Data collection fields
| 1. | Sociodemographic information: NHI, gender, age, ethnicity, usual residential address, occupation |
| 2. | Description of presenting complaint (narrative) |
| 3. | Date and time of SH |
| 4. | Date and time of hospital presentation and discharge |
| 5. | How the patient arrived at the hospital (ambulance/police/own transport) |
| 6. | Did the patient present with self-injury, self-poisoning, suicidal ideation |
| 7. | Location of SH (home/public place) |
| 8. | How did the patient harm themselves (record verbatim) |
| 9. | Was alcohol and/or an illegal substance involved |
| 10. | Did the patient make a statement of intention to die |
| 11. | Problems/difficulties associated with the current episode of SH or suicidal ideation |
| 12. | History of exposure to SH and suicide among peers/family |
| 13. | Prior history of SH |
| 14. | Referrals to specialist services such as social worker, ICU |
| 15. | Referral for mental health assessment during this episode |
| 16. | Did this episode lead to a hospital admission |
| 17. | Discharge location from ED |
| 18. | For cases of self-poisoning, name, amount, strength and source of substance used (Codes/categories available on request) |
ED, Emergency Department; ICU, Intensive Care Unit; NHI, National Health Index; SH, self-harm.