Quality of suicide mortality data is essential to adequately estimate lives lost to suicide worldwide, and their representativeness and coverage of the targeted population. Rates, methods, and characteristics of suicide vary across different countries and over time. To inform suicide prevention strategies, it is essential for countries to have up-to-date surveillance systems for suicides and attempted suicides. Adequate data collection and vital registration systems are necessary for suicide surveillance systems. Improving data quality of self-harm and suicide mortality data is one of the key priorities highlighted by the WHO for suicide prevention. Establishment of self-harm and suicide surveillance systems allow systematic data collection and improved data quality across countries globally. According to the iceberg model of self-harm, most self-harm presentations remain undisclosed given that these occur in the community, and it is only hospital-based self-harm presentations that are predominantly recorded. However, hospital-presenting self-harm behaviour is often more significant, requiring immediate medical attention and may have subsequent higher suicide risk. Furthermore, monitoring self-harm through hospital surveillance systems allows for more precise data collection. Globally, there are several hospital-presenting self-harm and suicide surveillance systems. Whilst a country’s suicide rate represents a key indicator to guide suicide prevention priorities and to determine impacts of suicide prevention programmes, many countries face the challenge of delays relating to officially published suicide figures and underreporting. The need for real-time suicide data has been greater than ever during the COVID-19 pandemic considering an increasing number of requests from policy makers and other stakeholders in suicide prevention. In addition to suicide, hospital presented self-harm represents an important indicator to determine impacts of national suicide prevention programmes. The National Self-Harm Registry represents a unique national surveillance system aimed at informing Connecting for Life about key priorities for self-harm and suicide prevention and providing indicators to determine its impacts.