Qualitative analysis of Coroners' data into the unnatural deaths of children and adolescents.
BACKGROUND
Unintentional injury and suicide are leading causes of death for adolescents, and reducing these is an important health priority. Coroners' records provide a valuable source of information on the events leading up to the death of an individual, and analysis of these records may help our understanding of the causal pathway, and elucidate potential areas for intervention.


METHODS
All cases of unnatural death (poisoning, violence, unintentional injury) in young people aged 8-18 between 1996 and 2002 were identified from the death registers of one region in the UK. Data from Coroners' inquests were analysed to determine cause of death and involvement of professional agencies. A thematic analysis of the transcripts of statements presented at inquests aimed to identify areas of concern in the time immediately prior to death.


RESULTS
A total of 77 cases were identified of whom 16 (20.8%) died from alcohol/drug misuse, 20 (26%) by suicide or probable suicide and 41 (53.2%) by other injuries and poisoning. Thematic analysis highlighted: bullying, teenage sexualization and pregnancy, alcohol and substance misuse, reconstituted family difficulties and out of control behaviour as being significant factors on the causal pathway.


CONCLUSIONS
This study based on comprehensive data from one region highlights some of the difficulties faced by young people as they negotiate how to deal with complex emotions and relationships. It also demonstrates how some parents and carers are uncertain about how to address their concerns. Finally, it shows how mortality among young people could potentially be markedly reduced if availability of alcohol and illicit and prescribed substances were reduced.
Valle
V
V
Park Hospital for Children, Oxford, UK.
Gosney
H
H
Sinclair
J
J
D000059:Accidents / Q000706:statistics & numerical data; D000293:Adolescent; D000987:Antisocial Personality Disorder / Q000401:mortality; D002423:Cause of Death; D002648:Child; D003334:Coroners and Medical Examiners / Q000706:statistics & numerical data*; D003710:Demography; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data; D012919:Social Behavior; D019966:Substance-Related Disorders / Q000401:mortality; D013405:Suicide / Q000706:statistics & numerical data; D014754:Violence / Q000706:statistics & numerical data