The 'Operationalized Predicaments of Suicide' (OPS) applied to Northern Territory coroners' reports.

OBJECTIVE: To apply the "Operationalized Predicaments of Suicide" (OPS) to coroners' reports with a view to classifying the drivers/triggers of suicide in the Northern Territory (Australia) for the years July 2000-December 2010, with attention to the total population, and to a comparison of suicide triggers for the Indigenous and non-Indigenous communities. METHODS: A total of 411 reports (Indigenous, 198; non-Indigenous, 213) were obtained from the National Coroners Information System (NCIS). A research officer thematically analysed each case report and classified each according to the four categories of the OPS. Calculations were performed for the entire sample and comparisons were made between Indigenous and non-Indigenous groups. RESULTS: For the total sample, 20% of suicides were triggered by mental illness, and 58% were triggered by social/environmental events. In 9% there were both mental illness and social/environmental factors, and in 14% no triggers could be identified. There were group differences; the non-Indigenous group was over represented in the mental illness category and the Indigenous group was over represented in the social/environmental category (χ(2) (3) = 41.5, p = 0.000). CONCLUSIONS: Social/environmental stressors are important triggers of suicide in the Northern Territory. Social/environmental stressors were more often the suicide trigger in Indigenous community suicide compared to non-Indigenous community suicide.

A Pilot Investigation of the Operationalized Predicaments of Suicide (OPS) Framework.

BACKGROUND: Suicide may be conceptualized as an escape from intolerable predicaments, in particular, mental illness and environmental stressors. The operationalized predicaments of suicide (OPS) is a 4 category framework designed to assist in the classification of suicide. The objective was to examine whether this framework is potentially useful. METHODS: 18 psychiatrists from 6 different countries examined 12 written coroners' reports of suicide and rated each report according to the OPS. 16 of these raters then also completed a qualitative questionnaire regarding the framework. RESULTS: In 89.8% of cases the raters where able to make a decision regarding the drivers which led to the suicides. The respondents displayed modest inter-rater correlation (Kappa = 0.42; P < 0.0001). In the qualitative section, respondents supported the face validity of OPS and considered it potentially useful. Feedback allowed improved wording of the OPS instructions. CONCLUSION: The OPS has potential as a useful framework. The OPS instructions have been improved and further studies are justified.

Thematic analysis of key factors associated with Indigenous and non-Indigenous suicide in the Northern Territory, Australia.

INTRODUCTION: Given the impact of suicide on individuals, families and communities, particularly for rural, remote and Indigenous populations, the current study was undertaken to enhance understanding on this topic. Coroners' reports were identified as a rich data source, amenable to thematic summary to reveal key factors associated with suicide. METHODS: Thematic analysis was undertaken of 411 coroners' reports of completed suicides across a 10 year period, occurring in the Northern Territory, Australia. Data were extracted numerically and qualitatively, categorised and tallied. RESULTS: Key factors associated with suicide in order of frequency of identification by coroners were (i) alcohol and other drug abuse, (ii) conflict and relationship breakdown and (iii) mental illness and mental health concerns. Considerable differences were noted between Indigenous and non-Indigenous cases. In addition to numerical summaries, examples of coroners' comments are provided that underscore the relevance of these factors. CONCLUSION: An array of factors was associated with suicide and considerable variation was found between Indigenous and non-Indigenous cases. The relative importance of social and contextual factors is confirmed for people at risk of suicide in rural, remote and Indigenous populations. These findings suggest relative priorities for suicide prevention and postvention.