UK Suicide Prevention Policies Prioritize Surveillance Over Social Change

UK policies fail to identify the social drivers of suicide and instead prioritize surveillance data and social control.

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Suicide prevention policies are a ‘biopolitical surveillance’ playground, according to a new paper in Critical Social Policy by United Kingdom-based authors Alexander Oaten, Ana Jordan, Amy Chandler, and Hazel Marzetti.

The researchers found that suicide prevention policies diminish the complexities of suicidality and frame suicide as a visible, predictable, and 100% preventable object that can be prevented by surveillance and risk management.

“Suicide is often hidden from the gaze of the state and exposes the explicit and inherent uncertainty and contingency which exists in the lives and deaths of citizens. Biopolitical governance responds to this uncertainty through the attempted construction of patterned regularity at the population level. Indeed, there has always been pressure to generate knowledge of suicide which is considered ‘useful’ for the governmental administration of the life of the population and for the scientific prediction of any risks posed to this administration of life,” the authors write.
“Premised on statistical, scientific, and biological knowledge, the biopolitical state seeks to provide security and negate the uncertainty of suicide through population-level surveillance, prediction and risk management. However, as this biopolitical security is concerned with the population as a whole, managing possible and probable events, it is decidedly myopic in terms of individual lives.”

Oaten and colleagues utilize a Foucauldian framework in their critical qualitative analysis to highlight the problematic implications of suicide prevention policy across the United Kingdom’s four nations. They use these findings to argue that each respective nation’s suicide prevention policy is a kind of biopolitical surveillance that limits the opportunity for society to understand suicide within contexts of social injustice.

Wales, Northern Ireland, Scotland, and England each have different but similar approaches to suicide prevention. The authors examined eight of these policies, two from each nation, and analyzed them with Bacchi’s post-structural policy analysis approach called “What’s The Problem Represented To Be (WPR) Approach.” This framework emphasizes six analytical questions for researchers. However, for the scope of their project, the authors prioritized two questions to focus their research.

  1. How has this representation of the problem come about?
  2. What effects are produced by this representation of the ‘problem?’

The researchers explain:

“Using the WPR approach as a guiding framework, the first stage of analysis involved exploratory, in-depth readings of the eight policy documents and open coding of each document supported by NVivo 12 qualitative analysis software. Authors A and D produced reports on themes (including ‘surveillance’), which were discussed amongst the team, with Authors B and C providing additional analysis. This collaborative and ongoing process enabled us to refine and articulate our interpretations.” 

Oaten, Jordan, Chandler, and Marzetti found that across all of the documents, there was a significant interest in scaling-up suicide surveillance across countries and policies—rendering suicide a mental health policy project rather than a human experience.

Indeed, many of the documents felt suicide surveillance was the only way to reduce suicides reliably. As a result, people are turned into “constellations of risk factors” that can be managed and tracked, and communities become at-risk groups that ought to be surveilled and monitored.

Some specific risk factors included:

  • Undiagnosed and untreated mental health problems
  • Alcohol and drug abuse
  • History of deliberate self-harm
  • Being adversely impacted by the recession
  • The recent separation of young men from partners/children
  • Long-term consequences of sexual abuse in childhood adolescence

Some specific high-risk groups included:

  • Young and middle-aged men
  • People in the care of mental health services, including inpatients
  • People in contact with the criminal justice system
  • Specific occupational groups such as doctors, nurses, veterinary workers, farmers, and agricultural workers
  • People with a history of self-harm

However, certain risk factors and high-risk groups “at risk” are frequently hard to measure because they make up so much of the population, reinforcing nationwide governmental suicide surveillance.

In England, the suicide prevention policy highlights that social security offices and unemployment centers would be promising places to identify people at risk of suicide. However, the suggestion misses the mark and prioritizes collecting suicide data and information rather than expressing actual concern, the authors argue.

“Whilst this is tacitly accepted in the policies, there is a failure to acknowledge, let alone address, the political contexts of injustice that produce suicide deaths by benefit claimants. Instead, the Jobcentre was framed as an apolitical site for opportunistic identification of those individuals deemed ‘at risk’, rather than as part of a complex systemic process of injustice.”

The authors conclude:

“A surveillance-centered approach means that even where ‘at risk’ populations are identified and become the subject of surveillance, there is no concrete action to address structural injustices that can place people at increased risk. Instead, the emphasis is simply on identifying predictable risk in order to provide ‘support’ and enhance governance rather than considering why such risk might occur in the first instance; surveillance thus becomes the means and ends of prevention policy.”

Suicide and suicide prevention have been made biopolitical, visible, predictable, and decontextualized in healthcare and political institutions. Indeed, suicide is a complex human behavior that, despite our greatest efforts, has never been predictable or wholly preventable. Rather than addressing influencing factors of suicide like racism and poverty, policies seek to monitor and treat the behavior via pharmaceuticals and involuntary commitments. Unfortunately, both of these responses may actually increase the prevalence of suicidality.

 

 

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Oaten, A., Jordan, A., Chandler, A., & Marzetti, H. (2023). Suicide prevention as biopolitical surveillance: A critical analysis of UK suicide prevention policies. Critical Social Policy, 02610183221142544. (Link)

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