Why a feminist perspective?
By: Dr Sarah Gillborn
The necessity of using a feminist perspective to study suicidality among nurses.
As Dr Ruth Riley notes, to understand suicidality among women nurses, we must investigate the political, social, and economic conditions that nurses work and live within. The most common ways of investigating suicidality tend to focus on women as distressed and ill individuals. This ignores the oppressive conditions that affect women’s lives. On the other hand, feminist approaches to research focus on the importance of political and structural conditions. Using this approach means that we can explore issues such as violence and discrimination, poor working conditions, race and gender inequalities and other issues that contribute to women nurses’ distress.
Most often, research methods focus on the personal at the expense of the political. Even in interview studies, which are often assumed to be more attuned to wider conditions, suicidality may be seen as being related to an inherent cognitive shortfall or mental illness. Using feminist methods guides researchers to take a wider view rather than be drawn toward the dominant, individualised approach that often takes hold.
We need methods, in nurse suicide research that are based on feminist understandings of the wider political, social, and economic conditions and systems that are relevant. Two such approaches are Foucauldian discourse analysis and feminist relational discourse analysis.
Why study discourses?
Foucauldian discourse analysis draws on philosopher Michel Foucault’s definition of discourses as ‘regimes of truth’ that form and sustain specific power relations. Discourses are ‘ways of talking’ that create a set of ideas about people and phenomena. Using Foucauldian discourse analysis informed by feminist ideas helps us in three ways: it helps us to understand the different ways of speaking about particular ideas or topics to show how these ways of speaking produce and shape knowledge and truth; and reveals what purposes or interests these ideas serve.
For example, in my explanations above and in Dr Ruth Riley’s blog post, we explain how suicidality is often constructed as the result of individual deficits. Understanding suicidality in this way serves to pathologise individual nurses while leaving the contexts, such as violence, discrimination, and poor working conditions, unaddressed. In fact, it is likely to draw on stereotypes – often maintained by men in positions of power - of ‘mad women’ who are prone to hysteria and less likely to handle the usual stresses of work. This victim-blaming paints women’s distress as a disease and maintains the systems that oppress women.
It is, therefore, vital to understand how suicide among nurses is understood by the people who influence public and political thinking in relation to suicide. That way, we can examine who is served by these ideas, and whether they will lead to positive structural change or support the continuation of current mainstream and patriarchal power structures. We can also get a sense of the ideas and stories that are available to nurses themselves who may want to understand nurse suicide. Therefore, we can begin to understand whether suicidality is understood as a structural and political issue or as an indication that something is ‘wrong’ with women. This is important because it will have an impact not only on how nurses seek help, and on their comfort in speaking about this issue more broadly.
Feminist approaches to discourse analysis
Feminist relational discourse analysis offers a more powerful and feminist approach to understanding how ideas around suicidality affect women nurses. First explained by Dr Lucy Thompson and colleagues , from a feminist point of view, Foucauldian discourse analysis can pose problems when seeking to understand individual voices and experiences. While Foucauldian discourse analysis is good at identifying and questioning the ideas that inform policy and public debate on feminist issues, the voices of individual women can be lost; that is, we must be careful not to lose the personal when drawing attention to the political.
Using feminist relational discourse analysis, we can understand the different ways people talk about things, including the main ideas and the alternative viewpoints they use. This approach helps us see the problems with common ideas about suicide, the various challenges women nurses face, and how they can resist these issues. It shows how nurses' experiences and views are shaped by both mainstream ideas and alternative perspectives, and how these ideas about suicide affect them.
Why a feminist perspective?
A feminist perspective is vital for this topic because nurse suicide is a feminist issue. As Dr Ruth Riley highlighted, the suicide rate among women nurses is 23% higher than women in other occupational groups. 89% of nurses are women, and a quarter are from the global ethnic majority. Despite this, the majority of suicide research and policy does not address the topics of gender, race, sexism, and racism.
In April of this year, Unison union published a report revealing that one in 10 NHS health workers reported being subjected to unwanted sexual incidents at work. A further report from the charity BRAP and researchers at Middlesex University revealed that more than 70% of global majority staff who’d been trained in the UK, and 53% who’d been trained abroad, experienced racial discrimination at work. In both reports, this harassment was revealed to be rarely reported due to staff’s concerns about how they would be treated and their lack of confidence that anything would be done. Taken together, these reports reveal everyday environments where racist and sexist behaviours and attitudes are accepted as normal in the NHS. This undoubtably impacts women nurses; yet, these situations are overlooked when discussions and research about suicide focus only on individual women's mental health and ignore the environments they live and work in.
This is why a feminist perspective is necessary; It helps us to focus on the power imbalances and inequalities that harm nurses and then re-traumatise them through silence and inaction. This approach uses an intersectional, feminist perspective to understand the root causes of nurse suicide and supports real, meaningful changes in how we think about suicide and improve women's workplaces.
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