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The comparability of suicide rates
The British Journal of Psychiatry : the Journal of Mental Science
|September 1, 1975
Summary
Epidemiological surveys for suicide prevention may be inaccurate. Differences in how coroners determine suicide causes, particularly between Denmark and England, cast doubt on reported suicide rates.
Area of Science:
- Public Health
- Epidemiology
- Forensic Pathology
Background:
- Accurate epidemiological surveys are crucial for effective suicide prevention programs.
- Existing suicide data may be unreliable due to under-reporting and inconsistent ascertainment methods.
Purpose of the Study:
- To investigate the accuracy and consistency of suicide ascertainment procedures in epidemiological surveys.
- To compare suicide ascertainment practices between Denmark and England.
- To examine variations in verdict allocation for deaths by poisoning within England and Wales.
Main Methods:
- Comparative analysis of suicide ascertainment procedures between Denmark and England.
- Blind review of case records by coroners in both countries.
- Examination of verdict distribution (accident, open, suicide) for deaths by poisoning in selected English and Welsh districts.
Main Results:
- Significant differences in suicide ascertainment procedures were observed between Denmark and England.
- Danish coroners consistently classified more cases as suicide than English coroners using identical case materials.
- Considerable variation in the proportion of accident, open, and suicide verdicts for deaths by poisoning was found among different coroners' districts in England and Wales.
Conclusions:
- The reliability of international comparisons of suicide rates based on current epidemiological surveys is questionable.
- Inconsistencies in suicide ascertainment criteria among coroners may exist within England and Wales.
- Caution is advised when interpreting epidemiological data and formulating hypotheses about suicide rate differences.
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