Content Warning — This blog deals with the topic of suicide and may be distressing to some readers. If any of the topics raised resonate with you or someone you know, at the end of this blog I have signposted charities and helplines that can provide a listening ear.
Male mental health has always been at the forefront of my mind growing up with a brother with Asperger’s. I noticed how he really struggled his whole life with getting the right support for his crippling anxiety and opening up about his mental health.
Then, throughout my late teens to early twenties, the rise of social media brought to my attention fundraising and awareness campaigns such as Movember and Men’s Minds Matter, which aim to get men talking about their mental health. This made me realise that maybe I am not the only one worrying about my brother doing the unthinkable and ending his life, or my inability to reach out to him in a way that he responds to…
…maybe this a societal thing.
As they say, women are from Venus and men are from Mars, how on earth can I understand how he would want help with his mental health, I do not have a male brain! Why are girls seemingly much better at talking about our emotions and providing support to each other? Then, on the other hand, is this changing? Are men getting better at opening up?
I am currently a final year medical student at the University of Sheffield and my passion lies with Psychiatry. My early exposure to mental health, from living with my brother, sparked my initial interest in the speciality by showing me the impact it can have on daily life. However, at medical school, I went on to join the Psychiatry Early Experience Programme, PsychSoc and completed my self-selected placement at Rampton (a high-secure forensic hospital), which collectively lead me to want to be an ambassador for and pursue a career in Psychiatry.
Societal factors of suicide
Globally, on average one man dies from suicide every minute of every day, making them on average three times more likely than women to kill themselves. This really does not sit well with me and I am sure it doesn’t with most of you reading this, so why aren’t we rushing to change it?
When researching for this blog, it became clear to me that this is a complex matter, but in my opinion, one of the main influences on this disparity is society, rather than the individual. It’s the male-side of the feminist argument (never thought I would say that!); toxic masculinity is programmed into men, which provides entirely unhealthy standards for men to ‘live up to’.
Obviously, there are other factors aside from ‘society’ that can contribute to someone taking their own life. Someone’s genetic lottery, past or current trauma, alcohol, and drug habits are among a few factors that can contribute, and these cannot be ignored.
However, societal contributors to male suicides are the things we can have some level of control over as a community and can work to minimise to hopefully, in turn, create an environment where males feel comfortable to seek help or speak to love ones before crisis point.
The charity Samaritans completed a systematic review of the current literature to find the potential societal factors of male life that can lead to suicide. However, it is important to note that this report did not take into consideration the role of intersectionality (i.e. ethnicity, the role of transgender identity, sexual orientation) on suicidality — more information on rational and focus population can be found in the report linked above.
This review found that when the men passed the age of 30 they seemed to lose their peers, whereas women tend to maintain these connections lifelong. This means they lost their support systems outside of their immediate family at an early stage of life. However, this difference may not matter as much as it may seem as the research also showed that male friendships tended to centre around activities, rather than divulging their recent struggles and anxieties, which was commonly shown in female peers.
This lack of emotional relationships between males was linked to the men throughout their childhood being taught to be ‘manly’ and not social or emotional. Allowing men to build up distress, which only rears its head when reaching crisis point. Explaining why the men included in the review suffered greater when they go through a ‘relationship breakdown’, as their only outsource of emotional turmoil tended to be their partners.
To add, it was shown this happens the most when the men hit middle age. Typically, by this point a lot of time has been invested into work and relationships, meaning they can feel trapped by their current life. Not only this, but ‘the boomers’ are trapped between their parents, who traditionally were silent and austere, and their children who are more progressive and open, leaving them not knowing which one to follow.
The next two factors were masculinity and low socioeconomic status. The concept of a ‘masculine dream’ which centres around power, control and invincibility was discussed in the report.
‘Being a man’, as in providing for your family, was shown to be an important factor in the participating males mental health. Therefore, if they did not meet these standards, they felt shame and defeat. (Which I am sure admitting mental health problems would have similar affects to this ‘dream ideal’ as castration!).
Low socioeconomic status was also shown to cause a feeling of powerlessness, stigma and disrespect, but also added poor education, housing and income. Which meant that the report found that the further down the social ladder you climb, the higher the rates of suicide you got.
What the report states is that all of these factors boil down to certain ‘mind sets’ that have been placed upon the male gender. This idea that they feel the need to always meet the high expectations of others. I guess being at the top of the privilege tree in terms of gender has its pressures too.
On reflection, what I think would be an interesting future research topic would be investigating why these men were affected by these factors leading them to commit suicide and why some men are not.
Why men and not women?
What this information suggests to me is that men might be more likely to consider suicide at times of serious mental struggles, whereas women have more barriers they utilise first, such as simply confiding in close friends or admitting to themselves that they have a problem.
However, what is interesting is that in the US women are 1.2 times more likely to attempt suicide and women generally have higher rates of depression. This is also reflecting the fact that men are tending to use more violent methods of suicide, such as firearms or jumping, rather than self-poisoning or exsanguination.
This is congruent with what is seen, yet exaggerated, in prisons: men make up almost 96% of the prison population in the UK and are 3.7 times more likely to commit suicide there than in the public, thus increasing the rate of male suicide significantly.
Not only this, but men are more likely to turn to alcohol and drugs, which is a factor that increases the risk of suicide, as represented by the specific section on the SAD PERSONS clinical suicide risk score.
What is clear is that societal pressure could be a major player in these differences. I guess in a capitalist world where the only way is up, we have become comfortable telling women that they can be surgeons, pilots and engineers, much quicker and more easily than we have been telling men that it is great if they want to be nurses, secretaries and shopkeepers.
To the future
In the writing of this blog, I sadly had the sobering realisation that in my life I too can only think of males that have taken their lives. Maybe this is just me, or maybe that is the same for you as readers, but it made me realise how terribly personal it makes this issue. I am sure I am not the only one.
On a more positive note and looking to the future, change and progress is happening.
There is a drive and push for change that has mainly come from the community, charities, and social media. From people who have had close relatives take their life and are saying enough is enough.
For example, male social media influencers such as Dr Alex and Chris Hughes from reality show Love Island, have recently been having open talks about their mental health to their large young male following. To add, movements such as the Campaign Against Living Miserably (CALM) are actively working and successfully to tackle male suicide.
However, what I feel is missing is a big public health movement coming from central government, looking for major societal change in the way we view men and how they access mental health support.
This change needs to happen right from day one, in schools and at home, talking to boys and men more about their mental health.
We need to stop treating the individual and focus on societies pitfalls, treating the cause, not the symptom.
This is when I believe we will start to see a major change in suicide rates in men.
I have a feeling that day is nearly on the horizon.
To get a different perspective on this topic, a previous blog post looks at this topic from an adolescent boy’s perspective and is an interesting read on comparison.
Note from the author:
If this topic has resonated with you about yourself or someone in your life, please see below charities that can provide a listening ear… and don’t forget help can be found from your GP!
Samaritans — 116 123 (free 24-hour helpline)
CALM is the Campaign Against Living Miserably — for men aged 15 to 35. Phone: 0800 58 58 58 (daily, 5pm to midnight)
Men’s health forum — 24/7 stress support for men by text, chat and email. Website: www.menshealthforum.org.uk
Special note from the editors: This is the sixth blog of our new series, The future of mental health as seen by the future leaders in mental health, written by the 2020 ‘Psych Stars.’ Selected by The Royal College of Psychiatrists, Psych Star ambassadors are a group of final year medical students awarded for their particular interest and commitment to psychiatry. During the year-long scheme as Psych Stars, students are nurtured in their interest in psychiatry through the assignment of mentors, by gaining access to learning resources and events, and by becoming part of a network of like-minded students. More information on the Psych Stars scheme can be read here. We have decided to invite each of the Psych Stars to write a blog on how they envision the future of mental health by choosing an area in which they are passionate. We have decided to run the series as a celebration of these student’s success and to provide an outlook for each of the awardees to share their passion. With a new blog published each Friday, the series will run over the next few months. If you enjoyed today’s blog by Bethany, be sure to head over to InSPIre the Mind and check out the previous blogs in our Psych Star series covering topics such as compassion, the mind-body interaction, the future of child & adolescent psychiatry, gender inequality, and global health.