Queering human rights-based approaches to suicide prevention: A case study of Scotland's time space compassion introductory guide

Abstract

Human rights-based approaches to suicide have gained global traction after the United Nations’ 2019 call for suicide prevention as an obligation of human rights. These approaches shift from viewing suicide as an individual problem to one rooted in socio-political conditions and societal injustice. In the UK, Scotland is notoriously progressive in its national suicide prevention strategies, championing human rights-based approaches that centre trauma-informed care, multi-sectoral engagement, and lived/living experience. The Scottish Government's Time Space Compassion approach is the country's most recent suicide response strategy. While Time Space Compassion maintains progressive intentions, normative and pathological assumptions permeate its representations of suicide and suicidality. This article utilises ‘queering’ as a methodological tool to challenge the approach's normalised ideals of suicidal time, space, and compassion and argue for a queering of the desire to die that mobilises structural change and capacitates more liveable futures.

Keywords

critical suicide studies human rights-based approach policy analysis queer theory suicide prevention

Introduction

Dominant discourses in contemporary suicidology and suicide prevention largely frame suicide as a medical and pathological problem that must be treated individually (Marsh, 2010; Oaten et al., 2023). These framings locate the onus of suicidality within suicidal people themselves, deflecting attention away from the fluctuating historical, structural, and cultural conditions that make suicide thinkable, possible, and realisable (Ansloos and White, 2025; Marsh, 2016; Mills, 2018; Reynolds, 2016). Strides towards more socio-politically situated suicide prevention efforts have recently taken hold after the United Nations’ 2019 call for a human rights-based approach to suicide. Taking a human rights-based approach to suicide requires prevention strategies to prioritise societal issues, going beyond mental health to centre ‘problems of inequality, homelessness, poverty, and discrimination’ (United Nations Human Rights Office of the High Commissioner, 2019: para. 17). In essence, these approaches shift towards a focus on enhancing liveability, or enhancing the contexts for life. Despite their holistic and socially oriented initiatives, human rights-based approaches are not without their challenges: normative and pathological assumptions of suicide continue to haunt these approaches and the ways in which they construct a certain reality of suicide. This article provides a compelling case study of a human rights-based prevention model being used in Scotland, UK: the Time Space Compassion approach. In this case study, I critically question the limitations of human rights-based models of suicide prevention and argue for the need for alternative, queer/crip suicide care approaches that (re)value suicidal individuals’ autonomy and epistemic authority.

In 2023, the Scottish Government launched the introductory guide to the Time Space Compassion principles and approach, a trauma-informed strategy to improve suicidal crisis in Scotland. This guide ‘is about securing better outcomes for people experiencing suicidal crisis…by focusing on people's experience, human connection and relationships, offering a shared language, resources, and ways to connect and take action together' (The Scottish Government, 2023: 6). The three principles of the guide (time, space, and compassion) attempt to address the immediacy of suicidal crisis, foster safe spaces to seek help, and underscore the importance of building trust with diverse individuals. As the guide delves into these principles, it performs a certain way of representing suicide. Temporally, the rhetoric of ‘crisis’ limits suicide to discrete moments of imminence. Spatially, the guide emphasises examples of structured mental health services, focusing on clinical ideals of recovery. Regarding compassion, it states that there are certain communities whose suicide needs are specific to their experiences, including men, autistic individuals, lesbian, gay, bisexual, transgender, and nonbinary people, those in rural communities, and perinatal women, because they are at a higher ‘risk’ for suicide. In other words, these communities are featured as requiring specific needs because they are ‘risky bodies.’

Time Space Compassion incorporates lived/living experience and demonstrates a progressive global shift towards more intersectional and relational suicide prevention measures. However, questions remain about whose lived/living experience of suicide matters and how lived/living experience is used in suicide prevention efforts, particularly those efforts situated within institutional spaces built on neo/colonialist practices. As mental health service users/survivors attest, those with lived/living experience that challenge the status quo continue to be silenced and excluded within institutions inherently built on neo/colonialist practices, and those with lived/living experience that can further institutional aims are included but disempowered (Clement, 2025; Frederick, 2025; Lindow, 1999). Despite efforts to enhance liveability through a human rights-based suicide prevention model, the discourse of ‘prevention’ still serves the purpose of pathologising suicide as a ‘problem,’ neglecting to consider the ways in which suicide, for some people, is a ‘reasonable’ and ‘legitimate’ response to structural violence and living in an unliveable world (LeMaster, 2022). Furthermore, there are unspoken assumptions as to what ‘liveability’ means in the context of suicide prevention discourse – what sort of lives are these models trying to promote, and for whom?

The purpose of this article is to critically reflect upon the suicidal reality portrayed in Time Space Compassion's introductory guide and consider its three core principles through a queer lens. I aim to:

Dismantle normative temporal assumptions of suicidality and counter crisis rhetoric through an examination of the biopolitical power inherent in isolating an ‘epidemic’ of suicidal ‘crisis.’

Subvert the emphasis on structured mental health services as spaces of care and advocate for the political potential of suicide to enact collective worldmaking through counterpublics and queer relationality.

Critically interrogate methods of identifying ‘at risk’ communities and provide a dynamic understanding of identity using transgender theory and embodied perspectives.

Enhancing liveability for suicidal people goes beyond logics of prevention. It requires interrogating the regimes of normalisation that silence, delegitimise, and enact harm on marginalised groups and ‘othered’ individuals, including those experiencing the desire to die. Recognising the biopolitical regimes guiding our assumptions of suicide and suicide prevention, this article takes a queer approach towards challenging the normative assumptions of suicidality and suicide care practices evident in the Time Space Compassion guide. It moves, instead, towards an adoption of queer community-building by and for suicidal people that counters these regimes and inspires liveability, honoring the complexity of what constitutes a liveable life and not pathologising the desire to die.

Methodology

Through data, queer theory, and my authorial subjectivity, I work to reassemble the text of Time Space and Compassion as a queer project – a project of queering – to reimagine new possibilities of temporality, spatiality, and compassion in approaches towards suicidal care. Particularly, possibilities predicated on the queer praxis of destabilising regimes of normalisation within a heteronormative, colonialist, ableist, and suicidist (Baril, 2018, 2020, 2023) society. Suicidism refers to ‘an oppressive system (stemming from nonsuicidal perspectives) functioning at the normative, discursive, medical, legal, social, political, economic, [religious], and epistemic levels, a system in which suicidal people experience multiple forms of injustice and violence' (Baril, 2018: 193). I will return to this concept of suicidism later in the article, as it forms the crux of the issues of temporality, spatiality, and compassion I outline in the following sections.

Queering as a methodology

This project to ‘queer’ Time Space Compassion arose after an initial reading of The Scottish Government's introductory guide. As a suicide researcher new to Scotland, I sought to familiarise myself with the scope and content of current Scottish suicide prevention strategies. Yet, while reading the guide, something did not sit right with me. The rhetoric of ‘crisis,’ the focus on clinical care spaces, and the repetitive use of ‘risk factors’ felt reductive and oppressive towards my suicidal reality. The guide did not give me the time, space, or compassion to exist as a suicidal person, much less a queer suicidal person. Nor did it allow me to embrace nonnormative dimensions of temporality, spatiality, and identity that give agency and urgency to my very existence as a queer suicidal person.

The idea of ‘queer’ goes beyond the scope of an identity; to ‘queer’ is a way of reshaping the world. To queer as a praxis is to reject ‘toleration or simple political interest-representation through resistance to regimes of the normal' (Warner, 1991: 16). Queering as a political praxis involves recognising the violence and power of heteronormative social systems and actively refusing these regimes of normalisation. As queer academics, we cannot simply ‘be queer,’ we must ‘queer’ as a methodology: queering as a methodology ‘operates … as a refusal of orthodoxy, normalisation, and homogenisation in the domain of knowledge, an approach that delights in revealing the hidden improprieties of disciplinarity and celebrating the perversities it is complicit in erasing (when it is not unwittingly producing them)' (Heike Schotten, 2018: 16).

With the methodology of queering in mind, I reread the introductory guide, paying close attention to its three principles of time, space, and compassion, and how queer theories of temporality, spatiality, and compassion towards identities and communities could apply in each instance. In doing so, I applied the concept of ‘plugging in’ one text into another (Jackson and Mazzei, 2013, 2022). Plugging in emerges from Deleuze and Guattari's (1987) idea that ‘[w]hen one writes, the only question is which other machine the literary machine can be plugged into, must be plugged into in order to work' (4). Plugging in as a process requires one to think through data, in this case, the Time Space Compassion introductory guide, alongside theory to produce new knowledge in becoming (Jackson and Mazzei, 2013, 2022). Moving away from representational attempts to understand what data ‘means,’ plugging in embraces experimentation to see data as a force that does something (Jackson and Mazzei, 2013, 2022). As I creatively encountered, felt, and documented the fragments, ideas, selves, and sensations that emerged in my rereading of the guide, I used plugging in to reassemble Time Space Compassion through queer theories and think the guide otherwise.

Reflexivity

Critical suicide scholarship informs much of the following analysis, and I am ethically committed to viewing suicide as a complex, dynamic experience entrenched in multiple, often contradictory, social and cultural meanings and embodiments (White et al., 2016). My ethical commitment is not only academic but also personal. As someone who has lived/living experience of suicidality and attempted suicide, I have borne witness to the harms of medicolegal suicide discourses and suicide treatment strategies. Being put on suicide crisis watch, confined to clinical treatment facilities, and categorised as a ‘risky body’ are experiences that I lived through. In my attempt to queer the suicidal reality portrayed in the Time Space Compassion guide, I hope to provide an alternative reality that reclaims the desire to die as a way to engender political change and relational possibilities for collective worldmaking.

Findings

Suicidal temporality: The biopolitical power of 'crisis'

Time Space Compassion is explicitly a guide to supporting people in suicidal crisis. Though the guide recognises that crises can happen over time and recommends providers follow up with individuals after initial interventions (The Scottish Government, 2023: 10), the guide's emphasis on crisis rhetoric preserves suicide as a discrete temporal phenomenon. The guide notes that the principle of time means ‘sticking with people over time, being able to offer continuity of support over time and offering ways back in – recognising people may experience recurring poor mental health or crisis over time' (The Scottish Government, 2023: 10). Such notions of ‘prolonged crises’ raise critical questions. When do crises start and end? How long can one experience a ‘crisis’ before the experience becomes part of someone's everyday experience, no longer a crisis but an aspect of the social and structural fabric of routine life?

Suicide is often depicted as an extreme that one ‘gets to the point of’ or ‘gets to the edge of’ (Chandler and Wright, 2024). Yet, people's felt and lived experience of suicidal ‘crisis’ can be banal and ordinary, emerging through the patterns of everyday life (Berlant, 2007; Chandler and Wright, 2024; Jafri, 2021). Critical conceptualisations of crisis view it not as something located in temporal immediacy but as an effect of conditions of privation over prolonged periods (Berlant, 2007; Puar, 2017). ‘Crisis’ emerges through slow death, defined as ‘the physical wearing out of a population and the deterioration of people in that population that is very nearly a defining condition of their experience and historical existence' (Berlant, 2007: 754). Lauren Berlant's (2007) concept of ‘slow death’ works to destabilise discrete temporal understandings of health ‘crises’ and ideas of ‘sovereign’ individual agency amid these crises, conceptualising agency as ‘lateral,’ spaced out, and floating, interrupting the rapid and propulsive force of capitalist temporalities and pulling them into abeyance. In the context of suicide, crisis rhetoric undermines the slow, steady degradation of individuals and their lateral agency under regimes of capitalist subordination and normalisation. Other critical suicide researchers have utilised the concept of slow death to argue that suicide is not a ‘crisis,’ but an embodied reality rooted in the destruction of bodies through heteronormative, paternalistic, colonialist, and capitalist societies wherein individuals must adhere to ideals of productive employment, family life, and material investments (Chandler and Wright, 2024; Jafri, 2021). Suicide prevention approaches that lean towards crisis management misrepresent the temporality, urgency, and scale of the problem ‘by calling a crisis that which is a fact of life’ (Berlant, 2007: 760).

Suicidality can be nonlinear, appearing and then disappearing, only to appear again. Why must suicidality necessitate intervention only when one is on the brink of attempting suicide? The guide emphasises that a ‘timely response’ is necessary in suicidal ‘crises,’ as ‘it is important for people to have clarity on when support will be given, and what they can access and expect’ (The Scottish Government, 2023: 10). But by focusing on crisis, Time Space Compassion offers help when it is already too late for prevention of the suicidal crisis and obscures the structural inequalities felt within everyday life that contribute to these points of ‘crisis’ (Berlant, 2007; Chandler and Wright, 2024).

Professional responses to suicidal crises that emphasise the acute nature of suicide and promote individualised treatments further ignore the broader idea of enhancing liveability as a structural obligation. A queer perspective, in comparison, recognises that the capitalist and colonialist destruction of the suicidal body is not simply a present ‘crisis’ but a long-term ‘ethicopolitical condition’ (Berlant, 2007: 769), and responses to improve liveability for suicidal people must destabilise longstanding systems of privation rather than react to discrete moments of crisis.

The idea of ‘crisis’ likewise operates under assumptions of an ‘epidemic’ of suicide. The concept of an epidemic is not neutral. Epidemics actively classify populations of individuals to allocate causality and responsibility (Berlant, 2007). The rhetoric of crisis and the implicit establishment of an epidemic of suicide effectively enact practices of biopower and biopolitics. Biopower, here, refers to the power to regulate life, to improve life, and to force ways of living that align with normative and colonialist expectations of regimes of power (Foucault, 1998, 2003), and biopolitics maintain diverse techniques that operate to identify what makes a life liveable and which lives count as human (Sawicki, 2015). The notions of suicidal ‘crisis’ and an ‘epidemic’ of suicide that emerge through the language of the Time Space Compassion guide situate suicidality as a biopolitical issue necessitating the subjection of suicidal individuals to heteronormative and capitalist standards of optimising life (Jafri, 2021; Tack, 2019).

The guide suggests that through timely intervention, we can ‘take practical action’ to ‘develop safety plans’ that suicidal people ‘feel in control of and a commitment to’ (The Scottish Government, 2023: 10). In essence, suicidal people are rendered intelligible and only have a right to live if they make a commitment to challenging their desire to die (Puar, 2012; Tack, 2019). Attempts to optimise life through normative assumptions of futurity orient these individuals towards a desire to live attached to a predetermined, naturalised future – one that privileges the livelihoods of those that conform to normative standards such as whiteness, middle-classness, non dis/ability, heterosexuality, and patriarchal ideals – that occludes the possibility of alternative futures (Ahmed, 2006a, 2006b; Marzetti et al., 2023). In effect, these orientations promote the idea that some lives are more deserving of liveability and longevity than others (Butler, 2004; Marzetti et al., 2024).

Notions of an ‘epidemic’ of suicidal ‘crisis’ likewise pathologise suicidal people as part of a dis/abled population and subject them to the temporal assumptions of ableist society (Puar, 2012, 2017). In practice, the guide suggests starting conversations with telling a suicidal person, 'I’m glad you’re here' (The Scottish Government, 2023: 19). The aim is to help people ‘move forward’ in their recovery (The Scottish Government, 2023: 20). Discourses of ‘I’m glad you’re here,’ or ‘it gets better,’ coupled with the rhetoric of suicidal ‘crisis,’ work to push dominant temporal arcs of teleological progress (Browne, 2014; Rice et al., 2017) and neoliberal ideals of recovery and ‘the good life’ that utilise dis/abled and suicidal populations as profitable enterprises (Jafri, 2021; Marzetti et al., 2023; Puar, 2012). These temporal arcs and ideals are based on dominant assumptions of the ‘value’ of bringing colonialist and capitalist narratives of progression to those that are ‘behind’ (Browne, 2014) – suicidal people must change their linear trajectory if they are to be ‘modern’ subjects under Westernised ideals of optimal futurity.

On the other hand, a feminist, crip, queer time (Browne, 2014; Changfoot et al., 2022; Halberstam, 2005; Rice et al., 2017) enables a nonlinear futurity of suicidality that ‘foregrounds the experiential, relational, and discursive aspects of temporal existence’ (Browne, 2014: 26). This temporal framework subverts normative logics of linear suicidality inherent in Time Space Compassion's crisis rhetoric and imagines new possibilities for shifting and nonlinear suicidal temporalities. These queered suicidal temporalities allow for multidirectional, nonnormative futures and recentre the here-and-now, placing importance on present relationalities and communities. In the next section, I will further explore how queer relationality and community care practices can transcend ideals of how individuals should ‘recover’ in the face of suicide.

Spaces of care: Queering suicidal care practices

The principle of ‘Space’ in Time Space Compassion conceptualises spatiality as multidimensional and suggests that providers cultivate accessible and safe environments to offer emotional and psychological spaces for individuals to be heard (The Scottish Government, 2023: 12). Although the guide mentions personal and community spaces of support, these spaces are supplemental to ‘safety planning…distress intervention and anonymous listening services…[and] clinical and medical support’ (The Scottish Government, 2023: 21). The guide provides a diagram of means of support, placing differing support methods along an axis of ‘Informal’ and ‘Structured’ versus ‘Of Community,’ ‘In Community,’ and ‘Alongside Community’ (see Figure 1).

Figure 1.

Map of places of support

While showcasing the numerous support options available to those experiencing suicidality, the labels given to these different forms of support contain implicit biases. For example, Time Space Compassion frequently mentions the importance of developing ‘safety plans’ and, in its suggestions of key resources, lists those available from third sector charities such as Samaritans, Papyrus, and Scottish Action for Mental Health (The Scottish Government, 2023: 21). This wholly structured approach is given precedence, with little attention paid to those seemingly ‘informal’ means of support. In fact, the guide suggests a structured approach is necessary to develop ‘informal’ means of support, stating that, in practice, ‘working with the person to develop their safety plan…unlocks all kinds of ideas about the places people can access informal support’ (The Scottish Government, 2023: 22, emphasis added). Such language implies a paternalist hierarchy wherein those in formal support roles possess the key to accessing informal support within the community.

Time Space Compassion's hierarchy of formal and informal support positions those in formal support systems as the ‘rescuer’ of suicidal people, which then make suicidal people the ‘fixer’ charged with identifying solutions. This positioning suggests that barriers to help-seeking are an individual issue that can be mitigated by providers in formal support roles, and which must be taken up by suicidal people as an individual project. To suggest that informal support must be ‘unlocked’ neglects the agential power of external factors in restricting suicidal people from accessing support. When someone is experiencing suicidality, they may struggle to recognise and find available community support systems, and the reasons for this are complex. Making the responsibility of accessing help-seeking an individual issue ignores the cultural and social barriers that prevent people experiencing suicidality from seeking help and neglects consideration of the broader institutional and structural barriers that prevent access to care.

Further, Time Space Compassion's examples of structural support means that work ‘alongside community’ are those of statutory mental health services, urgent healthcare settings, and ambulances (The Scottish Government, 2023: 23). Though these services can be lifesaving, they are also forms of medicalised containment that enforce punitive standards of control (Foucault, 1965) and ‘compulsory vivation,’ wherein suicidal individuals are kept alive by force through nonconsensual hospitalisation (Krebs, 2022). These forms of support can induce ‘epistemic violence’ (Spivak, 1988) over suicidal individuals by stripping them of their agency and enforcing the state's ‘right to maim,’ or right to debilitate and foreclose legibility and resources to those individuals who threaten the white, heteronormative state (Puar, 2017). In other words, they do not necessarily work alongside the community but often work against the very community they intend to help.

In its emphasis on support spaces offered by providers and medical professionals, Time Space Compassion adopts a hierarchy of what constitutes an ‘appropriate’ environment to address suicide and reinforces clinical approaches towards suicidal care. Using Berlant and Warner's (2002) concept of publics (i.e., those groups organised around dominant discourses of culture and society) and counterpublics (i.e., those ‘queer’ and ‘subversive’ groups that go against the grain of dominant discourses), I suggest that providers and medical professionals using Time Space Compassion comprise a specific ‘clinical public’ that follows the dominant discourses of psychiatric and psychotherapeutic suicide management: discourses that position suicide as a pathological issue (Krebs, 2020, 2022; Marsh, 2010). The clinical public of providers and medical professionals organised around Time Space Compassion's discourses of suicide prevention and recovery assume a universality of their address of suicide as wholly negative and something that must be ‘fixed’ (Krebs, 2020, 2022). In contrast, a counterpublic (Berlant and Warner, 2002; Warner, 2002) of suicidal individuals organised around discourses of suicidality as reasonable and legitimate (LeMaster, 2022) exposes a different way of imagining collective worldmaking and works to queer the desire to die (Krebs, 2022).

To queer the desire to die requires a repoliticisation and reclamation of suicide as a ‘normal’ response to living in Westernised societies of privation (Jafri, 2021; Krebs, 2022) and ‘calls attention to sociocultural oppression that inherently frames some people…as unworthy of living and care’ (Krebs, 2022: 171). Through critical and political consciousness raising (Freire, 2005) of the violences of colonialist, paternalistic, and heteronormative approaches towards suicidal care, a queer imaginary of suicidality and suicidal care practices materialises that rejects normative discourses of suicide as something negative to be ‘cured’ (Jafri, 2021; Krebs, 2022) and allows for the co-production of alternatives to suicide prevention (Marzetti et al., 2025).

By openly expressing suicidality and building a counterpublic of suicidal individuals, those experiencing the desire to die can reclaim interdependence through a queer relationality that embraces historically and culturally specific ways of inhabiting nonnormativities (Jafri, 2021; Krebs, 2022; Yep, 2003, 2017). Queer relationality (Muñoz, 2009; Yep, 2003, 2017) involves possibilities and potentialities for recognition, intelligibility, and intimacy outside of regimes of heteronormativity to encourage collective healing from the affective remains of the emotional and psychic injuries – the epistemic violence (Spivak, 1988) – of traditional suicide care practices.

One tool of queer relationality is access intimacy (Mingus, 2011). Access intimacy is a form of queer/crip solidarity that opposes medicalisation and ableist structures of isolation. It is the feeling of someone ‘getting’ your access needs and responding through intimate relationality (Krebs, 2022; Mingus, 2011). As queer/crip scholar Robert McRuer (2018: 23) states, cripping ‘exposes the ways in which able-bodiedness and able-mindedness get naturalised and the ways that bodies, minds, and impairments that should be at the absolute centre of a space or issue or discussion get purged from that space or issue or discussion.’ The queer/crip tool of access intimacy revalues suicidal people as part of an anti-capitalist, anti-oppressive, anti-sanist queer movement and recentres their presence in spaces of suicidal care (Krebs, 2022).

Care webs (Piepzna-Samarasinha, 2018) further expand the relational scope of access intimacy to queer/crip community care wherein collective knowledge counters the epistemic violence of clinical care systems and dismantles the colonialist, patriarchal hierarchy between ‘healers’ and the ‘sick’ (Krebs, 2022). Queer relationality nurtured through access intimacy and care webs gives suicidal individuals their agency back in the care encounter. Rather than the clinical other asking, ‘Can the subaltern speak?’ (Spivak, 1988), suicidal ‘subalterns’ have the authority to speak on their own terms. Queering the desire to die and queer relationality encourage an honouring of suicidal individuals’ autonomy and knowledge to engender collective queer worldmaking and liveability.

‘Risky bodies’: Turning towards an embrace of suicidal monsters

Who, then, are these suicidal individuals and how are their dynamic, intersectional, embodied identities accounted for in Time Space Compassion? The Time Space Compassion introductory guide emphasises ‘that a person's background, the people around them, their experiences and context (past and present), where they live, their job and other dimensions of their identity, shape their experience of crisis and support’ (The Scottish Government, 2023: 24). Yet, the guide simultaneously operates under the assumption that certain groups of people (i.e., men, autistic individuals, lesbian, gay, bisexual, transgender, and nonbinary people, those in rural communities, and perinatal women) are at greater ‘risk’ for suicide and that practitioners’ awareness of these risk factors is important to provide better care (The Scottish Government, 2023: 25). In practice, it is suggested that ‘[r]eading the latest evidence on risk and protective factors, including how they combine for different people at different stages in their life has helped’ (The Scottish Government, 2023: 25). This quote gives credence to the ‘evidence’ of ‘risk and protective factors,’ without questioning how such factors are ascertained or what may be missing from their generalised assumptions.

The Scottish Government (2022a, 2022b) ascertains risk factors through findings from existing organisational questionnaires and their own dissemination of questionnaires to populations of interest. How can these questionnaires encompass the varied and fluid identities of suicidal individuals? I will take Stonewall Scotland's (2018) LGBT Health Report questionnaire, used to assess suicide risk in LGBTQIA + populations, as an example. While this questionnaire allowed participants to self-identify their gender and sexuality, the report refers to the collective of self-identifying genders as ‘nonbinary’ within its findings, and the self-identified sexualities are not specified in the report except in the form of a statistic (Stonewall Scotland, 2018). This failure to encompass those identities that fall out of prescribed categorisations results in a lacking availability of systemic data on these individuals’ experiences of suicidal distress, leading to ‘statistical invisibility’ of these groups in suicide prevention and policy (Marzetti et al., 2024).

Considerations of the fluid nature of identity are limited in questionnaire data despite self-identification measures, particularly due to the limitations of quantitative reporting of risk factors. This questionnaire is not unique in its misgivings: in many of the quantitative reports of LGBTQIA + suicide, there are issues of homogenising LGBTQIA + identities ‘without considering the multiplicity of identities held by individuals, which may result in them experiencing intersecting oppressions (e.g., homophobia and racism) and geographical variations that have material consequences for suicidal distress' (Marzetti et al., 2024: 89). Such homogenisation poses an issue for not only LGBTQIA + people, but all people grouped into suicidal ‘risk’ categories.

Furthermore, identifying fixed categories of communities as ‘risky bodies’ cannot necessarily get at the varied embodied experiences of those within these communities. ‘Risk’ is often positioned as a decontextualised phenomenon in suicide prevention policies (Marzetti et al., 2023), and this is particularly problematic as it locates the onus of risk within these ‘risky bodies’ themselves. When risk is affixed to these bodies, the structural conditions that contribute to and produce such ‘risks’ fade into the background (Marzetti et al., 2023). In effect, ‘risk’ is ‘stuck’ (Ahmed, 2014) to community members’ bodies: these bodies are themselves seen as inherently suicidal because of their identities (Marzetti et al., 2023).

Alternatively, embodied approaches towards identity move beyond a binary of fixed essentialism and social constructionism to understand identity as an iterative interplay of embodied and constructed entanglements (Barad, 2015; Nagoshi and Brzuzy, 2010). Transgender theory advocates for ‘fluid self-embodiment and a self-construction of identity that would dynamically interact with this embodiment in the context of social expectations and lived experiences’ (Nagoshi and Brzuzy, 2010: 435). Here, identity is not fixed; instead, it is a site of infinite varieties of existence and ongoing becoming (Barad, 2015; Preciado, 2021). Rather than treat the communities identified by Time Space Compassion as static ‘risks,’ a queer, embodied perspective confronts how these communities’ experiences of suicide are dynamic and emerge through historical, social, and cultural contexts and individuals’ lived/living experiences of the world. By encouraging an embodied visibility of difference rather than rendering individuals invisible through hegemonic categorisation and signification of identity through identifiable ‘risk factors,’ one can eradicate constructed boundaries to allow individuals to constitute themselves on their own terms (Barad, 2015; Nagoshi and Brzuzy, 2010; Stryker, 1994).

Using ideas of queer ‘monsters’ (Halberstam, 1995; Preciado, 2021; Stryker, 1994) to reclaim suicidal identities (indeed, it has been my experience that suicidal individuals are often seen as monsters) further offers the potential to disrupt categories of risk and celebrate the unique and monstrous assemblages of suicidal individuals’ identities. Conceptualisations of queer monsters need not be limited to LGBTQIA + identities. All identities have specific embodied realities, self-stories, and social constructions, and in queering these identities, a myriad of possibilities can emerge that allow us to approach people's suicidal realities as complex and rooted in multiple social and cultural meanings and embodiments. In the monstrosity of identity, there is liberation for those suicidal individuals who do not (or do not wish to) fit neatly into categories of risk – those who exist at the borderlands of identity (Anzaldúa, 1987).

Discussion

Living and dying amongst suicidism

Time Space Compassion takes a human rights-based approach to suicide prevention and support (The Scottish Government, 2023), which follows the United Nations’ 2019 call for suicide to be addressed as a human rights obligation. Time Space Compassion is one of the more progressive responses to this call, predicated on the principles of trauma-informed practice and including ‘lived and living experiences of suicidal crisis' (The Scottish Government, 2023: 7). Yet, is trauma-informed practice enough to address the suicidism that exists within an inherently ableist and sanist society? When we include suicidal voices in suicide prevention, whose voices are included, and what are the politics of inclusion? Whose knowledges and realities are left out of suicide policy and practice? As I have outlined, Time Space Compassion perpetuates certain assumptions of suicidal temporality, the spatiality of suicidal care, and which bodies are more ‘at risk’ for suicide. Despite the approach's progressive intentions, these assumptions continue to adhere to normative and suicidist understandings of ‘crisis,’ paternalist treatments and ‘safety plans,’ and notions of ‘risk’ that stick suicidality to identity.

Although Time Space Compassion moves beyond individualist medical and psychiatric conceptualisations of suicide that treat it as ‘a compulsory ontology of pathology’ (Marsh, 2010: 219), the approach retains a preventative discourse that suggests ‘vulnerable’ suicidal individuals must subvert their desire to die (Baril, 2023; Krebs, 2020). This discourse is interlocked with ableist and sanist discourses that revoke suicidal individuals’ agency (Baril, 2023; Krebs, 2020), while simultaneously making it their responsibility to find the means to ‘get better.’ Even when locating suicide in societal and social contexts, the ‘pathology’ of suicide is moved to the socio-political realm, and suicide is still wholly stigmatised and a ‘problem’ in need of fixing (Baril, 2020). In other words, under a preventive discourse, suicidal people's desire to die remains an invalid response to socio-political oppression, and it is suicidal people's responsibility to access support and services to counter this desire to die. Time Space Compassion includes the voices of suicidal people in its approach, but does it listen to these voices and take seriously their concerns and desires? Understandings of how lived/living experience is used in policy development are limited, and the guide does not detail exactly what changes were made as a result of engaging with lived/living experience. When perpetuating suicide as an invalid response, we speak in such a way that encourages a silencing of the desire to die (Baril, 2020). Suicidal individuals need an approach that engages with their realities ‘on terms that affirm their feelings as valid and complex human feelings' (LeMaster, 2022: 392). Time Space Compassion's preventative approach does not necessarily provide suicidal individuals with the time, the space, or even the compassion to feel the realities of their desire to die and embrace these feelings as valid.

Preventative approaches perpetuate the narrative that suicidal people's realities should be prevented: they should ‘get better.’ Time Space Compassion remains entrenched in idea(l)s of ‘normalised’ futures, ‘normalised’ care spaces, and ‘normalised’ risk factors, and these ideals of ‘normalcy’ are determined and enacted through the oppressive forces of biopower and biopolitics. Why is suicide deemed to be ‘not normal?’ Why is it deemed ‘illegitimate’ and ‘unreasonable’ to choose death over life amidst the structural injustices that seethe within our everyday lives? In my attempts to destigmatise suicide, I am in no way advocating for suicide. However, I am encouraging that suicidal people ‘need to be listened to, for real' (Baril, 2020: para. 14). I am advocating for the existence and intelligibility of suicidal people as a heterogenous group with a plurality of experiences and opinions. Listening to suicidal people for real can move us towards mobilising structural changes that facilitate ‘a life worthy of living under late-stage necrocapitalism and climate collapse' (LeMaster, 2022: 392). It is not that we need to ‘reframe’ our prevention models to be more ‘progressive’ using trauma-informed principles and human rights-based approaches; rather, we need to move beyond the limiting discourse of ‘prevention’ to fully embrace the praxis of enhancing liveability. Progression lies in recognising the world as it currently exists is not liveable in for many individuals, taking seriously these individuals’ knowledges and perspectives, and creating, organising, and imagining a world worth living in – by and for suicidal people.

Conclusion

Reflections on queering suicide prevention and research as a suicidal person

Although the Time Space Compassion introductory guide is informed by lived/living experience and approaches suicide prevention using relational and intersectional care methods, its construction of suicidal reality through normative conceptions of suicidal temporality, spatiality, and identity lacks an awareness of the heteronormative, colonialist, and capitalist biopolitical regimes underlying these dominant assumptions of suicidality. Incorporating a queer perspective can enhance understandings of suicide as a dynamic, embodied reality with multiple social and cultural meanings that subtly interact with everyday, felt inequalities. Queering the desire to die allows for the potentiality of counterpublics of queer relationality and collective care focused on enhancing complex and contradictory forms of liveability rather than solely preventing suicide by orienting individuals towards a normative desire to live.

As I navigate critical suicide research as someone with lived/living experience of suicide, I find myself at the crossroads of academic explanations of suicidality and my personal reality. By queering my research practice, I utilise my failure to conform to normative ideals of futurity and a desire to live to offer more creative ways of being in the world to support those like me (Halberstam, 2011) – those who think about suicide daily, those who have been harmed by clinical care practices, and those who do not wish to be seen as ‘risks’ but for who they are as complex individuals. Queer theories provide researchers with the language to reconstitute a political vision of suicidality and reprioritise suicidal individuals’ knowledges and experiences to foster queer worldmaking and liveability. As a critical suicidologist, queering my research not only permits me to destabilise harmful normative conceptions of suicidality but also to make legible my identity as a researcher with lived/living experience of suicide and give that lived/living experience authority. Amidst a suicidist and sanist society, this authority is crucial and is perhaps one step forward towards listening to suicidal people for real.

Copyright statement

Figures contain information licensed under the Open Government Licence v3.0.^® Crown copyright. The author(s) obtained all necessary permissions for reproduction.

Footnotes

The author received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Ruth Chartoff

Author biography

Ruth Chartoff is a lived/living experience critical suicide researcher based at the School of Health in Social Science, University of Edinburgh. She specialises in qualitative and creative approaches towards understanding the social, political, and cultural contexts of suicide, with a specific interest in user/survivor activism and lived/living experience. She is primarily involved in contributing to the landscape of suicide research in Scotland as a Research Assistant on the sociologically and culturally informed Suicide Cultures: Reimagining Suicide Research project.

References

Ahmed

(2006a) Orientations: Toward a queer phenomenology. GLQ 12(4): 543–574.

Ahmed

(2006b) Queer Phenomenology: Orientations, Objects, Others. Durham: Duke University Press.

Ahmed

(2014) The Cultural Politics of Emotion. Edinburgh: Edinburgh University Press.

Ansloos

White

(2025) Critical suicide notes: On witnessing and prefigurative politics. Social Sciences 14(3): 140.

Anzaldúa

(1987) Borderlands/La Frontera: The New Mestiza. San Francisco: Aunt Lute Books.

Barad

(2015) Transmaterialities: Trans*/matter/realities and queer political imaginings. GLQ 21(2/3): 387–422.

Baril

(2018) Les personnes suicidaires peuvent-elles parler? Théoriser l’oppression suicidiste à partir d’un modèle sociosubjectif du handicap. Criminologie 51(2): 189–212.

Baril

(2020) Suicidism: A new theoretical framework to conceptualize suicide from an anti-oppressive perspective. Disability Studies Quarterly 40(3). Available at: https://doi.org/10.18061/dsq.v40i3.7053 (accessed 26 October 2025).

Baril

(2023) Undoing Suicidism: A Trans, Queer, Crip Approach to Rethinking (Assisted) Suicide. Philadelphia: Temple University Press.

10.

Berlant

(2007) Slow death (sovereignty, obesity, lateral agency). Critical Inquiry 33(4): 754–780.

11.

Berlant

Warner

(2002) Sex in public. In: Warner

(ed) Publics and Counterpublics. Princeton: Zone Books, 187–208.

12.

Browne

(2014) Feminism, Time, and Nonlinear History. New York: Palgrave.

13.

Butler

(2004) Undoing Gender. London: Routledge.

14.

Chandler

Wright

(2024) Suicide as slow death: Towards a haunted sociology of suicide. The Sociological Review 72(5): 1038–1056.

15.

Changfoot

Rice

Chivers

, et al. (2022) Revisioning aging: Indigenous, crip and queer renderings. Journal of Aging Studies 63: 1–9.

16.

Clement

(2025) The possibility of a lived experience industrial complex. In: National Survivor User Network. Available at: https://www.nsun.org.uk/the-possibility-of-a-lived-experience-industrial-complex/ (accessed 26 October 2025).

17.

Deleuze

Guattari

(1987) A Thousand Plateaus: Capitalism and Schizophrenia. Minneapolis: University of Minnesota Press.

18.

Foucault

(1965) Madness and Civilization: A History of Insanity in the Age of Reason. New York: Random House.

19.

Foucault

(1998) The Will to Knowledge: A History of Sexuality 1. London: Penguin Books.

20.

Foucault

(2003) Society Must Be Defended: Lectures at the College de France 1975–1976. London: Penguin Books.

21.

Frederick

(2025) Lived experience is not enough: The illusion of inclusion in mental health spaces. In: National Survivor User Network. Available at: https://www.nsun.org.uk/lived-experience-is-not-enough-the-illusion-of-inclusion-in-mental-health-spaces/ (accessed 26 October 2025).

22.

Freire

(2005) Education for Critical Consciousness. New York: Continuum.

23.

Halberstam

(1995) Skin Shows: Gothic Horror and the Technology of Monsters. Durham: Duke University Press.

24.

Halberstam

(2005) In a Queer Time and Place: Transgender Bodies, Subcultural Lives. New York: New York University Press.

25.

Halberstam

(2011) The Queer Art of Failure. Durham: Duke University Press.

26.

Heike Schotten

(2018) To exist is to resist: Palestine and the question of queer theory. Journal of Palestine Studies 47(3): 13–28.

27.

Jackson

Mazzei

(2013) Plugging one text into another: Thinking with theory in qualitative research. Qualitative Inquiry 19(4): 261–271.

28.

Jackson

Mazzei

(2022) Thinking with Theory in Qualitative Research. London: Routledge.

29.

Jafri

(2021) Reframing suicide: Queer diasporic and indigenous imaginaries. GLQ 27(4): 577–602.

30.

Krebs

(2020) Combating the ills of involuntary intake: A critical rhetorical analysis of Colorado’s state psychiatric policies for suicidal patients. Journal of Applied Communication Research 48(3): 310–327.

31.

Krebs

(2022) Queering the desire to die: Access intimacy as worldmaking for survival. Journal of Homosexuality 70(1): 168–191.

32.

LeMaster

(2022) Suicidal. Cultural Studies ↔ Critical Methodologies 22(4): 391–395.

33.

Lindow

(1999) Power, lies and injustice: The exclusion of service users’ voices. In: Parker

(eds) Ethics and Community in the Health Care Professions. London: Routledge, 154–177.

34.

Marsh

(2010) Suicide: Foucault, History and Truth. Cambridge: Cambridge University Press.

35.

Marsh

(2016) Critiquing contemporary suicidology. In: White

Marsh

Kral

Morris

(eds) Critical Suicidology: Transforming Suicide Research and Prevention for the 21st Century. Vancouver: University of British Columbia Press, 15–30.

36.

Marzetti

Chandler

Jordan

, et al. (2023) The politics of LGBT+ suicide and suicide prevention in the UK: Risk, responsibility and rhetoric. Culture, Health & Sexuality 25(11): 1559–1576.

37.

Marzetti

Chandler

Oaten

, et al. (2025) The cruel optimism of suicide prevention: Thinking beyond the mental health model. Sociology: 1–21.

38.

Marzetti

Cooper

Mason

, et al. (2024) LGBTQ+ suicide: A call to action for researchers and governments on the politics, practices, and possibilities of LGBTQ+ suicide prevention. Crisis 45(2): 87–92.

39.

McRuer

(2018) Crip Times: Disability, Globalization, and Resistance. New York: New York University Press.

40.

Mills

(2018) ‘Dead people don’t claim’: A psychopolitical autopsy of UK austerity suicides. Critical Social Policy 38(2): 302–322.

41.

Mingus

(2011) Access intimacy: The missing link. In: Leaving Evidence. Available at: https://leavingevidence.wordpress.com/2011/05/05/access-intimacy-the-missing-link/ (accessed 26 October 2025).

42.

Muñoz

(2009) Cruising Utopia: The Then and There of Queer Futurity. New York: New York University Press.

43.

Nagoshi

Brzuzy

(2010) Transgender theory: Embodying research and practice. Affilia: Feminist Theory in Social Work 25(4): 431–443.

44.

Oaten

Jordan

Chandler

, et al. (2023) Suicide prevention as biopolitical surveillance: A critical analysis of UK suicide prevention policies. Critical Social Policy 43(4): 654–75.

45.

Piepzna-Samarasinha

(2018) Care Work: Dreaming Disability Justice. British Columbia: Arsenal Pulp Press.

46.

Preciado

(2021) Can the Monster Speak? A Report to an Academy of Psychoanalysts. London: Fitzcarraldo Editions.

47.

Puar

(2012) Coda: The cost of getting better: Suicide, sensation, switchpoints. GLQ 18(1): 149–58.

48.

Puar

(2017) The Right to Maim: Debility, Capacity, Disability. Durham: Duke University Press.

49.

Reynolds

(2016) Hate kills: A social justice response to ‘suicide.’ In: White

Marsh

Kral

MJ,

et al. (eds) Critical Suicidology: Transforming Suicide Research and Prevention for the 21st Century. Vancouver: University of British Columbia Press, 169–187.

50.

Rice

Chandler

Rinaldi

, et al. (2017) Imagining disability futurities. Hypatia 32(2): 213–229.

51.

Sawicki

(2015) Precarious life: Butler and foucault on biopolitics. In: Cisney

Morar

(eds) Biopower: Foucault and Beyond. Chicago: University of Chicago Press, 228–242.

52.

Spivak

(1988) Can the subaltern speak? In: Nelson

Grossberg

(eds) Marxism and the Interpretation of Culture. London: Macmillan, 24–28.

53.

Stonewall Scotland (2018) LGBT in Scotland: Health. Available at: https://files.stonewall.org.uk/production/files/lgbt_in_scotland_-_health_report.pdf?dm=1725358758 (accessed 26 October 2025).

54.

Stryker

(1994) My words to Victor Frankenstein above the village of Chamounix: Performing transgender rage. GLQ 1: 237–254.

55.

Tack

(2019) The logic of life: Thinking suicide through somatechnics. Australian Feminist Studies 34(99): 46–59.

56.

The Scottish Government (2022a) Creating hope together: Scotland’s suicide prevention strategy 2022–2032: Equality impact assessment record. Available at: https://www.gov.scot/publications/creating-hope-together-scotlands-suicide-prevention-strategy-action-plan-equalities-impact-assessment/ (accessed 26 October 2025).

57.

The Scottish Government (2022b) Island communities impact assessment: A new suicide prevention strategy for Scotland. Available at: https://www.gov.scot/publications/creating-hope-together-scotlands-suicide-prevention-strategy-action-plan-island-communities-impact-assessment/documents/ (accessed 26 October 2025).

58.

The Scottish Government (2023) Time space compassion: Supporting people experiencing suicidal crisis: An introductory guide. Available at: https://www.gov.scot/publications/time-space-compassion-supporting-people-experiencing-suicidal-crisis-introductory-guide/ (accessed 26 October 2025).

59.

United Nations Human Rights Office of the High Commissioner (2019) Removing obstacles to liveable lives: A rights-based approach to suicide prevention. Available at: https://www.ohchr.org/en/statements-and-speeches/2019/10/world-mental-health-day-10-october-2019?LangID=E&NewsID=25117 (accessed 26 October 2025).

60.

Warner

(1991) Introduction: Fear of a queer planet. Social Text 29: 3–17.

61.

Warner

(2002) Publics and counterpublics. In: Warner

(ed) Publics and Counterpublics. Princeton: Zone Books, 65–124.

62.

White

Marsh

Kral

, et al. (eds) (2016) Critical Suicidology: Transforming Suicide Research and Prevention for the 21st Century. Vancouver: University of British Columbia Press.

63.

Yep

(2003) The violence of heteronormativity in communication studies: Notes on injury, healing, and queer worldmaking. Journal of Homosexuality 45(2-4): 11–59.

64.

Yep

(2017) Further notes on healing from ‘the violence of heteronormativity in communication studies’. QED: A Journal in GLBTQ Worldmaking 4(2): 115–122.