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Legislative Assembly for the ACT: 2004 Week 07 Hansard (Wednesday, 30 June 2004) . . Page.. 3050 ..

It is the clandestine nature of self-harm, through the way it can be easily concealed and excused, which has meant that many self-harmers remain out of the loop of treatment. Additionally, this has also led to the issue of self-harm losing the attention that it needs in order for it to be properly funded and treated. The extent of self-harm in our community can be partly reflected in a recent estimation that put 15 per cent of admissions to public hospital emergency departments as following from suicide attempts and other self-inflicted injuries. If this figure is correct, this equates to 25,000 patients each year. It is not necessarily the case that self-harm will then lead to suicide. I have spoken to people from Lifeline who have identified the issues as two quite separate mental health issues. They are both methods of self-injury—one with a permanent ending.

This is indeed a shocking figure but it cannot begin to accurately reflect the extent of the problem. People who deliberately self-harm have traditionally—even now—continued to remain anonymous and distant from the necessary support services needed to help them through their illness. The challenge then for government and the wider community is to, firstly, increase the awareness of self-harm so the community can identify self-harmers and refer them to appropriate support networks; secondly, make such support services accessible to self-harmers; and finally, support the continued research into and development of strategies for treatment and management.

Mental health as a prominent issue is only a recent phenomenon. I would say that awareness of self-harm is almost non-existent. As a consequence, this has significantly slowed the possibilities for policy to be developed to effectively prevent, identify and manage instances of self-harm. This traditional lack of awareness and education was identified in a report out of Western Australia published in 2001. In this report it was found that this shortfall manifested itself in the inadequacies of many key “gate-keeping” stages in the identification and treatment of self-harm. Having looked mainly at emergency departments, the report found that there was both an inadequate level of education and policy to identify and deal with instances of self-harm. In particular, it was found that opportunities for patients to “slip through the gaps” occurred at too many stages in a patient’s care—for example, during waiting periods and in transition between services. This was particularly significant given that in the period following a deliberate act of self-harm the risk of subsequent self-harm or suicide is considerably higher.

While the report also made recommendations for remedying these shortfalls, which accordingly have now been more or less uniformly adopted in many emergency departments across the country, similar policies have not been employed in other less obvious “gate-keeping” environments which frequently deal with self-harmers. One of the main reasons for this is that most of us will have come into contact with someone who has harmed or is harming themselves and we simply either have not or could not have recognised it.

At this point, a number of issues have been identified in the community’s capacity to identify and manage self-harm and other mental illnesses. Arguably, a common thread among these issues has been a traditional inadequate level of understanding and awareness of mental illnesses such as self-harm. What this has then meant is that self-harm as a target for funding, research and policy has been neglected. However, this is not to say that recent research and policy have not made inroads into remedying these

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