“The Two Okay Rule”: Conceptions of agency within suicide prevention 

This post is by Alex Oaten, the Lincoln based Research Associate on the Suicide in/as Politics project.   You can find out more about all the team on our People page!

Roman Kemp’s recent BBC documentary exploring issues of mental health and suicide in young men has been widely praised and has led to a public conversation about suicide on social media. Viewers thanked Roman for his powerful, deeply emotional portrayal of both his friend Joe’s death and his own personal experiences of suicidal thoughts. The documentary takes the viewer on a journey with Roman, who is seeking to discover the answers to two questions which he feels are important to answer: Why are young men dying by suicide? and Why are young men with suicidal thoughts not talking to their friends? “That’s what I have to figure out” says Roman, at the beginning of the documentary.

As someone who is currently researching the politics of suicide, I found this documentary fascinating because it tells us a great deal about how society thinks about the role of human agency within suicide prevention. My colleague Hazel Marzetti has already discussed the complexity of preventing death by suicide in a previous post which contrasted the Roman Kemp documentary with Channel 4’s Caroline Flack: Her Life and Death, both of which aired in the same week.

 The ‘Two Okay rule’

The documentary identifies silence as the biggest challenge we face in preventing suicide amongst young men. We are told that young men often struggle to talk about their mental health and suicidal feelings with their friends and that this is a significant contributing factor for young men’s deaths through suicide. After meeting one group of young men, whose friend had died by suicide, Roman is introduced to the ‘two okay rule’ where friends ask each other if they are okay twice. In our day-to-day conversations with friends we will often begin by asking them if they are okay, however, this can often be quite perfunctory, the briefest part of a conversation.

By asking the question twice and putting emphasis on the fact that we want to know how our friend is really doing, the documentary suggests that we can encourage them to open up to us, to tell us how they are truly feeling emotionally. Roman tells us that “are you okay is the most important question you can ask your friend”.

At the end of the documentary, Roman posts a video to Twitter encouraging everyone to go and speak to a friend and ask them if they are okay, twice. His video is widely viewed, with people sharing positive stories of how a friend has responded to being asked if they were okay. The documentary ends on a positive and empowering note, we are told that by asking our friends if they are okay and by chatting about how we really feel, we can prevent young men’s suicide. We can help solve the problem. Through watching the documentary, we have been provided with some simple, specific actions that we can carry out to help prevent a suicide and improve our friends’ lives. Through this framing of ‘the problem’ and ‘the solution’, the documentary tells us a lot about how we conceptualise our human agency in relation to suicide prevention.

 Conceptions of agency within suicide prevention

When we talk about human agency, we are referring to conduct and to the capacity of human actors to make a difference. Agency stresses the conduct of human actors, “that it is their behaviour, their conduct, their agency that is responsible for the effects and outcomes” of a given event (Hay, 2002, p.96). To place emphasis on agency is to see humans as being able to shape their context rather than being shaped by their context; emphasis on our agency stresses our power to make a difference and to enact some change.

The uncertainty of suicide is something which terrifies us because it deprives us of agency, of the power to act to prevent a suicide. In the documentary Roman struggles most with the fact that he could not see that his friend Joe was contemplating suicide. As Roman says “That’s what’s so scary, when I tell you, you can’t see it, you can’t see it”. Roman could not see the death coming and it is this fear of the uncertainty of suicide, its unknown and unknowable character which makes us feel powerless. If we do not know then we cannot act, if we do not know that someone is feeling suicidal then we cannot prevent them from taking their own life. This is what scares us most and so it is not surprising that much of the discourse of suicide prevention revolves around trying to address this issue of the uncertainty and the unknowable, in order make us feel that we can have agency as suicide ‘preventers’.

Roman Kemp’s documentary follows this theme. We are given a manageable and achievable action to undertake; we can ask our friends if they are okay, twice and by doing this we can know who is suicidal and act to prevent their death. Having watched the documentary we feel empowered, we feel that we could make a difference and we feel that through our actions suicide can become ‘known’ and can become more ‘certain’, because we can find out if our friend is suicidal. By emphasising the importance of talking as a way to prevent suicide the documentary makes us feel as if we can ‘know’ suicide, we can be more ‘certain’ about who is suicidal by talking to them. Suicide thus becomes knowable, enabling us to feel some individual control over it. Suicide prevention discourses try to give us agency by emphasising our ability to change the minds of those who are contemplating suicide and the first step in enhancing our agency as ‘preventers’ is the identification of people considering suicide.

Emphasising conduct rather than context

However, our over emphasis of individual agency in preventing suicide can risk over simplifying suicide. Roman’s documentary focused on talking, silence was identified as the problem and even the cause of suicide whilst talking and asking if your friends are okay was identified as key to suicide prevention. The message was simple, by talking we can help save our friends from suicide, we have agency as suicide ‘preventers’. However, by emphasising our role in being able to prevent suicide through our own easily achievable action, we risk reducing suicide simply to the act of talking or not talking.  Whilst this may be therapeutic to ‘us’ as ‘preventers’ because it makes us feel that we can make a tangible difference in preventing suicide, it is overly reductionist.

By focusing so much attention on ‘our’ conduct in preventing the act of suicide we risk paying too little attention to the wider contexts in which suicide occurs. Deeper political, social and economic contexts do affect suicide rates, as China Mills (2017) has pointed out in her research into suicide and austerity. Accepting and recognising the context within which suicide occurs forces us to recognise the complexity of suicide. It forces us to look beyond the individual. But because contextual factors cannot be solved easily at the individual level, recognising their importance can make us feel powerless.

And we don’t want to feel powerless, we want to feel like we can do something about suicide, that we have agency over suicide. Roman’s documentary was so well received for this reason, because it told us that we could do something, that as individuals we have the power to prevent suicide. As Roman said in a tweet after the programme:

We all want to be that hero that our friend needs, we want to keep our friends and loved ones alive and so we want to emphasise our agency and our power to prevent suicide through our actions. It is great that Roman’s documentary inspired so many people to check in with their friends and encouraged public conversations about destigmatising suicide. However, we need to be careful that in emphasising our power to prevent suicide, we do not simplify its complex contextual aspects, thereby reducing suicide to one singular and overly simplistic facet.

References:

Munster, D. and Broz, L. (2020). The Anthropology of Suicide: Ethnography and the Tension of Agency. In L. Broz and D. Munster (Eds.), Suicide and Agency: Anthropological Perspectives on Self-Destruction, Personhood, And Power (pp.3-23). Abingdon: Routledge

Hay, C. (2002). Political Analysis: A critical Introduction. Basingstoke: Palgrave

Mills, C. (2018). ‘Dead people don’t claim’: A psychopolitical autopsy of UK austerity suicides. Critical Social Policy, 38 (2), 302-322

 

 

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