Improving national data systems for surveillance of suicide-related events.

BACKGROUND Describing the characteristics and patterns of suicidal behavior is an essential component in developing successful prevention efforts. The Data and Surveillance Task Force (DSTF) of the National Action Alliance for Suicide Prevention was charged with making recommendations for improving national data systems for public health surveillance of suicide-related problems, including suicidal thoughts, suicide attempts, and deaths due to suicide. PURPOSE Data from the national systems can be used to draw attention to the magnitude of the problem and are useful for establishing national health priorities. National data can also be used to examine differences in rates across groups (e.g., sex, racial/ethnic, and age groups) and geographic regions, and are useful in identifying patterns in the mechanism of suicide, including those that rarely occur. METHODS Using evaluation criteria from the CDC, WHO, and the U.S.A.-based Safe States Alliance, the DSTF reviewed 28 national data systems for feasibility of use in the surveillance of suicidal behavior, including deaths, nonfatal attempts, and suicidal thoughts. The review criteria included attributes such as the aspects of the suicide-related spectrum (e.g., thoughts, attempts, deaths) covered by the system; how the data are collected (e.g., census, sample, survey, administrative data files, self-report, reporting by care providers); and the strengths and limitations of the survey or data system. RESULTS The DSTF identified common strengths and challenges among the data systems based on the underlying data source (e.g., death records, healthcare provider records, population-based surveys, health insurance claims). From these findings, the DSTF proposed several recommendations for improving existing data systems, such as using standard language and definitions, adding new variables to existing surveys, expanding the geographic scope of surveys to include areas where data are not currently collected, oversampling of underrepresented groups, and improving the completeness and quality of information on death certificates. CONCLUSIONS Some of the DSTF recommendations are potentially achievable in the short term (<1-3 years) within existing data systems, whereas others involve more extensive changes and will require longer-term efforts (4-10 years). Implementing these recommendations would assist in the development of a national coordinated program of fatal and nonfatal suicide surveillance to facilitate evidence-based action to reduce the incidence of suicide and suicidal behavior in all populations.