Becoming Best Friends with Your Deputy Medical Examiners: Development of a Novel Data Collection Instrument and a Timely Surveillance System for Suicide Risk Factors

BACKGROUND: Suicide was identified as a priority health issue in an extensive regional Community Health Needs Assessment. Oregon is a founding member of the National Violent Death Reporting System (NVDRS) which provides state-level risk factor data for suicide and other violent deaths. However, the demographics of the state level data were not generalizable to the local county. Specific and timely local risk factor data for suicide were needed to guide local prevention efforts. 

METHODS: To assess the public health risk factor data available, local epidemiologists attended over 100 violent death scenes with deputy medical examiners and the associated autopsies with forensic pathologists to study the data trail all the way from the death scene to the NVDRS reporting. Based on this experience, we developed a novel electronic data collection instrument, the Consolidated Risk Assessment Profile, for the Deputy Medical Examiners to complete within 24 hours after each suicide death. The instrument contains 47 unique, evidence-based risk factors and circumstances associated with suicide.   

RESULTS: Deputy Medical Examiners successfully completed the Consolidated Risk Assessment Profile within 24 hours of the suicide for all deaths in the study period. We have collected 38 suicides with this detailed risk factor information since the development of the data collection instrument. Comparing the count of risk factor reporting for suicides at the county level from the NVDRS data to the Consolidated Risk Assessment Profile, risk factor reporting increased 50 percent for both presence/absence/unknown reporting of suicide risk factors with the new instrument. Additionally, data were able to be analyzed and presented quarterly to the local Suicide Fatality Review Committee to guide specific suicide prevention training efforts in an incredibly timely manner.   

CONCLUSIONS: Data from NVDRS are reported at the state level and are often multiple years old. The Consolidated Risk Assessment Profile easily links with other state/local data sources and allows for immediate risk factor analysis for suicide at the local level for the best possible use of limited resources in suicide prevention.