Suicide mortality in NSW: an introduction to clinical audits.
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This article is an introduction to the use of clinical audit to identify possible preventive approaches to suicide. We examine the ethical issues, techniques and feasibility of this method for collecting information on suicides. A more detailed report on the practicalities of clinical audit is being prepared3. For more than three decades psychological autopsies and modified psychological autopsies have been employed worldwide to study risk factors for suicide. The term psychological autopsy most commonly refers to interviews with family and friends of the victim to reconstruct the circumstances of the suicide'. Sometimes the term is limited to the determination of the mental state of the individual, and at other times the modified psychological autopsy or clinical audit includes all the investigations relevant to the suicide, including the review of medical records and the physical autopsy4. Clinical audit in this article encompasses both the psychological autopsy and the physical autopsy, and any other relevant investigations. We prefer to use the term clinical audit to stress that interviewing bereaved people requires clinical skills and because attention should be given to the potential role clinical services may play in prevention.