Six major steps to make investigations of suicide valuable for learning and prevention

Objective The decline in suicide rates has leveled off in many countries during the last decade, suggesting that new interventions are needed in the work with suicide prevention. Learnings from investigations of suicide should contribute to the development of these new interventions. However, reviews of investigations have indicated that few new lessons have been learned. […]

A report on suicide deaths in Ontario

Coroners in Ontario – along with the Ontario Forensics Pathology Service – are tasked with ensuring that no death will be overlooked, concealed, or ignored. While not all deaths require investigation, coroners are charged with investigating all non-natural deaths as well as natural deaths that occur in certain circumstances, including: deaths that occur suddenly and […]

Circumstances of suicide after registration with a national digital mental health service: an analysis of coroners’ reports

Background: Little is known about the safety of mental healthcare provided remotely by digital mental health services (DMHS), which do not offer face-to-face contact. Aims: To examine the circumstances of suicide by patients registered with a national DMHS. Method: Data from 59 033 consenting patients registered with a national DMHS, the MindSpot Clinic, between 1 January 2013 and […]

Integrating medical examiner and police report data: Can this improve our knowledge of the social circumstances surrounding suicide?

Background: Recently, suicide in the United States has begun to be viewed as a preventable public health issue. This has led to the creation of a National Violent Death Reporting System that collects and integrates data on the social circumstances surrounding suicides. Aims: The study examines data on social circumstances surrounding suicides as collected by the medical […]

Using natural language processing to improve suicide classification requires consideration of race

Objectives To improve the accuracy of classification of deaths of undetermined intent and to examine racial differences in misclassification. Methods We used natural language processing and statistical text analysis on restricted-access case narratives of suicides, homicides, and undetermined deaths in 37 states collected from the National Violent Death Reporting System (NVDRS) (2017). We fit separate […]

The contribution of social norms and religious practices towards low death registration in 3 HDSS sites of Uganda

Background Uganda has low levels of death registration, estimated at two per cent by the National Identification and Registration Authority (NIRA). There are 56 tribes and over 5 religious denominations with so many social norms and religious practices that could have contributed to low death registration in Uganda. Previous studies on the factors affecting death […]

Interpersonal precipitants are associated with suicide intent communication among United States Air Force suicide decedents

Background Few studies explore differences between suicide intent communicators and noncommunicators, and to date, none have examined the association between suicide precipitants and intent communication. Methods United States Air Force suicide decedents (N = 236) were categorized as suicide intent communicators or non-communicators within 30 days prior to death. The top two frequently occurring suicide precipitants, categorized […]

Evidence for underregistration of suicide: Case report

In this case report, we will present two cases in which the Dutch municipal coroner registered a natural death, but treating psychiatrists doubted the validity of this decision on the grounds of clinical data and investigation. For both cases, we present evidence that deaths likely resulted from suicide, raising serious doubts about the accuracy of […]

Suicides and deaths of undetermined intent by poisoning: Reexamination of classification differences by race/ethnicity and state

This study examined differences by race/ethnicity and state in poisoning deaths of undetermined intent (UnD) versus suicide classification and the potential impact of state variations on UnD rates for Blacks and Hispanics. We used data from the 2005-2015 U.S. National Violent Death Reporting System (N = 29,567 aged 15+) and weighted coarsened exact matching. The odds […]

Deciphering suicide and other manners of death associated with drug intoxification: A Centers for Disease Control and prevention consultation meeting summary

Manner of death (MOD) classification (i.e., natural, accident, suicide, homicide, or undetermined cause) affects mortality surveillance and public health research, policy, and practice. Determination of MOD in deaths caused by drug intoxication is challenging, with marked variability across states. The Centers for Disease Control and Prevention hosted a multidisciplinary meeting to discuss drug intoxication deaths […]

Counting suicides and making suicide count as a public health problem

Relatively few countries credibly count their dead. Thus, differential sophistication as well as sociopolitical and economic support of healthcare and systems to investigate deaths inevitably leave a large gulf between richer and poorer countries in accurately registering manner and cause of death. And when suicide is in question, the variable stigma of self-harm combined with […]

Public perceptions of firearm- and non-firearm-related violent death in the United States: A national study

Background: Persons tend to estimate the likelihood of events, such as the risk for homicide versus suicide, in proportion to the ease with which they can retrieve examples of these incidents from memory (1). Because the recency of personal experience and media coverage can influence this retrieval (1–3), misperceptions about the relative frequency of suicide versus […]

Distinctive injury deaths: The role of environment, policy and measurement across states.

Background Maps identifying the most distinctive feature of each state have become popular on social media, but may also have important public health applications. A map identifying the most distinctive injury death in each state could be a useful tool for policymakers, enabling them to identify potential gaps in prevention efforts. Objective To identify the most distinctive […]

Deaths due to use of lethal force by law enforcement: Findings from the National Violent Death Reporting System, 17 U.S. States, 2009-2012.

INTRODUCTION: Several high-profile cases in the U.S. have drawn public attention to the use of lethal force by law enforcement (LE), yet research on such fatalities is limited. Using data from a public health surveillance system, this study examined the characteristics and circumstances of these violent deaths to inform prevention. METHODS: All fatalities (N=812) resulting […]

Five years of investigations April 1, 2012-March 31, 2017: Summary report.

Between April 1, 2012 and March 31, 2017, 255 serious injuries or deaths of young people were reported to the Advocate. Three of these notifications involved young people subject to a Courtesy Supervision Agreement or Medical Treatment Order and will not be included in this analysis. This means that we will be looking at 252 notifications. […]

Gender and age differences in suicide mortality in the context of violent death: Findings from a multi-state population-based surveillance system.

Objective Males are more likely than females to die by all forms of violent death, including suicide. The primary purpose of the present study was to explore whether the gender difference in suicide rates is largely accounted for by males’ general greater tendency to experience violent deaths. The current study examined gender and age differences […]

Beyond trauma: Disrupting cycles, effecting change.

Over seven months in 2015, the Child and Youth Advocate (the “Advocate”) received reports regarding the deaths of three girls: • 13-Year-Old Tina • 16-Year-Old Shirley • 19-Year-Old Jazmine Although these girls had unique life experiences, through our Investigative Review processes, some common themes emerged. Their mothers abused substances and were unable to care for them. The […]

Evaluation of the quality of cause of death statistics in rural China using verbal autopsies.

Death registration systems in rural China are in a developmental stage. The Disease Surveillance Points (DSP) system provides the only nationally representative information on causes of death. In this system, there are no standard procedures or instruments for ascertaining causes of death; hence available statistics require careful evaluation before use. Contact us for a copy […]

Comparative analysis of suicide, accidental, and undetermined cause of death classification.

Suicide determination is not standardized across medical examiners, and many suspected suicides are later classified as accidental or undetermined. The present study investigated patterns between these three groups using a medical examiner database and 633 structured interviews with next of kin. There were similarities across all three classification groups, including rates of mental illness and […]

People at Risk of Suicide Project: Identifying Activities and Opportunities in General Hospital Psychiatric Services. Report on Phases 1 and 2

This report is on the activities & outcomes from Phase I & II of the People at Risk of Suicide Project. Phase I presents highlights from a one-day conference, highlights from a literature review, presentation of a draft report, & implications for general hospital psychiatric services. Phase 2 discusses the development of a provincial fast […]

Frequency of Different Anti-Depressants Associated With Suicides and Drug Deaths

From each case of suicide & drug-related death autopsied in the Institute of Forensic Medicine, Munich during the years 2001-2005, a toxicological investigation for antidepressants was performed. In 180 suicides & 72 narcotic drug deaths, antidepressants were detected. There were serious differences in the frequency of antidepressants with respect to the manner of suicide. The […]

Suicides by Sharp Force: Typical and Atypical Features

65 consecutive cases of suicide by sharp force in Munster, Germany were investigated by evaluating autopsy & prosecution department records. Suicides constituted 17% of all fatalities from sharp force autopsied between 1967-1996. Young males & persons with a psychiatric history predominated among those who chose this method. (29 refs.) JA

Suicide in Detective Fiction (IN: Suicide and the Creative Arts, edited by S Stack & D Lester)

In real life, suicide may occur at a rate double the murder rate, yet is is relatively rare in detective fiction. This chapter examines reasons for this, asserting that the rules Auden, Van Dine, & Knox laid out for the genre have remained influential. These rules, particularly Auden’s, provide insight into audience needs & satisfactions […]