Objectives: To improve quality of suicide prevention by means of analysis of suicide notes. Suicide notes or death notes are the last and final words before bidding final goodbye and an important piece of personal evidence in the last stages of life of suicide. Suicide note is one of the most important sources to understand suicide, which may be beneficial in suicide prevention.  

Methods: A descriptive study of a total of 10 suicide notes of those individuals who committed suicide and brought for autopsy at the mortuary of Lady Hardinge Medical College.

Results: All suicide notes were handwritten and varied from one page to maximum of 4 pages and majority were in Hindi. The most common age group was 21-30 years, 54% were female. Only 20% of the notes had specific addresses. The main theme was grief and forgiveness in majority of suicide notes and financial crisis the main reason. 

Conclusion: Majority of suicide note contained guilt which is strong indicator of possible depression in deceased. Creating awareness about suicide is the need of the hour and this study would be beneficial for developing suicide prevention strategies. 

To improve quality of suicide prevention by means of analysis of suicide notes. Suicide notes or death notes are the last and final words before bidding final goodbye and an important piece of personal evidence in the last stages of life of suicide. Suicide note is one of the most important sources to understand suicide, which may be beneficial in suicide prevention. One in six suicide attempters leave a suicide note.1 They have been used as an important piece of evidence for abatement under section 306 and 107 of the Indian Penal Code2,3.  Majority suicide notes indicate impulse, guilt, physical illness, hopelessness, revenge, retaliation, drug dependence behavior, depression, mental illness, dowry harassment, social evils, torture, suicide pact, physical or psychological abuse, alcoholism related behavior and failure in love.

Unfortunately, very few studies have been conducted in this regard in the Indian subcontinent. This paper is an attempt to analyze and evaluate suicide notes recovered from the body. This article will be of quite help to forensic medicine practitioners in learning about suicide notes and it will be an aid in prevention of suicides.

A descriptive study of a total of 10 suicide notes of those individuals who committed suicide and brought for autopsy at the mortuary of Lady Hardinge Medical College. The content of the note examined, studied and corroborated with other circumstantial evidences.  Detailed information regarding the deceased and the circumstances of death was obtained using the psychological autopsy and history obtained from police and inquest papers. Photographs of scene of suicide were also evaluated. The suicide notes thus recovered were photographed using digital camera under proper day lighting. The suicide notes were read to obtain an understanding of the general content and they are analyzed.

Total of 10 suicide notes of those individuals who committed suicide, were examined and tabulated as follows-

Suicide notes are the windows to the mind of the deceased and an invaluable starting point for assessing and predicting suicide and para suicidal behavior [4].  Menniger suggested that three concepts 1) the wish to die 2) the wish to kill and 3) the wish to be killed must be present in suicide for suicide to occur [5].  Maximum length of suicide note is one page about 100 words in the present study whereas in another article length of notes varied from just few words to few pages [6].

It was concluded by another author that suicide notes written by young people were longer, rich in emotions, and often begging for forgiveness. Suicide notes written by the elderly were shorter, contained specific instructions, and were less emotional [7].

In the present study, the commonest themes were “guilt” (32%), “hopelessness” (26%), “apology” (24%) and “heartbreak” (18%). Notes of suicides with a previous history of deliberate self-harm were less likely than notes of suicides without a history of deliberate self-harm to contain the theme “guilt”. 

It is the duty of the forensic medicine expert to check the pockets, secret pockets in the clothes for presence of suicide note. Mouth should be clearly examined for any piece of paper.  A suicide note can be simple or complex as described below8. 

1. Simple-it is clearly conveying the message of self-killing and reasons are mentioned without blaming anyone. Self-blame or pessimism may be there. The circumstantial evidence, autopsy findings and observations of relatives and investigating agency are also in consistency.

2. Complex - Here suicide notes are not straight, requires proper work out of case before concluding these. These may be having contents suggestive of: i. blame towards any individual, agency, organization, work place, relatives, colleagues, fellow workers, ii. situation of compulsion forcing individual to kill self out of same, fear, guilt or unable to bear the trauma iii. mental illness

Suicide note is simple and straight suggestive of self-killing without any blame towards anybody. It is requiring further detailed investigation and corroboration. Majority of suicide notes are simple and straight but some requires thorough investigation. A major multicenter study will be helpful in making a policy on preventable measures.