Suicide and New York Essay

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Crisis 2011; Vol. 32(2):61–64
© 2011 Hogrefe Publishing

Cultural Context Is Crucial in Suicide Research and Prevention
Heidi Hjelmeland
Norwegian University of Science and Technology, Trondheim, and Norwegian Institute of Public Health, Oslo, Norway
According to Geertz (1973), “. . . there is no such thing as a human nature independent of culture . . . We are . . . incomplete or unfinished animals who complete or finish ourselves through culture . . .” (p. 49). And, in the words of
Markus and Hamedani (2007), “. . . biological beings become human beings through their engagement with the meanings and practices of their social world . . .” (p. 32).
Thus, the sociocultural context is crucial to peoples’ lives, which inevitably means that it also plays a crucial role in suicide. If we want to understand suicidal behavior and suicidal people, it is absolutely essential to take the cultural context into consideration in all kinds of suicidological research (e.g., Hjelmeland, 2010; Hjelmeland & Knizek,
2010; Hjelmeland & Knizek, in press). This should be selfevident. However, it turns out not to be, and in an endeavor to include a cultural perspective in suicidological research we face a number of challenges – conceptual, theoretical, methodological, ethical, and political challenges (Hjelmeland, 2010). One of the most important challenges, and the one to be discussed here, might be the current “biologification” of suicidology.
Among other sciences, psychiatry is one of the most prominent premise providers for suicidology; and there is no doubt that psychiatry, as well as behavioral sciences, have recently developed in a more biological direction
(Brinkmann, 2009). Thus, studies on biological factors
(e.g., genes, endophenotypes, neurotransmitters) are presently in demand (e.g., Mann et al., 2006), researchers are now describing the “suicidal brain” (e.g., Desmyter et al.,
2011), and various kinds of brain-imaging techniques are developing fast and maintained to be important also in suicidology. For example, Mann (2005) stated that “The clinician needs to know which depressed patient is at risk for suicide, and one promising direction is to begin using brain imaging to measure the predisposition to suicidal behavior
. . .” (p. 102). With this, we face some ethical challenges.
For instance, when and how is the information produced in such studies going to be used? If you are told that you have
© 2011 Hogrefe Publishing

a biological predisposition to suicide (or not), this information will inevitably have consequences for both you and your family and friends (Hjelmeland & Knizek, in press).
Moreover, such studies have their limitations. For instance,
Restak (2006) pointed out that correlations found in brainimaging research frequently – and inappropriately – are interpreted in terms of cause and effect relationships.
Furthermore, with the new brain-imaging techniques, psychiatry, and with it suicidology, may be heading toward (or back to?) a very mechanistic view of human beings. A potential consequence of finding biological markers for suicidal behavior is that this makes it rather easy to think of medication as the best/cheapest/easiest possible treatment available.
It may be considered easier to treat what is often referred to as “a chemical imbalance in the brain” with chemicals instead of spending a lot of resources on unveiling the reason(s) for this “imbalance,” which very well may be found in the person’s sociocultural environment, so that the patient should therefore rather be treated with alternative therapies. Take the current debate about whether the increased use/sales of antidepressants contributed to, or even caused, a reduction in suicide rates (e.g., Isacsson, Rich, Jureidini, & Raven, 2010).
Even though, according to Jureidini and Raven, the evidence base for such a relationship has proven methodologically weak, Isacsson and Rich maintain