Opportunities for enhanced suicide and suicidality surveillance in the Australian Army

The prevention of suicide mortality and suicidality (ideation, self-harm, and attempted suicide) is a key concern for the Australian Army. Currently, there are limitations to the scope of surveillance of these events, resulting in a restricted evidence base from which to design prevention and intervention strategies. This study aimed to examine opportunities to improve surveillance through analysis of the existing data landscape. A 10-year, mixed-methods, retrospective review of all events involving suicide or suicidality over the period Jan 2012 - Dec 2021 was conducted utilizing Army administrative records. Variables of interest related to demographics, event characteristics, and outcomes were summarized, and bivariate associations between variables were explored. Misclassification errors were common due to the inconsistent application of event definitions and the reliance on free-text narratives rather than structured data fields led to missing data and inconsistent data quality. Demographic data was the most reliable, while contextual and outcome data was scarce which limited statistical analysis. High-quality surveillance data contributes to many aspects of suicide and suicidality prevention. Our findings suggest the need for improved standardization and structured data fields, in addition to the expansion of data collection, particularly for event context and outcomes.