Category Archives: Article

Suicide in Nepal: Qualitative Findings from a Modified Case-Series Psychological Autopsy Investigation of Suicide Deaths

South Asia accounts for the majority of the world’s suicide deaths, but typical psychiatric or surveillance-based research approaches are limited due to incomplete vital surveillance. Despite rich anthropological scholarship in the region, such work has not been used to address public health gaps in surveillance and nor inform prevention programs designed based on surveillance data. Our goal was to leverage useful strategies from both public health and anthropological approaches to provide rich narrative reconstructions of suicide events, told by family members or loved ones of the deceased, to further contextualize the circumstances of suicide. Specifically, we sought to untangle socio-cultural and structural patterns in suicide cases to better inform systems-level surveillance strategies and salient community-level suicide prevention opportunities. Using a mixed-methods psychological autopsy approach for cross-cultural research (MPAC) in both urban and rural Nepal, 39 suicide deaths were examined. MPAC was used to document antecedent events, characteristics of persons completing suicide, and perceived drivers of each suicide. Patterns across suicide cases include (1) lack of education(72% of cases); (2) life stressors such as poverty (54%), violence (61.1%), migrant labor (33% of men), and family disputes often resulting in isolation or shame (56.4%); (3) family histories of suicidal behavior (62%), with the majority involving an immediate family member; (4) gender differences: female suicides were attributed to hopeless situations, such as spousal abuse, with high degrees of social stigma. In contrast, male suicides were most commonly associated with drinking and resulted from internalized stigma, such as financial failure or an inability to provide for their family; (5) justifications for suicide were attributions to ‘fate’ and personality characteristics such as ‘stubbornness’ and ‘egoism’; (5) power dynamics and available agencyprecluded some families from disputing the death as a suicide and also had implications for the condemnation or justification of particular suicides. Importantly, only 1 out of 3 men and 1 out of 6 women had any communication to family members about suicidal ideation prior to completion. Findings illustrate the importance of MPAC methods for capturing cultural narratives evoked after completed suicides, recognizing culturally salient warning signs, and identifying potential barriers to disclosure and justice seeking by families. These findings elucidate how suicide narratives are structured by family members and reveal public health opportunities for creating or supplementing mortality surveillance, intervening in higher risk populations such as survivors of suicide, and encouraging disclosure.

https://rdcu.be/VGhh

 

Structuring Roles and Gender Identities: Within Families Explaining Suicidal Behavior in South India

Lasrado, R.A. et al., (2016) Crisis.  DOI: 10.1027/0227-5910/a000379.

Abstract. Background: This paper examines the social structures, culture, gendered roles, and their implications for suicidal behavior in South India. Exploring the cultural process within the structures of family and society to understand suicide and attempted suicide from the perspectives of survivors, mental health professionals, and traditional healers has not been achieved in the existing suicide-related research studies conducted in India to date. Aims: This study aimed to explore the cultural implications of attempted suicide by examining the survivors’ life stories, their perceptions, and service providers’ interpretations of problem situation. Method: A qualitative design was used drawing on constant comparison method and thematic analysis. The analysis was underpinned by the theoretical concepts of Bourdieu’s work. In-depth interviews were conducted with 15 survivors of attempted suicide, eight mental health professionals, and eight traditional healers from Southern India. Results: The study found interactions among visible and invisible fields such as faith, power, control, culture, family, religion, and social systems to have strengthened the disparities in gender and role structures within families and societies and to have impacted survivors’ dispositions to situations. Conclusion: The role of culture in causing suicide and attempted suicide is explained by unraveling the negative impact of interacting cultural and structural mechanisms.

The influence of the Foehn wind (Halny) on the occurrence of suicide in the Tatra Mountains, 1999–2014

Koszewska, I., et al. 2016. The influence of the Foehn wind (Halny) on the occurrence of suicide in the Tatra Mountains, 1999–2014.European Psychiatry 33: S597
In the dawn of increasing interest in climate changes, including extreme weather events, e.g. the Foehn winds, and their influence on public health, it is of great importance to understand their role in suicide.The association between suicides in the Tatra Mountains, Poland from 1999 to 2014 and the Foehn wind (called Halny in this region) was examined. The belief that suicides are affected by Halny seems to be firmly rooted in local language and culture.The purpose of the study was to assess the Halny wind as a suicide risk factor.Data concerning all suicides in the region were included. Meteorological data were derived every three hours during the period of the study. Halny was defined as a complex of interacting meteorological conditions. The two days preceding and following the wind were recognized as the period of the Foehn influence (FI). The probability of suicide in the presence of Halny and during the FI period was calculated.From 1st January 1999 to 31 December 2014 (5844 days), 210 consecutive suicides were registered. The number of suicides in men was markedly higher than in women. Halny did not change the overall probability of suicide. However, the presence of Halny modified the suicide risk according to the season (P=0.00095, two-way ANOVA test). The FI periods appeared to increase suicide risk in summer and autumn.Halny may contribute to the increased suicide risk in summer and autumn. It should be taken into account in suicide preventive interventions in this region.

Life Experience following Suicide Attempt among Middle-aged Men

J Korean Acad Nurs. 2016 Apr;46(2):215-225. Korean.
Published online April 29, 2016.  http://dx.doi.org/10.4040/jkan.2016.46.2.215

PurposeThis study was performed to identify the meaning of life experience following suicide attempt among middle-aged men.

MethodsA qualitative research design was adopted using van Manen’s hermeneutic phenomenological approach. The participants were six middle-aged men who had attempted suicide at least one time. Data were collected in 2013 through in-depth interviews. Individual interviews were recorded; and literary, art works and phenomenological literature were searched to identify the meaning of the experience.

ResultsThe five essential themes of the life experience of middle-aged men who attempted suicide were ‘Bitter reality confronted again’, ‘Anger buried deep inside’, ‘Broken family, inescapable fetters’, ‘Blocked relationships, closed world’ and ‘A step towards a new life’.

ConclusionThe meaning of lived experience found in this study provides deep insight into the experience following suicide attempt in middle-aged men and crucial information to give directions to appropriate support and nursing interventions.

Durkheim, ethnography and suicide: Researching young male suicide in the transnational London Alevi-Kurdish community

Cetin, U. (2015). Durkheim, ethnography and suicide: Researching young male suicide in the transnational London Alevi-Kurdish community. Ethnography. doi:10.1177/1466138115586583

This study of the unusually high incidence of young male suicides in the transnational Alevi-Kurdish community in London demonstrates the benefits of combining a Durkheimian structural approach with a qualitatively driven ethnographic methodology. Examination of the life experiences of those who committed suicide is located within the underlying social organization of the transnational community in which the suicides occurred, enabling us to explore unanticipated events that render certain groups more at risk of committing suicide. Interviews with significant others facilitated a deeper understanding of the personal life paths of those who committed suicide. The suicide cases followed a particular assimilation trajectory that gradually positioned them in a ‘rainbow underclass’, an anomic social position leading to suicide. Despite the sensitivity of the subject, participants appreciated the opportunity to discuss their experience frankly and contribute towards a better understanding of the underlying causes in a desperate attempt to prevent further suicides.

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.

“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.