These last two weeks have featured a flurry of media coverage on the subject of suicide following Nick Clegg's 'Zero suicide' policy announcement, and the stand-out article for me was in The Guardian on 21 Jan 'Why are men more likely than women to take their own lives?'
This is an important question because according to the latest ONS figures for 2013, 78% of probable UK suicides were male. It was the single biggest cause of death of men aged between 20 and 45 that year, with record numbers of men aged over 85 taking their lives that year. So, why on average, do 13 men kill themselves every day in Britain?
The disappointment was that article reiterated and reinforced old fallacies in a way which I think tells us more about how we want men to be, than how we understand the issue.
The article begins: 'Research suggests that women are especially prone to psychological problems such as depression, which almost always precede suicide.' Damn. Really? Women are more 'prone' to psychological problems? And these problems 'almost always precede suicide'? The numbers of female suicides in the UK have almost halved since the 1980s*, but overall suicide numbers haven't changed. So, either women aren't that prone to psychological problems, or psychological problems don't 'almost always precede suicide'.
Men don't visit their GP in the same volume that women do, for either physical or mental problems, so whilst women are more likely to get diagnosed, this doesn't mean that men are not experiencing the same problems in the same numbers. They're just not seeking help. Simply counting heads popping through the NHS and being officially diagnosed as an indication of the prevalence of 'psychological problems' would be wildly inaccurate. Counting heads in prison would be a better indication.
But yes, it is commonly thought that women have weak minds and bodies. And we assume that someone who dies by suicide is, by definition, someone who has a weak mind, weak moral fibre, is easily buffeted when things go wrong.
The authors cite research that found 19% of women and 14% of men had considered taking their own life. I suggest that admitting to feeling suicidal - for men and women - is culturally hard, which may lead people to lie, but is probably a lot more common that we think. Our 2012 YouGov research showed 25% of respondents had considered taking their own life seriously or fairly seriously. CALM commissioned an audit into masculinity with Public Knowledge last year, with over 1000 respondents. These findings showed that an astonishing 50% of men and 59% of women said they had previously suffered from depression. 74% of the women had talked to someone about it, but only 53% of men had. Men were significantly more likely to say that they prefer to deal with the problem themselves (69% per cent). And drilling down into the behavior of those people who had been depressed was enlightening:-
This table clearly shows why men who are depressed are more likely to be arrested (because they've behaved badly) than see a GP (as they think they shouldn't talk about problems).
The article then posited that men:-
- use more effective means of killing themselves than women;
- are 'more intent on dying'
- are ' vulnerable to spur-of-the-moment suicidal behavior'.
I looked up the reference the authors gave and found in the summary the following sentence "The realization that cultural influences play an important role in the gender paradox of suicidal behaviors holds important implications for research and for public policy." Spot on.
Men have culturally been positioned as being the 'stronger gender', the gender who are in control. So, how does a man deal with things when it all gets really nasty? On Women's Hour in the UK we hear daily how women feel, respond and process stuff happening to them - and have listened to such stories for decades. As women, we repeat such stories and compare them to our own experiences. But for men, there is one clear no-go area; they mustn't talk about issues that affect them emotionally and negatively.
Bizarrely men can, legitimately, deal with or process issues in any other way - they can sing, act, write, create and pour their hearts and souls into such activity, and gain respect for doing so. But on a day-to-day level, talking about things that affect them negatively is verboten. They'll be told to 'grow a pair', 'man up', 'don't be a woman'. One guy I spoke to said that, years ago they could use black humour, could make jokes about some of the terrible stuff they went through. Now, in a world of political correctness, that's unacceptable.
As a society we don't want to hear that men talk about the things that make life hard for them. And if they go one step further, and ask for help, then that crosses the line. They have embarrassed their gender; gone against everything that 'being a man' means to society, which would explain why men won't go to their GP.
I don't see any paradox here that men account for 78% of all suicides.
I suggest that men and women equally suffer problems, equally consider suicide. But it is culturally acceptable for women to talk about problems and ask for help, but not for men. I suggest that women aren't simply rubbish at killing themselves, but as we are allowed to ask for help, then taking an overdose, or cutting and ringing a friend - maybe isn't that great - is acceptable. As 'the weaker sex', it's OK for us to mess up and cry and literally be weak without undermining our gender, because it is expected and accepted. We're never told we are less womanly for doing so.
I suggest that men aren't naturally 'more impulsive than women'. But if the message you get back from society is not to talk, and essentially not to process the issue, then you are literally paralyzed from moving on. All you can do is try and 'get out of yourself', hence men turn to drink and drugs, drive fast, take risky actions. All of which can lead to actions which are shameful, and will compound the problems. But as men can't with any cultural legitimacy ask for help, then by definition they feel the need to ensure they do kill themselves properly. And not do a halfway attempt, and get rescued, because that would embarrass you as a man.
And if you try and get out of yourself, drown your sorrows, be the life and soul of the party, do something daft - and if that all still fails to help, and you are still under the influence of alcohol, then yes, I'd suggest an attempt is likely.
What we see from the suicides we hear about is that most men who take their lives don't have a 'diagnosed condition' but their lives have, for one reason or another, become too much to bear. I'm not so sure that sending men to see their GP when their life falls apart is the solution here. Letting them talk, though, would be huge. Yes, of course we need a properly resourced mental health system, we need to have access to someone at the precise time we are suicidal - not three, six or nine months down the line. And it would be nice to get help without feeling like a total loser. I believe thousands of deaths could be prevented if we allowed that guy in the party - the one singing his head off, holding court in the corner with his jokes, that guy who is mates to all despite just being dumped by his girlfriend - to talk about his troubles without feeling less of a man for doing so.
The paradox here is the fact that while we are happy to look at preventing young male suicide, or tackle suicides in middle age men, we won't take a gendered approach, despite the fact that 78% of all suicides are male.
The paradox is that despite our inability to tackle the issue, we aren't putting money into researching 'why men?' but just accept it. The paradox is that we need to get across a different message - because actually, being silent is to be a victim, not strong at all - but we aren't focussing upon message.
What is bizarre is that there has just been a conference talking about suicide prevention entirely focused on talking about young people, vulnerable people and perinatal care. But not men.
If we won't talk about the audience, then I suggest there's slim chance of reaching them. Can you imagine a Breast Cancer campaign targeted 1) people who are overweight, 2) younger people with a history of breast cancer in the family, 3) people who smoke and 4) women in their 30s and 40s? No, they target women. Genius. There is another suicide prevention conference next week. Gender isn't, as such, on the agenda.
Lets stop marveling at the suicide paradox. How does our understanding and expectations of men affect the way we should address suicide? Lets make a plan, and in that plan, can we talk about gender.
* In 1980 there were 2177 probable female suicides, from 1986 this number started dropping year on year, and in 2013 the number was 1120.
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