Background:
In Ireland, the assessment of whether a death is a suicide is determined by a coroner’s inquest; it is based on legal guidance surrounding the weight of evidence that a person intended to take their life ‘beyond reasonable doubt’. However, ‘undetermined’ deaths as well as deaths by intentional self-harm, viewed through the established methodology ‘on the balance of probabilities’ may help to minimise the underreporting of suicide. Thus, the Irish Probable Suicide Death Study (IPSDS), based on the balance of probabilities methodology, was developed. This is a collaborative project involving the HSE National Office for Suicide Prevention (NOSP), Irish coroners and the Health Research Board (HRB; a statutory agency under the aegis of the Department of Health).

Objective:
To present: a) how to use death-investigation and administrative data collected as part of the coronial process, and b) the differences between those who received a suicide verdict by coroners in Ireland and those who did not.

Methods:
Flow chart presentation of the development and process of the IPSDS methodology and backward multivariate logistic regression to identify the factors which distinguish between suicide and non-suicide coronial verdicts, were used. The probability for stepwise removal was set at 0.01 and odds ratio with 95% confidence intervals CIs are presented,

Results:
The IPSDS presents information of 2,349 deaths by probable suicide for a four-year period from 2015 to 2018. The factors which distinguished between receiving a suicide verdict and a non-suicide verdict, were mainly: leaving a suicide note and lethality of the suicide method (hanging and shooting).

Conclusions:
Reviewing Completed coronial files through a wider lens has considerable potential to enhance our understanding of deaths by probable suicide and support the development of effective suicide prevention interventions for the most vulnerable populations.