Culture, Medicine, and Psychiatry

, Volume 36, Issue 2, pp 348–371 | Cite as

Mad, Bad or Heroic? Gender, Identity and Accountability in Lay Portrayals of Suicide in Late Twentieth-Century England

  • Christabel OwensEmail author
  • Helen Lambert


Suicide research has relied heavily on the psychological autopsy method, which uses interviews with the bereaved to ascertain the mental health status of the deceased prior to death. The resulting data are typically interpreted within a clinical diagnostic framework, which reinforces psychiatric assumptions concerning the ubiquity of mental illness amongst those who take their own lives. The ways in which informants reconstruct the past and the meanings they attach to events preceding the suicide are rarely examined. This paper uses qualitative methods to analyse the narratives given by bereaved people in an English psychological autopsy study, in order to understand how they made sense of a family member’s suicide. Some clear differences between the portrayal of male and female suicides emerged. The paper discusses the gendering of agency and accountability in relation to the differential medicalisation of male and female distress in the UK, and suggests that a preoccupation with mental illness in suicide research may have obscured other culturally normative understandings of self-accomplished death.


Suicide Bereaved Gender Psychological autopsy Qualitative 



Thanks are due to our colleagues Jenny Donovan and Keith Lloyd, who collaborated on the qualitative study and assisted with earlier stages of analysis.


  1. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Washington, DC: American Psychiatric Association. Google Scholar
  2. Barraclough, B, et al. (1974) A Hundred Cases of Suicide: Clinical Aspects. Br J Psychiatry 125:355-373. CrossRefGoogle Scholar
  3. Beskow, J, B Runeson, and U Asgard (1990) Psychological Autopsies: Methods and Ethics. Suicide Life Threat Behav 20(4):307-323. Google Scholar
  4. Boddy, J (1994) Spirit possession revisited: Beyond instrumentality. Annual Review of Anthropology 21:407-34. CrossRefGoogle Scholar
  5. Burrows, K (2010) Warriors and survivors: Constructing the gendered cancer patient as hero. Intersections. Women’s and Gender Studies in Review across Disciplines 8:14-36. Google Scholar
  6. Bury, M (2001) Illness narratives: fact or fiction? Sociology of Health & Illness 23(3):263-285. CrossRefGoogle Scholar
  7. Busfield, J (1983) Gender, mental illness and psychiatry. In Sexual Divisions: Patterns and Processes. M. Evans and C. Ungerson, eds. London: Tavistock. Google Scholar
  8. Canetto, SS (1992) Gender and suicide in the elderly. Suicide Life Threat Behav 22(1):80-97. Google Scholar
  9. Canetto, SS, and I Sakinofsky (1998) The gender paradox in suicide. Suicide Life Threat Behav 28(1):1-23. Google Scholar
  10. Cavanagh, JTO, et al. (2003) Psychological autopsy studies of suicide: a systematic review Psychol Med 33:395-405. CrossRefGoogle Scholar
  11. Chesler, P (1972) Women and Madness. New York: Doubleday. Google Scholar
  12. Connell, RW (2005) Masculinities. 2nd Edition Cambridge: Polity Press. Google Scholar
  13. Conrad, P, and J W Schneider (1992) Deviance and Medicalization: From Badness to Sickness. Philadelphia: Temple University Press. Google Scholar
  14. Department of Health (2002) Tackling health inequalities. London: Department of Health. Google Scholar
  15. Dorpat, T L, and H S Ripley (1960) A study of suicide in the Seattle area. Compr Psychiatry 1:349-359. CrossRefGoogle Scholar
  16. Foucault, M (1971) Madness and Civilization: A History of Insanity in the Age of Reason. London: TavistockGoogle Scholar
  17. Frank, A (1995) The Wounded Storyteller: Body, Illness and Ethics. Chicago: University of Chicago Press. Google Scholar
  18. Geertz, C (1973) The Interpretation of Cultures. New York: Basic Books. Google Scholar
  19. Hawton, K, et al. (1998) The psychological autopsy approach to studying suicide: a review of methodological issues. J Affect Disord 50:269-276. CrossRefGoogle Scholar
  20. Hjelmeland, H (2010) Cultural Research in Suicidology: Challenges and Opportunities. Suicidology Online 1:34-52. Google Scholar
  21. Holstein, JA, and JF Gubrium (2000) The Self We Live By: Narrative Identity in a Postmodern World. New York & Oxford: Oxford University Press. Google Scholar
  22. Hydén, L-C (1997) Illness and narrative. Sociology of Health & Illness 19(1):48-69. Google Scholar
  23. Ingelby D (1982) The social construction of mental illness. In P Wright, A Treacher (eds) The Problem of Medical Knowledge: Examining the Social Construction of Medicine. Edinburgh: Edinburgh University Press, pp 123-143Google Scholar
  24. Isometsa, E T (2001) Psychological autopsy studies - a review. European Psychiatry 16:379-385. CrossRefGoogle Scholar
  25. Jones, GA, E Herrera, and ST de Benitez (2007) Tears, Trauma and Suicide: Everyday Violence among Street Youth in Puebla, Mexico. Bulletin of Latin American Research 26(4):462-479. CrossRefGoogle Scholar
  26. Jones, J (1962) On Aristotle and Greek Tragedy. London: Chatto & Windus. Google Scholar
  27. Jordanova LJ (1981) Mental Illness, Mental Health: Changing Norms and Expectations. In: CWSS (ed) Women in Society. London: Virago, pp 95–114Google Scholar
  28. Katz S (1997) Secular morality. In A. Brandt, P. Rozin (eds) Morality and Health. New York: Routledge, pp 297–330Google Scholar
  29. Kelly, MP, and H Dickinson (2008) The narrative self in autobiographical accounts of illness. The Sociological Review 45(2):254-278. CrossRefGoogle Scholar
  30. Kittrie NN (1971) The Right to Be Different : Deviance and Enforced Therapy. Baltimore: Johns Hopkins PressGoogle Scholar
  31. Lakoff, G, and M Johnson (1980) Metaphors We Live By. Chicago & London: Chicago University Press. Google Scholar
  32. Lewis, IM (1971) Ecstatic religion : an anthropological study of spirit possession and shamanism. Harmondsworth: Penguin. CrossRefGoogle Scholar
  33. Marsh, I (2010) Suicide: Foucault, History and Truth. Cambridge: University Press. Google Scholar
  34. McAdams, DP (1993) The Stories We Live By: Personal Myths and the Making of the Self. New York & London: Guilford Press. Google Scholar
  35. Murchison, J (2010) Ethnography essentials: Designing, conducting, and presenting your research. San Francisco: Jossey-Bass. Google Scholar
  36. O’Brien, R, K Hunt, and G Hunt (2005) ‘It’s caveman stuff, but that is to a certain extent how guys still operate’: men’s accounts of masculinity and help seeking. Soc Sci Med 61:503-516. CrossRefGoogle Scholar
  37. Oliver, MI, et al. (2005) Help-seeking behaviour in men and women with common mental health problems: cross-sectional study. Br J Psychiatry 186:297-301. CrossRefGoogle Scholar
  38. Owens, C, et al. (2003) Suicide outside the care of mental health services: a case-controlled psychological autopsy study. Crisis 24(3):113-121. CrossRefGoogle Scholar
  39. Owens, C, et al. (2008) Tales of biographical disintegration: how parents make sense of their sons’ suicides. Sociol Health Illn 30(2):237-254. CrossRefGoogle Scholar
  40. Owens, C, et al. (2009) Public involvement in suicide prevention: understanding and strengthening lay responses to distress. BMC Public Health 9:308. CrossRefGoogle Scholar
  41. Oxford English Dictionary 1989 Online Version December 2011.; Accessed 23 February 2012. Earlier version first published in New English Dictionary, 1898
  42. Parsons, T (1951) The Social System. New York: The Free Press. Google Scholar
  43. Pearson, V, and M Liu (2002) Ling’s Death: An Ethnography of a Chinese Woman’s Suicide. Suicide Life Threat Behav 32(4):347-358. CrossRefGoogle Scholar
  44. Pilgrim, D, and A Rogers (1999) A Sociology of Mental Health and Illness. Buckingham: Open University Press. Google Scholar
  45. Pope, C, S Ziebland, and N Mays (2000) Analysing qualitative data. In Qualitative Research in Health Care. 2nd edition. C. Pope and N. Mays, eds. London: BMJ Publishing. Google Scholar
  46. Porter, R (2002) Madness: A Brief History. Oxford: University Press. Google Scholar
  47. Riessman, CK (1993) Narrative Analysis Newbury Park, Ca. & London: SageGoogle Scholar
  48. Romanucci-Ross L (1983) On madness, deviance, and culture. In L. Romanucci-Ross (ed) The Anthropology of Medicine. New York: Praeger, pp. 267-283. Google Scholar
  49. Sanborn, D E, and C J Sanborn (1976) The psychological autopsy as a therapeutic tool. Dis Nerv Syst 37:4-7. Google Scholar
  50. Scull, A (1979) Museums of Madness: The Social Organisation of Insanity in Nineteenth-century England. London: Allen Lane. Google Scholar
  51. Seale, C (1995) Dying alone. Sociol Health Illn 17(3):376-392. CrossRefGoogle Scholar
  52. Seale, C (2002) Cancer Heroics: A Study of News Reports with Particular Reference to Gender. Sociology 36(1):107-126. CrossRefGoogle Scholar
  53. Shneidman, E S (1981) The psychological autopsy. Suicide Life Threat Behav 11(4):325-340. Google Scholar
  54. Shorter, E (1997) A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. Chichester: Wiley. Google Scholar
  55. Showalter, E (1987) The Female Malady: Women, Madness and English Culture, 1830-1980. London: Virago. Google Scholar
  56. Sontag, S (1991) Illness as Metaphor. Harmondsworth: Penguin. Google Scholar
  57. World Health Organization (1992) The ICD-10 International Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organization. Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Peninsula Medical SchoolUniversity of ExeterExeterUK
  2. 2.Department of Social MedicineUniversity of BristolBristolUK

Personalised recommendations