Unlike other causes and circumstances of death, the suicide rate for young people aged 10-17 is increasing, according to the 2020-21 Child Death Review Team's annual report tabled in parliament this week.

While there were good systems in place for identifying young people at risk of suicide or with mental health problems, intervention remains lacking. Once a problem is identified, intervention can be episodic and fragmented, the report says.

"Identification of suicide risk must be supported by effective strategies to manage and contain risk to prevent suicide." The increasing demand for timely "developmentally appropriate specialist mental health services" for children and young people was not being met, it says.

The report acknowledges a Government commitment of $87 million via its Towards Zero Suicides program which is part of a plan to reduce teen suicide by 20 per cent by 2023, however, the number of child and adolescent mental health workers available to deliver interventions, particularly in regional areas, remained a concern.

The emphasis of initiatives was largely on the identification of risk, not the management of risk, the report says and it questioned the capacity and sustainability of initiatives co-funded by the Commonwealth and NSW Government. "It is unclear if initiatives like this ... will be expanded to all regions of NSW if successful, and how sustainability will be ensured."

The rate of suicide among children aged 10-17 has increased by 47 per cent over the past 15 years, in contrast to an overall decline in the mortality rate among children aged 1-17 years of 26 per cent.

Suicide was the leading cause of death for young people aged 15-17 years in 2018 and 2019, being the known cause of 51 deaths. That age group laid claim to the highest mortality rate among children.

Aboriginal and Torres Strait Islander children have a much higher rate of suicide, and more males than females die by suicide, a gender gap which has increased over the past five years.

The report says that gains have been made in other focus areas such as sudden unexpected death in infancy, safe infant sleep practices among vulnerable families, the role of schools in suicide prevention, and quad bike-related deaths.

The team is continuing to monitor progress in relation to other areas of concern, such as safer vehicle choices among teens, the use of seatbelts and child restraints, a public swimming pool non-compliance register, and the identification of illness in infants.

In relation to safer vehicle choices, the majority of transport-related deaths of children and young drivers involved older, less safe vehicles that did not have advanced safety technologies, the report says.

The team is also continuing to monitor progress on a study of seatbelts and child restraint practices across ten selected local government areas following a 10-year review found that just over half the children who died as passengers in NSW were not properly restrained, and that if they were, it may have prevented almost one in three of those deaths.

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