Under-reporting of suicide in South Yorkshire (West): a retrospective study of suicide and open verdicts returned by HM Coroner, 1992-1997.

A retrospective study was performed using information obtained from HM Coroner for South Yorkshire (West) over the period 1992-1997. All inquests which received a suicide or open verdict were reviewed to investigate the regional suicide statistics and the actual number of cases. Particular attention was paid to the age, sex, mental health and mode of death. There were 295 deaths believed to be suicidal in nature. Of these only 79% had suicide verdicts given and these comprise the official statistics. Of the open verdicts, many were suggestive of suicide but the circumstances were insufficient for the Coroner to be satisfied beyond reasonable doubt of the victims intention to kill themselves. Males and females had the same proportion of verdicts (80 and 76% respectively). Hanging was the commonest mode of suicide, (sex ratio 4.06 male: 1 female) and received a high percentage of suicide verdicts (81.5%). Self-poisoning was second but received suicide verdicts in only 66.3% of cases, whilst carbon-monoxide poisoning had a 98.1% rate of suicide verdict. Of the 295 cases, 202 decedents (88.5%) had a history of mental illness. Depression accounted for 153 cases (75.7%). Twelve decedents had psychotic illness (4%), one-half dying by jumping from a height. Official national data may under-report the annual suicide rate by over 20%. Deaths from poisoning by solid or liquid and jumping from a height appear particularly difficult to establish as suicide in coronial practice, with one-third of cases declared an open verdict.