Authors :
Clarisse Berthezène, Julie V. Gottlieb, Michal Shapira
Executive Summary
● Women’s suicide rates have risen somewhat in the UK in recent years, and charity organisations like SHOUT, MIND and the Samaritans have mobilised in an effort to reverse this troubling trend.
● Women in 1930s Britain had far fewer forms of support available to them. Looking back to this period illuminates the long history of public debate about mental health and the law, suicide and voluntary euthanasia and Assisted Dying. (see the Terminally Ill (End of Life) Bill and related controversy). Debates and ethical dilemmas around assisted dying were well rehearsed in the interwar period.
● Exhuming a case study and writing a History from Within of the psychiatric illness and suicide of birth control pioneer ‘Mrs’ Evelyn Fuller illuminates the major shifts in treating and pathologizing women’s mental illness.
● This history has important implications for understanding patient and service-user activism today.
● It is key to examine these topics from an interdisciplinary and gendered perspective. Historical research and the forensic case study must inform present policy initiatives, as is being realized by a new major international institute for women’s health (iWISH)
● Women’s suicide prevention cannot be reduced to clinical risk assessment alone. It also requires attention to voice, autonomy, stigma, institutional accountability, and the social conditions that make some women especially vulnerable.
‘THINKING IN CASES’: FROM THE MICRO TO A BROADER EXPLANATORY FRAMEWORK
Evelyn Fuller came to national prominence in 1938 due to her dramatic escape from a London asylum, and only weeks later, due to her death by suicide. At the time of her death, she was still on the run, a ‘lunatic at large,’ after having escaped her incarceration in the Camberwell House Mental Institution in South London. It appears that she took her life as an act of despair after having been dismissed from her work –her life’s work– for the Society for the Provision of Birth Control Clinics (later the Family Planning Association), following her certification as insane and her absconding from the asylum. Fuller had entrusted her care to a woman doctor and friend, Dr Greta Graff, who ultimately betrayed that confidence and set her, in Fuller’s own account, on a downward spiral from voluntary to incarcerated (and doped and abused) mental patient. Generously documented in an otherwise neglected file in the Wellcome Library, her story had sensation value on many registers, and it was widely reported in the newspapers.
COMPETING NARRATIVES
Equally interesting are the competing narrations, the contradictory explanations, many factual inconsistencies in the accounting and the reporting, and the attempts at explicating her suicide, including Fuller’s own rationalisation. Fuller left a number of testimonials that give us rare insight into her case, and ‘case’ here refers to both the psychiatric and the legal. Read together, these sources illuminate the historically entangled questions of bodily autonomy, reproductive control, psychiatric confinement, and self-determined death—issues that were intensely contested in interwar and 1930s Britain and remain far from settled. The richness of these intimate sources illuminating the psychological, psychiatric and philosophical dilemmas of an otherwise little-known figure provide an excellent opportunity to conduct a ‘history from within’.
The denouement to Fuller’s death should be read in the nexus of the gendered construction of mental illness, nervous disorder– personal and collective– and suicide in this period. The public responses to her story offer a vivid illustration of the growing sense of compassion and of support for the liberalisation of the laws governing mental illness and suicide, the latter a crime until the Suicide Act (1961). We can observe an unmistakable attitudinal shift from moral-religious stigma to the recognition of individual rights and bodily self-determination, and the consequent call for legal reform and decriminalisation. Feminist-minded women were prominent in the campaigns for these reforms, such as suffragist, pacifist, psychiatrist, lesbian and legal reformer Dr Doris Odlum, who emerged as a leading voice for reform of the suicide law. Women figure prominently in this tangled history of public health, mental health, psychoanalysis and campaigns for reform, even though most subsequently have been written out of institutional histories.
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