Introduction: rethinking suicide

Throughout the world, suicides account for a significant number of premature deaths each year. According to the World Health Organization (WHO), one million people die by suicide annually, representing a global mortality rate of 16/100,000 (WHO, 2013). Each suicide is estimated to personally affect at least seven individuals (Canadian Association for Suicide Prevention, 2004). Suicide, like many other complex social problems, is often a subproblem of other, larger problems (Brown, Harris, and Russell, 2010). For example, newspaper headlines such as “Greek woes drive up suicide rate” (Smith, 2011) or “Rape, bullying led to N.S. teen’s death says mom” (Canadian Broadcasting Corporation, 2013) attest to the fact that suicide cannot be easily understood in singular, static, or acontextual terms. On the contrary, suicide and suicidal behaviours are deeply embedded in particular social, political, ethical, and historical contexts. As such, they are rarely amenable to cause–effect reasoning, quick fixes, or technical solutions. In short, suicide is a complex problem that is always “on the move.” Not surprisingly, given its complexity, the evidence about how to prevent suicide and suicidal behaviours is rather sparse (DeLeo, 2002; Gould and Kramer, 2001; Mann et al., 2005; Thompson, 2005). We contend that this provides an opening for fresh thinking and justifies the consideration of alternative approaches.