In attendance: Regina Ward, Ross Hattaway (Department of Health), Dr Philip Dodd (National Office for Suicide Prevention), Dr Suzi Lyons (HRB National Drugs-Related Deaths Index), Emer O’Neill (Pieta House), Miriam Joyce (Department of Justice), Dr Crona Gallagher (Coroner’s Office) Prof Ella Arensman, Dr Paul Corcoran, Eileen Hegarty and Eileen Williamson, (National Suicide Research Foundation). Brian Ring, John G.O’Connor, Rosaleen White and Carol Anne Hennessy (CSO),
Apologies:
Jackie Hickey (General Registration Office)
Superintendent Kevin Gately (Gardaí) now retired
Agenda item No 1 - Welcome and Introductions
Brian Ring welcomed everyone to the meeting, made the relevant introductions and conveyed the apologies of the non-attendants to the meeting.
He also acknowledged the contribution to the group of Dr Deirdre O’Reilly of the Irish Prisons Service. Miriam Joyce of the Department of Justice has replaced Deirdre. He also welcomed Dr Crona Gallagher, representing the Coroner’s Office.
Agenda item No 2 - Agree Minutes of previous meeting held on 19th February 2020 and matters arising
The Minutes of the meeting held on the 19th February 2020 were unanimously agreed.
Status of Actions Arising from Previous Meeting:
Agenda item No 3 (Action arising)
It was agreed that a recommendation from the Group in relation to Form C71 be sent to the Garda Commissioner.
This action had not been completed since the last meeting. Dr Crona Gallagher outlined several concerns that the Coroners would have about sharing the information on this form with the CSO. The C71 is designed to provide information to the Coroners’ office and is completed by member(s) of the Gardaí (generally at Sergeant level). The C71 may contain information on other living individuals. It often contains other ancillary information like name of next-of-kin, other phone numbers, name of person that found the body, details if the deceased had been involved in an earlier dispute etc.
In light of these concerns and implications of GDPR etc. the CSO suggested that a dedicated meeting be set up involving the Coroner’s Office, the Gardaí and the CSO to discuss these issues and see what can be agreed in that forum.
Philip Dodd advised that the Gardaí need guidance on what are the characteristics/evidence of a suspected suicide. Department of Health further advised that there is a link-up between the police and the NHS in the UK, Northern Ireland and other jurisdictions. If information on best practice can be ascertained, then this information can be brought to the Board.
Agenda Item 4 – Research Microdata Requests (RMF) Updated Position
The CSO advised the group that the Director General can appoint researchers as Officer of Statistics to third parties to facilitate research projects.
However, there are certain issues arising at present:
Brian Ring has raised this issue as to whether the collection of data from the GRO should come under the Statistics Act and this is being considered by the Data Office (CSO).
The CSO is very conscious of the demand for information on COVID-19 deaths and the potential for increased demand for access to microdata on the release of Quarter 2 2020 mortality data as this is the first period that will capture such deaths.
Action: CSO to update group on any implications for access to Vital Statistics data
Agenda Item 5 – Suicide Observatory
Covered under item No. 5 of today’s agenda
Agenda item No 6 – Late Registered Deaths – Further Discussion
The CSO advised that the number of late registered deaths continues to rise which can impact on the number of suicides included in the Vital Statistics Annual Report that is published 22 months after the end of the reference year.
The Coroner advised that most inquest cases are registered within approximately 2 years by that office. A backlog had arisen since the start of the COVID-19 pandemic, but this is reducing now due with additional resources. The CSO confirmed that the bulk of the late registered suicide deaths do fall into the relevant earlier two years period – this is in line with the Coroners experience.
Paul Corcoran of the NSRF requested that the CSO drop table 16 from their summary report (i.e. provisional data) that publishes the number of suicides by county as Dublin has 30% of the country’s population and has only 10% of the registered suicide deaths. CSO said it is unlikely that this table would be dropped as it is of historical value to some. However, this table could be clearly caveated re issue of late registered deaths.
Miriam Joyce, Department of Justice offered to bring the issue of Dublin Coronial resources back to the Department which may help to escalate a resolution.
Action CSO to insert clear footnote into the appropriate table on summary report
Agenda item No 7 – Connecting for Life
CSO to attend the next Steering Group Meeting and present on how suicides are reported.
Action: CSO to make presentation on how suicides are reported at the next Steering Group Meeting.
Agenda Item 4: Work underway for more timely death registrations
As a point of information, the CSO advised the group that work is underway to change the way in which deaths are registered as a response to increased demand for more real-time statistics because of COVID deaths. At present, the Next-of-Kin/Qualified Informant has three months from date of death to register the death. Furthermore, deaths are often registered late i.e. outside the three-month period. More timely registration would bring Ireland in line with other European countries. This is a work in progress and a further update will be provided at next meeting.
Action: CSO to keep the group informed and report on progress at next meeting.
Agenda item No. 4 - Collaboration between CSO, NSRF and the National Centre for Geocomputation, Maynooth University, on incorporating data on socio-economic deprivation and fragmentation in the geospatial analysis of suicide clusters in County and City Cork.
Not fully discussed in absence of Ella Arensman
Agenda Item 5– Supporting real-time notification of possible suicide deaths
Paper on Development and Implementation of a Real-Time Suicide Surveillance System: Review of the Pilot Phase of the Suicide and Self-Harm Observatory was forwarded to all attendees prior to the meeting.
Professor Ella Arensman (NSRF) updated the group, that the Observatory is funded by the Health Research Board (HRB) and this pilot was set up at the beginning of 2018 and covers Cork City and Cork County. There is a need for real time information on suicide. To this end, a member of the research team contacts the Coroners in Cork City and Cork County every fortnight by telephone. This ensures that any increase in the number of deaths from intentional self-harm is quickly established and any trends in type of death, location etc. can establish, without delay, if there is contagion. Therefore, there can be more timelier interventions.
A similar study has been carried out in Queensland, Australia over a five-year period and was of huge benefit. The COVID related narrative in Queensland reveals that 23 identified suicide deaths since COVID had a pre-existing health condition.
The NSRF hope that this pilot will be upscaled to other or all regions in Ireland. The Cork pilot is not intensely resourced at present and if the upscaling of the pilot goes ahead, it will be more resource intensive.
This project is dependent on the co-operation of the Coroners and in Cork the NSRF has been working with the Coroners since 2008. Detailed ethical procedures are in place to allow this exchange of information. The Coroner verifies any cases identified that meet the international criteria of a suspected suicide. This information is not included in any reports, but the information collected in the study can help in identifying clustering/contagion and evaluate any misinformation that appears on social media platforms. Within a few days media stores around suicide can be verified with the Coroners. In addition, this information can be cross-checked with the HSE Patient Register (this only applies where the deceased interacted with the HSE services).
It was noted that misinformation around suicide can lead to contagion, in particular among adolescents, but this isn’t as much an issue for adults. The work done in the Observatory can identify and provide evidence based information around this narrative in a short period of time.
Agenda item No 6: AOB
The issue of misinformation being posted in various platforms was discussed. There was an article on a national website which stated that there were 33 deaths from suicide in one month and then this was reported elsewhere as 33 suicide deaths in one week. Dr Dodd had 23 enquiries around this misinformation. However, as definitive numbers of suicide deaths are not available in real-time, NOSP were not in a position to categorically state that these suicide deaths did not occur. This misinformation can act as a trigger to vulnerable individuals. There were also inaccuracies reported in fora regarding the Coroners processes including stories that Inquests were held behind closed doors or with no family members in attendance. The HSE offered to make available comprehensive Questions and Answers to Parliamentary Questions received by them to the group.
Next Meeting to be held February\March 2020