The Norwegian Surveillance System for Suicide in Mental Health and Substance Misuse Services is collecting data from two sources using a hybrid registry design:
- Information registered via an electronic questionnaire by a clinician who had contact with or clinical knowledge of the patient’s care.
- A linkage between the Norwegian Cause of Death Registry and the Norwegian Patient Registry containing all deaths by suicide (X60-X84, Y10-Y34, Y87.0, Y87.2) that was registered with activity in secondary mental health- or substance misuse services last year before suicide.
We are using a two-step model for data collection:
- Health trusts, including private practitioners under the specialist mental health services, continuously report all known patient suicides to the Surveillance System by completing an electronic questionnaire at our website. The Surveillance System also gathers relevant information from the Norwegian Patient Registry and the Norwegian Cause of Death Registry and these data are linked with the questionnaire.
- In order to identify all suicide deaths by people in contact with secondary mental health- and substance misuse services, an annual linkage of the Cause of Death Registry and the Patient Registry are conducted. The health trust or private practitioner that had been in contact with a deceased patient not registered through the first step, receives a request to complete the questionnaire. The linkage of the national registries thus ensures that even suicides which the health trusts were not familiar with are being included in the Norwegian Surveillance System for Suicide.
Since the questionnaire contains detailed questions regarding the patient, including the treatment and follow-up which the patient received, it is important that the questionnaire is completed by a clinician who knew the patient and preferably were responsible for the patient's care.
As the health trusts in Norway are already submitting clinical information to the Norwegian Patient Registry, the Surveillance System will use information available in this registry to make the questionnaire less comprehensive and time consuming for the clinicians. This will also improve the data quality and ensure that we avoid unnecessary double-reporting.
The data collected from the health trusts will be stored in a secure data solution called Services for sensitive data (TSD) at the University of Oslo. In order to collect sensitive and personal data about deceased patients, The Surveillance system is approved by the Norwegian Directorate of Health and given all the necessary permissions to collect these data.
The Surveillance System will not make use of individual data; all analyses are based on aggregated data. It will not be possible to identify individuals, health units or health professionals in reports or other publications.