Objective:To link South Carolina Violent Death Reporting System (SCVDRS) data with state government human services databases, enabling expanded analysis of suicide in South Carolina and providing a model for other jurisdictions.Design:The SCVDRS database compiles data from vital statistics, coroner reports, and law enforcement incident and supplemental reports. The Office of Research and Statistics, South Carolina Budget and Control Board (ORS) created a “Data Warehouse”, to which a variety of state agencies and healthcare providers submit data on a regular basis. A unique identifier was used to link SCVDRS data to the Data Warehouse so that data may be analyzed on aggregate and case-specific levels. Year 2004 suicide data from SCVDRS were linked to South Carolina Uniform Billing codes from hospital in-patient and emergency room billing records, State Department of Mental Health service records, and criminal justice databases.Results:SCVDRS year 2004 suicide data are augmented by hospitalization and emergency room visit data and diagnoses; State Department of Mental Health service provision; and criminal involvement. Of the 491 suicides occurring in 2004, 282 linked with hospitalization and emergency room data, 196 linked with criminal history databases, and 91 had previous contact with the State Department of Mental Health.Conclusions:Linking SCVDRS data to additional human services databases enables greater examination of factors surrounding suicide. Results show the positive benefits of partnerships created through SCVDRS, illustrate how SCVDRS and human service databases may augment each other, and suggest practitioners should explore implementation of prevention programs in specific settings.

Objectives: This article describes how seven states participating in a new public health surveillance system for violent death in the US, the National Violent Death Reporting System (NVDRS), have used data to support local suicide prevention activities. Setting: The NVDRS is unique in that it augments death certificate data with event and circumstance information from death investigation reports filed by coroners, medical examiners, and law enforcement. These data illuminate why the victim ended his or her life, fatal injury patterns, and toxicological findings at death. Results: Current suicide prevention efforts using these data fall into three categories: describing the problem of suicide and identifying opportunities for intervention; collaborating on statewide suicide prevention plans; and forming new partnerships for targeted prevention initiatives. Taken together, these three areas show early promise for state suicide prevention efforts. Conclusions: In each of the states, NVDRS data analyses are being shared with injury prevention colleagues, suicide prevention planning groups and policymakers, and adapted to respond to unique state and local suicide problems. A powerful surveillance tool, the NVDRS is bringing new clarity and direction to these state-based efforts. The NVDRS can serve as a model for other countries looking to establish timely suicide surveillance systems and data driven prevention strategies.

Objectives:Drawing from the experiences of individual state programs that currently participate in the National Violent Death Reporting System (NVDRS), this article reviews some of the practical benefits that may accrue from the introduction of violent death surveillance systems.Design:As a state-based surveillance system that uses multiple data sources and relies upon multiple stakeholders, the NVDRS program has fostered an array of initiatives within and among individual state programs. State-based initiatives highlighted in this article were selected on the basis of a purposive sampling strategy intended to illustrate key aspects of program development.Setting:The NVDRS state programs are in Alaska, California, Colorado, Georgia, Kentucky, Maryland, Massachusetts, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin.Results:The NVDRS has helped to build alliances and collaborative efforts between key stakeholders, facilitated the recognition of violent death as a public health problem through outreach and media attention, acted as a catalyst for new projects, enhanced surveillance of special populations and utility for evaluation, and identified key circumstances that will target interventions in state prevention planning.Conclusions:The NVDRS has implemented data collection efforts and is beginning to produce and analyze findings. In the process of implementing the data collection system and publicizing findings, state NVDRS programs are realizing other gains that strengthen their surveillance efforts. The use of data for prevention purposes will be the ultimate indicator of program success.

A review of the literature on integrated and holistic treatment approaches of posttraumatic stress disorder (PTSD) and substance use disorder (SUD) diagnoses is presented. Perspectives on the etiology of PTSD-SUD comorbidity and the interrelation of symptoms are explored.