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Article ; Online: Identifying typologies among persons admitted to hospital for non-fatal intentional self-harm in Victoria, Australia.

Clapperton, Angela J

Social psychiatry and psychiatric epidemiology

2019 Volume 54, Issue 12, Page(s) 1497–1504

Abstract: Purpose: The aim of this study was to determine whether people who have been hospitalised as the result of non-fatal self-harm form meaningful groups based on mechanism of injury, and demographic and mental health-related factors.: Methods: A ... ...

Abstract	Purpose: The aim of this study was to determine whether people who have been hospitalised as the result of non-fatal self-harm form meaningful groups based on mechanism of injury, and demographic and mental health-related factors. Methods: A retrospective analysis of 18,103 hospital admissions for self-harm in Victoria, Australia over the 3-year period 2014/2015-2016/2017 recorded on the Victorian Admitted Episodes Dataset (VAED). The VAED records all hospital admissions in public and private hospitals in Victoria. The primary analysis used a two-step method of cluster analysis. Initial analysis determined two distinct groups, one composed of individuals who had a recorded mental illness diagnosis and one composed of individuals with no recorded mental illness diagnosis. Subsequent cluster analysis identified four subgroups within each of the initial two groups. Results: Within the diagnosed mental illness subgroups, each subgroup was characterised by a particular mental disorder or a combination of disorders. Within the no diagnosis of mental illness groups, the youngest group was also the most homogenous (all females who self-poisoned), the oldest group had a high proportion of rural/regional residents, the group with the highest proportion of males also had the highest proportion of people who used cutting as the method of self-harm, and the group with the highest proportion of metropolitan residents also had the highest proportion of people who were married. Conclusions: Preventative interventions need to take into account that those who are admitted to hospital for self-harm are a heterogeneous group.
MeSH term(s)	Adolescent ; Adult ; Demography ; Female ; Hospitalization/statistics & numerical data ; Hospitals ; Humans ; Male ; Mental Health/statistics & numerical data ; Middle Aged ; Retrospective Studies ; Rural Population ; Self-Injurious Behavior/epidemiology ; Self-Injurious Behavior/psychology ; Victoria/epidemiology ; Young Adult
Language	English
Publishing date	2019-07-16
Publishing country	Germany
Document type	Journal Article
ZDB-ID	623071-4
ISSN	1433-9285 ; 0037-7813 ; 0933-7954
ISSN (online)	1433-9285
ISSN	0037-7813 ; 0933-7954
DOI	10.1007/s00127-019-01747-1
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Article ; Online: The effectiveness of installing trackside fencing in preventing railway suicides: a pre-post study design in Victoria, Australia.

Clapperton, Angela / Dwyer, Jeremy / Spittal, Matthew / Pirkis, Jane

Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention

2023 Volume 29, Issue 6, Page(s) 525–527

MeSH term(s)	Humans ; Suicide ; Victoria/epidemiology ; Suicide Prevention ; Railroads
Language	English
Publishing date	2023-11-27
Publishing country	England
Document type	Journal Article
ZDB-ID	1433667-4
ISSN	1475-5785 ; 1353-8047
ISSN (online)	1475-5785
ISSN	1353-8047
DOI	10.1136/ip-2023-044897
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Zs.A 4910: Show issues

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Article ; Online: Using Real-Time Suicide Monitoring Systems to Inform Policy and Practice.

Spittal, Matthew J / Roberts, Leo / Clapperton, Angela

Crisis

2023 Volume 44, Issue 6, Page(s) 445–450

Language	English
Publishing date	2023-11-09
Publishing country	Canada
Document type	Editorial
ZDB-ID	801380-9
ISSN	2151-2396 ; 0227-5910
ISSN (online)	2151-2396
ISSN	0227-5910
DOI	10.1027/0227-5910/a000931
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Article ; Online: Identification of young females at high risk of suicide following hospital-treated self-harm in Victoria, Australia.

Clapperton, Angela J / Dwyer, Jeremy / Spittal, Matthew J

The Australian and New Zealand journal of psychiatry

2023 Volume 57, Issue 8, Page(s) 1163–1171

Abstract: Objective: We conducted a data linkage study in Victoria, Australia, to determine the proportion of young females who are treated in hospital for self-harm who go on to die by suicide within 5 years and to identify factors associated with increased ... ...

Abstract	Objective: We conducted a data linkage study in Victoria, Australia, to determine the proportion of young females who are treated in hospital for self-harm who go on to die by suicide within 5 years and to identify factors associated with increased suicide risk in this same cohort. Method: We undertook a cohort study following 3689 female patients aged 10-24 years, who were initially treated in hospital for self-harm during the 2-year period January 2011 to December 2012. We followed each patient for 5 years unless they died first, in which case, they were followed until their date of death. We used inpatient admissions from the Victorian Admitted Episodes Dataset and emergency department presentations from the Victorian Emergency Minimum Dataset linked to death data from two sources, the Victorian Suicide Register and the National Death Index. Results: Twenty-eight individuals (0.76% of the total cohort) died by suicide within 5 years of their index admission. In multivariate survival analysis, only suicide ideation at the time of self-harm (hazard ratio = 4.59; 95% confidence interval: 1.70, 12.38) and a decreasing time between successive self-harm episodes (hazard ratio = 4.38; 95% confidence interval: 1.28, 15.00) were associated with increased suicide risk. Conclusion: Although the vast majority of young females who present to hospital for self-harm do not die by suicide within 5 years, our results suggest young females expressing suicide ideation and those presenting frequently with decreasing time between successive episodes should be prioritised for suicide-prevention efforts.
MeSH term(s)	Humans ; Female ; Cohort Studies ; Victoria/epidemiology ; Self-Injurious Behavior/epidemiology ; Suicide Prevention ; Hospitals ; Emergency Service, Hospital ; Risk Factors
Language	English
Publishing date	2023-04-07
Publishing country	England
Document type	Journal Article
ZDB-ID	221140-3
ISSN	1440-1614 ; 0004-8674
ISSN (online)	1440-1614
ISSN	0004-8674
DOI	10.1177/00048674231165226
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Article ; Online: Suicide within five years of hospital-treated self-harm: A data linkage cohort study.

Clapperton, Angela / Spittal, Matthew J / Dwyer, Jeremy / Nicholas, Angela / Pirkis, Jane

Journal of affective disorders

2024

Abstract: Background: Hospital-treated self-harm is a strong predictor of suicide and hospital contacts may include missed opportunities for suicide prevention. We conducted a data linkage study to identify factors associated with suicide in people treated in ... ...

Abstract	Background: Hospital-treated self-harm is a strong predictor of suicide and hospital contacts may include missed opportunities for suicide prevention. We conducted a data linkage study to identify factors associated with suicide in people treated in hospital for self-harm in Victoria, Australia. Method: We undertook a cohort study following 14,307 people treated in hospital for an episode of self-harm (i.e., either admitted or non-admitted ED presentations) over the period 2011 and 2012 and used data from the Victorian Suicide Register to identify suicides within 5 years. We estimated unadjusted hazard ratios (HRs) for suicide using survival analysis for each exposure variable and then computed adjusted HRs using a multivariate model that included all exposure variables. Results: Among females, the risk of suicide was higher in those aged 50-74 years (HR 1.78; Cl: 1.02, 3.10), residing in areas of least disadvantage (HR 2.58; Cl: 1.21, 5.50), who used hanging as a method of self-harm (HR 5.17; Cl: 1.86, 14.35) and with organic disorders (HR 6.71; Cl: 2.61, 17.23) or disorders of adult personality and behaviour (HR 2.10; Cl: 1.03, 4.27). In males, the risk of suicide was higher in those who used motor vehicle exhaust gas as a method of self-harm (HR 3.48; Cl: 1.73, 7.01), and with disorders due to psychoactive substance abuse (HR 1.75; Cl: 1.14, 2.67). Conclusion: Although all patients should be routinely assessed for risk and needs following hospital-treated self-harm including appropriate follow-up care, people who use MVEG or hanging as methods of self-harm are obvious candidates for close follow-up.
Language	English
Publishing date	2024-04-22
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2024.04.092
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Article ; Online: Road vehicle collision suicide in Australia: Trends, collision types, and individual characteristics.

Law, Phillip C F / Too, Lay San / Spittal, Mathew J / Pirkis, Jane / Clapperton, Angela J

PloS one

2024 Volume 19, Issue 4, Page(s) e0299590

Abstract: Background: Suicide by road vehicle collision in Australia is under-explored with mixed findings. We aimed to address this research gap by examining time trends, different types of vehicle collision, and individual characteristics related to vehicle- ... ...

Abstract	Background: Suicide by road vehicle collision in Australia is under-explored with mixed findings. We aimed to address this research gap by examining time trends, different types of vehicle collision, and individual characteristics related to vehicle-collision suicide. Method: We retrospectively analyzed deaths by suicide between 1st January 2001 and 31st December 2017 in Australia, using coronial records from the National Coronial Information System. The travel mode used and collision counterpart were retrieved from records of death by vehicle-collision suicide using all available information. We conducted negative binomial regression analysis to examine annual changes in suicide rate by vehicle collision on a public road (N = 640) and other methods of suicide (N = 41,890), and logistic regression analysis to examine individual characteristics associated with the likelihood of dying by suicide via road vehicle collision. Results: Overall, the national suicide rate involving road vehicle collision significantly increased, while the rate by other methods significantly decreased. Drivers accounted for 61% of suicide events by vehicle collision, of which 72% were single-vehicle collisions (commonly involving a tree). For multiple-vehicle collision suicide events, 82% involved collision with a truck. Pedestrians accounted for more than one-third of suicide events, of which 58% involved collision with a truck and 23% involved collision with a car/van. Individuals who were male (odds ratio 1.15; 95% CI 0.88-1.50), aged <25 years old (odds ratio 5.27; 95% CI 3.05-9.10), non-Indigenous (odds ratio 3.36; 95% CI 1.71-6.62), and born overseas (odds ratio 1.40; 95% CI 1.10-1.79) were more likely to die by vehicle-collision suicide than by other methods of suicide. Conclusions: This study provides a better understanding of road vehicle collision suicide in Australia and informs future research directions on topic. Our findings can be used to inform suicide prevention initiatives to reduce vehicle-collision suicide deaths.
MeSH term(s)	Humans ; Accidents, Traffic/mortality ; Accidents, Traffic/statistics & numerical data ; Accidents, Traffic/trends ; Australia/epidemiology ; Male ; Female ; Adult ; Middle Aged ; Suicide/statistics & numerical data ; Suicide/trends ; Aged ; Young Adult ; Retrospective Studies ; Adolescent
Language	English
Publishing date	2024-04-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0299590
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Article ; Online: Suicide following hospital admission for mental health conditions, physical illness, injury and intentional self-harm in Victoria, Australia.

Fernando, Dasamal Tharanga / Clapperton, Angela / Berecki-Gisolf, Janneke

PloS one

2022 Volume 17, Issue 7, Page(s) e0271341

Abstract: Objective: The majority of suicide decedents have had contact with health services close to their death. Some of these contacts include admissions to hospitals for physical and mental health conditions, injury and intentional self-harm. This study aims ... ...

Abstract	Objective: The majority of suicide decedents have had contact with health services close to their death. Some of these contacts include admissions to hospitals for physical and mental health conditions, injury and intentional self-harm. This study aims to establish and quantify the risks of suicide following hospital admission for a range of mental and physical illnesses. Methods: A retrospective analysis was carried out on existing morbidity and mortality data in Victoria. Data was extracted from the Victorian Admitted Episodes Dataset and the Victorian Suicide Register. Unplanned hospital admissions among adult patients (> = 15 years of age), discharged between 01 January 2011 and 31 December 2016 (2,430,154 admissions), were selected. Standardised Mortality Ratios were calculated for conditions with at least five linked suicides within one year of discharge from hospital. Results: Forty-three conditions defined at the three-digit level of the International Statistical Classification of Diseases and Related Health Problems 10th Revision, were associated with at least five subsequent suicides (within one year of hospital discharge); 14 physical illnesses, 5 symptoms, signs and abnormal clinical and laboratory findings, 12 mental health conditions, and 12 types of injury and poisonings. The highest Standardised Mortality Ratios were for poisonings (range; 27.8 to 140.0) and intentional self-harm (78.8), followed by mental health conditions (range; 15.5 to 72.9), symptoms, signs and abnormal clinical and laboratory findings (range; 1.4 to 43.2) and physical illnesses (range; 0.7 to 4.9). Conclusions: Hospital admissions related to mental health conditions and injury and poisonings including self-harm were associated with a greater risk of suicide than physical conditions. Mental health conditions such as depressive episodes, personality disorders and psychotic episodes, injuries caused by intentional-self-harm and poisonings by certain types of drugs, carbon monoxide and hormones such as insulin can be prioritised for targeting suicide prevention initiatives for persons discharged from hospitals.
MeSH term(s)	Adult ; Hospitals ; Humans ; Mental Health ; Retrospective Studies ; Self-Injurious Behavior/psychology ; Suicide/prevention & control ; Victoria/epidemiology
Language	English
Publishing date	2022-07-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0271341
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Article ; Online: Preventing railway suicides through level crossing removal: a multiple-arm pre-post study design in Victoria, Australia.

Clapperton, Angela / Dwyer, Jeremy / Spittal, Matthew J / Roberts, Leo / Pirkis, Jane

Social psychiatry and psychiatric epidemiology

2022 Volume 57, Issue 11, Page(s) 2261–2266

Abstract: Purpose: Rail level crossing removals to improve transport performance across metropolitan Melbourne (state of Victoria) resulted in new rail fencing and grade-separation of tracks from the surrounding environment at several sites. These design changes ... ...

Abstract	Purpose: Rail level crossing removals to improve transport performance across metropolitan Melbourne (state of Victoria) resulted in new rail fencing and grade-separation of tracks from the surrounding environment at several sites. These design changes restricted pedestrian access to the rail tracks, which is a countermeasure known to prevent railway suicide in other settings. We examined whether any such suicide prevention effect followed the removals. Methods: We used a multiple-arm pre-post design to test whether a decrease in monthly frequency of railway suicides occurred at level crossing removal sites (intervention sites), compared to randomly matched sites where level crossings had not yet been removed (control sites). We used data available in the Victorian Suicide Register covering the period 1st January 2008 to 30th June 2021. Results: The mean monthly number of railway suicides decreased by 68% within a 500 m radius of intervention sites (RR: 0.32; CI 95% 0.11-0.74) and by 61% within a 1000 m radius of intervention sites (RR: 0.39; CI 95% 0.21-0.68). There was no evidence that the mean monthly number of railway suicides changed at the control sites, either within a 500 m radius (RR: 0.88; CI 95% 0.47-1.56) or a 1000 m radius (RR: 0.82; CI 95% 0.52-1.26). Conclusion: The reduction in railway suicides at locations where level crossings were removed, demonstrates the suicide prevention benefits that can be derived from a major infrastructure project even if not initially intended. Planning for major infrastructure projects should include consideration of these benefits, with designs incorporating features to maximise suicide prevention impact.
MeSH term(s)	Humans ; Suicide/prevention & control ; Railroads ; Victoria/epidemiology
Language	English
Publishing date	2022-07-21
Publishing country	Germany
Document type	Journal Article
ZDB-ID	623071-4
ISSN	1433-9285 ; 0037-7813 ; 0933-7954
ISSN (online)	1433-9285
ISSN	0037-7813 ; 0933-7954
DOI	10.1007/s00127-022-02340-9
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Article ; Online: Characteristics of suicide decedents with no federally funded mental health service contact in the 12 months before death in a population-based sample of Australians 45 years of age and over.

Carter, Gregory / Sperandei, Sandro / Spittal, Matthew J / Chitty, Kate / Clapperton, Angela / Page, Andrew

Suicide & life-threatening behavior

2022 Volume 53, Issue 1, Page(s) 110–123

Abstract: Introduction: More than half of suicide decedents have no contact with mental health services 12 months before death. It is uncertain if they have different characteristics than decedents who use mental health services.: Methods: A case-series design. ...

Abstract	Introduction: More than half of suicide decedents have no contact with mental health services 12 months before death. It is uncertain if they have different characteristics than decedents who use mental health services. Methods: A case-series design. Participants 45 years and older, who died by suicide (2006-2018). Comparisons were made between those who did and did not have contact with mental health services, using individually linked data from federal services in the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS). Results: Of 186 cases, 71% had no contact with mental health services. Physical health services were used equally by 75%. Psychiatric medication use was uncommon, except for antidepressants, 50% with mental health service contact and 20% with no contact. Older age, lower income, involuntarily unemployed, firearms as suicide method, greater physical disability, less functional impairment due to emotional problems and lesser proportions with mental illness, were associated with no contact with mental health services. Conclusions: For suicide prevention, middle-older aged adults may have less requirement for mental health intervention, and greater requirement for the development of complementary interventions focused on physical health and social issues, which are not necessarily best delivered by clinical mental health services.
MeSH term(s)	Adult ; Humans ; Aged ; Middle Aged ; Australia ; National Health Programs ; Suicide/psychology ; Mental Disorders ; Mental Health Services
Language	English
Publishing date	2022-11-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	750058-0
ISSN	1943-278X ; 0047-4592 ; 0363-0234
ISSN (online)	1943-278X
ISSN	0047-4592 ; 0363-0234
DOI	10.1111/sltb.12928
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Article ; Online: Relative risk of suicide following exposure to recent stressors, Victoria, Australia.

Clapperton, Angela / Newstead, Stuart / Bugeja, Lyndal / Pirkis, Jane

Australian and New Zealand journal of public health

2019 Volume 43, Issue 3, Page(s) 254–260

Abstract: Objective: This study aimed to identify stressors over-represented in the 12 months prior to death among 553 Victorian adults who died by suicide.: Methods: Age- and sex-specific suicide rates and relative risks of suicide were calculated using ... ...

Abstract	Objective: This study aimed to identify stressors over-represented in the 12 months prior to death among 553 Victorian adults who died by suicide. Methods: Age- and sex-specific suicide rates and relative risks of suicide were calculated using numerator data on suicides occurring in 2013 by people with a given exposure sourced from the Victorian Suicide Register and denominator data on the total Victorian population with that exposure sourced from the 2014 Australian Bureau of Statistics General Social Survey. Results: Mental illness was associated with increased suicide risk among people of all age groups and both sexes. Alcohol and/or other drug problems were associated with increased risk for males and females of all ages, with the exceptions of the oldest males and females, and the youngest females. Trouble with the police was associated with increased risk among all but the oldest males, whereas among females it was associated with elevated risk in those aged 25-44 years and 65+ years. Conclusions and Implications for public health: Males experiencing mental illness and alcohol and other drug problems should be a particular priority for suicide prevention initiatives but people exposed to other stressors such as contact with the police and divorce/relationship separation also warrant attention.
MeSH term(s)	Adolescent ; Adult ; Aged ; Cause of Death ; Female ; Humans ; Male ; Mental Disorders/epidemiology ; Mental Disorders/psychology ; Middle Aged ; Risk Factors ; Sex Distribution ; Stress, Psychological/psychology ; Suicide/statistics & numerical data ; Victoria/epidemiology ; Violence ; Young Adult
Language	English
Publishing date	2019-03-04
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1323548-5
ISSN	1753-6405 ; 1326-0200
ISSN (online)	1753-6405
ISSN	1326-0200
DOI	10.1111/1753-6405.12886
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