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 […]

Dementia: Suicide by Drowning

In these letters to the editor, the authors comment on a study, published in 2009, by Purandare & colleagues on suicide in dementia. Questions are raised about the study design. The reply of Purandare & colleagues follows.

Pickwick’s Interpolated Tales and the Examination of Suicide: the Science of an Ending

This article examines the influence that the suicide of Robert Seymour, an illustrator, had upon Charles Dickens & the development of “The Pickwick Papers”. {35 notes)

‘Hidden’ Suicides Amongst Deaths Certified as Undetermined Intent, Accident by Pesticide Poisoning and Accident by Suffocation in Taiwan

This study sought to identify cause-of-death categories in which suicides might be misclassified in Taiwan. Secular trends, 1971-2007, were plotted in gender- & method-specific rates of death classified as suicide, undetermined intent, & accident for the Taiwanese population aged 15 years & older & compared the gender, age, & marital status profiles in these 3 […]

Psychiatric Autopsy: its use in Police Suicides (In: Suicide and Law Enforcement, edited by D C Sheehan & J I Warren)

This chapter outlines the use of psychiatric autopsy techniques as a tool in understanding police suicide. The psychiatric autopsy approach is a synthesis of assessment methods taken from both psychological autopsy & psychobiography. After a discussion of the background, purpose, & methodology of psychiatric autopsy, the chapter explores a specific case of police suicide-homicide by […]

Using Civil law Occupational Death Procedures in Police Suicide Reporting (In: Suicide and Law Enforcement, edited by D C Sheehan & J I Warren)

Both state & federal civil law require mandatory procedures in the event of occupational death. Any deviation from these procedures can result in civil monetary penalties & criminal charges. Statutory law & recent case law provide the legal foundation for development of mandatory police suicide reporting procedures. Using the occupational death reporting procedures outlined by […]

Police Humor in Suicide Investigation (In: Suicide and Law Enforcement, edited by D C Sheehan & J I Warren)

Humour is a highly specialized psychological response to the stress of human tragedy. This chapter reports personal observations of police humour encountered in more than 2500 suicide investigations; describes the red, yellow, greeen, & white zones of primitive, immature, adolescent, & mature humour; relates these zones to officer maturity; gives examples of each zone, & […]

Death at the Hands of Police: Suicide or Homicide? (In: Suicide and Law Enforcement, edited by D C Sheehan & J I Warren)

This chapter explores the medical examiner’s investigative process leading to the final manner of death determination in a “death at the hands of police”. A comparison of police shooting cases investigated by several Chief Medical Examiner’s offices in a large metropolitan area reveals that it varies by office & by examiner. The final classification by […]