Community-based suicide prevention in Scotland: Mobilising the social within psychiatric epistemologies

This paper presents on-going ethnographic research with people who have attempted, been bereaved by, or work in areas that respond to suicide. Drawing from anthropology (Kleinman, 1988; Chua, 2012; Jenkins 2013) and critical suicidology (Marsh, 2010; Chandler, 2020), this paper outlines tensions that arise as peer led responses to suicide work with and challenge clinical forms of mental health care.

For over a century, suicide has been largely constructed within the epistemology of psychiatry. People who experience suicide attempts are seen as pathologically ill and irrational (Tack 2019; White et al. 2016; Marsh et al., 2021). Statutory responses to suicide reflect contradictory logics of care and control. They focus on individual interventions like pharmaceutical medication, psychological therapies, or in some cases techniques of surveillance and restraint, which are delivered by psychiatrists, GPs, the police, and suicide prevention organisations.

The often brutal, legalistic ways that people who have attempted suicide are treated by law enforcement and hospitals has motivated Scottish citizens to launch peer-led responses that engage in social and community-based care. These lived experience-led groups challenge dominant discourses that frame grief and suicidality as departures from, rather than part of, normal life, by conceptualising suicide within both discourses of mental illness as well as the affective, social and cultural worlds in which they take place. Statutory services have an ambivalent relationship to these peer-led responses just as community-based organisations harbour resentful attitudes towards state mental health care which they see as neglectful and sometimes abusive.