How Reliable Are Official Annual Suicide Numbers in Sri Lanka?

Area of Science:

• Public Health
• Epidemiology
• Sociology

Background:

• The World Health Organization (WHO) highlights suicide surveillance as crucial for prevention strategies.
• In Sri Lanka, police registers are the primary source for national suicide data.
• Effective suicide prevention relies on accurate and complete data collection.

Purpose of the Study:

• To evaluate the completeness of police suicide records in Sri Lanka.
• To compare police data with hospital and civil registration records.
• To assess the extent of underreporting in police suicide data.

Main Methods:

• Secondary analysis of a suicide case series from Anuradhapura District, Sri Lanka (April 2019-September 2023).
• Linking police records with hospital admission and civil registration data.
• Calculating sensitivity and confidence intervals for police record completeness.

Main Results:

• A total of 663 suicide deaths were identified across all sources.
• Police registers captured 615 deaths, achieving a sensitivity of 91.0% for hospital deaths and 94.0% for non-hospital deaths.
• Sensitivity varied by method, with hanging at 97.3% and non-pesticide poisoning at 70.7%.

Conclusions:

• Police registers are a substantially comprehensive source for suicide surveillance in Sri Lanka.
• Underreporting exists, particularly for less common suicide methods, potentially leading to underestimated national rates.
• Police data remain vital for suicide surveillance and public health planning in settings without robust civil registration systems.