CHAPTER 3
SUICIDE REPORTING & STATISTICS
Introduction
3.1
This chapter will address term of reference (b) the accuracy of suicide
reporting in Australia, factors that may impede accurate identification and
recording of possible suicides, (and the consequences of any underreporting on
understanding risk factors and providing services to those at risk). This was
an issue which received considerable attention during the inquiry in part due
to an existing debate regarding the underreporting of suicide in Australia.
Data on suicide and trends
3.2
The Australian Bureau of Statistics (ABS), Australia's official national
statistical agency, reports annually on all registered deaths where sufficient
information exists for coding. The 2008 Causes of Death stated there
were 2,191 deaths coded as Intentional self harm [Suicide]. Of these deaths
1,710 (78 per cent) were male and 481 (22 per cent) were female. Suicide was
identified as the 14th leading cause of death as 1.5 per cent of all
deaths in 2008.[1]
3.3
The ABS statistics over the past decade have suggested a steady decline
in the number of suicides in Australia, from 2,683 in 1998 to 1,799 in 2006.
However the ABS has acknowledged these figures may be influenced by reporting
issues. Since 2005, the ABS has published a caution in relation to the reported
suicides data. The caution reads:
Care should be taken in using and interpreting suicide data
due to issues affecting data quality. It is important to note that the number
of suicide deaths may be affected by the number of open coronial cases with
insufficient information available for coding at the time of ABS processing.[2]
3.4
On these unrevised figures the largest falls in the number of suicides
reported appear to have occurred in the large states, particularly NSW and
Queensland. The rate of suicide appears relatively even across Australia (9.8
deaths per 100,000) with the exceptions of Tasmania (15.4 deaths per 100,000)
and the Northern Territory (22.8 deaths per 100,000).[3]
3.5
In recent years there has been growing concern regarding the accuracy of
the ABS statistics of deaths by suicide. For example in 2007 Professor Diego De
Leo highlighted discrepancies between the ABS data for suicides in Queensland
and the Queensland Suicide Register (QSR) maintained by AISRP.[4]
Comparison of Queensland Suicide Register and ABS data[5]
3.6
In 2009 the AIHW published a report into suicide statistics which
investigated deaths occurring in 2004 using cases extracted from the National
Coroners Information System (NCIS) from early 2008. It concluded that the ABS
mortality data underestimated death by Intentional self harm [Suicide] '...to a
significant extent, at least for deaths in 2004'. The revised estimate of 2,458
deaths from Intentional self harm [Suicide] compared to the ABS data of 2,110.[6]
3.7
In response to the concerns regarding the reporting of suicides in
Australia SPA has facilitated the establishment of the National Committee for
Standardised Reporting on Suicide (NCSRS) with the support of DoHA. The NCSRS
is a cross jurisdictional committee to coordinate the various projects and
stakeholders involved in the collection and compilation of suicide statistics,
with the aim of achieving a standardised, accurate and consistent approach to
suicide recording and statistical reporting.
ABS revisions
3.8
Reacting to the concerns raised regarding the underreporting of suicide
deaths the ABS has implemented a revision process in the Causes of Death
data collection process. All coroner certified deaths registered after 1
January 2007 will be subject to the revision process. The revision process will
enable the use of additional information relating to coroner certified deaths
as it becomes available over time, resulting in increased ability to identify
suicide deaths. In particular this process will be able to include the results
of completed coronial cases which have been finalised.
3.9
This is a change from previous years where ABS processing of Causes
of Death data was finalised approximately 13 months after the end of the
reference period. Where insufficient information was available to code a cause
of death, less specific codes were assigned. The ABS noted the revision process
would increase the number of deaths that are identified as 'suicides' for a
given reference period compared to statistics previously released for that
period.[7]
3.10
On 31 March 2010 the ABS released the latest Causes of Death data
including the revised data for deaths by suicide which was clearly higher than
previously reported. The revised data from 2007 showed a 9.2 per cent increase
in the number of deaths coded to suicide, from 1,881 to 2,054.[8]
3.11
The ABS also outlined to the Committee a number of other activities it
has recently undertaken to improve the quality of suicide data. These included
revised instructions for ABS coders in coding suicides to ensure greater
consistency in outcomes between individual coders and the implementation of
revised rules for the use of the 'undetermined intent' coding which has had the
effect of removing a number of potential suicides from 'accidental' death codes,
making potential suicides easier to identify.[9]
The collection of suicide data in Australia
3.12
The registration of deaths is the responsibility of the individual State
and Territory Registrars of Births, Deaths and Marriages (RBDMs). As part of the
registration process, information about the cause of death is supplied by the
medical practitioner certifying the death or by a coroner. Each state and
territory has its own legislation covering the death registration process, as
well as the role and responsibilities of the RBDM. Additionally, each
jurisdiction has its own coronial legislation covering the role and
responsibilities of coroners and the manner in which deaths reported to the
coroner are investigated and findings made.[10]
3.13
In order to classify a death as a suicide the current International
Classification of Diseases (ICD-10) requires that specific documentation from a
medical or legal authority be available regarding both the self-inflicted
nature and suicidal intent of the incident.[11]
The ABS Causes of Death notes:
Coronial processes to determine the intent of a death
(whether intentional self harm, accidental, homicide, undetermined intent) are
especially important for statistics on suicide deaths because information on
intent is necessary to complete the coding under ICD-10 coding rules.[12]
3.14
Since 2006 the ABS has used the NCIS as its primary source of
information for coding causes of death for cases reported to the coroner. The
NCIS is a database which contains information concerning every death reported
to a coroner in Australia since 1 July 2000 (Queensland data commenced in 1
January 2001). Based on standardised coding performed by staff at coroners’ offices
around Australia, authorised users of the NCIS are able to view details about
deaths reported to a coroner using a web based interface.[13]
Flowchart Causes of Death data collection[14]
Impediments to accurate suicide reporting
3.15
A number of impediments to the accurate collection of suicide data in
Australia were highlighted during the inquiry.
Determining intent
3.16
The difficulties in determining the intent of a person who might have
completed suicide were frequently raised as an impediment to accurate suicide
recording. Many examples were given of situations where it would be difficult
to accurately determine the intent of a person in the absence of an obvious
indication (such as the discovery of a suicide note). These scenarios included:
- drug overdoses which may be accidental or a suicide;
- single vehicle accidents where the driver has crashed into a
fixed object;
- falls or drowning which could also be accidental;
- incidents of murder/suicide which could also be a double suicide;
and
- hangings where there is the possibility of autoeroticism or there
may be questions about the capacity of the person to understand the seriousness
of their actions (for example young children).
3.17
The WA State Coroner, Mr Alastair Hope noted there was also a 'grey
area' between recklessness and intent. He used the example of a person driving
a '...vehicle in a manner which was so reckless that it would be very difficult
to decide whether she wanted to die or just did not care'.[15]
Duration of coronial processes
3.18
The main rationale for the ABS revision process was that the time taken
for coronial processes to occur did not allow data to be included in their
regular annual reports. DoHA noted a key problem 'has been the increasing
number of still pending decisions by coroners, that is ‘open’ cases, at the
time the ABS must finalise the data for annual publication'. They also noted
that there was significant variation in the case closure rates of states and
territories, from 10.6 per cent in the ACT to 72.3 per cent in Queensland.[16]
3.19
While SPA considered the retrospective revision of suicide numbers was
commendable, it noted the process would delay final counts and the benefit of
this information by several years. Similarly Associate Professor James Harrison
commented that this 'slowness greatly reduces the value of the data for
purposes related to policy and programs'.[17]
Coronial legislation and practices
3.20
Coroners are judicial officers who under coronial legislation
investigate reportable deaths and make findings as to the cause of death. Each
State and Territory has its own coronial legislation which may prescribe the
roles and responsibilities of the coroner differently. For example Mr Mark
Johns, State Coroner of SA, told the Committee that under the coronial
legislation in that jurisdiction there were two avenues for reportable deaths,
either an inquest or making a finding. He noted that because of the wording of
the legislation 'unless there is an inquest [the SA Coroner] will not make a
coronial finding as to the intention of the deceased'.[18]
3.21
The NCSRS commented:
Given differences in legislative requirements across States
and Territories, particularly with regards to coroners’ requirements to
determine and report ‘intent’, national consistency may necessitate legislative
reform as well as coronial practice guidelines. With a view to achieving a
unified system, it is suggested that recommendations regarding coronial
determination of intent be made at the National level for adoption by the
various States and Territories.[19]
3.22
In addition to legislative differences between jurisdictions the ABS
highlighted the lack of standardisation in coronial reporting practices. They
stated '...different reporting formats, structures and forms are used in
different coronial offices' and that '...coronial statements about the intent of
a death are worded in different ways, there may be no statement regarding
intent and if there is a statement of intent, it can be located anywhere in the
coronial finding'.[20]
3.23
There were also differences between the jurisdictions identified in the
availability of full-time coroners as opposed to local magistrates acting as
coroners. The NCSRS argued the use of full-time coroners would improve the
consistency of reporting practices.[21]
3.24
DoHA noted that accurate suicide statistics depend on '...what coroners
conclude and write, they are a by‐product
of their work'.[22]
However currently facilitating quality mortality statistics is not a formal
part of a coroner’s role. Coroners can rule on the intent of person but are not
mandated to do so.[23]
3.25
No jurisdiction in Australia requires a coroner to make a specific
determination about intent. The NCIS noted that an informal review of relevant coronial
findings revealed 29 per cent had no mention of intent made by a coroner.[24]
Similarly the AIHW study of suicide statistics found a large variation between different
jurisdictions in the extent to which coronial findings provide a clear
statement of the conclusion that the coroner reached about the role of intent
in the death.[25]
The Queensland Coroner commented that NCIS coding was a '...much lower priority
for coroners than case managing their own workloads with a view to making
findings to satisfy family members’ concerns and getting deaths registered onto
the local deaths registries'.[26]
3.26
To resolve this issue the NCIS recommended the amendment of coronial
legislation in each jurisdiction to require a determination of intent and
professional education for coroners about the importance of their suicide
determinations.[27]
3.27
The high standard of proof used by coroners was also identified as a
possible factor in the underreporting of suicides. The standard of proof for
coroners is the civil standard, namely the balance of probabilities, but the
gravity of the consequences of a finding of suicide is also a consideration. A high
degree of certainty regarding intent is often required before a coroner will
rule a death as a suicide. However Mr Michael Dudley of SPA noted this legal
standard of proof may be '...not necessarily the same as a research or a suicidologist’s
standard of proof'.[28]
The NCIS commented:
This test of probability can result in some instances where
it is 'possible' that a suicide occurred although was not determined as such by
a coroner, with a statement such as 'I am unable to determine whether the
deceased intended to take their own life' seen in some coronial findings.[29]
Data entry and coding
3.28
The NCIS noted several issues with the recording of intent data on their
system. The first was that some coroners' offices were not completing the Intent
Notification field until an investigation by the coroner has been
completed. This field was included to allow timely data collection as to the
prevalence of 'suspected suicides', without the need to wait until all coronial
processes were completed. They also commented that where a coroner does not
make a statement as to intent 'a conservative process of assigning intent has
to be undertaken by the coronial clerks entering the code on NCIS'. They
stated:
This current method of determination of intent is ultimately
unsatisfactory, as it places the onus of determination for suicide on a
coronial clerk, and only allows for capture of the most unambiguous self harm
events.[30]
3.29
The SA State Coroner also raised the issue of resources and staff in
coronial offices in relation to accurately coding data in the NCIS system. He
noted this task was delegated to relatively junior staff who were '... under a
fair bit of pressure'. He suggested staff were not always identifying 'the more
ambiguous causes of death' and as a result '... there is simply no way that in
South Australia we are accurately recording via the NCIS all the suicides that occur'.[31]
3.30
Finally NCIS noted that for the ABS to have complete information when
compiling official statistics the data entry into NCIS needs to be timely. They
stated that a backlog of coding exists and not all coroners' offices are able
to complete coding on the NCIS with 60 days of a coroner's finding. This could
contribute to the underreporting of suicides.[32]
The system of data collection
3.31
The ABS noted the accuracy and timeliness of suicide statistics
'...depends on the goodwill and resources available in other organisations'. It
was noted that the complexity of the data gathering system meant it was 'so
fragile that decisions made by individuals can have a massive impact'.[33]
3.32
SPA commented:
Part of the current problem is attributable to the fact that,
in Australia, suicide statistics depend on a complex process of information
capture, distribution and processing that involves numerous organisations and
individuals. No one body or portfolio is responsible for producing mortality
data. Multiple parties collect data for different, sometimes disparate,
purposes (e.g. legal, statistical, research-oriented) with different standards
of proof and reporting timelines.[34]
3.33
Some witnesses argued that the recent ABS reliance on the NCIS had also
affected the accuracy of data collection. Dr Michael Dudley of SPA noted that
with the '...transfer to a purely electronic system, there had been an
abandonment of file inspections at coroners’ offices...' by the ABS. [35]
Similarly Mr Michael Barnes stated that following the change to the new
system it was unlikely '...there will be same consistency and accuracy as when
[ABS] staff reviewed coroners' files themselves'.[36]
Police data collection
3.34
The NCIS noted that some progress had been made towards a national
standard form for police to collect information regarding a death reported to a
coroner. Several jurisdictions (ACT, Queensland, Tasmania and NSW) have
introduced to varying degrees a standard national police form that records
evidence of suspected suicide and demographic data.[37]
However the other four jurisdictions had not implemented the national standard
form and there were inconsistencies in the use of the form. Technology and
resource constraints are generally cited as the primary reasons for delay in adopting
the form.[38]
3.35
Ms Jessica Pearse of NCIS commented that there was no standard process
for police in investigating a possible suicide. She stated they '...collect a
range of information about what they consider relevant and, depending on that
variable level of information provided to them, a coroner may not have all the
relevant information needed to help make a determination'. She stated:
Any method that would encourage more standard information
collection—things like the deceased’s history, any previous attempts and
possible triggers—would assist in the best evidence-based determination being
made by a coroner.[39]
3.36
The NCIS recommended support for research to determine the reliability
of initial 'intent notification' codes based on police notifications and/or
initial clerk assessments. They suggested an initial assessment as to 'suspected
suicides' could provide a guide to current trends or patterns surrounding such
instances in the community, which could later be revised/confirmed once
coronial investigations are completed. [40]
Similarly Associate Professor James Harrison highlighted that most deaths that
are ultimately found by a coroner to be due to suicide have been flagged as
likely suicides when they were notified to the coroner, generally by police. He
argued this 'intent notification' could provide a good proxy measure as
'sufficiently complete data based on it could be reported quickly'.[41]
National Police Reporting Form Template[42]
Stigma and family pressure
3.37
The stigma around suicide was also frequently mentioned as a reason a
death may not be recorded as a suicide. Lifeline Australia commented that
stigma as well as cultural and religious beliefs could lead to circumstances
where 'family members either directly or indirectly seek to influence death
certificate statements regarding suicide'.[43]
3.38
The ABS also noted there may be reluctance by coroners to record a
finding of suicidal intent because of 'sympathy with the feelings of the
family, or sensitivity to the cultural practices and religious beliefs of the family'.[44]
It was suggested these types of inconclusive findings were delivered by
coroners and others to 'spare the family shame and chagrin, the agonising
doubts and questions'.[45]
3.39
Mr Alastair Hope, State Coroner of WA also noted that there is
frequently pressure from families in the case of public inquests 'to find that
the death is by accident or some other mechanism apart from suicide'. Family
members may believe that a finding of suicide might reflect adversely on their
own interaction with the deceased person.[46]
The Queensland Coroner, Mr Michael Barnes commented that there had been 'numerous
appeals against suicide finding by family members seeking a different finding
and this may also cause coroners to be more hesitant to make a finding of
suicide.[47]
3.40
No evidence was received which estimated the extent to which stigma
influences the reporting of suicide. However the ACT Government noted the
feedback it had received from '...emergency workers and others who are frequently
first on the scene at motor vehicle fatalities report is that indicators such
as [suicide] notes in single vehicles are frequently overlooked during coronial
determinations'.[48]
Insurance and financial issues
3.41
Family and relatives may also fear that an official report of a death as
a suicide may prevent or delay the payment of life insurance or other forms of
financial payment. Lifeline Australia stated:
In regional and rural areas in particular, this delay can
have a catastrophic impact on the economic future of a family, such as where a
family farm or business is involved. Accordingly, inaccurate recording of the
cause of death can occur through the intention to avoid financial hardship for
a family – especially in smaller communities where families know each other and
socialise together.[49]
3.42
Other submissions noted the practice for life insurance policies to
include a clause excluding payments for deaths by suicide within a certain
period following commencement of the policy. Typically this exclusionary period
was between 13 and 24 months. It was suggested that these life insurance
policies contributed to the underreporting of deaths as suicides.[50]
Consequences of underreporting
3.43
The underreporting of suicide deaths was seen as masking the extent of
the problem in Australia and thwarting efforts to assess the efficacy of
suicide prevention programs and activities. Professor Ian Hickie from BMRI
described the lack of accurate suicide figures as a 'national catastrophe'. He
suggested underreporting of suicides presented two major problems for policy
makers:
First, it means we have no way of monitoring, with any
confidence, that policy and program initiatives are having the intended effect.
Second, it is highly unlikely that underreporting is really
an issue across all population sub-groups. This means that we may be directing
the already meagre resources for suicide prevention away from high risk groups
in the community.[51]
3.44
Similarly the Royal Australian and New Zealand College of Psychiatrists
(RANZCP) commented:
Accurate statistics provide the foundation for appropriately
targeted prevention strategies and research and understanding the full costs of
suicide. Without reliable data, the effectiveness of suicide prevention strategies
is not detectable.[52]
3.45
Underreporting was also seen as having consequences for research into
the causes of suicide. The NCIS commented that a '...reduced amount of
information collected in a consistent, searchable format about suspected
suicides may also later limit the ability of researchers to identify risk
factors for suicide'.[53]
3.46
The Suicide is Preventable submission commented that while there was
general agreement that suicide rates are underreported in Australia there was
disagreement about whether, despite this underreporting, '...enough is known to
establish patterns, the dimensions of the phenomenon' and to base effective
prevention programs.[54]
3.47
For example the Queensland Coroner Mr Michael Barnes considered the
need for accurate suicide statistics was self evident, noting that it was difficult
to design, implement or evaluate prevention strategies if there was uncertainty
regarding the size, scope and distribution of the problem. He argued that the changes
to way the ABS has been gathering data had resulted in 'obscuring even the
trend in the statistics'.[55]
SPA also highlighted the uncertainty created by underreporting. They stated:
How much of the downward trend in deaths registered as
suicides since 1998 is due to a real decline in the number of suicide deaths as
opposed to under-enumeration or misclassification is therefore not immediately
apparent, nor the full extent of the problem of under-reporting known.[56]
3.48
However Professor Graham Martin and others argued that suicide
prevention activities to date have been 'quite successful' and there was
evidence that there had been a real decline in the number of suicides in
Australia, particularly amongst men, despite the problems with data collection
and the issue of misclassification of deaths.[57]
Professor Robert Goldney commented that ambiguity in suicide statistics had a
long history but that '... detailed analyses have been re-assuring in
establishing that broad trends can be reliably inferred from data provided'.[58]
3.49
Similarly Dr Ching Choi and Dr Lado Ruzicka commented that while it was clear
that the ABS have been under reporting suicide deaths, '...it is not at all clear
that the declining suicide mortality trend is not real'. They pointed to the
declining trends in many other developed countries as well as the decline in
suicides associated with firearms but noted suicides by hanging have not
declined.[59]
Scope of reporting
3.50
Another area of reform in reporting was the scope of data collected in
relation to suicide. RANZCP noted that the 'lack of information in death
records on some characteristics of people dying by suicide further contributes
to the ignorance of suicide risk factors and distribution'.[60]
The Committee frequently heard evidence that there was little reliability in
the recording of the characteristics of a person who completed suicide.
Additional information such as whether the person was Indigenous, gay, lesbian,
bisexual, transsexual or intersex or from a particular ethnic community was not
being consistently recorded.[61]
Others noted that the lack of ethnicity data made it impossible for assessments
of trends and issues in culturally and linguistically diverse communities.[62]
3.51
The NCSRS noted that a range of information gathered during a police
investigation which has the potential to inform both coronial determinations
and suicide prevention activities and research. They suggested the collection
of more wide ranging background information concerning the deceased’s social life
and relationships and a complete medical and mental health history could assist
the determination of suicide intent or risk. The NCSRS recommended a standard
psycho-social autopsy be developed, taking into account a broad source of
information, and implemented as a matter of course in all cases of suspected
suicide.[63]
3.52
Accurate and timely recording of suicides could also enable authorities
to identify problem areas, clusters of suicides or areas requiring postvention
services following a series of related suicides. Lifeline Australia stated:
Better access to accurate information on suicide and suicidal
behaviour could enable more effective local responses to communities and
regions in Australia – notably in cases where several deaths by suicide occur
in a short space of time. The early identification of ‘clusters’ of suicide in
localities or particular social/demographic groups will support more effective
suicide prevention responses.[64]
3.53
A number of submissions and witnesses argued that not only did the
number of suicides in Australia need to be accurately recorded but other
factors also needed to be tracked. Professor Ian Hickie noted that contacts
with care were common for people before they attempted suicide but that no
national tracking mechanisms existed to link cares services to patient
outcomes. He stated:
...we need to track those who have contact with the health system
through its emergency departments, its primary care services and particularly
its specialist mental health services. We have seen a complete lack of will in
the health systems to join up occasions of service with the key outcome of
care: are you alive or dead at three months? Are you alive or dead at 12 months?
If dead, what is the cause of death? They are the simple things that we need to
know.[65]
3.54
Professor Ian Hickie also commented that there may be services which do
not want to be held accountable for outcomes because they provide short
episodes of care to people who may be at risk of suicide.[66]
3.55
Broader data collection regarding suicide could also assist service
providers refine the targeting of groups at risk of suicide. OzHelp commented
it would be assisted if data such as age, gender, occupation, income and other
social determinants of health could be collected.[67]
Orygen Youth Health Research Centre argued that the failure to record suicide
attempts '... restricts our ability to accurately monitor progress towards
reducing suicide and significantly hampers research in this area'.[68]
3.56
The Private Mental Health Consumer Carer Network Australia recommended
that the reporting protocol of deaths with 28 days of discharge from a mental
health facility be linked to coronial reporting requirements. The Network
concluded that efforts must be made to collect, report and review all occasions
of death by suicide following discharge from mental health services.[69]
3.57
Mr Michael Barnes suggested one solution to the scope and accuracy of
the recording of suicides would be to expand the QSR model nationally. The QSR
is a database of suicide mortality data managed since 1990 by AISRP. The
database gathers information on deaths by suicide of all residents of
Queensland, including data obtained from police reports, post-mortem and
toxicology reports. This information is predominantly provided by the
Queensland Office of the State Coroner and cross-checked with the data
available on the NCIS. Causes of death are then scrutinised in the QSR
following a Suicide Classification Flow Chart, developed by AISRP, and
categorised into: Beyond Reasonable Doubt, Probable, or Possible.[70]
Conclusion
3.58
Accurate and timely statistics are essential to the creation,
implementation and evaluation of good policy in any area, but particularly for
social and health policy. The rate of suicide is widely used internationally as
a broad progress measure or indicator of the effectiveness of social and health
(particularly mental health) policy.
3.59
The Committee acknowledges that because of the difficulties around
determining intent a completely accurate recording of suicides in any given
year is unlikely to be achieved. However this does not preclude substantially
more accurate, timely and useful recording of suicide. The Committee considers
that accurate and timely statistics about suicide and attempted suicide should
be given a high priority under the NSPS.
3.60
The Committee acknowledges the recent efforts made by the ABS to improve
the accurate recording of suicide data through revisions. Without the benefit
of several years of ABS revised data, it is not clear whether there is a clear
downward trend in deaths registered as being a result of suicide. As the
revision of previous years by the ABS continues this situation will become
clearer.
3.61
The creation of the NCSRS, which brings together many of the
participants and users of suicide data collection system, demonstrates there is
considerable goodwill and a shared commitment to reforming many of the
technical issues which prevent accurate suicide reporting.
Recommendation 2
3.3 The Committee recommends that Commonwealth, State
and Territory governments, in consultation with the National Committee for
Standardised Reporting on Suicide, implement reforms to improve the accuracy of
suicide statistics.
3.62
It is clear that standardising coronial legislation and practices in
relation to determining intent would have the effect of improving the quality
of suicide reporting in Australia. However the Committee has concerns about
proposals to require coroners to make determinations as to the intent of the
deceased in relation to possible suicides. There is a significant difference between
a coroner publicly recording a death as a suicide and a coroner officially
recording a death as a suicide. The Committee considers it may be possible to
develop a system whereby coroners maintain their discretion to not publicly
make a finding of suicide (on compassionate grounds) but are required to record
their determination officially (on the NCIS or otherwise). This is a difficult
area of reform as it involves coronial legislation and practices in all
jurisdictions. The Standing Committee of Attorneys-General appears an
appropriate forum to progress this issue, particularly considering its previous
experience in implementing uniformity of legislation across Australian
jurisdictions.
Recommendation 3
3.63 The Committee recommends that the Standing Committee of
Attorneys-General, in consultation with the National Committee for Standardised
Reporting on Suicide, standardise coronial legislation and practices to improve
the accurate reporting of suicide.
3.64
Standardising the input that coroners receive from primary sources such
as police will also positively impact the recording of suicides. The important
role that police currently (and potentially could) undertake in gathering
information about persons at risk of suicide was highlighted to the Committee a
number times during the inquiry. The Committee is concerned that the police
forces of Victoria, SA, WA and NT do not appear to have implemented the
standardised national police form for the collection of information regarding a
death reported to a coroner.
Recommendation 4
3.65 The Committee recommends all Australian governments implement a
standardised national police form for the collection of information regarding a
death reported to a coroner.
Recommendation 5
3.66 The Committee recommends that the Commonwealth, State and Territory
governments enable timely distribution of suicide data from coroners' offices
regarding suicides to allow early notification of emerging suicide clusters to
public health authorities and community organisations.
Recommendation 6
3.67 The Committee recommends that State and Territory governments provide additional
resources and training to staff in coronial offices to assist in the accurate and
timely recording of mortality data.
3.68
In relation to life insurance policies the Committee is cautious to make
any recommendations to change the practice of standard exclusions if the person
completes suicide within a certain time period after the policy is commenced.
The financial implications of these policies would have the effect of
discouraging the reporting of deaths as suicides in some cases. Nonetheless
there is also possibility that a change to these insurance policies could act
as a dangerous incentive or encouragement those at risk of suicide.
Recommendation 7
3.69 The Committee recommends the National Committee for Standardisation of
Reporting on Suicide liaise with peak insurance and financial associations,
such as the Insurance Council of Australia, regarding exclusionary conditions
in contracts which may deter the reporting of suicides.
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