Suicide is the number one killer of young men in the UK, with 4552 male suicides in 2011, 75% of all suicides. The Office for National Statistics (ONS) data also shows that male suicide rates are climbing among older men who are aged 45 to 59-years-old. With such striking figures, I do wonder why male suicide is not seen as the public health emergency that it actually is.
When the HIV epidemic emerged in the 1980s as a major killer of young men, an unprecedented political, health and community response meant that against impossible odds, and within 15 years, highly effective treatments were developed and made available. If a virus was killing over 4000 men a year in the UK, I bet that there would be an enormous public outcry and irresistible pressure to do more to help men.
The logic of our response to male suicide is difficult to untangle. Perhaps this is because the scandal has been going on for so many years that we tend to look away from what is an unsettling reality. It is not newsworthy. There is also our shameful history of past criminalisation of suicide, and like other issues linked to mental health, suicide is still very much stigmatised. Not to mention the traditional British "stiff upper lip" approach to male distress, which is only slowly being challenged in recent times. Then there is the old slight of hand: "but men use more violent means to kill themselves," as if this could explain it all away. So we end up downplaying the enormous differences that exist between men and women when it comes to the topic of suicide.
In the past, we thought of masculinity as a trait that men more or less possessed. Today, many key thinkers focus on the "performative" nature of masculinity. In this way of thinking, we - men and women - are all "bit players" in the "masculinity show". And in our supporting roles, many of us feel rather uncomfortable seeing men in distress. In an Irish study of young men who had recently attempted suicide, a high level of distress was uncovered. Yet, as one participant in the study said: "Lads can't turn around and talk to their friends. If you turned around and gave a sign of being weak and stuff like that, you'd be ridiculed. There's no way you could show your emotions like that... Men, if they feel depressed or whatever, they see themselves as being weak and man is supposed to be the stronger one."
But professionals also play along with this masculinity show. They too are frequently more comfortable considering men as strong and independent, not as vulnerable, and so they may collude with men to keep their vulnerability hidden. And men are acutely aware that they are at risk of being mocked - by men and women - for their public displays of vulnerability or emotional intimacy.
However, in the right setting and when given a safe environment to talk about it, boys and men do open up. They are able to talk with insight about the façade that masculine ideals often require of them, revealing their hidden complexity, distress and vulnerability behind their public performances. A US study of adolescent boys showed how very articulate they were in discussing the pressure on them to maintain constant vigilance. As one boy, Ron, put it: "you're always, like, under a microscope ... You're always being, like, looked at, so no matter what you do, you always have to keep up your guard and worry about ... what other things are happening around you and what other people think."
So we collude with boys and men in staying silent, and we encourage them to do this perfectly. At some level, all men deeply understand the masculinity show, and they know the rules of the game. When asked how anyone would know if a man was distressed in the Irish study mentioned above, someone who took part in the research said "You wouldn't, that's the weird thing, you wouldn't notice at all." If we don't silence men completely, then we struggle to de-code the way they present their distress under the system of vigilance imposed such as for example as gastrointestinal upset, heavy drinking, irritability or angry acts.
When I've talked to men about suicide in my research, the impression I get is that there is an internal 'suicide logic' that they can become transfixed by. As one man, Craig, described to me, suicide was like a "spell" for him. But it is a spell that can be broken, as Craig also explained: "[I was unsure how to kill myself]. I was sitting there trying to figure out this problem [um] when the phone rang. And my wife phoned to check how I was getting on. And the spell broke. And I just sobbed and I sobbed and I sobbed and I cried and it struck me... you know, what I was trying to do."
I truly hope we can go forward, for the sake of men like Craig, and break our unhelpful society-wide suicide logic, as well as our knee-jerk discomfort with men in distress.
*If this article raises any issues for you, text 'CALM1' to 07537 404717 or call the CALMzone helpline 0808 802585 (London) or 0800 58 58 58 (outside London). Or call the Samaritans on 08457 90 90 90 (UK) or 1850 60 90 90 (ROI), or email firstname.lastname@example.org.
**If you are worried about a boy or a man in your life, you can also raise the issue with him. Professor Appleby, from the Department of Health, advises that you ask if you are worried: "While asking about suicide can be uncomfortable, it may save a life. And asking about suicide will never put the idea into a person's head - they may well be relieved that someone realises how bad they feel."
*** The names used in this blog are pseudonyms