Meeting 16

CSO Suicide Mortality Statistics Liaison Group Meeting

Via Zoom

Wednesday April 6th, 2022 at 9.30am

Action Points

Present: Brian Ring, John O’Connor, Gerard Doolan, David Griffin, Suzi Lyons, Laura Galligan, Dr Philip Dodd, Kevin Kelly, Alice Wainwright, Prof Ella Arensman, Dr Paul Corcoran, Dr Cróna Gallagher, Dr Mary Flannagan, Eileen Williamson, Niall McTernan, Superintendent Aidan Minnock (An Garda Síochána)

Apologies: Jackie Hickey, Regina Ward 

Action Points: Niall McTernan

 Minutes of meeting held on February 16th, 2022

• Brian reviewed the minutes and action points from the previous group meeting held on February 16th, 2022
• HSE NOSP PULSE Advisory Group finalised in week beginning April 4^th, membership to be shared after meeting

Action points:

• Share membership of NOSP PULSE Steering Group (Philip)

Document accompanying release of suicide figures

• Ger provided a summary of the updated CSO summary note following submissions from NOSP/NSRF and the Department of Justice
• Signposting and help seeking resources to be included prior to publication in line with CSO sexual violence survey
• Detailed discussion in relation to context of note re. press release or note. Release with methodology note also mentioned
• Ger advised regional county breakdown could also be included with an option for annual or five-year periods
• Ella indicated that three- or five-year trends would be important for methods
• Philip suggested that it would be important to include an explanation of the late registration process and the media guidelines for reporting suicide
• Philip indicated that a ‘special’ release indicates that the CSO are doing something different which is not the case and there is a need to consider this
• Brian suggested that the group needs to decide what the key purpose of the information note is. What it is and what was the basis for preparing it? Factual or stating how statistics are measured. Statistical release or process around it?
• Ger suggested that the document be released around WSPD 2022 to raise awareness of the area in line with other CSO initiatives. Ella indicated this would be appropriate but it is important to consider the negative impacts of such a release. There is a balance between providing figures and information on services
• Paul stated that this would be timely with the vital statistics annual report usually being published in October and the group needs to consider overlap with this
• Philip suggested the formation of a subgroup to work on this action. Brian specified that the CSO needs to speak with the head of dissemination and senior management team prior to moving forward. Feedback to be provided by end of April
• Kevin highlighted ongoing Department of Health work with coronial data
• Philip suggested that the group review the template used by the Office of National Statistics (ONS) in the UK - https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/latest
• Ella suggested that Connecting for Life and the United Nations Sustainable Goals are mentioned in the document

Action points:

• Clarify participation in subgroup relating to information note (CSO)
• Review template used by the Office of National Statistics in the UK (CSO) 

Proposed change to the suicide category in An Gárda Siochána Pulse System 

• Superintendent Minnock thanked all stakeholders for their submissions and indicated that the Gardaí were grateful for the offer from the NSRF/NOSP of training of the persons who input data on Pulse
• Next steps for Gardaí - Finalise motive, submit to Gardai Executive, then progress IT, training and policy
• John stated that ‘probable’ would be discounted in the ICD classification system, as there is no definition for this term. This would be classified as ‘uncertain diagnosis’

          -The following guidance was provided: 23.1 Uncertain diagnosis - Ignore expressions indicating doubt as to the certainty of the diagnosis, for example ‘apparently’,                 ‘presumably’, ‘probably’ or ‘possibly’. A tentative diagnosis, although uncertain, is of better use to mortality statistics than no diagnosis at all.

          -https://icd.who.int/browse10/Content/statichtml/ICD10Volume2_en_2019.pdf

           -https://icdcdn.who.int/icd11referenceguide/en/html/index.html#uncertain-diagnosis

• John suggested it would be aspirational for all agencies to use the same code but recognised that this would be very difficult to achieve
• Superintendent Minnock reiterated that there would be no change to the form 104 and the Pulse system is not the final classification, it is merely based on the individual Garda’s initial interpretation
• Dr Gallagher indicated concern around motive and intent and that the system is screening criteria only. If possible/probable it is likely that deaths will get eliminated at a later stage
• Ella stated that from the perspective of suicide prevention and intervention, access to the preliminary suicide data would be extremely relevant
• Eileen queried if recommendation 12 of the Commentary by the Irish Policing Authority on the Final Report of the Garda Síochána Homicide Investigation Review Team could be considered as part of the current work and Superintendent Minnock confirmed that it was outside of the current scope
• Superintendent Minnock indicated that it is likely that ‘Probable’ will be removed and that the new policy will be implemented based on ‘balance of probability’ as it is recognised that it is the role of the Coroner to investigate motive. Paul agreed that balance of probability is the correct way to proceed
• Dr Gallagher suggested that impact of ‘probable’ on family members is considered
• Eileen queried timeline of investigation. Superintendent Minnock indicated that some investigations will close quickly, and some will progress for years
• Ella mentioned the possibility of comparative research
• Superintendent Minnock thanked the group for their time and insights. Dr Gallagher indicated that all submissions were very helpful
• Dr Gallagher suggested that there is clear separation between preliminary and final data and that the CSO consider receiving coroner verdicts in an official way. Eileen stated that had previously been discussed by the Group and certainly was worth revisiting at future meetings. 

Action points: 

• Consider receiving coroner verdicts in an official way (CSO) 

AOB 

• John offered to provide a demonstration on the detail that can be added to the CSO system
• Update from Jackie Hickey in relation to the electronic death notification project noted, no progress to report

Action points: 

• Provide demonstration on detail that can be added at next meeting (John) 

Date and venue for next meeting: June 2022, perhaps in person.