Victoria (Vic), Tasmania (Tas) and the Australian Capital Territory (ACT) combined:

  • the age-specific rate of ambulance attendances for suicidal ideation, suicide attempts and self-injury was lower among older Australians compared to those under 65 years. This is similar to trends in intentional self-harm hospitalisations among these two populations (see Intentional self-harm hospitalisations for older people compared to those under 65 years and all ages, Australia, 2008–09 to 2022–23, above).
  • The age-specific rates among older Australians remained steady over time for suicidal ideation, suicide attempts and self-injury ambulance attendances.
  • Among older Australians, the age-specific rates for ambulance attendances for suicide attempts and self-injury were similar for males and females. However, among those aged under 65, the rates were almost twice as high (1.8 times higher) on average for females compared to males.
  • On average, suicidal ideation was around 1.4 times higher among males aged 65 years and over compared to females of the same age.

State and territory variations in self-harm ambulance attendances among older Australians

Comparing ambulance data between states and territories

Comparing ambulance attendance rates across states and territories requires careful interpretation due to varying factors such as the availability of ambulance services, cost coverage differences, and access to 24-hour health centres. Additionally, inconsistencies in paramedic patient records across jurisdictions can affect the data, making it challenging to fully understand the reasons behind the differences in attendance rates. For further information on comparing state and territory data please refer to the technical notes.

The interactive bar chart visualisation shows ambulance attendances aggregated by year for 2021 and 2022. Data are shown by 10-year age groups over 65 years (65–75, 75–84 and 85+) and total age groups (‘65 years and over’, ‘under 65 years’ and ‘all ages’). Age-specific rates (per 100,000) and number can be chosen. Data may also be viewed by females, males and persons. The user may also view data by attendance type.

In 2022:

  • across all states and territories, older Australians had lower age-specific rates of ambulance attendances for suicidal ideation, suicide attempt and self-injury compared to those under 65 years.  
  • In NSW, the rate of ambulance attendances for suicide attempts was significantly higher among males aged 85+ (77.6 per 100,000; 95% confidence interval (CI): 58.6–100.7), compared to those aged 65–74 years (32.6; 95% CI: 27.0–38.9) and 75–84 years (37.8; 95% CI: 30.1–46.9). This rate was almost as high as the NSW rate for people aged under 65 years (83.8; 95% CI: 80.8–86.9). The higher rates among males aged 85 years and over were also observed in Qld and Vic, although the overlapping 95% CIs among the younger age groups suggest the differences may not be significant (see Methods for more information on uncertainty). The number of attendances among males aged 85 years and over was too small to present rates for NT, Tas and the ACT.
  • The rate of ambulance attendances for suicidal ideation tended to decrease with increasing age among older Australians, in NSW, Vic, Qld, and Tas. In the ACT however, attendances were highest among those aged 85 years and over (96.0 per 100,000; 95% CI: 38.6–197.7), though the 95% CI overlaps with people in the 65–74 years (66.6; 95% CI: 42.2–99.9) and 74–84 years (64.2; 95% CI: 34.2–109.8) age groups.
  • The rate of attendances for self-injury was significantly lower among older Australians compared to those aged under 65 years across all states and territories. The number of attendances for self-injury among those aged over 65 years was too small to draw meaningful comparisons.

Further information

References

Australian Bureau of Statistics (ABS) (September 2023), Population by age and sex - national, ABS Website, accessed 30 May 2024.

Australian Institute of Health and Welfare (AIHW) (2023) Older Australians, AIHW, Australian Government, accessed 30 May 2024.

AIHW (2024) Suicide & self-harm monitoring: Intentional self-harm hospitalisations by age groups, AIHW, Australian Government, accessed 20 July 2024.

Klein B, Shandley K, McLaren S, Clinnick L and Nguyen HV (2023) ‘Suicidality among older Australian adults’, Front Public Health, 9(10):992884. doi: 10.3389/fpubh.2022.992884.

The Commonwealth of Australia (2022) The National Mental Health and Suicide Prevention Agreement, The Federal Financial Relations, accessed 30 May 2024.

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