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Scoping Event for PCTs in Cumbria and Lacashire 15th December 2003.

Suicides in the North West - epidemiology update Developing Suicide Prevention in Primary Care Trusts. Scoping Event for PCTs in Cumbria and Lacashire 15th December 2003. Tom Hennell - Senior Analyst, NW Public Health Team thomas.hennell@doh.gsi.gov.uk tel: 0161 952 4359 . Male Life

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Scoping Event for PCTs in Cumbria and Lacashire 15th December 2003.

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  1. Suicides in the North West - epidemiology updateDeveloping Suicide Prevention in Primary Care Trusts Scoping Event for PCTs in Cumbria and Lacashire 15th December 2003. Tom Hennell - Senior Analyst, NW Public Health Team thomas.hennell@doh.gsi.gov.uk tel: 0161 952 4359

  2. Male Life Expectancy at Birth for PCTs in the North West: 2000 - 2002

  3. Female Life Expectancy at Birth for PCTs in the North West: 2000 - 2002

  4. Data Sources for Suicides • Compendium of Clinical and Health Indicators 2002 • Suicides categorised under Mental Illness • On-line on NHS net, or by CD to permitted NHS users • source data may not be copied outside the NHS • Public Health Mortality File • produced by ONS and distributed to PCTs (monthly) • text version of the Medical Certificate of Cause of Death • District Annual Deaths extracts • coded version of deaths registration • consistent with the Vital Statistics Tabulations

  5. Data Issues • Date of Death and Date of Registration • District Deaths extracts, Compendium, PHMF and Vital Statistics Tables all relate to year of registration. For most causes of death this involves a lag of only a few days - but suicides cannot be registered without an inquest being opened. • Place of Residence and Place of Death • Deaths are registered by usual residence (home address for persons in prison less than 6 months) • Deaths are investigated by where the body lies – usually place of death. • Classification of Self Harm • Any death whose cause is suspected to be unknown or unnatural - or which has been contributed to by unnatural causes - must be reported to the Coroner • If the Coroner decides that, on the balance of probability, the death was accidental- then it will not be coded as self harm • If the Coroner decides, beyond reasonable doubt, that the deceased took their own life - the death will be coded as suicide. • About 30% of self harm is classified as being of undetermined intent - in these cases the coroner will have given an open verdict.

  6. Coroners and Suicides • There are 7 Coroner’s districts in Cumbria and Lancashire • Blackburn, Blackpool, East Lancashire, Furness, Cumbria NE, S, W. • The Coroners job is to determine how, when and where the deceased came by their death • almost all deaths are certified by the Coroner if the attending doctor cannot certify death as due to natural causes • the Coroner may not determine blame • each death is decided on its own merits • the Coroner certifies the cause of death for civil registration • Coroners have discretion over making records available to subsequent inquiry • Coroners may bring to the attention of public authorities matters discovered at the inquest that raise issues of public concern, and may prevent a recurrence of similar fatalities. • Coroner services are under review – post Shipman and Alder Hey

  7. Key Recommendations • PCTs should take note of both suicides and ‘undetermined’ deaths. • Incidence of self harm varies widely • relates strongly to historic patterns of mental illness services • relates less strongly to deprivation factors • other patterns unexplained e.g high female rates in Blackburn • PCTs should review recent local trends • current pattern is one of decreasing incidence • note article on “Trends in Suicide” in Health Statistics Quarterly 20 (2003) • PCTs should consider approaching coroners to ascertain if they have made recommendations on individual suicides in the recent past.

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