Young people in Western Australia, the Northern Territory and South Australia exhibit the country's highest prevalence of self-harm.
The Australian Youth Self-Harm Atlas has, for the first time, identified significant clusters and how triggering factors vary in each region and state.
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It found some locations are more vulnerable and need a more localised approach to tackle youth suicide.
"We found the Northern Territory, Western Australia and South Australia had the highest estimated prevalence of youth self-harm across all states and territories, indicating their communities are particularly vulnerable," said QIMR Berghofer researcher Emily Hielscher.
"They should be the highest priority for funding, support and research."
Suicide is the leading cause of death among young people across the country and remains higher in remote regions.
Specifically, the study identified self-harm clusters in regional parts of WA, the Northern Territory and north and central Queensland, as well as in eastern Melbourne, Adelaide's outer southeast and Sydney's outer west.
"The prevalence of youth self-harm and suicidality was generally higher in regional and remote areas, with Aboriginal and Torres Strait Islander communities disproportionately affected," Dr Hielscher said.
Key risk factors include mental illness, parental unemployment, insecure housing and having Australian-born parents.
E-safety concerns and being victim of homophobia were also found to increase risk.
The significance varied between metropolitan and regional areas, with financial barriers, transport limitations and community stigma appearing to be more significant challenges in regional Australia.
Young people also felt the effects of COVID-19 and climate change, with the pandemic and natural disasters contributing to hopelessness and uncertainty.
Dr Hielscher said the study also unexpectedly revealed young people with overseas-born parents were at a reduced risk of self-harm.
"It may be that the support that exists for young people living in communities with overseas-born parents is protective against self-harm.
"Detailed research with culturally diverse groups is needed to better understand the potential protective qualities of having a parent who was born overseas and whether it may carry broader lessons for youth self-harm and suicide prevention."
The results highlighted the importance of regionally-tailored approaches, Dr Hielscher said.
"We can't adopt a blanket, one-size-fits-all approach ... this research shows different regions have varying risk factors, challenges and needs."
Key recommendations from the study include making real-time localised data more readily available and improving youth mental health and e-safety.
The Atlas study was funded by Suicide Prevention Australia and carried out in collaboration with colleagues at Roses in the Ocean, the University of Western Australia and Australian National University.
The project analysed census data and nationally representative youth data, the Young Minds Matter survey.
It conducted 14 focus groups to investigate the prevalence and critical influences of youth self-harm across different geographic areas of Australia.
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