Suicide in Gaol: The Construction and Measurement of a Phenomenon

The Royal Commission into Aboriginal Deaths in Custody has brought the issue of inmate death, especially suicide, to public attention. This paper examines theoretical accounts and existing research on suicide during imprisonment. Current international findings on the characteristics of inmate suicide are discussed and compared with the findings from the first Australian study of death in prison. It is argued that the extant research on suicide presents a fragmented and incomplete account of the phenomenon. Further, the theoretical construction of suicide within international and local research and the methodological approach to its measurement contribute to the obfuscation of specific aspects of the phenomenon. In particular, attention is deflected from the policies and procedures within the institution. Suggested remedies for reducing the incidence of inmate suicide are thus constrained by the initial construction of the issue. The paper concludes with a discussion of the challenges posed for the Royal Commission into Aboriginal Deaths in Custody. This is contrasted with the need for comprehensive accounts of death in custody which apply to all inmates.     

The Association of Suicide Rates with Individual‐Level Suicide Attitudes: A Cross‐National Analysis*

Objective. Research on the predictors of individual‐level attitudes toward suicide has neglected the possible role of contextual‐level predictors. The present study addresses this gap in the literature by assessing the association between suicide rates and the attitudes of individuals. Based on social learning theory, it is argued that persons socialized in nations with relatively high rates of suicide are more likely to be exposed to suicidal role models, which provide positive definitions of suicide. Methods. Data refer to 40,873 adults in 31 nations, and are taken from the World Health Organization and World Values Surveys. Given the bi‐level nature of the data, hierarchical linear modeling techniques (HLM) are utilized. Additional predictor variables are incorporated from previous research and include religious participation and political orientation from social learning theory, marital status and life satisfaction from control theory, and basic demographics such as age and gender. Results. The results of the HLM indicate that controlling for individual‐level predictors, as well as other Level 2 variables, persons residing in nations with relatively high suicide rates are more approving of suicide than their counterparts. The model was replicated for the prediction of support for euthanasia. A social learning perspective was further supported by results linking 1970 suicide rates with suicide acceptability among older adults in 1990. Conclusion. National suicide rates are predictive of individual‐level suicide acceptability. However, the main predictors of suicide acceptability included a measure from social learning theory, religiosity, and a neglected measure of control theory, life satisfaction.     

Suicide prevention in Bangladesh: The current state and the way forward

Despite the World Health Organization's (WHO) call to adopt a national action plan on suicide, Bangladesh is yet to respond proactively to prevent this serious public health problem. The existing government and non‐government prevention interventions are very limited, segmented and almost invisible. Suicide (including attempted suicide) is currently a criminal offense under the Bangladeshi legal framework. The aim of this paper is to propose a framing toward a national suicide prevention action plan in Bangladesh based on a situational analysis of local existing suicide prevention interventions. International policy documents, empirical and review works, and legal documents that speak to suicide interventions were reviewed. Critical analysis of these interventions suggests that Bangladesh should prioritize the adoption of a multi‐sectoral suicide prevention action plan. The issue of decriminalization suicide should be carefully considered and policies harmonized before adopting the plan. Obtaining commitment from the policymakers to launch such intervention may be challenging. Considering the seriousness of the problem, Bangladeshi policymakers should be proactive in adopting a suicide prevention action plan. Neighboring countries provide useful lessons of the implementation measures that may assist with developing a suicide prevention action plan.     

Research with Older Adult Methadone Clients: The Importance of Monitoring Suicide Ideation

ABSTRACT

This study reports on the importance of monitoring suicide ideation among older adult research participants. A recently completed randomized controlled trial of older adults who are current clients in methadone maintenance treatment (MMT) served as a case study to elucidate a suicide protocol that was designed to account for the potential instances of suicide ideation within the research project structure. As the numbers of older adult heroin users increases, this study’s findings seek to influence research protocols that involve older adults with addictions who may be particularly vulnerable to suicide risk due to comorbid psychiatric conditions and psychosocial adversities.     

The Politics of Hope and Despair: The Effect of Presidential Election Outcomes on Suicide Rates*

Objectives. This article examines the effect of election outcomes on suicide rates by combining the theory of social integration developed by Durkheim with the models of rational choice used in economics. Methods. Theory predicts that states with a greater percentage of residents who supported the losing candidate would tend to exhibit a relative increase in suicide rates. However, being around others who also supported the losing candidate may indicate a greater degree of social integration at the local level, thereby lowering relative suicide rates. We therefore use fixed‐effects regression of state suicide rates from 1981 to 2005 on state election outcomes during presidential elections to determine which effect is stronger. Results. We find that the local effect of social integration is dominant. The suicide rate when a state supports the losing candidate will tend to be lower than if the state had supported the winning candidate—4.6 percent lower for males and 5.3 percent lower for females. Conclusion. Social integration works at many levels; it not only affects suicide risk directly, but can mediate other shocks that influence suicide risk.     

The problem of inadequately relieved suffering

A request for euthanasia or assistance in suicide usually derives from severe patient distress and indicates significant suffering. Although the Hippocratic purview of medicine requires that suffering be acknowledged, its causes be identified, and that steps be taken to provide adequate relief, an appreciation of the diversity of factors that may contribute to suffering underscores the need for methodical assessment and familiarity with a range of therapeutic strategies. It may be argued that when other options to effectively relieve suffering are available, euthanasia and assisted suicide fall outside of the purview of Hippocratic medicine. Given the existence of other options, the capacity for human maleficence, and the lack of resources currently allocated to the relief of suffering, this paper presents a number of reservations regarding the legalization of euthanasia and assisted suicide. In addition, it is suggested that the current community focus on the issue of inadequately relieved suffering should be harnessed to work toward the provision of care that would diminish the impression that elective death is necessary to ensure adequate relief.     

Impact of Social Service Expenditures on the Suicide Rate: The Cases of Asia Countries

An empirical study reported that the economic crisis in European countries affected their suicide rates and described that an increase in social services expenditures of US$10 per person in labor market programs impacted the decrease in unemployment suicides by 0.038%. However, there has no study that the economic crisis in Asia countries affected their suicide rates. Since 2008, South Korea has been ranked first for suicide rate in the OECD countries. Many studies have blamed the economic crisis that followed from the US financial crisis in 2007 as the critical cause. However, in the case of Japan, the suicide rate decreased in the same time period (2008–2011) even though they faced the same financial crisis. The purpose of this study was to examine why the different situations in Korea and Japan occurred with the economic crisis through testing whether the government’s social service expenditure affects the people’s suicide rate in Asia countries. These efforts will contribute to understanding the critical role of social service.     

A Comparison of Child-sex-abuse-related and Mental-disorder-related Suicide in a Six-year Cohort of Regional Suicides: The Importance of the Child Protection-Psychiatric Interface

Correspondence to: Professor Colin Pritchard, Department of Mental Health, School of Medicine, Southampton University, Royal South Hants Hospital, Southampton SO14 0YG, UK. E-mail: cp1{at}soton.ac.uk Summary The study compares Mental-Disorder-Related (MDR) suicide rateswith Child-Sex-Abuse-Related (CSAR) suicide of ‘Victims’and ‘Perpetrators’ of child sex abuse, based uponan examination of all Coroners’ inquest files over a six-yearperiod (n = 1,017). Census data, psychiatric case register andpolice records were used to calculate the potential MDR andCSAR populations. There were five main findings: (i) male andfemale CSAR victim suicide rates were 2.2. and 2.5 times theGeneral Population Suicide Rate (GPSR), respectively; (ii) everyfemale, and 80 per cent of male CSAR victim suicides, also hada mental disorder but none of the CSAR perpetrator suicides;(iii) male and female MDR suicide rates were 5 and 6 times theCSAR Victim rates; (iv) the sex abuser perpetrators’ suiciderate was more than 3 times the male MDR rate; (v) the intra-and extra-familial perpetrator suicide rates, were 25 and 78times the GPSR, respectively. Possible explanations for thesesurprising results are briefly discussed. They confirm the overrepresentationof people with mental disorder amongst suicides, and identifyan overrepresentation of CSAR suicides, particularly perpetrators.The results have implications for suicide prevention programmes,whilst highlighting the importance of the child protection-psychiatricinterface, and indicates the futility of simple explanationsin an area of practical and moral complexity.     

Rebellion and revenge: the meaning of suicide of women in rural China

The current literature on suicide in China shows that the female suicide rate is extraordinarily higher than the rate for males. Many studies have been conducted on the prevalence and perpetrating factors for suicidal incidents. Few have attempted to understand women's suicide acts. In this article, the ethnographic data are used to explore the special meaning of the suicide act in a Chinese family and its impact on the other family members. Research has shown that suicide may have a different meaning in the Chinese context, especially for women with an inferior status within the family. Suicide is taken as an act of revenge in a moral and spiritual sense. The act of suicide is very powerful; it grants the woman so much power that she may achieve what she could not during her lifetime. The suicide event remains in the collective memory of the relatives and other people who knew the person. Its powerful meaning is related to the memory of the transgressive event of taking one's own life as well as to the collective and personal guilt connected with the event.     

Social integration and suicide: Denmark, 1906–2006

Research on the relationship between social integration and suicide rates has neglected a historical perspective. Analyses are often based on relatively short time periods where there may not be enough variation in integration to affect the national suicide rate, or where overall integration levels are not low enough to buttress a link between a specific index of low integration, such as divorce, and suicide. The present investigation contributes to the literature by testing a hypothesis on domestic integration and suicide over a century, the longest period studied to date, encompassing periods of low and high overall social integration, and emergent risk and protective factors. Data are available for core variables for Denmark, 1906–2006. Annual data include those on suicide, and indicators of integration (divorces, births, marriages), as well as for economic strain (unemployment) and time trends. A log linear Poisson model is estimated, which explores the central divorce–suicide relationship under controls for confounders. Controlling for confounders, a one percent increase in divorce increases male suicides by 0.52% and female suicides by 1.12%. As anticipated, marriages decrease suicide: a one percent increase in marriages reduces suicide by 0.77% for men and by 0.63% for women. The trend in divorce, in particular, offers accurate predictions of suicide throughout the century. The relationship between divorce and suicide over a century is robust. The results offer the strongest support to date in support of a social integration model based on long term historical data on suicide and divorce.     

Protest Suicide: A Systematic Model with Heuristic Archetypes

Suicide as a form of political protest is a little studied social phenomenon that cannot be dismissed simply as being irrational or patholognomic. We consider protest suicide to be a meaningful social action as purposive political act intended to change oppressive policies or practices. This paper synthesizes theoretical propositions associated with suicide in general, and protest suicide in particular, so as to construct a general explanatory model of protest suicide as a social phenomenon. Then, it analyzes protest suicide as a meaningful social action. People considering protest suicide have to discern the logic of the situation in which such action is to take place. This involves answering two fundamental questions: Is suicide an acceptable course of social action? Is the envisaged protest suicide likely to achieve their hopes, aspirations and goals? How these questions are answered gives rise to a set of protest suicide archetypes. Our analysis generates a more sophisticated understanding of the potential reasons for, and motivations behind, protest suicide as a social phenomenon.     

角色危机与社会紧张:民国时期北平平民自杀样本研究

通过考察民国时期北平平民自杀样本的档案,初步分析了自杀者的分类及原因,揭示了北京在民国时期近代化和转型过程中所产生的各种社会矛盾,并从微观的角度展示了当时北平城市基层社会的生活结构。     

个体的自我保存与社会学的现代道德人格属性:《自杀论》中的双重结构

根据涂尔干关于自杀的定义,自杀必然意味着有意识的选择死亡。死亡只有一种对立面,即不死,二者之间没有中间项。所以,当涂尔干在《自杀论》中讨论自杀的时候,同时必然是在隐秘地讨论自杀的对立面,即自我保存。在《自杀论》的中译本中,这一隐秘线索的许多证据都被清除,导致书中“自我保存”这一线索在中文学界没有受到重视。本文尝试通过文本分析的方法来理解涂尔干的这一线索。他将不同类型的自杀视为不同道德的极端表达,在具体分析中常常采用一体两面的视角去讨论行动者在何种道德状态下才可能实现“自我保存”。本文试图通过比较说明,涂尔干对这三种自杀类型的界定,以及通过这一界定所呼吁的道德状态,与他对社会学的界定有内在实质的关联。在这个意义上,对于涂尔干来说,社会学本身即是某种现代道德人格的表达,而这种道德人格对于现代性个体与社会学这门学科来说,都具有自我保存的效力。     

涂尔干:道德本原与现代潮流——以自杀类型为线索

与通常的看法不同,涂尔干的《自杀论》并不是一部通过统计分析达到实证性结论的“科学”著作,在《自杀论》的四种自杀类型背后,有着关于现代社会的完整的病理学分析。本文尝试从自杀类型入手,联系涂尔干有关道德教育与原始宗教的著作,揭示涂尔干有关人性与社会之健康道德本原的思想;另一方面则从文明史的角度出发,结合涂尔干关于法国中等教育史以及政治和法律史的讨论,深入发掘涂尔干对西欧现代社会之源起和演进的思考。在涂尔干看来,正是现代社会潮流的极端化发展,导致社会的种种危机与病态。要克服现代社会的这一危险倾向,必须回到历史来考察现代潮流的源起和演进,才能在变化的现实条件下接续传统,重建人心和道德秩序。     

自杀与现代人的境况——涂尔干的“自杀类型学”及其人性基础

涂尔干在《自杀论》中提出的“自杀类型学”是他对自杀研究做出的一个重要的理论贡献。他通过自杀的社会类型展开的广泛解释和论述,是和其著作中的一些实质问题密切相关的。本文检视了这个类型学的一些关键方面和存在的问题,并结合涂尔干的人性论进行了比较深入的分析,强调了涂尔干社会理论的人性基础;这种分析也表明,涂尔干的自杀类型学是他继《社会分工论》之后对个体与社会关系问题的进一步思考和推进。另外,涂尔干通过对作为社会事实的“自杀潮”的独特的社会病理学分析,深刻揭示了现代人的生存境况。因此,《自杀论》的经典意义在于其将理论图式与时代问题紧密结合起来的研究范式,这充分体现了古典社会理论的本质特征。     

Unemployment and suicide: Panel data analyses

This study uses two panel data sets for both Taiwan and other Asian countries, and employs fixed-effects models to examine the relationship between the unemployment rate and the suicide death rate. The research results in both cases indicate that the suicide death rate moves counter-cyclically with the unemployment rate. At the same time, the death rate for males, those who are older, and those with higher levels of education are relatively high. However, the higher the income, the lower will be the suicide death rate.     

SOCIAL AND FAMILIAL ASPECTS OF ATTEMPTED AND COMPLETED SUICIDE OF YOUNG PEOPLE IN VICTORIA

A prospective study of youth suicide was carried out to determine the causes of the dramatic increase of suicide rates in males 15 to 25 years of age. Comprehensive information was collected through coronial enquiries on all 148 cases of completed youth suicide in Victoria during a 16 month period. Similar data were obtained through in-depth interviews of 105 hospitalised and 101 non-hospitalised attempters. In this paper only social and familial aspects of youth suicide are covered. Whilst the family setting of youth who attempted or completed suicide was similar to that of the general population, a higher proportion were homeless or living alone. Contrary to common assumptions, family relationships were much closer among completed than among attempted suicides. The unemployment rates were not higher than in all young people, and few subjects named unemployment as cause, but a relatively high number of them were neither studying nor looking for work. A high proportion of those who completed suicide had prior contact with the police. In conclusion, social factors do not significantly affect suicidal behaviour in young people.     

Geriatric Case Managers’ Perspectives on Suicide Among Community-Dwelling Older Adults

It has been suggested that clinical screening for suicide, along with firearm assessment and safety counseling, are important in service provision to older adults. It is unclear, however, how geriatric case managers respond to these issues. This study surveyed geriatric case managers (n=161) from Area Agencies on Aging in Ohio on their knowledge, attitudes, and behaviors related to suicide, firearm assessment, and safety counseling. Results indicated that the majority of respondents (70%) agree their clients are at risk for suicide. However, few (30%) in this study reported that they assess for firearms and less than half (48%) discuss firearms with their clients/family members when specifically assessing for suicide. Analyses identified barriers that contribute to the decreased likelihood that routine firearm assessment and safety counseling would occur, such as lack of training and time. Implications include the need for training with geriatric case managers that addresses barriers to suicide, firearm assessment and safety counseling as a means to decrease these population risks.     

Psychological issues in euthanasia, suicide, and assisted suicide

This paper reviews various life-ending techniques such as euthanasia, suicide, and assisted suicide in order to better address the psychological issues related to these actions. Specific attention is paid to investigating when a death is deemed to be appropriate and the role that the level of appropriateness should play in the decisions of individuals to terminate a life. In addition, a number of additional psychological concepts such as locus of control and subjective norms are examined in terms of their importance for decisions regarding euthanasia and suicide.     

Human Capital Attainment and Gender Empowerment: The Kerala Paradox*

Objectives. The State of Kerala in southwestern India shows the highest gender development index in the country. Despite having the highest literacy rate and educational achievements of women, the suicide rate among females is very high, and domestic violence committed against women is increasing every year in Kerala. This article attempts to analyze the demographic, social, and cultural changes that are occurring in order to understand this apparent paradox of high human capital attainment and high violence and suicides experienced by women in Kerala. Methods. The study uses data from the Census of India (1991, 2001) , National Crime Records Bureau (1998–2000), and Reproductive and Child Health ( District Level House Hold Survey—2001 ) to analyze trends in crime, violence, and suicide rates, and demographic profiles of the different districts in Kerala. Results. High educational attainment has fostered new aspirations and attitudes among women in Kerala. Yet, societal and cultural norms still dictate that women should be subservient to men both at home and in the labor market. This imbalance often contributes to family violence and suicides in Kerala. Thus, beneath the veil of development lie some disturbing social, cultural, and economic issues that may be contributing to high rates of suicide and family violence in Kerala. Conclusions. This study demonstrates that high educational attainment alone will not promote gender empowerment unless the social and cultural fabric of a country or state ensures equality of women in all areas of life.