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Suicide Cultures: Reimagining Suicide Research

A blog about the Suicide Cultures research project

Insights from the Field: Learning from our Qualitative Research on Suicide in Scotland

Here at the Suicide Cultures project we have reached an exciting phase of our research. After a year and a half of data collection involving interviews and ethnographic engagement with people affected by suicide, we are beginning to transition to data analysis. This means we are working to pick out patterns or themes from the stories we have gathered, with the hope of understanding how people understand and experience suicide across our three sites in Scotland. As well as conversations, our research has involved attending mental health and suicide related events, arts-based activities with participants, and analysis of institutional and multi-agency reports on suicides within the Scottish Prison Service and the NHS. In this blog we share a brief summary of how our fieldwork unfolded, reflecting on some of the lessons we have learned while doing qualitative research on suicide.  

What Did We Do? 

Over the last year and a half, we conducted 58 in-depth qualitative interviews with people who have been affected by suicide. This includes 28 interviews with people bereaved by suicide, 18 with people who have attempted suicide, and 27 from people who work in suicide prevention1. We also spoke with many more people during ethnographic work with 12 mental health and suicide prevention community organisations who have kindly opened their events and offered their time to us. Our three larger sites represent a diverse picture of ways of life in Scotland, including rural, suburban, urban, and island communities, different levels of economic affluence and disadvantage, as well as a range of ages from 18 – 80. Interestingly, our data tends to skew towards older demographics of people. 

These qualitative methods have provided an unprecedented window into the individual, social and cultural contexts that underlie the issue of suicide in Scotland. Using different methods has meant we could talk to people who either can’t or don’t want to sit down for a formal interview. For people with severe mental health issues or for those who have experienced abuse at the hands of people they trusted (whether a loved one, stranger, medical provider, or service) there may be good reasons to want to avoid doing a recorded interview. Less formal conversations during our extended fieldwork have allowed us to explore how distress can be caused by issues like poverty, the cost-of-living crisis, state institutions (like schools, prisons, hospitals), families, discrimination, as well as other cultural factors.  

Insights and Limitations  

One of the major limiting factors across all three of our sites was that community groups and third sector organisations are operating within a funding landscape defined by scarcity of resources. We did a spend a lot of time with 12 organisations, including several who are under-resourced. However, we sometimes found that groups were unable to engage with us because staff members did not have the time to include us at events and/or facilitate conversations with service users, simply because they were so thinly stretched themselves. One CEO of a suicide prevention charity was officially a part time employee yet told us that she worked over 60 hours a week just to keep the organisation running effectively for their members. These groups provide a vital service to the community in the absence of adequate statutory care, yet short term limits and competition for funding means that they have to be flexible and many struggle to keep staff for longer periods of time. This absence of consistent funding is to the detriment of the many people these organisations support as well as to the staff who work so hard to maintain them. 

Secondly, there has been some difficulty with engaging groups who have a more general focus on mental illness or disability rather than specifically suicide. Our interviews have given us ample space to think through suicide with our participants, but there hasn’t always been space to ask explicit questions about it in our ethnographic research within community organisations. Some groups suggested that mentioning suicide at their events may have a damaging effect on service users, reflecting widespread beliefs (often framed as ‘myths’ in suicide prevention literature) that talking about suicide might cause suicide. At the same time, fears of ‘contagion’ – that the very idea of suicide can be dangerous, are also prominent. These issues are especially challenging for us as “suicide researchers” attempting to work in and with a range of community groups. While, some literature does suggest that talking about suicide is ‘safe’, we recognised that the focus of our work – our identity as ‘suicide researchers’ – may have brought the wrong atmosphere to groups that are about living well despite distress. 

The Emotions of Suicide Research 

In any project that uses ethnography and qualitative interviewing the researcher is brought into intimate contact with their participants. This is particularly the case for people researching suicide. We have been sitting alongside people as they talk us through some of the more difficult emotional experiences it is possible to have. Each of us has felt an immense privilege in being witness to these stories, and we have received feedback that we have been able to offer people a non-judgmental space to explore their experiences. Unlike many of the services they engage with, we did not require that our participants aim to recover or get better, nor did we demand that they begin courses of medication or change their habits. The simple act of gently inquiring without judgment has given people a unique space to think through their experiences.  

Yet, we also have to acknowledge that this work has at times been difficult for us. Each of the research fellows on the project have needed to process challenging emotions while attending to other people’s stories about suicide. Empathising with and feeling others’ emotions can be powerfully positive for ourselves, for the people we spoke with, as well as for producing rich qualitative data, yet whenever we engaged in fieldwork or an interview, we learned to be aware that we may come away with an imprint of those emotions.  

So, how have we attempted to stay as healthy and stable as possible while researching suicide? We have held monthly peer support sessions within our team dedicated to expressing and exploring the challenges that have been arising in the course of our research. Throughout our work we have also developed relationships within the team that allow more informal and frequent check-ins and debriefs after particularly challenging moments. While creating more spaces to talk has been useful, often what we needed was time away from the topic of suicide all-together. In the hours after an interview or piece of ethnographic work we found it important to create space for rest and time to engage in hobbies or activities that bring us joy. 

Our Plans for Analysis 

As we move into our analysis phase, we are meeting weekly to discuss specific pieces of data. Using a combined approach of abductive, thematic, and narrative analysis we will be processing this data over the next six months or so. As themes emerge from this analysis, we will also start planning publications and other outputs to share our findings. This is an exciting phase, and we invite you to keep an eye on our blog, podcast, and newsletter to stay up to date about when we will be releasing this information.  

The Suicide Cultures Conference Zine

Click the link below to access a digital version of the zine the Suicide Cultures Research Fellows made for the Suicide Cultures Conference, which took place 13th-14th June 2023!

Zine – Copy for Blog

Reflections on the International Association for Suicide Prevention Conference (IASP) 2023

Recently, several members of the Suicide Cultures research team had the chance to present preliminary analyses from the project at the International Association for Suicide Prevention (IASP) conference in Piran, Slovenia. Amy Chandler, Emily Yue, and Sarah Huque all presented Suicide Cultures work. Our colleague Hazel Marzetti presented on behalf of the Suicide In/As Politics (SIAP) project.

Sarah’s presentation was entitled “Still here: Recovery and protective factors in the lived experience of people who have attempted suicide”. Within the contexts of moving away from ‘risk factors’ for suicide prevention towards ‘protective factors’ for suicide ‘recovery’, Sarah called for considering the messy ways in which ‘protective factors’ for suicide may be emotionally challenging and entangled with broader social scripts around suicide. Drawing on the construction of ‘social isolation’ as a ‘risk factor’ for suicide, Amy considered social exclusion as a way of thinking about suicide in ways that go beyond locating loneliness in the individual, bringing a sociological theory lens to a talk (originally developed and submitted by Rebecca Helman) entitled “Suicide and social exclusion: Thinking beyond individual disconnectedness”. Emily presented critical, innovative work from her PhD, in a talk entitled “Constructing suicide in the research process,” around in/authenticity and suicidal subjects.

Hazel presented SIAP work during the Pecha Kucha and poster events – and won the People’s Choice award for her Pecha Kucha, which brilliantly displayed artistic outputs from the SIAP workshops.

The team also had the chance to engage in a lot of learning over the course of the conference, with hundreds of talks and workshops from which to choose. Emily, Hazel, and Sarah attended the Early Career Researcher (ECR) pre-conference workshop, where, among other activities, they listened to a range of lightning talks highlighting the varied work done by ECRs in suicide research globally. Amy attended the ‘Partnerships for Life’ pre-conference workshop, in order to learn more about IASP’s work on developing suicide prevention strategies in diverse national contexts.

Other highlights from the conference included a talk from sociologist Steven Stack that showcased the relationship between social inequality and suicide in the USA, emphasising the role of Republican politics in particular; a workshop on suicidality and suicide prevention with people with intellectual disabilities; and a special lecture from Navneet Kapur on “Contradictory findings and the nature of truth in suicide research”.

In thinking about how we engage different groups in research, and enable increased lived experience research, Marianne Webb’s presentation on guidelines for involving young people in suicide research, and Mirabel Pelton’s presentation and poster about using an online card sort task in researching self-harm in autistic adults also provided food for thought.

Overall, this year’s IASP conference included a notable presence of lived experience research, qualitative work, and increasingly challenging and critical questions. While many of these are questions that Critical Suicide Studies has grappled with for years, it was heartening to see these debates happening within the international suicide prevention research space, as well.

Socially compassionate responses to suicide: A contribution to the Time Space Compassion approach

The Suicide Cultures team was invited to present at the Scottish Government’s Time Space Compassion event in March. The Time Space Compassion approach “is about securing better outcomes for people experiencing suicidal crisis. It does this by focusing on people’s experience, human connection and relationships, offering a shared language, resources, and ways to connect and take action together”.

The event brought together people working with and affected by suicide to discuss and develop the approach.

In line with our focus on the social and cultural contexts in which suicide is embedded, I presented some reflections on the relationship between forms of social-political and cultural ‘crisis’, including austerity, the cost of living crisis, transphobia, and suicidal crisis. I asked what the use of the term ‘crisis’ might conceal, particularly in relation to how many people’s experiences of distress and suicidality are bound up with longstanding, slow and more ‘unspectacular’ forms of violence, including being slowly ground down by unfeeling or uncompassionate structures, day by day.

Drawing on the idea of “creating a radically different cultural landscape”, as highlighted in the Time Space Compassion report, my presentation focused on some examples from ongoing ethnography with a community-based organisation, which I have pseudonymised as In the Open. In the Open provides support for people with enduring mental health challenges, through what I argued is a socially compassionate approach.

This included examples of:

  •  forms of accompaniment offered by In the Open staff, though which they support people to access health and other forms of care
  • how In the Open operates as a space of inclusion and belonging for people who, for various reasons, are socially excluded and may even be positioned by other institutions and social structures as ‘burdensome’
  • how the long-term nature of the support that In the Open offers allows for the development of supportive, caring and trusting relationships between the members of the group, as well as with staff members


I also shared an example of the systematic denial of compassion to certain people, based on our analysis of the Fatal Accident and Sudden Deaths Inquiries (FAIs) of deaths by suicide that occur in Scottish prisons. My presentation reflected on how in these reports, many people who have died by suicide in prison are constructed as ‘difficult’, ‘non-compliant’ and ultimately ‘unhelpable’. I argued that many of these inquiries fail to engage with the broader uncompassionate environment of the prison and how this contributes to people’s distress and even death.

My presentation ended by asking people to think about and share examples of other socially compassionate or uncompassionate spaces and how these may be related to suicide or suicide prevention. This was taken up in smaller group discussions following my presentation.

Later in the day, I was in conversation with Haylis Smith, discussing the Time Space Compassion approach:



Suicide Cultures and ‘the edge’

In May 2023 I was delighted to be featured as the speaker for the ‘First Thursday Seminar Series’ organised by the Centre for Creative-Relational Inquiry, in the School of Health in Social Science, at the University of Edinburgh.

This was a wonderful opportunity to share some thoughts, ideas and ongoing analyses from the pilot work that I did – along with Sarah Wright – for the Suicide Cultures project. We ran a series of arts-based workshops – testing out approaches to working with different community groups to have conversations about suicide, its meanings, and its effects. The audience was a broad mix of counselling and psychotherapy practitioners and researchers, as well other scholars of suicide, and the discussion afterwards was a welcome chance to hear how others connected with the findings, and our analysis of these.

The paper I gave for the seminar drew on some eclectic theoretical resources – Lauren Berlant’s ‘slow death’ and Avery Gordon’s ‘haunted’ sociological imagination – to think through some of the stories that were told about living with and experiencing suicidal distress in our workshops.

You can listen to the seminar here.


Suicidescapes; how we are mapping the cultures and contexts in which suicide occurs

by Joe Anderson

Here at the Suicide Cultures project we have been hard at work all over Scotland gathering data about people’s experiences of suicide. In our interviews, the events we have been attending, and in the notes we’ve been keeping about local areas, we have been privileged to hear profoundly moving stories about people’s struggles and their resilience in the face of huge challenges.  

One of our aims with this work is to understand the contexts in which suicides happen. This means thinking beyond dominant ways that the medical field, psychologists, and many researchers construct suicide by thinking of it as a result of mental illness. We want to challenge the idea that contemplating and attempting suicide, as well as the grief that follows bereavement by suicide, is located only in the mind, instead proposing that there are many other dimensions of human life that are implicated in suicidality. This includes how suicide is embedded in the physical, social, emotional, and political geography of the areas we are working in to get a larger image of the complex ways that distress is generated within institutions, discourses, and systems.  

Some of the people we have interviewed and spent time with have told us about difficulties with their mental health, while others have explained their suicide attempts as related to their need to escape abusive relationships, the ongoing fear produced by financial insecurity, as well as the negative emotions that accompany not fitting in or social and physical isolation. 

Our desire to map and understand contexts that contribute towards suicide has led us to propose the concept of Suicidescapes. In the rest of this blog, we outline why this concept is useful for understanding suicide in Scotland and crucially, how it helps us think differently than work that sees suicide as a problem to be solved only with individual responses like talking therapy and pharmaceutical medication. Excitingly, this new way of thinking has the potential to generate interventions that acknowledge how suicide is bound up with many different scales of human experience, from the individual and familial, to larger communities and cultures.  

Why Suicidescapes?

After spending time with literature from the field of Geographies of Death, we came across the concept of ‘Deathscapes’ – an idea that acknowledges that death has both a physical association with particular spaces, like cemeteries and memorials, and a social-emotional life that extends beyond them. For example, death is present for the mother of a child who has died far beyond the physical space of their burial. A photo on a mantelpiece may evoke their presence, an activity that used to be shared may provoke waves of emotion, while the story that people tell of someone’s life and death takes on a larger social meaning when it is shared among a community.  

We recognise that suicide is a particular kind of death, often marked by silences and a sense of taboo. As one participant in our research said, when someone dies of old age or from an illness it is tragic, but when someone dies by suicide you have to deal with complex emotions that reflect the uncertain nature of why someone would take their life and whether more could have been done for them. There is also the silence and taboo that often accompanies suicide more generally in our society that can make a loved one feel isolated or misunderstood. This separates these deaths out as particularly challenging for families and communities who have to grapple with the uncertainties left behind. We felt that Deathscapes could be extended to help us understand why suicide seems to carry such fraught moral weight within private and public spheres. 

The concept of Suicidescapes allows us to account for the ways that suicide occurs in local areas as it becomes associated with physical landscapes (in other words, where it happens), the emotions of the people involved (how it feels when someone dies by suicide), and the stories that are told and shared among the people or communities affected (how suicide is constructed and explained). By thinking of these three levels as connected yet distinct, real yet imagined, we want to emphasize that knowledge about suicide is never free of the moral judgments that abound in its wake. The way we think about suicide affects how it appears and is responded to.  

So, if this concept is supposed to help us understand the contexts in which suicides happen, what does a Suicidescape actually look like?  

What is a Suicidescape? 

Let’s use a bounded example that we are working with in our project – suicide in the context of prisons. Prison is a unique Suicidescape that elicits suicide at higher rates than in the general population of Scotland. While we could say that suicide in prison occurs because of mental illness or other individual risk factors like drug and alcohol use or specific life trauma, Suicidescapes asks us to look at the ways that the physical, social, administrative, and emotional logics of prison life play a role in creating conditions that invite suicidality.  

First of all, prison is designed primarily as a space of punishment, where shame, exclusion, and dehumanisation are enacted on people who have broken or are accused of breaking particular laws of the state. The stigma that accompanies being incarcerated or even having been in prison in the past is clear to see. The social mark of prison can make an individual feel they are different than others. Secondly, even when prisons aim to improve the mental health of their residents, they tend to implement policies that further the punitive logics of incarceration. People who express suicidal thoughts are closely monitored, even woken multiple times throughout the night to ensure they have not attempted suicide. In some cases, prisoners are strip searched for sharp objects, placed in special anti-suicide clothing, and isolated alone in a cell so they can be more closely monitored. It is easy to see why each of these interventions may further compound someone’s suicidal distress.  

Suicide is constructed by the prison as an issue of tighter regulation and control, rather than care and compassion, therefore justifying punitive measures.  In this example, our concept has illuminated that the way suicide is constructed as a problem within institutions or cultures relates to the larger societal function of that institution. This case study demonstrates how we are conceptualising the spaces we work within across Scotland. Each unique area encompasses a variety of landscapes, institutions, social norms, cultural practices, discourses, and types of population that make up its particular Suicidescape, although it is never fully bounded and is in relationship with larger national and global Suicidescapes.  

For more information about how we are representing these spaces have a look at our audio-visual poster in a previous blog post.  

How does this help us understand suicide? 

This concept is helping us to understand and imagine suicide in new ways. It avoids reducing suicide to individual risk factors, like mental illness, and instead embeds the issue in the wider social and cultural networks, as well as the physical landscapes in which it takes place. At the same time, our work allows each individual we engage with to define their experience using their own words. This is giving us data about the reality of the emotions that accompany experiences with suicide as well as allowing people to speak about suicide in ways that goes beyond the mental illness model.  

This approach also helps us to hold tensions and disagreements about suicide without seeing these as necessarily contradictory. When professionals in suicide prevention organisations and the medical profession, service users, and people with experience of suicide disagree it offers us an opportunity to understand where our models of suicide are going wrong. It also allows us to see how frustration and anger about seemingly unrelated factors such as the current cost of living crisis, the inability to access services for drug users, or reductions in funding for public transport links in deprived rural areas might be related to someone’s expressed desire to die. This concept pushes us to see inequality as an active ingredient that produces harm in Scotland and around the world, including increasing suicidality.  

Finally, Suicidescapes gives us a practical way to map suicide cultures in our study. By focusing on the physical environments in which suicide happens, its accompanying emotions and social interactions, as well as discourses about suicide we can see how deaths are produced by and become part of the cultures in which they occur.  

Mapping Suicidescapes: A Socio-cultural, Geographic, and Politically Engaged Approach to Suicide

This is the Suicide Cultures research team’s audio-visual poster, originally presented at the Critical Suicide Studies Symposium, 21-22 October 2022.

SuicideCultures_CSS 2022 Poster

Working through the ethics of ‘Suicide Cultures’: Part II – The ethics of anonymization

In this post we continue with a discussion of some of the ethical challenges we are encountering as part of the Suicide Cultures project. Here we will focus specifically on the ethical challenges of working with the Fatal Accident and Sudden Deaths Inquiries (FAIs) of people who have died by suicide in prison. This post is intended as an explicit and transparent reflection on the complexities of issues of anonymization and an ongoing thinking project about issues of care, privacy and critiques of institutional framings of suicide. The reflections we present here have been born out of many discussions within the Suicide Cultures research team, as well as consultation with Sarah Armstrong, Linda Allan and Betsy Barkas, who are also working with FAIs.

As part of the Suicide Cultures project we are conducting an analysis of all the FAIs of deaths in prison due to suicide in Scotland from 2016 until the present. Prisons have been identified as having high rates of suicide (Tomczak, 2018; Zhong et al., 2021). Scottish prisons record higher rates than those in England and Wales, although there are a number of issues which make comparisons problematic (Armstrong & McGhee, 2019). Given that prisons are significant sites of suicide, it is important to explore how suicide is understood and responded to within these contexts. Our analysis focuses on how suicide is constructed within FAIs and the implications of these constructions for understanding the role of the prison environment in deaths by suicide.

When we say ‘how suicide is constructed’, we mean that the ways in which suicide is talked about and portrayed creates particular social ‘truths’ about suicide. These include ‘truths’ about what causes suicide and how it should be responded to. These ‘truths’ come to be taken for granted and regarded as the only explanation for suicide. For example, one of the dominant ways in which suicide is often constructed in research, as well as public policy, is as an individual mental health problem (see Marsh, 2020). This is done through explaining suicide as being caused by mental illness such as depression and proposing that the best way to prevent suicide is through individual therapeutic and pharmacological interventions. These constructions tend to focus solely on the ‘suicidal’ individual, neglecting the broader context in which the individual lives. In contrast, research which focuses on the social contexts in which people live highlights “the heart-rendering suffering, daily indignities, and desolation many people struggle with” (Reynolds, 2016, p.169), including poverty, homophobia, racism and other forms of social exclusion and violence (White, 2017). This kind of work constructs suicide as an issue of social justice rather than an individual mental health issue and proposes that suicide can only be ‘prevented’ by making lives more liveable for all people. It is important to note that these social constructions of suicide are not static and that they change and shift over time[1]. In our analysis we are interested in the kinds of truths about suicide that are presented in the FAIs.

An FAI is an inquiry, conducted by a sheriff, the purpose of which is to “(a) establish the circumstances of the death, and (b) consider what steps (if any) might be taken to prevent other deaths in similar circumstances”. An FAI is carried out for certain kinds of deaths, including when the death occurs while a person is in legal custody. As one sheriff noted in their report “The primary purpose of a fatal accident inquiry (‘FAI’) is to give a public airing of the facts surrounding a death or fatal accident. This affords those with a direct interest, such as the family of the deceased, the chance to hear first-hand from witnesses and learn the full circumstances of the death as they are known”.

These reports are publicly available, to facilitate transparency and public accountability, and include full names and many other personal details of the person who has died, and in some instances of their family, partners and friends. In light of the public nature of these reports, the issue of anonymization to protect people’s privacy is complicated. Normally in qualitative research, we pseudonymise participants – changing people’s names, and sometimes key details, in order to protect their privacy. This allows people to participate in a research project without necessarily exposing personal details about themselves. However, as Betsy Barkas noted in our discussion about working with FAIs, people’s anonymity has already been violated by the state in the case of FAIs, making it difficult for researchers to preserve people’s privacy.

As a research team we have found ourselves asking: how we can present a critical analysis of the FAIs, which explores the often-problematic ways in which people who have died by suicide are constructed, while preserving, as far as possible, the dignity of those who have died, as well as their loved ones who have been affected by their deaths?

We feel that a critical analysis, which draws directly on quotes from the FAIs, is important to be able to both highlight and disrupt the decontextualized ways in which prison suicides are understood, as well as the ways in which the systems and environment of the prison are implicated in people’s deaths. We have all been deeply moved, distressed and angered by what we have read in the FAIs and we hope to be able to draw on some of these feelings in our writing, to communicate in more affective ways about the people who have died by suicide in prison.  We recognise that each person who has died by suicide is a human being, deserving of dignity and respect, whose life cannot and should not be reduced to the details of their deaths as recounted in the FAI.  We aim to make this point clear in our writing about the FAIs, as well as, as far as possible, not to reproduce harmful constructions of those who have died. We hope that through presenting a critical analysis of the institutional frameworks through which suicide is presented, we can challenge dehumanising representations of people who have died by suicide.

We also recognise that our analysis of the FAIs, which includes potentially recognisable information about the person who has died, may be distressing for their loved ones. We have, therefore, decided not to use people’s real names. We will be using pseudonyms for all participants, as well as removing or altering demographic information in order to reduce, as far as possible, identifying information. However, as we have highlighted above, the publicly available nature of the FAIs mean we cannot guarantee that people will not be identifiable.

It was mentioned in our discussion with Linda Allan, Betsy Barkas and Sarah Armstrong that some families may want their loved ones explicitly named, as this may be an important way of honouring them and the conditions under which they died. It is possible that some of the families of the people represented in the FAIs we are analysing may feel similarly. However, after long deliberation we have decided not to reach out to families. The FAI process is, more often than not, very drawn out and so many of the deaths we will be analysing occurred many years ago. We recognise that some families may find it intrusive to be contacted by researchers after so many years and that they may not wish to revisit the death of their loved one in this way. This is in line with our original ethics application, where we proposed that we would not contact the families. After having seen the reviews, it has also become clear that in many instances the families are not named and therefore finding and contacting them would itself be intrusive and something we feel is ethically questionable.

There are no easy ethical answers when it comes to doing research on suicide, which becomes even more complicated when working with publicly available data collected by the state. The institutional environment of the prison removes certain rights from prisoners, while the FAIs construct their lives backwards through their final act of suicide. In our work we want to take care to avoid creating further suffering for the families of those who have died by treating the subjects of FAIs as whole human beings caught within complex institutional, legal, social, and economic forms of oppression.  We hope that by more explicitly articulating our own ethical position, we make ourselves more ethically accountable as we continue this difficult work.


Armstrong, S., & McGhee, J. (2019). Mental health and wellbeing of young people in custody: Evidence review. The Scottish Centre for Crime & Justice Research.

Marsh, I. (2020). Suicide and social justice: Discourse, politics and experience. In M. E. Button & I. Marsh (Eds.), Suicide and social justice: New perspectives of the politics of suicide and suicide prevention. Routledge.

Reynolds, V. (2016). Hate kills: A social justice response to “suicide”. In J. White, I. Marsh, M. Kral, &. J. Morris (Eds.), Critical suicidology: Towards creative alternatives. University of British Columbia Press.

Tomczak, P. (2018). Prison suicide: What happens afterward? Bristol, Bristol University Press.

White J. (2017). What can critical suicidology do? Death Studies, 41(8), 472–480.

Zhong, S., Senior, M., Yu, R., Perry, A., Hawton, K., Shaw, J., and Fazel, S. (2021). Risk factors for suicide in prisons: a systematic review and meta-analysis. Lancet Public Health, 2020(6), e164-74.

[1] For example, in many contexts suicide was historically regarded as a criminal act. In contemporary societies this ‘truth’ has been replaced by the ‘truth’ that suicide is caused by mental illness.

Prison cell” by decade_null is licensed under CC BY 2.0.

Interrupting the conversation: Inserting social inequality into a discussion about suicide

In this post I reflect on an instance of interrupting a discussion about suicide. I explore how asking different questions about the relationship between suicide and social inequality allows for different kinds of engagements with suicide.  These kind of interruptions are simultaneously challenging, uncomfortable and necessary.  

On the 17th of March, my colleague Sarah Huque and I attended an online roundtable discussion hosted by the Psychological Society of South Africa (PsySSA) entitled Suicide in South Africa: An Intersectional Dialogue. I was looking forward to the discussion, both as a researcher who works on suicide and as a research psychologist who previously trained and worked in South Africa.  

I was particularly looking forward to the ‘intersectional’ focus of the discussion. The roundtable brought together the Operations Director of the South African Depression and Anxiety Group (SADAG); a mental health journalist who had lost her son to suicide; a psychiatrist; and a journalist who has survived “suicidal ideation/experimentation” (their words).  The panel was attended by nearly 250 people, from across South Africa.  

However, I was disappointed to discover that the discussion was dominated by a narrow, individualised, medicalised understanding of suicide. Someone repeated the phrase “the most dangerous kind of depression is an unmedicated one” and the psychiatrist proclaimed that “90% of those who die by suicide have a mental illness”[1]. The panelist from SADAG mentioned that since the beginning of the  COVID pandemic they were experiencing a dramatic increase in calls to their crisis hotline but in the panel discussion there was no connection made between this increase and the particular social realities of South Africa, which has often been described as “the most unequal country in the world”. For me this was a clear and problematic missed opportunity to explore how the COVID-19 pandemic has intersected with existing social inequalities to make lives unliveable for millions of people in South Africa. This was but one example of the failure to engage with issues of inequality during the discussion.

By the end of the session I was feeling extremely frustrated and angry. In conversation with my colleagues in the Suicide Cultures project the next day, we reflected on how these kinds of discussions perpetuate decontextualised understandings of suicide. Spurred on by my colleagues’ shared concerns, I decided to write to the organisers of the event and express my disappointment. In my email I explained how I was especially disappointed by the lack of reflection on and engagement with the structural conditions which produce distress, in light of South Africa’s various intersecting legacies of inequality. I also noted that I felt PsySSA, as the representative body of psychologists in South Africa, had a responsibility to promote more holistic, ethical and contextually-relevant understandings of suicide rather than merely perpetuating individualised, psychiatric ones. I felt slightly better having, at least, articulated my frustration in this way but I did not have high hopes of a constructive response. 

I was pleasantly surprised to receive a response a few days later acknowledging my concerns and inviting me to participate in a follow-up question and answer session. I was invited, during this session, to share my reflections on the initial discussion and to pose some questions to the panellists. I was both pleased and daunted at this opportunity to interrupt the discussion about suicide, especially as someone who is not a clinical professional. But I also felt a sense of responsibility to insert issues of inequality into the discussion of suicide, so I accepted the invitation. 

I began my reflection by noting that the initial session had focused predominantly on identifying “signs” that people may be suicidal; promoting medication as the most effective treatment of suicidal distress; as well as suggesting that people who are experiencing suicidal distress can be protected using (coercive) forms of surveillance. I reflected on how these kinds of discussions are part of dominant ways of thinking about suicide, not only in South Africa but across the globe. I noted that it was important to expand understandings of suicide beyond these narrow focuses in order to more meaningfully contextualise people’s distress. Informed by many of the discussions we have had as the Suicide Cultures research team, as well as engagement with work of others in critical suicidology, I then posed the following questions: 

  • How can we talk about ‘mental health’ and suicide in South Africa without centring issues of inequality and justice? By this I do not mean merely mentioning ‘social determinants of health’ or how some people’s distress may be caused by a lack of sense of safety in their communities, but rather what would it mean to reframe suicide as a social and political issue that is produced by social injustice, which demands social and political rather than merely individual responses?
  • What would it mean to shift from thinking about suicide as a mental health problem caused by depression to thinking about it as an expected and reasonable response to socioeconomic disadvantage or other kinds of social exclusion?
  • How do medicalised understandings of suicide and distress normalise social contexts which make life unliveable for many people?
  • How can we develop psychopolitical approaches which make connections between social inequality, injustice, and the emotional impact this has on people?
  • How can we shift from individual to collective efforts to repair ongoing social injustices?


Unfortunately, two of the previous panellists were unable to join the question and answer session due to load-shedding[2].  However, it seemed the questions I posed spoke to many of the challenges that South African psychologists and counsellors were facing, with many of them sharing their frustration about the difficulties of supporting people struggling with distress. There was also much discussion about inequalities in terms of being able to access mental health care, particularly for people living in rural areas. In this way, the critical interruption that I posed appeared to open up ways to talk differently about suicide. This was an important reminder of the power of interrupting normative conversations about suicide and how these interruptions can reframe suicide in relation to issues of social inequality. This is part of the work that we as the Suicide Cultures research team are doing through a variety of channels, including our seminar series, podcast and this blog.  

[1] For reflections on the problematic nature of these kinds of statistics see Examining the Claim that 80–90% of Suicide Cases Had Depression – PMC (

[2]  Load-shedding refers to scheduled rolling blackouts due to an insufficient supply of electricity, which is a relatively frequent occurrence in South Africa.

The image included here is “Unequal Scenes – Durban, South Africa” by Global Landscapes Forum, licensed under CC BY-NC-ND 2.0.

Working through the ethics of ‘Suicide Cultures’: Part I – In Good Faith

This post is the first in a new series on the Suicide Cultures blog, exploring the ethics of the project. We will periodically post new pieces discussing ethical challenges we encounter, discussions we have, and actions we take to try to find solutions.

The idea of moving discussions of complex ethical issues into actions came up during our most recent Suicide Cultures seminar, led by Fiona Malpass and Jennifer White. That presentation invited participants to discuss the Critical Suicide Studies ethics statement, and at the end, the facilitators asked us to think about what actions we would take as a result of the rich and challenging discussion during the session. [Keep an eye out for the recording/summary coming to the Seminar Series section of this blog soon.] To respect the privacy of participants, we will not discuss the details of the seminar in depth here – though many of the issues raised are similar to those raised within the Suicide Cultures team, which we will discuss throughout this ethics blog series.

The ethics application: Ethics 101

For all researchers working with people, an institutional ethics application is one of the fundamental actions we must take. In this first ethics blog post, we review some of the ethical challenges the Suicide Cultures team faces – discussing both the process of putting together our actual ethics application as well as some of the ‘less tangible’ ethical conundrums with which we struggle. We used the process of writing the ethics application as a starting point in moving our theoretical ethical questioning into the realm of the practical, as we prepare for fieldwork to commence this year. The process of engaging in what can feel like a bureaucratic ‘box-ticking’ exercise can be an action that jump-starts more complexity in thinking about ethics than the form may allow – if we engage with ethics as an on-going process, in good faith. For further reading, and a recent example of deep reflection on, challenging of, and expansion of thinking around the ethical considerations of suicide research, see Jaworski (2022).

There are plenty of scathing indictments of institutional ethics procedures, and for good reason. We will touch on some of these negatives but want to focus on the positives that can arise from engaging with institutional ethics – and the ways in which researchers can help their institutions evolve by putting more, and more in-depth thought, into their ethics applications. Here are some of the ways in which we tried to push the bounds of our ethics application.

One of the challenges can be when bureaucracy seeks to ‘protect’ ‘vulnerable’ participants in ways which provide legal cover but little real support. This tension can present in many ways, for example in researchers jumping through hoops to provide standardised procedures and token protections that do not allow for the development of individualised safety plans for participants. For the Suicide Cultures project, we contended with this challenge by creating a standard format for developing safety plans with participants, with some general resources populated, but also leaving space for one-to-one discussions of support needs with participants. By including this in our ethics application, we hope to build upon the idea of what protection means – and introduce agency and self-determination into the development of safety plans. This issue can also manifest in a tension between agency and protection – for example, we as researchers may be required to inform authorities if we believe a participant is intending to harm themselves in the immediate future. We stated this requirement clearly on our participant information sheets, in order to be up front with the constraints on researchers as professionals, which in turn can constrain participants’ agency. We hope this will enable participants to choose what they share with us carefully.

We are also working with a range of creative methodologies – which come with their own challenges, not least of which is the additional scrutiny applied to non-traditional methods. Part of ensuring we can justify the use and value of these methods involved exploring the lessons learned from those already using these methods; we read about photo voice, mapping, walking interviews (as well as interviewing in general and ethnography/participant observation) in-depth, discussed what we found, and explored legal and copyright rules and health-and-safety concerns. We continued this action by hosting a small internal seminar on all of these methods – to share this learning and discuss the implications of these methods – in a similar manner to the ethics seminar discussed in the introduction. These are small, early-stage actions that can help us to engage in research in as ethical a way as we can – and to continue the conversations beyond the forms.

Continuously engaging with ethics is important, because one of the major challenges we faced in trying to translate some of our ethical concerns into concrete actions for the research project was doing this with all of the uncertainties that accompany research planning. Realistically, we cannot predict every challenging situation that will arise across the lifetime of the project – especially since at the moment in-person versus digital is still a major question as Covid-19 continues to disrupt our ‘usual’ ways of doing research.

Institutional ethics is important in that it compels researchers to think about accountability and protection. It can also jump start more complex thought processes around ethics; we are challenged to think ahead and to think about ALL of the people who may be involved/impacted. For example, in a previous ethics application we submitted, for a review of Fatal Accident Inquiry (FAI) reports of deaths by suicide in prison, we had to consider the impact of our document review on (for example) the families of the person who has died, witnesses in the inquiry, and the sheriff who wrote the report. We also continue to grapple with the use of reports about a person who cannot consent or contribute to the process. [We plan to dedicate a separate post in this series to the ethics of these FAI reviews, and to issues around the use of information about and creation of subjectivity around someone who has died.]

Ethics beyond the application: The struggle to do no harm – and to try to do good

During a recent Suicide Cultures team meeting, we discussed the newsletter that we send to our mailing list with updates about the project. This discussion naturally segued into a conversation about how much to reveal, how identifiable areas we work in might be from different outputs we have/will produce, and the discomfort of writing about other people. We did not come up with any ‘good’ answers, but we agreed that having these discussions was a positive sign – and that engaging with ethics in research is an ongoing process that must be undertaken to the best of our abilities. We are trying to work in good faith – knowing that there is no such thing as perfectly ‘ethical’ research. Following this discussion, we took the action of dedicating a session of our monthly meeting series on emotions to think through the discomfort that comes along with trying to do research in an ethical manner – and how we can use, engage with, and sit with that discomfort.

To conclude this introductory post in our ethics series, we made a list of some of the concerns we continue to grapple with – engaging in discussions and imagining ways to translate these discussions into actions. We will explore some of these topics in future posts in this series – for now, we leave you with only (a limited list of) questions:

  • The tension between agency and protection (revisited).
    • How do we engage communities?
    • How do we incorporate feedback into our work?
    • How do we navigate the line between agency/self-determination and qualitative analysis?
  • Moving online: ethics of research during Covid-19.
    • Ensuring safety;
    • Following rules;
    • The impact of the digital divide.
  • How do we relate to ethics ourselves?
    • In what ways are we implicated in systems (e.g. through analysis of FAI reports)?
    • To what extent do we have the right to do this research? Why do we do it (anyway)?
  • How can we keep engaging in actions to do ethical research in good faith?



Jaworski, K. (2022). The ethics of facing the Other in suicide. Health, 26(1), pp. 47-65.

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