The construction of people in suicide prevention documents

The politics of LGBT+ suicide and suicide prevention in the UK: risk, responsibility and rhetoric

Suicide is a major public health concern, patterned by systematic inequalities, with lesbian, gay, bisexual and trans (LGBT+) people being one example of a minoritised group that is more likely to think about and attempt suicide worldwide. To address this, UK national suicide prevention policies have suggested that LGBT+ people should be prioritised in prevention activities. However, there is little research seeking to understand how LGBT+ suicide is re/presented in political and policy spheres. In this article, we critically analyse all mentions of LGBT+ suicide in UK parliamentary debates between 2009 and 2019 and in the eight suicide prevention policies in use during this period. We argue that LGBT+ suicide is understood in two contrasting ways: firstly, as a pathological 'problem', positioning LGBT+ people either as risks or as at risk and in need of mental health support. Alternatively, suicide can be seen as externally attributable to perpetrators of homophobic, biphobic and transphobic hate, requiring anti-hate activities as part of suicide prevention. In response, we argue that although these explanations may appear oppositional; they both draw on reductive explanations of LGBT+ suicide, failing to consider the complexity of suicidal distress, thus constraining understandings of suicide and suicide prevention.

Self-inflicted. Deliberate. Death-intentioned. A critical policy analysis of UK suicide prevention policies 2009-2019

Purpose

With encouragement from the World Health Organisation, national suicide prevention policies have come to be regarded as an essential component of the global effort to reduce suicide. However, despite their global significance, the construction, conceptualisation and proposed provisions offered in suicide prevention policies have, to date, been under researched; this study aims to address this gap.

Design/methodology/approach

we critically analysed eight contemporary UK suicide prevention policy documents in use in all four nations of the UK between 2009 and 2019, using Bacchi and Goodwin’s post-structural critical policy analysis.

Findings

The authors argue that across this sample of suicide prevention policies, suicide is constructed as self-inflicted, deliberate and death-intentioned. Consequently, these supposedly neutral definitions of suicide have some significant and problematic effects, often individualising, pathologising and depoliticising suicide in ways that dislocate suicides from the emotional worlds in which they occur. Accordingly, although suicide prevention policies have the potential to think beyond the boundaries of clinical practice, and consider suicide prevention more holistically, the policies in this sample take a relatively narrow focus, often reducing suicide to a single momentary act and centring death prevention at the expense of considering ways to make individual lives more liveable.

Originality/value

UK suicide prevention policies have not been subject to critical analysis; to the best of the authors’ knowledge, this study represents the first attempt to examine the way in which suicide is constructed in UK suicide prevention policy documents.

A poststructural analysis: Current practices for suicide prevention by nurses in the emergency department and areas of improvement

AIMS AND OBJECTIVES

To use a poststructuralist framework to critique historical, social and institutional constructions of emergency nursing and examine conflicting discourses surrounding suicide prevention. The aim is to also demonstrate practical guidance for enhancing emergency nursing practice and research with regard to suicide prevention.

BACKGROUND

Emergency departments have been historically constructed as places for treating life-threatening physical crises, thereby constructing other "nonurgent" health needs as less of a priority. Physical needs take priority over psychological needs, such as suicide-related thoughts and behaviours, negatively impacting the quality of care that certain groups of patients receive.

DESIGN

A theoretical analysis of the published literature on the topic of emergency nursing and suicide prevention was conducted and analysed using a poststructuralist framework.

METHODS

Relevant literature on the topic of emergency nursing related to suicide prevention was analysed for a poststructuralist construct of power, language, subjectivity and discourse. Implications to practice and research were identified, as well as expanding emergency nursing using a poststructuralist framework. SQUIRE guidelines were used (see Supporting Information).

DISCUSSION

The emergency department is a critical point of intervention for patients with urgent and life-threatening needs. However, the biomedical model and historical, social, and institutional expectations that influence emergency nurses' beliefs and values do not effectively respond to the needs of suicidal patients. One step to address this issue is to deconstruct the current understanding of emergency nursing as a treatment for only life-threatening physical crises in order to become inclusive of psychological crises such as suicide-related thoughts and behaviours.

RELEVANCE TO CLINICAL PRACTICE

How a poststructural framework can be used to expand emergency care is discussed. Examples include empowering nurses to challenge the "taken-for-granted" emergency nursing and recognizing the health needs that fall outside of the dominant discourse of emergency care.