A qualitatively-driven sociological autopsy of 100 suicides Jonathan Scourfield Ben Fincham Susanne Langer

The development of sociological research on suicide Durkheim and the social context of an ostensibly individual act. Social facts about suicide rates and social integration Jack Douglas – we need to understand subjective meanings to social actors J. M. Atkinson – the coroners common sense construction of a suicide case

Psychological and sociological autopsy studies The tradition of psychological autopsy studies of suicide The study of individual suicides is generally seen as irredeemably psychological The term social autopsy used by Klinenberg to mean the macro-level social and political context (of a disaster – the Chicago heat wave) Duneier claims that Klinenbergs work succumbs to the ecological fallacy by not finding out about individuals stories Can there be a qualitative sociology of individual suicides - the study of both what we know about suicidal lives and the knowledge itself?

Multi-modal data on individual suicides Coroners files on 100 cases – a district which includes a medium-sized city, an industrial town and a rural area [also: a small number of in-depth cases: interviews with relatives, friends and professionals Media accounts]

Diverse data in case files Data which are multi-modal, though not multi- media Forms filled out by coroner Scribbles on file wallets Police statements from witnesses and significant others Forensic pathology reports Medical letters and reports, especially psychiatric ones Suicide notes Mobile phone records Photographs Other: letters to the coroner, newspaper clippings

Ethical implications of working with suicide case files The challenge of preserving both anonymity and context Access to the files The emotional well-being of the researcher

The analytical implications of working with diverse documentary data The files reveal the following kinds of evidence about the social context of suicide: The preoccupations of the deceased in the days leading up to the suicide. Perhaps also some longer-term social history The medicalisation of suicide – concentration on diagnosis even where the social context is compelling The impact on families and friends Lay beliefs about mental health problems Theoretical implications – the need for a holistic and psycho-social approach. Cautious naturalism (Fine, 1997) Making explicit where interpretation comes from – making analysis visible.

How do we make sense of accounts of suicide in coroners files? The conditions under which the accounts are constructed. What we do and do not know. We have to work with tensions within and between sources – recognise them and resolve them or incorporate them where possible. Not just case studies. We have 100 of these, so some quantification will also be needed.

Qualitatively-driven mixed methods via N-vivo and SPSS N-vivo attributes are often quantified, but nodes can be too Code whole cases under themes (nodes) On the N-vivo Project Pad, click documents in the menu bar at the top, then Profile coding for all documents and then number of passages. This produces a table that can be exported to SPSS (click file then export).

An example of quantified coding Relationships problems etc * Problems related to children Crosstabulation %6.7%100.0% %52.7%100.0% %32.0%100.0% Count % within relationships problems etc Count % within relationships problems etc Count % within whole sample no yes Relationship problems etc Total noyes Problems related to children Total

Final thoughts. A qualitatively-driven approach to sociological autopsy can be: Both case-based and variable-based Inductive more than deductive Encompassing tensions and even contradictions in data rather than eliminating them, to provide messy, not smooth accounts (Law, 2004).

References Atkinson, J.M. (1978) Discovering Suicide. Studies in the Social Organization of Sudden Death. Pittsburgh, PA: University of Pittsburgh Press.. Douglas, J. (1967) The Social Meanings of Suicide, Princeton, Princeton University Press. Duneier, Mitchell (2006) Ethnography, the ecological fallacy, and the 1995 Chicago Heat Wave. American Sociological Review 71: Durkheim, E. (2002 [1897]) Suicide, London, Routledge. Fine, G. A. (1997) Scandal, social conditions and the creation of public attention: Fatty Arbuckle and the Problem of Hollywood. Social Problems, 44 (3): Klinenberg, E. (2002) Heat Wave: A Social Autopsy of Disaster in Chicago, Chicago, Chicago University Press. Law, J. (2004) After Method: Mess in Social Science Research, Routledge, London Mason, J. (2006) Mixing methods in a qualitatively-driven way. Qualitative Research, 6 (1): 9-25.