¹ Two useful overviews are Louis Wekstein, Handbook of Suicidology: Principles, Problems, and Practice (New York, 1979) and Edwin S. Shneidman, Comprehending Suicide: Landmarks in Twentieth-Century Suicidology (Washington, DC, 2001). For a more purely psychological or psychoanalytical overview of important work on suicide, see John T. Maltsberger and Mark J. Goldblatt, ed., Essential Papers on Suicide (New York, 1996).

² See, for example, Hans Rost, Bibliographie des Selbstmords mit textlichen Einführungen zu jedem Kapitel (Augsburg, 1927) or Emilio Motta, Bibliografia del Suicidio (Bellinzona, 1899).

³ The U.S. Department of Health and Human Services, for example, provides information on suicide: “National Center for Suicide Prevention Training,” Department of Health and Human Services, www.ncspt.org (accessed 13 November 2007); the National Library of Medicine has extensive materials: “MedlinePlus Health Information from the National Library of Medicine,” National Library of Medicine, www.nlm.nih.gov/medlineplus (accessed 13 November 2007); and the National Strategy for Suicide Prevention (an umbrella group of several national organizations) has further references: “Suicide Prevention Facts, Mental Health Information Centers,” National Strategy for Suicide Prevention, www.mentalhealth.samhsa.gov/suicideprevention (accessed 13 November 2007).

⁴ See, for example, Michael MacDonald and Terrence Murphy, Sleepless Souls: Suicide in Early Modern England (Oxford, 1990); Olive Anderson, Suicide in Victorian and Edwardian England (Oxford, 1987); Victor Bailey, This Rash Act: Suicide Across the Life Cycle in the Victorian City (Stanford, 1998); Georges Minois, History of Suicide: Voluntary Death in Western Culture (Baltimore, 1999); Vera Lind, Selbstmord in der frühen Neuzeit: Diskurs, Lebenswelt und kultureller Wandel am Beispiel der Herzogtümer Schleswig und Holstein (Göttingen, 1999); Alexander Murray, Suicide in the Middle Ages, 2 vols. (Oxford, 2000); Irina Paperno, Suicide: As a Cultural Institution in Dostoevsky's Russia (Ithaca, NY, 1997); and Jeffrey R. Watt, ed., From Sin to Insanity: Suicide in Early Modern Europe (Ithaca, NY, 2004).

⁵ Baumann's book (Weimar, 2001) is a convincing study that focuses on the issue of whether suicide is morally and personally justifiable and whether individuals can make a rational or balanced choice to end their own lives. Mischler's work (Hamburg, 2000) is a popular history of suicide.

⁶ The work in Jeffrey R. Watt, ed., From Sin to Insanity: Suicide in Early Modern Europe, follows this school of thought, although it traces some of the transition to the “medicalization” of suicide to periods earlier than the eighteenth century. In Austria, the growth of the medical profession and the development of a network of hospitals seem to have encouraged the beginning of this transition during the last decades of the eighteenth century, specifically during the reign of Joseph II (1780–90).

⁷ On the development of psychiatric institutions in Vienna, the area under discussion in this article, see Helmut Gröger, Eberhard Gabriel, and Siegfried Kasper, eds., Zur Geschichte der Psychiatrie in Wien (Vienna, 1997).

⁸ Ursula Baumann's Vom Recht auf den eigenen Tod falls broadly into this category of contemporary scholarship. It is also a monumental contribution to the study of suicide in the modern era.

⁹ For an overview of some of these contemporary discussions within an Austrian context, see Gernot Sonneck, Krisenintervention und Suizidverhütung (Vienna, 2000); Gernot Sonneck, ed., 25 Jahre Internationale Vereinigung fuer Selbstmordverhütung und Krisenintervention (Vienna, 1985); and Gernot Sonneck and Elmar Etzendorfer, “Preventing Suicide by Influencing Mass-Media Reporting. The Viennese Experience 1980–86,” Archives of Suicide Research 4 (1998): 67–74. Sonneck is widely regarded within Austria as the leading living expert on suicide and suicide prevention. For arguments in favor of seeing suicide as an individual matter, see Jean Améry, Hand an sich legen: Diskurs über den Freitod (Stuttgart, 1976). Améry (Hans Mayer) was born in Vienna in 1921, fled Austria in 1938, and joined the anti-Nazi resistance in Belgium. Caught in 1943, he survived the concentration camps and became a leading post-World War II commentator and intellectual. He committed suicide in 1978.

¹⁰ Georges Minois, a leading French scholar of suicide, does not fit comfortably into either of these two “schools.” He finds the medicalization of suicide in the modern period largely uninteresting. He dedicates only twenty-seven pages in an epilogue—entitled suitably “From the French Revolution to the Twentieth Century, or From Free Debate to Silence”—to the topic. Further, he hopes that the contemporary debate returns to the more philosophical treatments of the ancient, medieval, and early modern world. He is not, of course, referring to the opinions of clerics and moralists, but rather to the writings of John Donne, Montesquieu, and Voltaire, among many others.

¹¹ Some of the classic modern “Austrian” discussions of suicide and its causes (works largely written in Vienna) would include Leopold Auenbrugger, Von der Stillen Wuth oder dem Triebe zum Selbstmorde als einer wirklichen Krankheit, mit Original-Beobachtungen und Anmerkungen (Dessau, 1783); Thomas Masaryk, Der Selbstmord als sociale Massenerscheinung der modernen Civilisation (Vienna, 1881); and Sigmund Freud, “Trauer und Melancholie.” Internationale Zeitschrift für Psychoanalyse 4 (1917): 288–301.

¹² One of the best discussions of the problematic nature of using statistics on suicide is Jack Douglas, The Social Meanings of Suicide (Princeton, 1967). Douglas argues, among other things, that preexisting professional and popular notions about suicide influence the way people define it and categorize “suicidal” behavior. In Vienna, medical doctors, sociologists, and psychologists all viewed suicide according to their own professional models of explaining human behavior.

¹³ For example, the suicide of Ludwig Boltzmann in 1906 generated detailed stories in Austria's newspapers. The Neue Freie Presse, one of Austria's more serious publications, carried a notice and commentary about Boltzmann's suicide on 8 September 1906.

¹⁴ William M. Johnston, The Austrian Mind (Berkeley, 1972), 174–78.

¹⁵ Ibid., 178.

¹⁶ One can find reports and commentary on suicide in most of Vienna's newspapers, especially boulevard-type productions, from the nineteenth and early twentieth centuries. See, for example, the Illustrirtes Wiener Extrablatt, 23 March 1894, 9 April 1894, 15 April 1894, 13 July 1894, 14 July 1894, 7 September 1894, 5 October 1894, 3 March 1895, 31 May 1895, and 27 July 1895.

¹⁷ Published, respectively, in 1897 and 1903.

¹⁸ Steinhof has become famous because of its church, which was designed by Otto Wagner. Some scholars have recently focused their attention on the psychiatric activities at Steinhof during the Nazi period in Austria. See, for example, Susanne Mende, Die Wiener Heil- und Pflegeanstalt “Am Steinhof” im Nationalsozialismus (Frankfurt, 2000). For a comprehensive history of Steinhof, see Eberhard Gabriel, 100 Jahre Gesundheitsort Baumgartner Höhe: Von den Heil- und Pflegeanstalten am Steinhof zum Otto Wagner-Spital (Vienna, 2007). For a historical overview of Vienna's General Hospital, see Helmut Wylicky and Manfred Skopec, 200 Jahre Allgemeines Krankenhaus in Wien (Vienna, 1984) and Bernhard Grois, Das Allgemeine Krankenhaus in Wien und seine Geschichte (Vienna, 1965). On its Psychiatric Clinic, see Helmut Wylicky, “Zur Geschichte der Psychiatrie in Österreich,” in Zur Geschichte der Psychiatrie in Wien, ed. Helmut Gröger, Eberhard Gabriel, and Siegfried Kasper (Vienna, 1997), 9–13. Of course, the establishment of institutions such as Steinhof (and its predecessors in Vienna), which was founded in 1907 and largely regarded as a model of its kind for the day, has much to do with the growth of social welfare ideas in the modern era. Such ideas clearly predated World War I, gaining momentum in the post-1918 period as politicians and the public often concluded that such concerns as health, housing, and education, to name but three examples, should be more in the hands of the state than they had been in earlier generations. Such an impulse and momentum was perhaps particularly strong in interwar Vienna where, for a time, a social democratic government (Red Vienna) was in place to support social welfare initiatives. On the need for and the growth and establishment of social welfare programs in Vienna, see Maureen Healy, Vienna and the Fall of the Habsburg Empire: Total War and Everyday Life in World War I (Cambridge, 2004). On Red Vienna in general, see Helmut Gruber, Red Vienna: Experiment in Working-Class Culture, 1919–1934 (New York, 1991).

¹⁹ To establish a basis of comparison, it would be helpful to evaluate patient histories from hospitals and clinics other than the General Hospital in Vienna. Unfortunately, it is difficult to gain access to medical histories from private clinics and hospitals, which presumably contain records of suicide attempts from more well-to-do segments of Viennese society. Most of the people who ended up at Vienna's General Hospital came from the city's economic and social margins. The documents examined in this article betray a certain class-based bias that could only be overcome with access to medical histories from private hospitals and institutions.

²⁰ On the Psychiatric Clinic at Vienna's General Hospital, see Bernhard Grois, Das Allgemeine Krankenhaus in Wien und seine Geschichte (Vienna, 1965), 111–12, 116–17, 125, 149, 152–53, 164, 198. The clinic had been established in the early 1870s and had several directors in the late nineteenth and early twentieth centuries. In the late 1920s and early 1930s, the clinic was under the direction of Professor Otto Pötzl, who was removed from his position after the annexation of Austria by Nazi Germany in 1938.

²¹ The medical histories at the Psychiatric Clinic and at Steinhof are complicated documents in a variety of handwriting styles, often with multiple entries and few signatures or initials. Although they sometimes carry the name of a medical professional, it is not always clear that this individual conducted the whole of a patient's interview; assistants and other clerical staff appear to have been involved. For this reason, this article employs generic language, such as “clinical staff,” to describe those professionals who conducted and wrote the medical histories. In the case of Steinhof, certainly prominent figures such as Viktor Frankl were at work in the 1930s as he headed the “Selbstmordpavillion” there and was directly involved in the evaluation of patients who had attempted suicide. Frankl, who survived the concentration camps during World War II, would later write important interpretations of suicide. See, for example, Viktor Frankl, Logotherapie und Existenzanalyse: Texte aus sechs Jahrzehnten (Berlin, 1994); Viktor Frankl, Der leidende Mensch: Anthropologische Grundlagen der Psychotherapie. 2^nd ed, (Bern, 1996); and Viktor Frankl, …trotzdem Ja zum Leben sagen: Ein Psychologe erlebt das Konzentrationslager, 15^th ed. (Munich, 1997).

²² Psychogenic depression refers to a condition originating in the mind (psyche) as opposed to the body. Thus, in these documents from the Psychiatric Clinic it refers to a suicide attempt brought on by mental or psychological processes rather than physiological ones. In the documents from Vienna, the term “psychogenic depression” appears to have been used as a general, descriptive psychological condition and not to refer to a precise diagnosis. In the older psychological literature, psychogenic depression would most often have been rendered as “melancholy,” which also could be used as a generic term rather than as a precise diagnosis. In both cases—melancholy and psychogenic depression—medical professionals, clinical psychologists, and other professionals would have attempted, and often strenuously, to analyze the precise cause or source of the condition.

²³ Examples of these assumptions and arguments about gender differences and suicide can be found in various statistical reports from the late nineteenth and early twentieth centuries. See, for example, Mitteilungen aus Statistik und Verwaltung der Stadt Wien (Vienna, 1928), 46–47, 128–29, 236–37, 326–27, which utilizes all of these various categories—men and women, suicide or suicide attempt, means of suicide or suicide attempt—in its reports.

²⁴ Statistics on attempted suicides are even less complete than those on suicide itself. Many suicide attempts go unreported or are recorded as accidents. As noted above, many authors have claimed that the statistics on suicide and attempted suicide reveal more about cultural and social assumptions than they do about the acts themselves. See, for example, Douglas, Social Meanings of Suicide (Princeton, 1967).

²⁵ For one analysis of the social problems of turn-of-the-century Vienna, see Hubert Christian Ehalt, Gernot Heiß, and Hannes Stekl, Glücklich ist, wer vergißt…? Das Andere Wien um 1900 (Vienna, 1986).

²⁶ I am grateful to Professor Eberhard Gabriel for this information. Professor Gabriel, now retired, was active at Steinhof in various capacities for many years.

²⁷ On all of these general political and economic developments in interwar Austria, see Steven Beller, A Concise History of Austria (Cambridge, 2006), 197–231; and Barbara Jelavich, Modern Austria: Empire and Republic, 1815–1986 (Cambridge, 1987), 151–224.

²⁸ For some statistics on and interpretation of this wave of suicides among Austria's Jews, which is outside the scope of this article, see Norbert Ortmayer, “Selbstmord in Österreich 1819–1988,” Zeitgeschichte 17 (1990): 209–225; “Terror und Selbstmord in Wien nach der Annexion Österreichs,” Noch Mehr (October, 1987): 63–73. The latter is a journalistic publication that details the suicides of several individuals, primarily of Jewish background.

²⁹ Under agreement with the archivists and staff at Vienna's Stadt und Landessarchiv, who hold the records from the Psychiatric Clinic of Vienna's General Hospital and from Steinhof, the names of the people who attempted suicide and were brought in for evaluation cannot be revealed. It is not necessary to do so in any case. One can understand the nature of these cases, the debates they created, and what they reveal about attitudes toward and definitions of suicide without naming names and to do so would be unethical and unprofessional. The materials from the Wiener Stadt- und Landesarchiv can be found in the collection for the Wiener Allgemeines Krankenhaus (Viennese General Hospital), Psychiatrische Klinik and Abteilung (Psychiatric Clinic and Division). Hereafter, this collection will be referred to as WSLA, AKH, PKA. Pseudonyms have been used for all of the individuals mentioned in this article.

³⁰ WSLA, AKH, PKA, 4225/269. The patient histories from the Psychiatric Clinic at the General Hospital usually have a journal and a protocol number. The documents can be found in the Wiener Stadt- und Landesarchiv [hereafter cited as WSLA]. Special permission from the staff is needed to work with the documents.

³¹ WSLA, Steinhof [hereafter cited as SH], 2601/35. The documents from Steinhof have a two-part journal number with the second number representing the year of treatment. They are currently housed in the Wiener Stadt- und Landesarchiv. At the time I worked with them, the Steinhof documents from the 1930s were still at Baumgartner Höhe. Prof. Eberhard Gabriel, then director of the facility, allowed me access to them, for which I wish to thank him. For reasons discussed above, the real names of patients at Steinhof will not be given in the text or footnotes. In some cases the documents from the Psychiatric Clinic at the General Hospital and those from Steinhof have different details about patients, such as conflicting dates of birth. In those cases, however, a thorough reading of the documents reveals that one and the same person is under examination.

³² WSLA, SH, 2601/35. According to government documents, in 1931 Steinhof had 3,700 beds for patients and logged 1,406,039 days of patient care (Verpflegstage). See Österrreichisches Staatsarchiv, Bundesministerium für soziale Verwaltung, Volksgesundheit, Karton 2031 (Irrenwesen).

³³ WSLA, AKH, PKA. No journal or protocol numbers were listed on the copy provided me. Andrew's date of treatment at the Psychiatric Clinic was in this instance on 1 September 1934.

³⁴ WSLA, AKH, PKA. This patient history has no journal number but has the protocol number 2006. Andrew's date of treatment was in this instance on 21 July 1930.

³⁵ WSLA, AKH, PKA, document dated 1934.

³⁶ The relationship between chronic alcoholism and suicide attempts is complicated. Even to this day, suicidologists regard alcoholism as a primary indicator of suicidal behavior. In post-World War I Vienna, medical professionals and the state, to their credit, began to treat alcoholism as a disease rather than as a behavioral problem—hence, the foundation of the treatment center at Steinhof. In the discussions in this article about suicide and suicide attempts, however, the diagnosis of chronic alcoholism usually ended the negotiation or debate about a patient's behavior in the favor of the medical or psychological staff and thus landed a person at Steinhof or elsewhere for further institutional care.

³⁷ WSLA, SH, 2837/1930. Unfortunately, it is not always possible to find documents from the Psychiatric Clinic and Steinhof from one and the same period of treatment. That is, one institution may have a patient history from one stay in a given year, and the other institution may have the patient's history from a different year of treatment. Nevertheless, it is clear from the details in the patient's histories that the same person is under treatment.

³⁸ WSLA, SH, 2837/1930.

³⁹ Several attempts to turn up documents from Andrew's later stay at Steinhof were unsuccessful. He possibly was in and out of Vienna's institutions for many years. It would be interesting to learn of his ultimate fate.

⁴⁰ WSLA, AKH, PKA. This document has no journal or protocol number. Johann's date of treatment at the Psychiatric Clinic in this instance was 6 September 1934.

⁴¹ As far as I know, almost no scholarly work has been done on the Friedhof der Namenlosen.

⁴² WSLA, AKH, PKA, 8800/584.

⁴³ WSLA, AKH, PKA, 12912/902.

⁴⁴ WSLA, AKH, PKA, 12912/902.

⁴⁵ WSLA, SH, 1490/31.

⁴⁶ WSLA, AKH, PKA, 5170/340.

⁴⁷ WSLA, AKH, PKA, 5170/340.

⁴⁸ WSLA, AKH, PKA, 10758/734.

⁴⁹ WSLA, AKH, PKA, 10758/734.

⁵⁰ WSLA, SH, 1208/31.

⁵¹ WSLA, SH, 4357/28.

⁵² WSLA, SH, 3052/63.

⁵³ WSLA, AKH, PKA, 8930/586.

⁵⁴ WSLA, AKH, PKA, 8930/586.

⁵⁵ WSLA, AKH, PKA, 39071/2453.

⁵⁶ WSLA, AKH, PKA, 39071/2453.

⁵⁷ WSLA, AKH, PKA, 33312/1943. The journal number for this patient history is also listed in another location on the document as 33712.

⁵⁸ On Baden, see Friedrich Bensch, Baden bei Wien: Geschichten aus Geschichte (Bruck an der Leitha, 2002); and Paul Tausig, Berühmte Besucher Badens: Ein Beitrag zur Geschichte der Stadt Baden bei Wien (Vienna, 1912).

⁵⁹ WSLA, AKH, PKA, 33312/1943.

⁶⁰ WSLA, AKH, PKA, 33312/1943.

⁶¹ WSLA, AKH, PKA, 33312/1943. The literature on Stalin's Soviet Union is, of course, extensive. For overviews, see Nicholas V. Riasanovsky, A History of Russia, 6^th ed. (Oxford, 2000), 465–538; J. N. Westwood, Endurance and Endeavour, Russian History 1812–2001 (Oxford, 2002), 313–75; and Sheila Fitzpatrick, The Russian Revolution (Oxford, 1994), 120–72.

⁶² WSLA, AKH, PKA, 33312/1943.

⁶³ The classic text on the “cry for help” phenomenon among suicide attempts is Norman L. Farberow and Edwin S. Shneidman, ed., The Cry for Help (New York, 1961).

⁶⁴ Even as one reads these medical and psychological records for what they reveal about interpretations of suicide in early twentieth-century Vienna, one should not forget that these records are evaluations of real people's lives.