Re-inventing the "cry for help":attempted suicide in Britain in the mid twentieth century c1937-1969

Abstract

After 1945 in Britain there emerges an ‘epidemic’ of ‘attempted suicide’ that is read as not aiming at death exclusively, but is instead a form of communication – a ‘cry for help’. This ‘epidemic’ consists predominantly of young people (increasingly gendered female) who present at general hospitals after having taken an amount of medication that is deemed excessive, but insufficient to kill them. This thesis places this ‘epidemic’ into historical context by looking at two interlinked developments in healthcare provision in Britain. First, models of mental healthcare provision change. With mental health included in the NHS, provision slowly and unevenly moves away from the geographically remote asylum, and into general hospitals and ‘the community’. The legislative high point of this process is the 1959 Mental Health Act, removing all legal barriers to mental treatment in general hospitals. This enables consistent psychological scrutiny upon patients presenting at general hospitals. This is cemented by the Suicide Act 1961 which decriminalises suicide and attempted suicide, and is swiftly followed by a government memorandum asking hospitals to ensure that all ‘attempted suicide’ patients presenting at casualty receive psychiatric assessment. The second development is in psychiatric thought, moving towards a socially-focused model of the causation of mental disorder. This is underpinned by broad concepts of ‘mental stress’ which enable pathology to be located in social relationships and social situations. This is achieved through much intellectual and practical labour, with psychiatric social workers carrying out home visits and follow-up, as well as interviewing friends, relatives and even employers, in order to construct a ‘social constellation’ around the ‘overdose’. Thus, the increased scrutiny at general hospitals recasts that presenting ‘physical injury’ as a symptom of a disordered social situation, and a communication with a social circle: ‘a cry for help’, newly possible on a nationwide scale