AUTHOR=Pham Thi Thu Le , O'Brien Kerry S. , Liu Sara , Gibson Katharine , Berecki-Gisolf Janneke 

TITLE=Suicide and mortality following self-harm in Culturally and Linguistically Diverse communities in Victoria, Australia: insights from a data linkage study

JOURNAL=Frontiers in Public Health

VOLUME=Volume 12 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1256572

DOI=10.3389/fpubh.2024.1256572

ISSN=2296-2565

ABSTRACT=While cultural backgrounds are well documented to be relevant to intentional selfharm, little is known about how Cultural and Linguistically Diverse (CALD) backgroundsaffect mortality outcomes following self-harm.To compare the risk of all-cause mortality and suicide after intentional self-harm hospital admission among people from CALD (vs non-CALD) backgrounds.: Linked hospital and mortality data in Victoria, Australia was used to assess suicide and all-cause death after self-harm hospital admission among patients aged 15+ years. All-cause death was identified by following up 42,122 self-harm patients (hospitalised betweem 01/July/2007 and 30/June/2019) until death or 15/February/2021. Suicide death was evaluated in 16,928 self-harm inpatients (01/Jan/2013 and 31/Dec/2017) until death or 28/March/2018. Cox regression models were fitted to compare mortality outcomes in self-harm patients from CALD versus non-CALD backgrounds.Outcomes: During the follow-up periods, 3,716/42,122 (8.8%) participants died by any cause (by 15/February/2021) and 304/16,928 (1.8%) people died by suicide (by 28/March/2018). Compared to non-CALD group, CALD intentional self-harm inpatients had a 20% lower risk of all-cause mortality (HR:0.8,[95% CI, 0.7-0.9]) and 30% lower risk of suicide (HR: 0.7,[CI: 049-0.97]). Specifically, being from North Africa/Middle East and Asian backgrounds lowered all-cause mortality risk; however, the suicide risk in Asians was as high as in non-CALD people.Conclusions: Overall, people from CALD backgrounds had lower risks of all-cause mortality and suicide following self-harm hospital admission than the non-CALD group.When comparing by regions of birth, the risks varied, which argues for cultural background-specific suicide preventive actions. The study focused on outcomes following self-harm hospital admission and did not capture outcomes of self-harm that did not result in hospital admission. This limits generalisability as some CALD people might avoid accessing healthcare after self-harm due to cultural factors. Future research on outcomes following self-harm, which is not limited to hospital data, is suggested to build on these results.