Thursday, 29 March 2012

The Coronial System and Aboriginal Suicide

There are definitional problems of what is youth and what is suicide. It is also clear, that coronial under-reporting of suicide is common in New Zealand, the United States, Canada and elsewhere. I am disinclined to accept that the extremely low rates of male youth suicide reported in Spain, Portugal, Chile and Italy are due
solely to Catholic inoculation against the behaviour. It must be repeated that coronial bias is not obstructive. On the contrary, kindness, the avoidance of stigma and chagrin, caring for the families of the bereaved, are a notable feature of small town life. However, if we are to focus on a specific problem of age, race, class or gender-related suicides, we have to demarcate those categories, and we have to do it within ‘margins of error’ to enable a greater breadth of perspectives about suicide than we have at present.

The movement towards a national database on youth suicide is laudable. But it will be a flawed resource if we perpetuate the current system which either allows or produces serious under-reporting.

There is urgent need to reintroduce the concept of a national, uniform coronial system, with minimal standards of education and professional training, especially in rural and remote areas.

There is need for in-service courses and ‘refresher’ seminars for those currently in office, including such topics as the goals and approaches of national and state suicide strategy bodies; the problems posed by youth suicide in general; youth suicide in other countries; and the matter of Aboriginal suicide.

There is a need to reconsider the prevailing attitude on the exclusion of a presumption of suicide. Britain, according to a High Court decision in June 1999, is now ‘a foreign power’. British tradition about suicide verdicts may well have outworn its applicability in Australia in 1999. Coroners should be allowed the latitude of the three-verdict model: definite suicides, probable suicide and possible suicide, even if that classificatory system were not made public (to avoid undue distress) but were available as a guide to those engaged in research and strategy planning.

In addition to the making of physical findings at autopsy, there is an urgent need of a national system of ‘socially profiling’ suicide. Recording the social features surrounding a suicidal act is preferable to attempts at conducting a post-mortem ‘psychiatric’ analysis.

Police investigators have a special and important role in the Coroner’s Office in Glebe. There are no specialist police officers in rural towns. In all domains, there is need of a team of assessors to work with the police to establish such social profiles. Assessors need to be appropriately trained people: they don’t have to be psychiatrists or forensic anthropologists—but the latter should be included in any such assessment teams.

Key Messages:
• Consideration should be given to a national, uniform coronial system, with appropriate (legal, medical and sociological) training for would-be coroners and those already in office.
• The British-inherited tradition that coroners may not presume suicide should be reconsidered.
• Coroners should be allowed the flexibility of designating suicide as being beyond reasonable doubt, probable suicide, and possible suicide, even if these broader categories are used only for policy formulation by research workers and ‘alleviation’ agencies.
• Assessment teams, including the [American-based] appointment of forensic anthropologists, should establish ‘social profiles’ of suicides rather than the proposed system of ‘psychiatric autopsies’.

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