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Undetermined Deaths in Leeds 2011-2013

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Area for action 6

Area for action 6 Support research, data collection and monitoring. The 2008-10 audit was recognised as a national example of good practice. However, as discussed in the ‘Limitations’ section, the audit process is retrospective. There has been an increasing recognition that real-time surveillance of suicides can aid in the detection of a suicide cluster. 6 Recommendation 10 Continue to undertake a suicide audit at regular intervals to gather detailed knowledge about the epidemiology and risk factors of those taking their own life in the city. Recommendation 11 Consider the development of a real-time surveillance system for suspected suicide through working closely with key identified partners across the city. 50

Limitations of this Audit As an audit team we have made every effort to ensure that the research process was as robust as possible. However, there are some limitations to the methodology: Breadth of the Source Material The Coroner’s records are the best possible resource that can be used to obtain the kind of detailed information required in relation to suicides occurring in Leeds. The primary aim of the Coroner’s process is to judge the cause of the death in question. This means that, in some respects, the Coroner’s file cannot always contain all of the desirable information. Two examples of this are accurate ethnicity and sexual orientation data. The only failsafe way to ascertain these factors would be to ask the individual in question, which is not a possibility. Accuracy of the Source Material Much of the information we obtained about risk factors was ascertained from witness statements provided by people who knew the deceased individual. This information is subjective and may not represent the true situation. This introduces the possibility of bias into the audit. Time Lag The audit is retrospective and looks back on the years 2011 to 2013; this means these deaths occurred five to three years prior to the publication of this research. This time lag is unavoidable as in order to access the Coroner’s record, the evidence needs to have already been assembled and the inquest completed by Coroner. This process can be lengthy, particularly if the case is a complex one (for instance, a death within a prison). One record could not be obtained for this audit because the inquest was yet to be heard. The delay could not be avoided but it does mean we need to be careful when interpreting the results of the audit as they do not necessarily reflect the current situation in Leeds. Low Number of Cases There were 213 cases included in this audit which is a small number, especially when divided into subcategories. The small numbers mean that it can be difficult to tell if change between audits, or differences between categories, actually represents true differences or if they are due to chance. Statistical tests of differences typically do not work well when the numbers are this small. 51

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