“Suicide and its prevention” conference, an impression

Cecile aan de Stegge and Manon Parry

On May 19-21, 2022, the conference “Suicide and its Prevention: Contemporary and Historical Perspectives in Nursing, 1890-2020” took place at the Rijksmuseum Boerhaave in Leiden as a starting point for nurses and other mental health workers to engage with research on the history, sociology and philosophy of psychiatry.

This interdisciplinary conference was co-organised with the European Association for the History of Nursing (EAHN) and will result in a special issue of the European Journal for Nursing History and Ethics. The event brought together 26 speakers based in The Netherlands, the United Sates, Belgium, Germany, and the United Kingdom. Alongside historians, these included nurses, nursing scientists, a doctor working with homeless people in Dutch cities, two professors of psychiatry, museum curators, a philosopher, an artist, and suicide prevention professionals such as a student psychologist. People with lived experience of suicidal thoughts or the loss of someone due to death by suicide were among the presenters as well as the audience.

For this brief article, we focus on an impression of the historical contributions. These included Hannah Zeavin’s presentation on the history of the suicide hotline, drawing on her new book The Distance Cure: A History of Teletherapy, framed by presentations on the work of the Dutch helpline and suicide prevention organisation, Buro 113. In his keynote lecture, Ian Marsh introduced an historical overview of changing conceptualisations of suicide and his approach to critical suicidology, which he first published in 2010 (see image).

Slide summarising historical shifts in the conceptualization of suicide
(Courtesy of Ian Marsh)

Chris Millard raised questions about historians’ approaches to categorising failed versus completed suicide attempts, while Georgina Laragy critiqued scholars’ privileging of ‘Political’ suicides over seemingly individual acts that may, in fact, also have had a political dimension – such as protesting the stigma of single motherhood or the punishment of institutionalisation in the poorhouse. Lyndsay Galpin drew parallels between 19th-century Malthusian ideology and contemporary austerity politics, highlighting the role of ideals of masculine self-sufficiency among men driven to suicide by poverty and its associated shame.

Catharina Bakker examined autobiographies, diaries, and novels by former patients across the 20th century to explore changes in the way suicide has been written about and to reveal the impact of suicide attempts on other patients. Considering the impact of the Covid 19 pandemic on the nursing profession and wider society from an historical perspective, Sarah Waters reflected on caregivers’ and nurses’ heightened risk for suicide, and Julie Gottlieb considered the impact of crises, finding that in times of extreme societal stress, such as war, suicide rates have sometimes decreased – although the true figures may be hidden in the data. Although this seems to be the case at this particular moment in the Covid 19 pandemic for the general population overall, rates have risen among nurses specifically.

Exhibitions and public engagement specialist Sarah Chaney addressed the history of the tools and techniques of suicide prevention within asylum settings, turning our attention not only to the ideology but also to the means of restraint. This focus on material culture was further explored by Carine Neefjes of the Museum of the Mind in Haarlem, and artist Jantien de Bruijn, whose installation in memory of her sister is displayed in the new permanent exhibition there. This session was completed by Rijksmuseum Boerhaave curator Mieneke te Hennepe, and curator of the Florence Nightingale Institute, Hugo Schalkwijk, who highlighted historical objects useful for researching nursing history in their collections.

Throughout the conference, the interdisciplinary group as a whole reflected on the need to understand suicide not as an individual issue, but see instead how it is shaped by historical, cultural, and societal factors.  Buro 113 has built a prevention-program with a national agenda 2021-2025 that shifts their focus from the mental health field to address “the whole of society” and calls for a “psychosocial autopsy” after every suicide. This led attendees to discuss whether our societies are open enough about suicide and the degree to which it remains a taboo topic, as well as the historical role of religious, moral, and legal condemnation of suicide as a deterrent – although the full complexity of our discussion on a range of complex issues, including the autonomy of suicidal people and the attitudes of healthcare workers who express concern about their responsibility for preventing suicide, cannot be summarised easily here. Future plans include an educational module for nursing students expanding training resources on this topic and integrating historical perspectives.

We thank the Vrije Universiteit Amsterdam, Academy of Applied Sciences Leiden, Stichting Zuster Vernède, Vitale Delta, 113 Suicide Prevention and GGzVS for their financial support for the conference, and invite readers to visit the conference website where powerpoints and links to the recorded lectures are available online from 20 July onwards.