Vast amounts of better personal data are routinely collected on a daily basis by health and social care systems around the world to support clinical management and patient care. Linking these data records for the same individuals across different services and over time offers a powerful, population-wide resource. Such integrated data sets have been used to study a range of health issues to identify risk and protective factors and to examine outcomes. The secondary use of these data has enormous potential in suicide research. Improved consideration of the prior health, wider social

circumstances and points of access to services of all individuals who complete suicide can be achieved.2–4 Studies from the Nordic countries have demonstrated the usefulness of data linkage across register-based studies in suicide

research.5–10 Others11–13 have demonstrated that collating and linking sets of routinely collected whole population-based data, such as General Practice (GP) records, outpatient data and inpatient activity, with mortality data enable more detailed analysis of risk factors for those people completing suicide. Most previous research linking suicide mortality data with routinely collected electronic health records involves only one or two domains of healthcare provision such as psychiatric inpatient care. In the UK, various systems exist to examine suicide deaths. The National Confidential Inquiry into Suicide and Homicide (NCISH) by people with Mental Illness focuses on suicide cases who were in contact with mental health services (approximately 25% of total) in the year prior to their deaths.3 However, this provides limited information on issues of suicide in the general population and may hamper the effectiveness of wider preventive efforts.1 In a recent report, NCISH14 examined aspects of primary healthcare prior to all suicides in England between 2002 and 2011; however, no linkage was made with data from other service providers such as emergency departments. Scotland has recently established enhanced data collection

in relation to suicide, however, further development is needed in order for the Scottish Suicide Information Database (‘ScotSID’) to be able to examine healthcare pathways and contact with more than one health service;15 England does not currently have AV-951 a dedicated repository for suicide data though studies have made use of the Clinical Practice Research Datalink (CPRD; http://www.cprd.com), which represents approximately 8.5% of the UK population from 600 general practices (GP’s) in England.16 CPRD can be linked with data from the National Health Service (NHS) Hospital Episode Statistics (HES; http://www.hscic.gov.uk/hes) and mortality data from the Office of National Statistics (ONS; http://www.ons.gov.uk) but has limited emergency department data.