The positioning of women nurses as 'risky' in United Kingdom suicide prevention policy documents: A critical policy analysis

Abstract

Introduction: Women nurses in the global north more likely to die by suicide than women in other occupations. Current suicide research is largely quantitative and individualises and pathologizes nurses. Suicide prevention policy echoes this approach, focusing on individualised risk factors, thereby missing the opportunity to explore contextual, systemic and workplace factors that may contribute to suicide in women nurses. This critical policy analysis explores how distress, suicidality and suicide prevention in women nurses is positioned and constructed in policy and with what political, social and personal consequences. Methods: A critical intersectional feminist design was adopted to interrogate the data and draw out issues pertinent to women nurses. This work was co-produced with women nurses. Bacchi's 'What's the problem represented to be?' method of critical policy analysis to inform the data extraction and analysis. We employed a feminist perspective and adapted Lazar's five principles of feminist discourse praxis. Documents were sourced from governmental and organisational websites and via search engines and were screened against our inclusion criteria. Data was extracted to inform an overview of included documents and for the critical analysis. Results: Nine documents met our inclusion criteria. We found some stark silences in the included documents regarding suicide in women nurses, and in the health services. Suicide is positioned as a problem of risky people, and as a workforce, rather than a workplace issue. Three narratives were developed to convey the core findings of the analysis: Invisible nurses and silenced suicide; People as risky; Responsibilising the workforce. Four themes sit within 'Responsibilising the workforce': Nurses as risky; Knowledge and means; Workforce problems; Workforce solutions. Conclusion: Current policy documents engage a language of risk which pathologizes and responsibilises individuals and minoritised groups as causing high rates of suicide within communities and health workplaces. The impact of socio-economic, political and systemic contexts is overlooked as shaping the lives of suicidal people.