Draft Minutes of the Central Statistics Office (CSO) Liaison Group on-line Meeting on Suicide Mortality Statistics held on 6 April 2021.
In attendance: Regina Ward, Ross Hattaway (Department of Health), Dr Philip Dodd (National Office for Suicide Prevention), Ena Lynn (HRB National Drugs-Related Deaths Index), Emer O’Neill (Pieta House), Miriam Joyce (Department of Justice), Dr Cróna Gallagher (Coroner’s Office) Prof Ella Arensman, Dr Paul Corcoran, Niall McTiernan, and Eileen Williamson, (National Suicide Research Foundation), Jackie Hickey, (GRO), Laura Galligan (Gardaí), Brian Ring and Carol Anne Hennessy (CSO).
Apologies:
John G. O’Connor (CSO), Eileen Hegarty (NSRF).
Agenda item No 1 - Welcome and Introductions
Brian Ring welcomed everyone to the meeting.
Agenda item No 2 - Agree Minutes of previous meeting held on 9 October 2020 and matters arising
The Minutes of the meeting held on the 9 September 2020 were unanimously agreed.
Subsequently two changes requested by Philip Dodd and Minutes duly adjusted to reflect same.
Status of Actions Arising from Previous Meeting:
Agenda item No 3 (Action arising) Minutes on Meeting with Dr Cróna Gallagher
The CSO circulated copy of the Minutes of the above meeting with the Dublin City Coroner in advance of the Suicide Liaison Group meeting on the 6 April.
It was agreed that the group would submit a formal request to the President of the Coroners Group (currently, Frank O’Connell) for consideration by the Council of the Coroner Society, requesting access to relevant data on the C71 Form that would inform/support the most accurate assignment of the underlying cause of death by the Mortality Coders in the CSO. The formal request should include the purpose for which this supplementary information is sought, how this information would be used and how it would be stored by the CSO. The specific information being requested should also be identified.
Action: CSO to write to Frank O’Connell, the current President of the Coroners Group requesting access to relevant information contained in the Form C71.
Agenda Item 4 – GRO Consultation on Death Registration
Jackie Hickey of the GRO advised the group that the closing date for the submission of observations regarding the consultation process on death registration was April 12, 2021 and invited submissions from organisations represented on the Suicide Liaison Group. Prof Arensman advised that the NSRF would be making a submission to the GRO. Jackie advised that the GRO expected several submissions from interested parties nearer the closing date. The GRO also asked if the group wanted to make a submission to them requesting an expansion of the data collected by the GRO e.g. include question on suspected suicide on the medical certificate. The Coroner advised that as all unnatural deaths must be referred to the Coroners Office for investigation and subsequent registration then any doctor attending the scene of death cannot complete the medical death certificate and therefore this information wouldn’t be captured here. A Medical Doctor’s Certificate cannot be accepted by Coroners when it goes to Inquest. The Coroner advised that if the GRO want this to be considered i.e. Statement Verdict or Mode of Death then the GRO should make a submission to the Coroners Group.
The NSRF reiterated how critical the element of standardisation between Coroners is. The use of a Unique Health Identifier (UHI) is required and needs to be developed. The responsibility for this lies with the HSE. However, this work has been interrupted due to the current COVID-19 pandemic.
Philip Dodd asked if the CSO intended to make a submission to the GRO under this consultation process. The CSO advised the group that they had participated in workshops with the GRO at the start of the process and that other members of the group would be best placed to make submissions on this.
The GRO advised that Eircodes will be added to the data being transmitted to the CSO shortly. However, it is not mandatory to report Eircodes and these Eircodes will not be validated initially. However, they hope that these Eircodes will be validated in time using HSE data. The GRO are building some safeguards into the collection of these Eircodes.
Action: The GRO to advise the CSO several weeks in advance of when the Eircodes will be submitted to allow the CSO to make the necessary IT changes.
Agenda Item 5 – Protocol for Linking and Integrating Data Holdings for Statistical Purposes
The NSRF would like to do some research involving data linkages.
The CSO provided some background to the National Data Infrastructure and the variables that can be potentially used to link different data sources:
The CSO can add value by linking and tabulating outputs.
The CSO further stressed that although deceased persons do not have data protection they do have privacy rights and there can be people residing at the address of the deceased.
Brian advised the group that the Vital Statistics team has raised several issues with the CSO Data Office and await clarification from that office and in the meantime RMF applications to Vital Statistics are on hold, awaiting this clarification.
Agenda item No 6 Brief update on the Suicide and Self-Harm Observatory
Prof. Arensman provided the liaison group with update. The Suicide and Self-harm Observatory, set up in December 2018 as a pilot study, was funded by the Health Research Board and uses internationally validated criteria. The pilot Observatory in Cork originated from the Suicide Support and Information System, which was initially funded by the National Office for Suicide Prevention.
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. is known, without delay and the availability of such information quickly highlights evidence of contagion or clustering and facilitates an early response. Therefore, there can be more timely interventions. Up to March 2021, the Observatory has not seen a significant increase in the number of suicide deaths between pre and post COVID-19.
Internationally, Japan has seen an increase in suicide deaths in women between March-October 2020. Australia has not evidenced an increase in suicide deaths post pandemic.
On 1st April the observatory expanded to County Kerry. In addition to Kerry, numerous other regions have enquired re the possible expansion of the observatory to other areas. Discussions are taking place on how to move on expanding and upscaling this project.
The Coroner advised that the number of deaths reported in Dublin are much higher and numbers of suspected suicide deaths would not be known immediately while in other areas the numbers would be much smaller and in a better position to provide numbers faster.
Agenda item No 7
Papers: Undercounting of suicides: Where suicide data lie Hidden
Suicide Trends During the First Months of theCOVID-19 Pandemic
Hospital-presenting self-harm during January-August 2020
The above 3 papers were circulated to the group in advance of the meeting. Prof Arensman and Paul Corcoran provided the group with a brief background to each of the papers.
Agenda item No 8 AOB
The CSO enquired from Laura Galligan, representing An Garda Síochána, what was the position re ascertaining relevant information from the form C71 from their perspective. Laura advised that the details on the C71 is exclusively not for sharing. However, it may be possible to share some information from the Pulse record. This raises the question of how this information can be captured and transmitted to the CSO.
There is a need for a National Coronial Database. Some of the Coroners input information electronically but some Coroners do not. In the context of the form C71 there is an additional wealth of data that needs to be pulled together to realise this potential. Ena Lynn advised that they manually go through the Coroners files to meet the requirements of the National Drug Related Deaths Index (NDRDI). Therefore, this would appear to be a cross-sectoral issue. There is a need for the setting up of a National Coronial Database to support public health, Justice etc as a policy-informing tool. It was suggested that this may best be pursued by working up a proposal through the National Office for Suicide Prevention (NOSP) and that the progressive place to bring the proposal would be the Connecting for Life Cross Sectoral Group.
Dr Cróna Gallagher will bring this to the Coroners Group to explore the possibility of having greater integration of information. Miriam Joyce will also bring this item to the appropriate personnel in the Department of Justice.
Next Meeting to be held in October 2021.