A prospective study of suicide and self-harm among young carers using an Australian cohort

Objectives: Data from a longitudinal national cohort study was used to test associations between young caregiving and self-harming and suicidal behaviours. Methods: We used data from Waves 6–8 (2014–2018) of the Longitudinal Study of Australian Children to assess the effect of ‘core’ caregiving activities (e.g. personal care, assistance moving around) on suicidal and self-harming behaviours. Care activities at 16–17 years were classified as core caregiving, non-core caregiving and no caregiving. Five self-harming and suicidal measures, collected at age 18/19 years, were used to form two outcomes: thoughts (of self-harm or suicide, or plan to suicide) and behaviours (self-harm, suicide attempt), operationalised as binary variables. Analyses were carried out using augmented inverse probability treatment weighting, adjusting for potential confounders, on complete case data. Results: Core caregiving was associated with higher levels of suicidal and self-harming behaviours compared no caregiving, with an average treatment effect (ATE) of 0.07 (95% confidence interval [CI] = 0.02, 0.12), equating to a risk ratio of 1.86 (95% CI = [1.21, 2.45]). The ATE of core caregiving on thoughts of suicide or self-harm (compared to non-caregiving) was 0.05 (95% CI = [−0.00, 0.11]), equating to a risk ratio of 1.26 (95% CI = [0.97, 1.56]). There was no evidence of an association between non-core care and any outcomes tested. Sensitivity analyses confirmed main findings. Discussion: Core caregiving is associated with elevated risks of self-harm among young carers, underlining the crucial need to better identify and support young carers to mitigate these adverse outcomes.