As part of our Leverhulme funded ‘Suicide in/as Politics’ project we have undertaken in-depth qualitative analysis of UK suicide prevention policies, which were produced between 2009-2019. Whilst suicide prevention policies have come to be seen as an essential part of suicide reduction, they have received limited academic attention and remain under-studied.
Through our study of suicide prevention policies, we aim to better understand the ways in which suicide is conceptualised within contemporary UK suicide prevention and to consider the effects that these conceptualisations have for the lives and deaths of citizens. Our research is informed by post- structural critical policy analysis (Bacchi and Goodwin, 2016) which recognises that policies actively produce social realities. Policy does not simply reflect or respond to an ‘external reality’, instead policy constructs realities by producing certain ‘problems’ in certain ways. The ways in which problems are constructed will thus influence the ways in which we think about potential ‘solutions’ to these problems. It is therefore vital for us to interrogate some of the underlying assumptions contained within suicide prevention policies.
At the heart of suicide prevention policies is a central message which says that suicide prevention is ‘everybody’s business’, that ‘we’ can all play a part in the prevention of suicides. The Scotland 2018 policy document is representative of most other UK policies in stating that:
We envisage a Scotland where suicide is preventable; where help and support is available to anyone contemplating suicide… Suicide prevention is everyone’s business (Scotland 2018, p.3).
This is a very positive message, it emphasises that everyone has the agency and skills to help prevent suicide, it stresses our agency in preventing suicide. However, we need to recognise that there are some problematic underlying assumptions contained within this current approach, I will examine two of them here.
Assumption 1 – The suicidal subject as “knowable and recognizable”
Jonathan Morris’ research into suicide prevention training in Canada highlights how such training assumes the ability of individuals, once trained, to recognise the suicidal subject. The suicidal subject is thus assumed (and emphasised) to be “knowable and recognizable” (Morris in White et al, 2016, p.85). We see the same assumption within the UK policy documents. Ultimately, suicide is seen as preventable because it is framed as being amenable to detection and identification. The identification of the suicidal subject is assumed to be unproblematic, the ‘fact’ that we can, and we will (with appropriate training or awareness raising) be able to identify, know and recognise the suicidal subject is unquestioned within the policies.
For example, let us consider an England 2012 suicide prevention document that tells us that by “developing suicide awareness and education or training programmes…[we can] teach people how to recognise and respond to the warning signs for suicide in themselves or in others” (p.29). We see here how suicide is assumed to be easily recognisable once we are trained or taught how to spot the warning signs’. However, assuming that suicide is unproblematically amenable to identification through the recognition of specific warning signs, risks diminishing individual complexities. Thus, making us less likely to recognise the diverse range of people who may experience suicide and suicidality. A lack of diversity in our understandings and knowledge of suicide and suicidality “can totalize perceptions and opinions” about people who attempt suicide. We risk homogenising suicide.
Assumption 2 – Context is less important than conduct
Intertwined with the assumption that people experiencing suicidal ideations can be unproblematically identified, is a second underlying assumption regarding the importance of conduct (or agency). The policies that we examined tended to stress the role of individuals in ‘preventing’ suicide through the identification of a suicidal subject. Context appears of less importance and often goes underacknowledged. Even when context is mentioned it remains cursory. For example, one policy document states that:
A range of front-line agencies, including primary and secondary health and social care services, local authorities, the police and Jobcentre Plus, can identify and support… vulnerable people who may be at risk of suicide (England 2012, p.29).
Whilst different contexts are mentioned there is no explicit awareness as to why these contexts are associated with vulnerable individuals who may be in distress. There really needs to be a deeper and more meaningful interrogation of these contexts and the roles that they play in making the lives of individuals less livable and thus increasing the risk of suicide. For example, the Jobcentre Plus is a location where individuals who are unemployed, in need of benefits and sometimes facing benefit sanctions are forced to attend, it is thus not just a physical location but also acts as a site of structured contextual inequality which may create vulnerability to death by suicide; this remains unacknowledged in the policy document.
Context is thus underemphasised whilst the conduct of individuals to spot those people experiencing suicidal distress is overemphasised. This focus on the role of conduct over context is problematic because of the complex and often contradictory nature of suicide, as Jennifer White has argued, suicide “cannot ever be already known in advance” (White, 2020, p.76). In her research China Mills (2017) has also highlighted how deeper political, social and economic contexts affect suicide and so I would like to see these suicide prevention policies more explicitly acknowledge these deeper contextual factors.
The emphasis on ‘preventer’ agency
I have highlighted two underlying assumptions which lie at the heart of the message that suicide prevention is ‘everybody’s business’, a message which is central to many suicide prevention policies:
- Prevention is linked with identification and suicide is assumed to be unproblematically knowable and recognizable
- There is little explicit acknowledgment of how deeper contextual factors shape suicide risks, instead the emphasis remains largely on individual conduct
These assumptions shape the potential ‘solutions’ proposed to the problem of suicide within the policies. A consequence of these underlying logics is that the policies tend to overemphasise the capacity of a broad ‘general public’, as well as specialists, to act as ‘preventers’ of suicide (who can identify and detect suicidal individuals) whilst largely ignoring deeper structural contextual factors that may make individuals more or less vulnerable to dying by suicide.