BACKGROUND: Suicide was identified as a top health issue in several Community Health Needs Assessments in Washington County, Oregon. Oregon is a founding participant of the National Violent Death Reporting System (NVDRS) which provides state-level risk factor data for suicide and other violent deaths. However, due to funding constraints, these data are not timely nor easily available at the county-level. Specific and timely local suicide risk factor data were needed to guide local prevention efforts. A novel and near-real time suicide surveillance system, SRFSS, was developed.
METHODS: A novel electronic data collection instrument was developed, the Suicide Consolidated Risk Assessment Profile (SCRAP), which Deputy Medical Examiners (DME) complete within 24 hours after each suicide. The instrument contains 47 evidence-based risk factors and circumstances associated with suicide from the National Violent Death Reporting System (NVDRS). Each risk factor has a yes/no/unknown/not available answer option for maximum granularity not available in the NVDRS. Data were collected from July 2015 prospectively, and the DMEs retrospectively completed SCRAPs for 18 months prior to July 2015, for a total of three years of data. This is the first release of those data.
RESULTS: Over 200 Washington County suicides were analyzed across 47 risk factors and circumstances. Prevalent crisis risk factors in the two weeks preceding death were: relationship problem, substance use, and/or a criminal legal problem. At the time of death, common risk factors were current mental health problem, intimate partner problems and social isolation. The least common risk factor was perpetrating interpersonal violence within the last 30 days. Perhaps most striking, the majority of decedents had contact with the healthcare system with two weeks of their death.
CONCLUSIONS: SRFSS represents a unique local collaboration between public health epidemiology and deputy medical examiners that provides a valuable resource to community. SRFSS allows for immediate risk factor analysis for suicide at the local level for the best possible use of limited resources in suicide prevention.