Targeting suicide

Mental Health Nursing,  Nov/Dec 2002  by Jones, Alun

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Editorial

Traumatic and unexpected death can have far-reaching consequences. As an effect of suicide, complex bereavement problems can influence the health of those who survive. Families can pass on difficulties generation-to-- generation.

The Health of the Nation document (DoH, 1992) viewed suicide and acts of attempted suicide as of major concern for health policy. It, and a later document, Targeting Practice (DoH, 1993), set objectives for reducing suicide by 2000. But 10 years on, health and social policy have barely scratched at the surface. Suicide rates have declined in women and elderly men over the past two decades, but for young men under 35 they have risen. Alarmingly, suicide is considered the most common reason for death in this group.

Subsequently the government's white paper, Saving lives: Our healthier nation (DoH, 2000) proposed to reduce suicides by 2010 by 20 per cent. The means of achieving this are set out in the consultative document for the National Suicide Prevention Strategy for England, just published.

The wide-ranging strategy attempts to address problems but reading the document leaves an impression that; perhaps inevitably, pragmatism, underpins much current thinking about suicide prevention. A good deal is admirable, yet possibly overly concerned with containment, environmental constraints, and precautions. To seriously address issues related to suicide we need more than surface thinking.

The pressures of living in an increasingly competitive and outcome oriented society must also be considered. Some issues touch all aspects of modern life and are now an inherent part of the educational systems - witness the recent A level debacle.

The causes of suicide are multifaceted with many complexities. The medical model is unhelpful, seeing problems as belonging to an individual. Accordingly health interventions and social tweaking are considered appropriate ways of attending to the issues in hand. These notions are limited in vision and reflect reductionism. To seriously tackle suicides, a good look at the causes for high-risk groups is essential. We need to think carefully about the reasons why people kill themselves, along with struggles of personal identity character, relational, social and organisational factors that contribute.

Undeniably, difficulties of living in contemporary society play a part in suicides. These include homelessness, unemployment, family pressures, perfectionism and conceivably reckless media influences. Some are addressed in the strategy but all underpin the pursuit of infinite economic growth together with collective and individual distinction. They are the social constructs that encroach on self-worth.

A National Strategy for the Prevention of Suicide appears laudable. Yet it would be absurd, if corresponding social and economic policies contributed, however obliquely; to inspiring potentially vulnerable people to regard death as an option for resolving problems of living.

Alun Jones

Copyright Community Psychiatric Nurses Association Nov/Dec 2002
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