A national centre that deals with major pelvic and related fractures has reported an increase in cases of suspected attempted suicide involving single-vehicle collisions.
The report is from the National Centre for Treatment of Pelvic and Acetabular Fractures at Tallaght Hospital in Dublin.
It says that around 10% of cases it sees each year involving a single-vehicle collision with one occupant in the vehicle are suspected attempted suicides.
Dr John McElwain, a professor of trauma orthopaedic surgery, said this means that around 12 out of the 120 major trauma cases the centre sees at the hospital unit each year are likely attempted suicides and that the numbers are increasing.
Some of the attempted suicide cases treated at the centre have also involved people who have jumped from a height.
Prof McElwain said the injuries are the most difficult musculoskeletal fractures to deal with and require intensive skill.
He said that while the bone injuries that arise are very severe and there is often nerve and organ damage, many patients are able to walk again after surgery and rehabilitation.
A related survey of the country's coroners by RTÉ News has revealed a small number of suspected suicides involving cars.
While many coroners have not seen any cases over the past five years, of the 13 coroners who responded to the survey, eight cases have been identified as possible or attempted suicides by four coroners.
Six cases were possible suicides, two were attempted suicides. They involved men and women.
Some of the attempted suicide cases treated at the centre have also involved people who have jumped from a height.
Some coroners are GPs and have knowledge of attempted suicide cases in their role as family doctors.
Prof Denis Cusack, Director of the Medical Bureau of Road Safety at University College Dublin, said that national studies and information from coroners’ inquests show that the number of intended deaths through single-vehicle, single-occupant car crashes is relatively small, in the overall context of road deaths.
He said that deliberate self-harm by means of a car crash is more likely to result in serious or catastrophic injury.
Prof Cusack said that the priority must be to provide the social, psychological and mental health service supports for people who are in distress and at risk.
He said that while the number of such deaths is likely to be in the low single-figure percentage, each one was important.
A coroner can only return a verdict of suicide if three conditions are met: that the deceased took their own life without any third party, the person was intent on taking their life and the self-killing and the intention are proven on the evidence beyond a reasonable doubt.
In a rare joint study on the issue of single-vehicle collisions published in late 2006, Prof Cusack said that when the coroner decides that these conditions cannot be met, without proof, the possibility that an animal or person was on the road, or that the driver was distracted or fell asleep cannot be discounted.
The Road Safety Authority said that in the case of young males and single-vehicle collisions, the key factors are more likely to be speed, alcohol, drugs and fatigue, rather than suicide.
A study by Monash University in Australia in 2003 estimated that anywhere between zero and over 14% of driver fatalities have been noted as possible suicides, although most studies in that review put the percentages at between 1% and 3%.
For anyone with concerns about this subject the following helplines may be of use.
Samaritans 1850-60-90-90 ¦ Aware 1890-303-302 ¦ Console 1800-201-890
