The Curious Case of Suicide Literacy
Date: February 28, 2020
Author: Research Fellow Dr Scott Fitzpatrick
The concept of suicide literacy is a curious one. Not only because of the way it sets limits on the ways we understand suicide, but also because of the way it views literacy. Asked to contribute to a special issue on Critical Suicide Studies, I decided to explore the concept and what it means for suicide prevention communication and education.
At the heart of the issue is a paradox. On the one hand, it is widely believed that a lack of awareness of risk factors leads to poor help-seeking behaviours and low treatment uptake. On the other hand, those with lived experience have often described their experiences of medical care following a suicide attempt as unsatisfactory. In these cases, previous contact with services may actually be a barrier to future help-seeking.
Of course, both of these things can be true and apply in different circumstances. We also know that there are many reasons why people in distress do not seek professional help, especially in regional and remote areas: a preference for self-reliance, existing strong social supports; concerns over confidentiality, lack of transport, long waiting lists, low rates of bulk billing, and so forth.
Another reason, often overlooked, is that people’s views about suicide, its causes, and how best to respond to it, may vary. As those working in the sector have been at pains to point out, suicide is a complex and multifaceted issue, and the reasons given for suicide are many.
Incorporating aspects of mental health literacy and broader health literacy, suicide literacy refers to public knowledge about the causes of suicide, risk factors, treatment and prevention. As with other definitions of health literacy, suicide literacy is linked with specific health actions such as improving knowledge about risk factors and encouraging treatment seeking.
An underlying assumption of this work is that medical knowledge is the most suitable form of knowledge for understanding suicidal distress. Public beliefs and attitudes toward suicide contrast sharply with professional knowledge. User/survivor accounts that do not align with these views are largely seen as deficient.
This is perplexing given that so much of the work of those with lived experience has focused on expanding our understandings of the different ways that suicide is experienced. In doing so, this work has also revealed a number of shortcomings in health professionals’ knowledge and attitudes when working with persons experiencing suicidal distress.
It is important to acknowledge that personal experiences of suicide can, and often do, diverge from expert medical views. This does not mean that they are any less important for individual recovery and wellbeing. Indeed, the notion of recovery has been taken up for this very reason: to highlight the importance of non-medical factors to recovery such as social connectedness, meaning, hope, and living a contributing life.
Indigenous ways of knowing that emphasise historical injustices, culture and spirituality are also distinctive. These provide important ways of understanding suicide whose potential is only now being realised in the creation of suicide prevention programs for First Nations peoples.
Community-driven learning approaches have been used to develop new and creative ways of approaching suicide literacy. This work is directed toward enhancing the responsiveness of suicide education to local needs, histories, cultures, politics and experiences.
In doing so, these approaches take a more democratic view of suicide literacy. Literacy is not understood as a one-way-street, but as a collective effort directed at building knowledge to address the educational needs of both the public and health professionals alike. This corresponds with shifts in thinking about health literacy more broadly, and the view that knowledge is co-produced within and across social contexts.
Understanding a complex issue like suicide requires wide-ranging contributions from health practitioners and the public alike. Skills that enable people to make meaning and exert control over a range of factors that influence and protect against suicide, therefore, are important objectives of literacy programs.
This post is adapted from the article: “Epistemic Justice and the Struggle for Critical Suicide Literacy” published in a special issue on Critical Suicide Studies in the journal Social Epistemology. Copies of the article can be accessed at https://doi.org/10.1080/02691728.2020.1725921 or by emailing Scott at firstname.lastname@example.org