8.2. Strengths and limitations
The coronial services provided a complete record on all older
people who completed suicide during a five and a half years period,
but only the content of half of the suicide notes was available
for qualitative analysis. The content of suicide notes was sometimes
not available in their entirety and we therefore relied on
using quotes and/or paraphrases on such content documented in
the coronial judgment. We were also not able to determine the
length of the suicide notes. Although these quotes and paraphrases
provided evidence on the person’s state of mind prior to suicide as
part of the coronial inquiry, we cannot exclude the possibility that
material might have been lost during the coronial process. It is
recognised that the stigma associated with suicide and the concerns
of public health officials may also affect coronial practice/
medical examination (Freckelton and Ranson, 2006; Timmermans,
2005). Nevertheless, the insight gained from suicide note content
analysis is invaluable and has allowed us to have a better understanding
of the issues faced by older people who are at risk of
suicide. Other limitations of this study include the exclusion of
verbal, telephone/text messages, emails, or notes that were not
found. There is a lack of information regarding alcohol/substance
use disorders. We decided not to collect such information because
the presence (or absence) of alcohol/substance use disorders is
often not specifically mentioned in coronial records. Information
on alcohol levels detected at post-mortem (a more reliable variable)
was collected instead and reported when available.