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Burden and benefits-related suicides: “misperception” or state crafted reality?

Mills, C. (2022). Burden and benefits-related suicides: “misperception” or state crafted reality?. Journal of Public Mental Health, 21(1), pp. 46-56. doi: 10.1108/jpmh-09-2021-0124


Purpose: This article aims to focus on deaths by suicide in relation to UK welfare reform as a case study to question one of suicidology’s most dominant theories – the Interpersonal Theory of Suicide (Joiner, 2005) and its influential ideas on “perceived burdensomeness” – as well as wider ideologies on suicide and mental health reflected in this approach.

Design/methodology/approach: This article draws on evidence from disabled people’s campaigning groups (primary sources) and research literature (secondary sources), which shows the negative psychological impact of burden discourse and how this shows up in people’s accounts of feeling suicidal, in suicide notes and in family accounts of those who have died by suicide. It uses this evidence to problematise the Interpersonal Theory of Suicide (Joiner, 2005), specifically its ideas about “burden” as an individual misperception, and the assumption that suicide is always the outcome of mental health problems.

Findings: The findings highlight the systemic, intersectional and cumulative production of suicidality by governmental “welfare reform” in the UK, through positioning welfare claimants as “burdens” on society. They show that by locating the problem of burdensomeness in individual “misperceptions”, the Interpersonal Theory allows the government’s role in crafting stigmatisation and conditions of suicidality to be overlooked and to be reproduced.

Originality/value: The article raises urgent ethical questions about the application of approaches, such as the Interpersonal Theory of Suicide, to benefits-related suicides and calls for approaches to benefits-related harm and suicide to be rooted in social and disability justice.

Publication Type: Article
Additional Information: This author accepted manuscript is deposited under a Creative Commons Attribution Non-commercial 4.0 International (CC BY-NC) licence. This means that anyone may distribute, adapt, and build upon the work for non-commercial purposes, subject to full attribution. If you wish to use this manuscript for commercial purposes, please contact
Publisher Keywords: benefits, burden, epistemic justice, Interpersonal Theory of Suicide, mental health, social justice, stigma, suicide, welfare reform, work capability assessment
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: School of Health & Psychological Sciences > Healthcare Services Research & Management
SWORD Depositor:
[thumbnail of Mills JPMH v3 Nov 2021.pdf]
Text - Accepted Version
Available under License Creative Commons Attribution Non-commercial.

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