Pure elderly suicide rates versus combined pure elderly suicide, accidental and undetermined death rates: methodological issues in cross-national studies

Abstract

The verdict of suicide depends upon local legal definitions, culture, and reporting practices and procedures (Shah and Ganesvaran, 1994). Legal definitions of suicide vary across countries. In Austria, officers of the Federal Statistics Division may count a death as suicide if it is suspected as such, even without legal evidence. In Luxembourg, a suicide note is required for a verdict of suicide. In the U.K. and Australia, the verdict of suicide is reached by the coroner, who must be satisfied that suicide has been proved beyond reasonable doubt; if there is reasonable doubt, then a verdict of undetermined death or an open verdict is returned. Owing to the possibility of some probable suicides being misclassified as accidental and undetermined deaths (Chishti et al., 2003), it has been suggested that accidental and undetermined deaths should also be utilized in suicide research (O'Donnell and Farmer, 1995). However, there is evidence from European Union countries that misclassification contributes to only a minor proportion of the variation in general population suicide rates (Chishti et al., 2003), although this has not been specifically examined for elderly suicide rates.