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Reviewing the revisions: what are the Australian Bureau of Statistics suicide figures really telling us?

To the Editor: For several years, the Australian Bureau of Statistics (ABS) has cautioned data users of likely underreporting of suicide statistics due to delays in coronial processes and (since 2006) exclusive reliance on the National Coronial Information System, which often contains incomplete information on cause of death.1 In 2009, the ABS introduced data revision processes that allowed additional information received to be added in two rounds of revisions at 12 and 24 months after the initial processing of coroner-certified deaths. This assisted coders in assigning more specific causes of death, thereby replacing the previous default “accident” category for ambiguous cases.

These changes have increased reported suicide rates, predominantly due to parallel reductions in deaths assigned to “Other ill-defined and unspecified causes of mortality” (International Classification of Diseases, 10th revision [ICD-10] code R99), which have more than halved, and “Event of undetermined intent” (ICD-10 codes Y10–Y34, Y87.2), which have reduced by around two-thirds.2,3 As these categories often represent “holding bays” for cases with…