Oral Presentation National Suicide Prevention Conference 2026

Geographic intersections between adverse childhood experiences and suicidal/self-injurious behaviour in New South Wales, Australia (131413)

Oliver J Watkeys 1 , Kristin R Laurens 1 2 , Stacy Tzoumakis 1 3 4 , Kimberlie Dean 1 5 , Felicity Harris 1 , Melissa Mei Yin Cheung 1 , Vaughan J Carr 1 , Melissa J Green 1
  1. School of Clinical Medicine, Discipline of Psychiatry and Mental Health, UNSW, Kensington, NSW, Australia
  2. School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, QLD, Australia
  3. Griffith Criminology Institute, Griffith University, Southport, QLD, Australia
  4. School of Criminology and Criminal Justice, Griffith University, Southport, QLD, Australia
  5. Justice Health & Forensic Mental Network, Matraville, NSW, Australia

Introduction

Young people in geographically remote and socio-economically disadvantaged areas, and those exposed to adverse childhood experiences (ACEs), are significantly more likely to experience suicidal ideation and self-harm. The reduced accessibility of mental health services in such regions, has been posited as one potential explanation for the increased likelihood suicidal ideation/self-harm in these areas. However, there has been limited examination of the geographic intersections between these factors. The current mapping study aimed to examine associations between the incidence of adolescent suicidal ideation/self-harm throughout New South Wales (NSW) and the average number of ACEs, geographic remoteness, socio-economic disadvantage, and number of mental health professionals working in each region. 

Method

Participants were 73,883 young people drawn from the NSW Child Development Study (NSW-CDS), a longitudinal study of children (born between 2002-2005) and their parents, followed via record-linkage to approximately 18 years of age. Individual level data, derived for each from Commonwealth and NSW state government records, were geographically aggregated based on the young people’s statistical area of residence. The number of mental health workers per 100,000 people in each region was derived from Australian Institute of Health and Welfare (for psychiatrists, psychologists, and mental health nurses). This information was used to build statistical maps of NSW and to examine associations between these variables.

Results

The incidence of suicidal ideation/self-harm within each region was significantly associated with the average number of ACEs (B=4.272, 95% CI=2.756-5.787), and percentage of children residing in outer regional, remote, or very remote areas (B=0.062, 95% CI=0.037-0.087), within each region in adjusted models. However, the regional number of mental health service providers (per 100,000 residents) was not significantly associated with the incidence of adolescent suicidal ideation/self-harm. All regions outside of greater Sydney, but particularly those in the North and North-West of NSW, showed particularly high incidence of adolescent suicidal ideation/self-harm and ACEs.

Discussion

Increased resources dedicated to suicide prevention are required for regions outside greater Sydney. These findings further add to growing calls to addresses ACEs as a means of improving suicide prevention. Collaboration with the NSW-CDS Lived Experience Network highlighted the importance of improving access to community, peer, and digital mental health services to overcome issues of stigma, distrust, and lack of access to local services which may underpin regional disparities in adolescent suicidal ideation/self-harm. Further collaboration local communities experiencing elevated incidence of adolescent suicidal ideation/self-harm is needed to identify and meet the needs of each unique community.