Anne Ferris (Wicklow, Labour)
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143. To ask the Taoiseach the processes undertaken by the Central Statistics Office in the recording and reporting of suicide statistics, including the collection of statistics from Garda stations through the form 104 process; the collection of such statistics from the Prison Service and the Central Mental Hospital; if there has been any recent internal or external review of the effectiveness and accuracy of the data collection and reporting process; the recommendations of any such review; and if he will make a statement on the matter. [22125/15]

Paul Kehoe (Wexford, Fine Gael)
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Suicide is defined as the act of intentionally killing oneself. The classification of a death as suicide is based on a Coroner's report and, where necessary, a report from the Garda that attended the scene. All deaths, whether natural or unnatural must be registered with the General Registration Office (GRO).

The average annual number of deaths over the five year period from 2007 to 2011 was approximately 28,000. In many cases the cause of death is known, i.e. the deceased was under the care of a doctor etc. In these cases the doctor can fill out the Medical Certificate of the Cause of Deathin a relatively straightforward manner as the cause was generally an illness or sickness the deceased suffered.

However in approximately 20% of all cases (5,000 to 6,000 cases annually) the cause of death is not immediately known and the case is referred to a Coroner. Deaths from sudden, unexplained, violent and unnatural deaths must be reported and investigated by the Coroner. The Coroner is an independent office holder with responsibility under the law for the medico-legal investigation into these types of deaths.

The Coroner's investigation may require a post-mortem examination, sometimes followed by an inquest. The Coroner's inquiry will establish whether death was due to natural or unnatural causes. If death is due to unnatural causes then an inquest must be held by law. Approximately 30% of all cases referred to the Coroner undergo a post-mortem examination and/or and inquest (some 1,500 to 1,800 cases each year). The death will be registered by means of a Coroner's Certificate when the inquest is concluded (or adjourned in some cases).

A Form 104 is issued to the Gardaí in respect of most inquest cases. This form is sent to the Divisional Inspector of the relevant location where the death occurred and is then redirected to the Garda that attended the scene of the death. The Form 104 collects additional information on the circumstances\location of the death and the information returned on this form is strictly confidential.

The Garda completing the Form 104 provides his/her opinion as to whether the death was an accident, homicide, suicide or undetermined and then that is taken into consideration by the mortality coder in the CSO. If there is no mention of suicide on the Coroner's certificate and the Garda states that in his\her opinion the death was as a result of intentional self-harm, the cause of death code is attributed to suicide by the mortality coder in the CSO. Conversely, if the Coroner's certificate states that death was by suicide and he\she provides enough information to attribute an accurate cause of death code then it is not necessary to issue a Form 104 to Gardaí.

The mortality coder in the CSO uses the information from both the Form 104 and the Coroner's certificate to assign the detailed external cause code that described the type and nature of the accident, homicide, suicide or undetermined death. In cases where a completed Form 104 is not returned, the cause of death is coded based solely on the Coroner's certificate.

The CSO codes the exact cause of death using World Health Organisation's International Classification of Diseases and related health problems 10^thedition (ICD-10). All death records are given an ICD-10 cause of death code and the code is assigned in accordance with the medical evidence of cause of death detailed on the Medical Certificate of the Cause of Death or the Coroner's Certificate.

If there is any doubt about the accuracy of a cause of death code it is flagged for manual intervention by a mortality coder in the CSO who will visually inspect the details. All inquest cases (which always include any possible suicides) are always flagged and selected for manual intervention for coding by a mortality coder.

There are also a series of edits included in the data capture system that will highlight certain cause of death codes for further checking and correction where necessary. Where hanging is mentioned on the certificate, the mortality coder always attributes an external cause of death i.e. suicide and intentional self-harm to the record.

The CSO does not collect statistics from the Prison Service or the Central Mental Hospital but collects data from the GRO and the Garda.

The National Suicide Research Foundation carried out a study on inquested deaths in Ireland in 2007. The recommendations of this report were reviewed and, with the exception of the review of the form 104, were outside the remit of the CSO. The form 104 was reviewed by the CSO and found fit for purpose. The CSO, in collaboration with the National Suicide Research Foundation, established the CSO Liaison group on Suicide Mortality Statistics in 2015. The remit of this group is to review processes and documentation relating to suicide statistics but no recommendations have been made yet.