Background
Previous research on the protective effects of school holidays on adolescent suicidal and non-suicidal self-injury (NSSI) has relied on hospital records which underestimate self-harm prevalence and has not been explored in the post pandemic environment. This study utilised ambulance attendance data to explore whether protective effects of school holidays on suicidal and NSSI behaviours were present pre- and post-COVID-19 restrictions.
Methods
Using data from the National Ambulance Surveillance System, weekly ambulance attendances for suicidal and NSSI behaviours among adolescents (12–17) and young adults (18–25) in Victoria, Australia, were analysed. Trends in rates per 10,000 population pre- (2015–2019) and post-COVID-19 restrictions (2022–2023) were modelled using seasonal autoregressive integrated moving average with exogenous variables, stratified by age and gender.
Results
There were 20,635 suicidal and NSSI related ambulance attendances among adolescents and 36,510 among young adults. Pre-COVID-19 there was a significant decline in weekly rate of attendances per 10,000 population for adolescent females during the December/January (−0.35, p < .001), June/July (−0.46, p = .007) and September/October (−0.41, p = .004) holidays. Similar declines were seen in adolescent males during the December/January (−0.12, p = .003), April/May (−0.22, p = .001), June/July (−0.26, p = .003) and September/October (−0.15, p = .027) holidays. No significant effects were observed for young adults or post-pandemic.
Conclusions
Seasonal trends in adolescent suicidal and NSSI harms were evident prior to COVID-19, but were no longer present post-pandemic. Understanding these changes is crucial for informing targeted mental health interventions and support for adolescents.