Psychiatrists have frequently pointed out that in a high proportion of individuals who commit suicide it is apparent that there is pre-existing psychiatric illness. It has been further shown that many of these people have received medical care and have been attending their doctor within four weeks of their death (Motto and Greene, 1958; Seager and Flood, 1965). The implication of these findings is that doctors do not always recognize psychiatric illness in their patients and are certainly not attuned to the possibility of suicide, even when the patient frankly states that he finds life is not worth living and that he has considered ending his life. Such straightforward information is not accepted at its face value. The doctor may hold the mistaken view that people who talk about suicide do not in fact commit the act. This statement is manifestly incorrect. It has been shown (Robins et al., 1959) that 70 per cent. of suicides have declared their intention of committing the act days or weeks beforehand.

“That the deceased took his life while the balance of his mind was temporarily disturbed” has been the Coroner's traditional verdict in cases of suicide; a verdict adopted to circumvent retribution by society and particularly to allow of burial in consecrated ground and avoid forfeiture of property to the Crown (Williams, 1958). There is a distinction between such a finding with its legal import and that of the psychiatric assessment, and this must necessarily affect psychiatric studies undertaken in the endeavour to understand the state of mind of the person who encompasses his own death, or to examine the wider implications of suicide in relation to the epidemiology of mental illness. Public opinion and cultural pressures have their effects on coroners' verdicts; and guilt or shame on the part of relatives or medical attendants may result in distortion or concealment of information.