The Coroner's System and Under-Reporting of Suicide

Abstract

This study investigates the under-reporting of suicide with particular reference to differences between sex and age groups and the various modes of suicide. The study was performed retrospectively using the files of H M Coroner for South Yorkshire (West) over the years 1985 to 1991. There were 536 deaths judged on the balance of probability to be suicidal in nature. Only 60 per cent of these deaths received a suicide verdict and would therefore register in official suicide statistics. A significantly smaller proportion of females (51.7 per cent) received a suicide verdict than males (64.5 per cent). Of the young females (< 45) 61.7 per cent were given a suicide verdict compared to 46.6 per cent of older females (45+). These differences are explained by different preferences for mode of suicide, in particular for poisoning using solids or liquids. Only 40 per cent of cases within this category received a suicide verdict. Drowning showed an even smaller percentage (24 per cent). Self-immolation (42 per cent) and jumping from a height (51 per cent) were also under-represented. Of these, self-poisoning, drowning and jumping from a height were relatively popular among females. In contrast, common causes of death favoured predominantly by males--hanging and carbon monoxide poisoning--received a high percentage of suicide verdicts (81 per cent and 90 per cent). Thus official suicide statistics produce a distorted view of the suicide population with relative under-reporting of females, particularly older females, and marked under-reporting of some causes of death, notably poisoning using solids or liquids, drowning, self-immolation and jumping from a height.

Misclassification of Suicide – The Contribution of Opiates

“…This is in keeping with other studies [2,[8][9][10][11][12]. Previous studies have generally not addressed which types of overdoses might be more prone to misclassification.…”

A multicentre programme of clinical and public health research in support of the National Suicide Prevention Strategy for England

“…As found in other studies, 26,64 the main reasons that patients gave for using paracetamol for overdose were that it was cheap and easily available (either already in the household or easy to buy from multiple outlets). Over half of the patients took all of the tablets that were available to them, compared with one-third of patients in an earlier interview study in Oxford 65 (in which patients who took smaller overdoses were included).…”

“…This finding is consistent with that from other studies. 26,31,64 If people who take a paracetamol overdose expect to lose consciousness but do not, they may think that they have not taken a dangerous amount and may not seek medical attention until symptoms of liver damage appear, by which time it may be too late to treat successfully. Half of the patients in our study who were unaware that they would not lose consciousness immediately said that they would not have taken the paracetamol overdose if they had known this.…”

“…[26][27][28] For this reason, ONS suicide statistics and monitoring of suicide trends in the National Suicide Prevention Strategy 3 are based on deaths given suicide verdicts by coroners as well as a high proportion of open verdict deaths.…”

Suicide Rates in Greece: Comparing Mortality Data with Police Reporting Statistics and Investigating Recent Trends

“…There seems to be enough evidence from different countries that medical examiners often carefully omit the word "suicide" and record the death circumstances rather than the real cause (i.e. "severe injuries due to falling from a height" or "poisoning") to spare the victim and his/her family the social stigma often associated with this very specific cause of death (Cooper and Milroy 1995). In Greece, when a suicide is suspected, there is always an inquest involving a police officer, a physician and if necessary a coroner.…”