Men and Suicide – What are we going to do about it?

The latest data from The Office for National Statistics shows that contrary to what people feared may happen during lockdown there were fewer deaths from suicide. The data shows that there were 1,603 suicides in England and Wales between April and July 2020, which is less than the  1,955 in the same period in 2019, and fewer than the same period in the previous five years, with an average of 1,835 suicides between 2015 and 2019. Never the less suicide remains the biggest killer of young men in England under aged 45, with the highest risk group being men between 45 -49. Men are three times more likely to die by suicide than women. What’s happening to men?

Men tend to choose a more lethal method compared to women, access to firearms is also a significant risk. Perhaps men are just better at suicide.

Its common to assign blame towards men bottling up their feelings and not talking to anyone when they struggle. Even if that happens it must be more complex than that. 

For every successful suicide there are 20 attempts, suicidal thoughts themselves are common, it is estimated that 1 in 5 people have a suicidal thought in their lifetime, but that does not mean that these will be acted upon.

To understand why men might take their own lives we should begin by looking back at how boys are encultured when very young, this sets them off on a path to today. Research shows boys don’t start out being “boys” this maleness occurs through socialisation. We see that parents talk differently to boys and girls, mothers use more emotional words with girls ( Ana Aznar, Harriet R. Tenenbaum 2014) Teachers use more negative emotion language with boys (Elizabeth K. King 2019) both mothers and fathers used more emotion words with daughters (Janet Kuebli & Robyn Fivush 1992) . Parents also mentioned sad aspects of events more with daughters than with sons. Girls might be receiving stronger emotion messages and boys focus on anger while girls focus on sadness. And in Western cultures, parents typically try to increase children’s expression of positive emotions and minimize the expression of negative emotions (Pérez-Edger, 2019) we are programming a smaller emotional vocabulary in boys thus reducing social emotional competence. As boys grow older although they might have close emotionally intimate male friends, these change in adolescence to less trust and fear of betrayal. They begin to internalise masculine norms they see from peers, society and media. It is at this point, they begin their solo journey to adulthood and less likely to have close male friends even though they may want one. Boys minimise sadness displays in order to achieve peer acceptance (Carisa Perry-Parrish, Janice Zeman 2011) in the masculine stereotype emotional display is avoided as weakness “gay” or “girly”. Taunting and mocking increase acceptance and reinforce masculinity. In her research into boys, Niobe Way noted the boys levels of loneliness and depression began to increase during this time.

Masculinity is the opposite of femininity, desirable and status conferring. What men see then is a culture of masculinity that is difficult to escape, in effects it creates bonds that bind them to it. In movies men are often in teams to solve a problem, these are not led by women. And although this may now be changing, the past experiences are driving the present men. As an aside, consider The Bechdal test, this looks at the role of women in movies and has three tests that need to be passed (1) it has to have at least two women in it, who (2) who talk to each other, about (3) something besides a man.

In male stereotypes, we see expected behaviours and vices reinforced, while the adoption of female behaviours and vices are derided, even to at a higher level for female vices. What this looks like is  authoritative, courageous, self-assured and physical are seen as positive male assets, with vices such as combative, aggressive, egotistical, vain and brazen being desirable. Such vices in women are seen as three times more negative. This serves to reinforce maleness. If we look at female virutes such as tactful, thoughtful empathetic and caring as being positive for women these are neutral for men. Again this reinforces the collective socialisation of men into a construct termed masculinity. To criticise masculinity risks derision, shunning and rejection. And thus doing nothing is as enabling as perpetuating. Other research has labelled this a “The Man Box” or in the UK more recently anti-feminist stance of  “laddism” which goes further to shun what we might call “new-man” behaviours like sensitivity, empathy and caring, towards chauvinism, drinking, classist, sexist and even homophobic.

There is a divergence between what men externalise as expectations from society and what they agree with. For example in research The Man Box, 55% of respondents agreed that society tells them real men never say no to sex, while 33% say they agree. 45% say society is telling them that men should do household chores, while 27% agree or strongly agree themselves. In this way they are externalising male stereotyping and acting to comply with societal expectations or even a form of tribalism.

Attempts to shift thinking toward openness in men, to talking and sharing have been somewhat clumsy. “man up” as a message tries to attach more caring, sharing and openness to a male strereotype, whilst at the same time offers shame and reinforces the social construct of the “man” gender. The message “its OK not to be OK” seems to fully reinforce a deficit model of not being OK when compared to some hidden norm, while attempting to positivise the deficit into a positive labelled “OK”

This deficit position is one that creates shame for men and is one of the very reasons while men find it difficult to identify and discuss feelings and emotions. It seems men need re-educating and instructing on the deeply buried emotions and feelings that have been socially suppressed. Mental health and suicide messages based around statistic alone fail to land because they do not help men to understand what to do now or next. Identifying that three quarters of men are unable to talk about how they feel is not a call to action, or indeed instructive. At best, such messages fall into a “so-what” category of indifference, or at worst man-shaming. Taken further the shaming of men for not having more feminine attributes, both shames men and reinforces the socialised gender differences, thus being counterproductive.

A concept of manfulness may be more useful, however we do have to recognise the “man” component comes fully loaded. This idea promotes valueas and behaviours such as flexible, open minded, Self-Identity, Comfortable in own skin, tender, emotional, caring, honest, loyal, compassionate, self aware, family orientated, kin, confident, responsible, respectful, appreciative. These and other ways of acting and behaving are far less gender loaded and provide more instruction of how to be, how to act rather than garnering feminine traits.

Leaders who exhibit behaviours and actions are more likely to change men, than shaming. An example might be The England football manager Gareth Soutgate who exhibits emotionality towards players, sees no shame in embrace and hugs. 

Men have a lower tendency to seek professional help for mental health conditions than women (Addis & Mahalik, 2003). Further, men report a lower likelihood of seeking help from informal help sources (i.e. friends) for common mental health conditions than women (Weissman & Klerman, 1977) Help seeking needs encouragement and instruction, but first men need to recognise and accept the need for support. As men have performed a life of emotional suppression and denial it may well be difficult for them to label and accept what they are feeling and rank that above shame and stigma. In addition the fear of shame and exposure through not being able to see a psychologically safe place in which they may choose to open up. By seeing other men as examples and hearing their stories they may be encouraged rather than shamed into action. 

We need to change the narrative – to reinforce what a good kind caring man is and how he has mastery of his emotions and feelings. The gains are being a better person, better human not a better “man” By reinforcing what is gained from this shift we are not fighting against “the bonds of masculinity” that cause men to push back through learned masculine traits.

Even the terms we use such as “mental health” have become loaded and associated with shame and a deficit model, this creates labelling that in turn becomes rejected. Instructing men to “talk” about their mental health fights to male stereotypical socialised model. Through normalisation demonstrated by leaders, role models story tellers and peers we have more opportunity to show by example what desirable behaviours and outcomes look like. And finally we need to signal safe spaces where men can feel confident to take that step down a different path.