Suicide is a complex issue that touches many lives, and is the concern of a range of social and health-care professionals. It is also an important public health problem, being the “tenth leading cause of death worldwide” (Windfuhr & Kapur 2011: 28). While suicide is strongly related to poor mental health; it is widely understood that suicide often occurs in the absence of a psychiatric diagnosis. Although psychiatry and related mental health professionals have an important role to play in suicide prevention, the complexity of suicide necessitates the involvement of multi-disciplinary researchers and practitioners.
Published last year, Understanding Suicide: A Sociological Autopsy (Fincham, Langer, Scourfield & Shiner 2011) presents research from a broadly sociological (though incorporating other social scientific approaches) investigation of 100 suicide case files from a coroner’s office. The study incorporated both qualitative and quantitative analysis of the files, in an adaption of the more well established psychological autopsy approach to studying suicide. The research findings illuminate important, but often overlooked, social factors relating to suicide:
1. That the group of people most at risk of suicide are men in mid-life.
Fincham et al combine a quantitative analysis of the 100 case files they studied, with official statistics on suicide rates. Through this, they highlight that suicide rates for men peak between the ages of 35 and 45, with suicide being a relatively rare occurrence among young men. However, many suicide prevention programmes have focused on reducing suicide among young men. This reflects an increase in the suicide rate among young men; but obscures the fact that the men in mid-life complete suicide in greater numbers. Fincham et al’s analysis examines the ways that age and stage of life might be implicated in suicides. In particular, they highlight the varying strength and importance of social relationships and social bonds in youth, mid-life and old-age.
2. The importance social relationships in understanding suicide.
A commonly held understanding of suicide is that it is related to social isolation – leading from Emile Durkheim’s pioneering work on the sociology of suicide, which argued that social isolation increased the chances of suicide. However, Fincham et al argue that social relationships – or more accurately, unravelling social relationships – might be a more appropriate way of explaining suicide. Their research found that the deceased in the case files had often recently experienced a break-up in a relationship or had lost contact with their children. This approach to understanding suicide provides one way of explaining the connection between suicide and unemployment, with work being an important source of social relationships – particularly for men, particularly men in mid-life. A related finding was that suicide can be seen as a way of trying to work on social relationships. Analysis of the suicide notes included in just under half of the case files studied suggested that the notes were often used to attempt to heal, create, or sever social ties. Fincham et al suggest that “[r]ather than seeing death as the end … suicide notes can be a means to continue or even to initiate relationships through which agency can be exerted” (p. 89)
3. The role of gender in understanding suicide.
In an earlier paper, Jonathan Scourfield (2005) highlighted the importance of gender in seeking to better understand suicide. Scourfield’s approach emphasised the problematic way in which much previous research on suicide had addressed gender: that is in a rather straightforward way, looking at ‘males’ and ‘females’ as two separate, largely similar groups. In Understanding Suicide, a more nuanced gendered analysis is presented. This takes account of the importance of differences within men and women, rather than focusing on the differences between men and women. Thus, in Understanding Suicide, greater attention is paid to the complex interactions between gender, life stage, and employment, family-life, and intimate relationships.
Each of the above points serves to improve our understandings of why people die by suicide. By examining the role of life-stage, social relationships and gender on individual suicides, Fincham et al propose novel ways of explaining why certain groups of people are more vulnerable to suicide. Additionally, their approach further confirms the usefulness of qualitative approaches to researching suicide. Perhaps most importantly, Understanding Suicide demonstrates the need for wide-ranging approaches to suicide prevention, which incorporate social interventions alongside medical and psychological treatment (p. 185).
This blog draws on an earlier review, published in Network, the magazine of the British Sociological Association (Chandler, 2012).
Dr Amy Chandler
Centre for Research on Families and Relationships University of Edinburgh
Chandler, A. (2012), ‘Understanding Suicide: A Sociological Autopsy, by Ben Fincham, Susanne Langer, Jonathan Scourfield and Michael Shiner, Book Review’, Network, 111, 37.
Fincham, B., Langer, S., Scourfield, J. and Shiner, M. (2011), Understanding Suicide: A Sociological Autopsy, London, Palgrave Macmillan.
Scourfield, J. (2005), ‘Suicidal Masculinities’, Sociological Research Online, 10, 2.
Windfuhr, K. and Kapur, N. (2011), ‘International Perspectives on the Epidemiology and Aetiology of Suicide and Self-Harm’, in O’Connor, R.C., Platt, S. and Gordon, J. (eds.), International Handbook of Suicide Prevention: Research, Policy and Practice, Chichester, Wiley-Blackwell.