Monthly Archives: March 2015

FINAL REPORT: Suicide in Sri Lanka: Past, Present and Future Transformations, University of Colombo, 21-22 March 2013

FINAL REPORT

Suicide in Sri Lanka: Past, Present and Future Transformations, University of Colombo, 21-22 March 2013

Introduction

Since the middle of the 20th century, rates of suicide and self-harm rose to ‘epidemic’ proportions in Sri Lanka. From the mid-1990s a series of restrictions placed on the import and sale of the most toxic agrochemicals led to a substantial decreased in the suicide rate. However, emerging evidence – much of it presented at this symposium – suggests that the rate of self-harm has increased exponentially since then. The objective of this symposium was to engage academic researchers and policy makers and intervention practitioners in a dialog concerning the socio-cultural causes and meanings of self-harm and suicide in Sri Lanka, and the implications of this for the development and delivery of effective interventions.

Methodology

The symposium was organised by Dr Tom Widger (University of Sussex) and Ms Tharindi Udalagama (University of Colombo). In February 2013 a Call for Papers (CfP) was announced via academic and policy/practice channels. The CfP attracted twelve abstracts from local and international researchers and interventionists. The resulting programme spread across two days and included five sessions, including a final roundtable debate seeking to integrate the results of discussions from the previous sessions:

Opening session:         Welcome & Plenary Address

Session 1:                    Reading Sri Lanka’s suicide rate

Session 2:                    Self-harm and suicide in ethnographic contexts

Session 3:                    Interventions: transforming suicidalities in Sri Lanka

Session 4:                    Roundtable debate

Formal invitations were sent to a list of academic and policy/practice stakeholders, including representatives of the Ministry of Health, Ministry of Social Services, and local and international NGOs. A few days before the symposium feature stories were published in the Sri Lankan press, which elicited requests for further information and/or requests for an invitation to attend. The symposium was also publicised on the website of the Forum for Suicide & Culture Research (FSCR), and via FSCR Twitter feeds. This helped to raise the profile of the symposium among local researchers.

Results of the sessions

Welcome & Plenary Address

The symposium was introduced by Dr S.M.K. Herath (Head, Department of Sociology, University of Colombo). Dr Herath reminded the audience of the importance of social scientific studies of suicide, especially in Sri Lanka where suicide rates are so high. Next to speak was Dr F.R. Metha (country representative, WHO), who pointed out the heavy psychological and social burden represented by, and caused by, Sri Lanka’s suicide and self-harm epidemic. The plenary address was given by Professor N. Fernando (National Institute of Mental Health). Professor Fernando’s talk provided a general introduction to self-harm and suicide from a global perspective. A lively debate followed concerning the relationship between suicide and mental illness, with one side arguing for a strong relationship with depression and the other suggesting only a weak correlation.

Session 1: Reading Sri Lanka’s suicide rate

The aim of this session was to establish the quantitative framework of suicide and self-harm in Sri Lanka. Three papers were presented, each exploring the rise and fall of the suicide rate from, broadly, medical epidemiological, sociological, and anthropological perspectives. Results of the session included an increased awareness that even though suicide rates have fallen, the rate of self-harm is increasing. A consensus was reached that self-harm remains a major health and social problem and renewed commitments to prevention should be made.

Session 2: Self-harm and suicide in ethnographic contexts

The aim of this session was to provide context to the quantitative picture. Three papers were presented, including two concerned with self-harm and suicide in southern Sri Lanka and one with suicide in northern Sri Lanka. The papers included discussions of suicide and gender, suicide and kinship, and suicide and war. The papers showed how acts of self-harm and self-inflicted death are caused by relational disputes and accusations of shame, and exist as a social practice rather than the consequence of deep-seated psychopathology.

Session 3: Interventions

The aim of this session was to provide an overview of suicide interventions in Sri Lanka and to assess their effectiveness. Five papers were presented, including a review of government policies and in particular the national suicide prevention strategy published in 1997. While the GoSL was lauded for being the first government in Asia to produce such a document, consensus was reached that a new policy is urgently needed and that this should include an implementing body. Building on the findings of the previous sessions, it was also generally agreed that interventions based on Euro-American approaches were unlikely to be effective in the Sri Lankan socio-cultural context.

Session 4: Roundtable debate

The aim of the debate was to address the theme of the conference – what are the social and cultural challenges of suicide prevention in Sri Lanka, and how might they be overcome? – by building of the results of the past two days’ discussions. Six panelists took part, representing the GoSL, local and international suicide prevention organisations, and academia. Results of the debate included calls for greater communication and collaboration between academic researchers and interventionists, and for greater commitments to research targeting the needs of policy and practice experts. It was also expressed that interventionists rely too much on Euro-American approaches to understanding suicide and suicide prevention, and that greater attempts should be made to engage with socio-cultural approaches relevant to the Sri Lankan context.

Outcomes of the symposium

The symposium generated a large amount of interest. Among those who presented at or attended the symposium, there was keen enthusiasm to maintain the momentum started and to forge lasting networks of researchers and prevention experts. To facilitate this, the presentations were made available on the FSCR website. Selected papers will be published in English, Sinhala, and Tamil as part of a special issue of the University of Colombo’s sociology journal.

Among policy/practice stakeholders the symposium provided further impetus to start new projects. The World Bank, in particular, has showed a strong interest to build on the results of the symposium. The Development Partners Secretariat requested a one-page brief to distribute amongst donor organisations and INGOs in order to raise further awareness of the issue. A few days later, the organisers and WHO met with the World Bank’s Senior Health Specialist to discuss how intervention programmes could be taken forward and these meetings are still continuing.

Overall the symposium demonstrated that a large network of researchers and policy/practice experts exists in Sri Lanka, which until the event had not met or had the chance to hear about each other’s work. The symposium suggested that there is significant potential to develop a consortium of experts to conduct policy/practice orientated research studies and develop socio-culturally relevant suicide interventions. As a direct result of the symposium several stakeholders are now in discussions about how this might happen.

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Death and the City: Female Public Suicide and Meaningful Space in Modern Mexico City

Sloan, K. A. (2015). Death and the City Female Public Suicide and Meaningful Space in Modern Mexico City. Journal of Urban History, 0096144214566973.

Poised on the cusp of the twentieth century, many urban citizens believed their societies to be sickened by suicide epidemics. It was assumed that rapid modernization and technological advance caused some individuals to develop nervous conditions that negated their impulses for self-preservation. Although statistical evidence pointed to higher rates of suicide among adult men, society believed that youth and women were most vulnerable to the epidemic. This article examines cases of young women carefully planning their suicides in symbolic spaces of Mexico City. It argues that public suicides made self-conscious decisions on how they would die, in particular choosing the sites of their deaths for their cultural meanings. How society viewed their deaths depended upon their virtue in life; nevertheless, Mexicans perpetuated their culture of commemorating the dead by erecting ephemeral memorials at the sites of death.

In Pursuit of the Good Life: Aspiration and Suicide in Globalizing South India

Chua, J. L. (2014). In Pursuit of the Good Life: Aspiration and Suicide in Globalizing South India. Univ of California Press.

Chua

Once celebrated as a model development for its progressive social indicators, the southern Indian state of Kerala has earned the new distinction as the nation’s suicide capital, with suicide rates soaring to triple the national average since 1990. Rather than an aberration on the path to development and modernity, Keralites understand this crisis to be the bitter fruit borne of these historical struggles and the aspirational dilemmas they have produced in everyday life. Suicide, therefore, offers a powerful lens onto the experiential and affective dimensions of development and global change in the postcolonial world.

In the long shadow of fear and uncertainty that suicide casts in Kerala, living acquires new meaning and contours. In this powerful ethnography, Jocelyn Chua draws on years of fieldwork to broaden the field of vision beyond suicide as the termination of life, considering how suicide generates new ways of living in these anxious times.

“Suicidology as a Social Practice”: A Reply

Widger, Tom “‘Suicidology as a Social Practice’: A Reply.” Social Epistemology Review and Reply Collective 4, no. 3 (2015): 1-4. http://social-epistemology.com/2015/02/01/suicidology-as-a-social-practice-a-reply-tom-widger/

In their excellent and provocative article ‘Suicidology as a Social Practice’ (2014), Scott Fitzpatrick, Claire Hooker, and Ian Kerridge extend the literature ‘historicizing’ the study of suicide to provide an account of the field’s constituting norms and behaviours. Thus, and underpinning the article, a solid body of work now exists which points out how during the 19th century suicide became a problem for nomothetic social and medical study and intervention due to a confluence of factors including the development of state mechanisms for counting and classifying deaths alongside moral concerns over the effects of modernisation. These studies have shown how the designation by sociologists and psychologists of ‘suicide’ as a particular kind of problem (of ‘”self”-destruction’) and of ‘suicidal people’ as particular kinds of people (as suffering from some kind of illness), generated a new understanding of suicide that was radically different to what had gone before. This new understanding transformed the idea of suicide from one of theological, philosophical, legal, and aesthetical ‘interest’ to one of social and psychiatric ‘concern.’

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Suicidology as a Social Practice

Fitzpatrick, S. J., Hooker, C., & Kerridge, I. (2014). Suicidology as a Social Practice. Social Epistemology, (ahead-of-print), 1-20.DOI:10.1080/02691728.2014.895448

Suicide has long been the subject of philosophical, literary, theological and cultural–historical inquiry. But despite the diversity of disciplinary and methodological approaches that have been brought to bear in the study of suicide, we argue that the formal study of suicide, that is, suicidology, is characterized by intellectual, organizational and professional values that distinguish it from other ways of thinking and knowing. Further, we suggest that considering suicidology as a “social practice” offers ways to usefully conceptualize its epistemological, philosophical and practical norms. This study develops the idea of suicidology as a social practice and considers the implications for research, practice and public discourse.

Farmers’ Suicides as Public Death: Politics, Agency and Statistics in a Suicide-Prone District (South India)

Münster, D. N. (2014). Farmers’ Suicides as Public Death: Politics, Agency and Statistics in a Suicide-Prone District (South India). Modern Asian Studies, 1-26.

This paper argues that Indian farmers’ suicides may fruitfully be described as public deaths. Based on ethnographic fieldwork in the South Indian district of Wayanad (Kerala), it shows that farmers’ suicides become ‘public deaths’ only via the enumerative and statistical practices of the Indian state and their scandalization in the media. The political nature of suicide as public death thus depends entirely on suicide rates and their production by the state itself. But the power of representations complicates the ethnographic critique of statistical knowledge about suicide. In a context like Wayanad, which had been declared a suicide-prone district by the Indian state, public representations of suicides have taken on a life of their own; statistical categories and the media interpretations of these statistics have had a curious feedback—mediated by development encounters—onto the situated meanings of individual suicides. Local interpretations of individual suicides mostly commented on personal failures of the suicide and on the perils of speculative smallholder agriculture. Ethnography of farmers’ suicide based on case studies alone, however, would soon encounter limitations equally grave as the limitations of statistical analysis. Not only is the meaning of suicide (intentions, causes, motives) at the actor level off limits for ethnography, but in addition to that the (public) meaning of suicide is co-determined by state practice including statistical accounting.

Unikkaartuit: Meanings and Experiences of Suicide Among Inuit in Nunavut, Canada

Kral, M. J., Idlout, L., Minore, J. B., Dyck, R. J., & Kirmayer, L. J. (2014). Unikkaartuit: Meanings and Experiences of Suicide Among Inuit in Nunavut, Canada. International Journal of Indigenous Health, 10(1), 55-67.

Inuit in Arctic Canada have one of the highest suicide rates in the world. Most of these suicides occur among youth, especially males, between the ages of 15 and 24. The goal of this study was to gain an understanding of Inuit experiences with suicide and what suicide means to Inuit, including suicide attempters and bereaved survivors. Fifty Inuit between the ages of 14 and 94 were interviewed about suicides in two communities in Nunavut. Sixty-three high school and college students were also surveyed with the same questions. It was found that suicide was most closely related to romantic relationship and family problems, and to experiences of loneliness and anger. These findings are interpreted in the context of massive social change, on-going colonization, and multigenerational trauma following the colonial government era of the 1950s and 1960s, when family and interpersonal relationships were significantly affected. The study stresses that suicide prevention strategies focus on youth and family, particularly on parenting, and ensure that Inuit communities take control of prevention programs. It recommends that family and community resources be further mobilized for suicide prevention.