Background: Hospital-treated deliberate self harm and suicide among older adults have rarely been examined at a national level.

Methods: The Irish Central Statistics Office provided suicide and undetermined death data for 1980–2006. The National Registry of Deliberate Self Harm collected data relating to deliberate self harm presentations made in 2006–2008 to all 40 Irish hospital emergency departments.

Results: Rates of female suicide among older adults (over 55 years) were relatively stable in Ireland during 1980–2006 whereas male rates increased in the 1980s and decreased in more recent decades. Respectively, the annual male and female suicide and undetermined death rate was 22.1 and 7.6 per 100,000 in 1997–2006. Male and female deliberate self harm was 3.0 and 11.0 times higher at 67.4 and 83.4 per 100,000, respectively. Deliberate self harm and suicide decreased in incidence with increasing age. Deliberate self harm generally involved drug overdose (male: 72%; female 85%) or self-cutting (male: 15%; female 9%). The most common methods of suicide were hanging (41%) and drowning (29%) for men and drowning (39%) and drug overdose (24%) for women. City and urban district populations had the highest rates of hospital-treated self harm. The highest suicide rates were in urban districts.

Conclusions: Older Irish adults have high rates of hospital-treated deliberate self harm but below average rates of suicide. Drowning was relatively common as a method of suicide. Restricting availability of specific medications may reduce both forms of suicidal behavior.