“Hoping men will become more like women is costing us the lives of our fathers, brothers, sons, uncles and nephews.”
This year the theme for International Men’s Day is Stop Male Suicide.
On average one person dies by suicide every 40 seconds somewhere in the world, and many more attempt suicide. In Ireland men are 5 times more likely to die by suicide than women, and worldwide the rates average out at about three men to one woman.
University College Dublin sociologist Anne Cleary found a common theme among 52 young Irish men who survived suicide attempts: all expressed reluctance to disclose to anyone the “significant, long-lasting” emotional pain they felt. Instead they used alcohol and drugs to cope, worsening their levels of distress, and ultimately leading to a time where suicide seemed to be the only credible way of managing their pain.
A recent survey commissioned by the UK’s Mental Health Foundation shows that men are less likely than women to seek professional support or disclose mental health problems to friends and family. 28% of men surveyed admitted they had not sought medical help, while only 25% of the men told friends or family about the problem within a month of it arising. This finding is backed up by several decades of studies showing that men of all ages are less likely than women to seek help for mental and physical health issues.
One of the common theories given for men’s reluctance to seek help is that from an early age men are socialised to hide their feelings and rewarded for solving their problems on their own. In essence, the familiar refrains of “big boys don’t cry” and “fight your own battles”. Men are offered the stereotype that “real men” are self-reliant and strong to the point of physical and emotional invulnerability.
But blaming the male suicide epidemic on socialisation belies some more subtle aspects of the issue. The fact that historically more women than men have sought help has some interesting sequalae. Depression and anxiety are often described in terms that better reflect women’s experience of the conditions and so men’s mental health issues may not be identified as readily. When the need for help is identified, the services offered often do not have a “man friendly” orientation.
Paul Quinett, a US psychologist dedicated to suicide prevention says,
“So long as we keep repeating the phrase, ‘encourage male help- seeking behavior’ … suicidal men will just keep dying. Hoping men will become more like women is costing us the lives of our fathers, brothers, sons, uncles and nephews.”
When men suffer from depression they are more likely to use drink and alcohol, work long hours, exercise to excess, and feel highly irritable or angry. They are also more likely to complain of somatic symptoms such as fatigue, pain, and sleep problems. They are unlikely to consider themselves as suffering from depression, so awareness campaigns with a message like “Feeling depressed? Help is available” are not actually of much use. Men, healthcare professionals, and the people who support men need better education on the manifestation of mental and emotional health issues in men.
Men are more likely to be attracted to strategies that focus on self-mastery, take a time limited approach, and have mechanisms for showing progress. As far back as 1992 John Robertson, PhD, an emeritus professor at Kansas State University, created two brochures for a campus counselling center and distributed them to community college students in auto mechanics, welding and other mostly male arenas. One brochure described the center’s counseling services in traditional terms, the other used terms like “consultations” rather than “therapy” and emphasised self-help and achievement. The men who received the second brochure were more likely to say they’d seek help than those that received the traditional one.
Media coverage can have a major impact too. A study in Australia showed that that there are characteristics common to media stories that result in men seeking help in greater numbers. It is important that men see role models that are relatable, and that the stories have an optimistic focus on recovery, and provide information about resources and helplines, encouraging men to take the first step themselves. Letting men know that people they admire have successfully found help for similar problems, and then making sure to provide information on how to find help, goes a long way to encouraging men to seek help.
If we want to help address male suicide rates here are some things to consider:
Let men know they are not alone – what they are experiencing is both common and normal!
It is normal to experience mental health issues at some time in life. The WHO estimates every year 1 out of 15 people suffer from major depression in Europe, and when anxiety and all forms of depression are included nearly 4 out of 15 people are affected.
Men need to see relatable role models. A recent survey of male professional rugby players in Ireland showed that high percentages of players struggled with mental wellbeing issues, and well known GAA sports figures have recently spoken out about mental health challenges. These stories help enormously – let’s publish more of them!
Learn to identify the indicators of mental and emotional distress in men
We need to increase our awareness of how men express mental and emotional distress. Look out for changing patterns in alcohol, drug, or gambling use; risky behaviours such as dangerous driving; excessive work or exercise; or somatic problems like aches, pains, or digestive problems.
Create “man friendly” services
A number of studies have challenged the stereotype that men won’t use psychotherapy services. When services include positive messages about men seeking support we see that men are willing to and want to talk about their problems. Moreover men report that psychotherapy is helpful.
In one study 70% of men seeking help from a psychiatric service chose psychotherapy, while only 27% preferred medication. Men indicated that they prefer to feel like they are in charge of their recovery rather than becoming dependent on medication. Other studies have shown that men are interested in self-help strategies and like approaches that show evidence of results.
ManTherapy.org provides a great example of a “man friendly” service. It is a public/private/nonprofit partnership based in Colorado that aims to prevent suicide through a website that uses humour to breakdown the stigma around mental health. It provides a wealth of resources including mental health quizzes, self-help guides, and referrals to organisations and crisis lines.
Real men get help because seeking help is a sign of strength
It is time we started supporting men in believing that seeking help is a sign of strength rather than weakness. That is just what the Irish Rugby Union Players Association campaign “Tackle your Feelings” aims to do with the words “Be honest with yourself. Face your feelings head on. Empower yourself, Inspire others”. In a similar vein ManTherapy.org encourages men “to have the balls to take action” on depression and anxiety while reminding them that a real man looks after his friends.
If you have been affected by this article, and would like to talk to someone, then a 24/7 Suicide Helpline is available by calling 1800 247 247 or texting “HELP” to 51444.
An extensive list of services available in Ireland can be found at Tackle Your Feelings
The Mental Health Support and Information Line is a confidential telephone and email service staffed by experienced mental health professionals Monday to Friday from 09.00 am to 05.00 pm with an answering and call-back facility outside hours. You can contact the Mental Health Support and Information Line service by calling 01 249 3333, or email firstname.lastname@example.org.
MyMind Centre for Mental Wellbeing has centres in Dublin, Cork and Limerick and provide multilingual counselling and psychotherapy services. Fees are based upon employment status, offering the unemployed or students affordable services. Revenue generated from full fee clients is reinvested, enabling us to provide services to all. Clients self-refer and appointments are within 72 hours. Call 076 680 1060 or email email@example.com
Cheshire, A., Peters, D., & Ridge, D. (2016). How do we improve men’s mental health via primary care? An evaluation of the Atlas Men’s Well-being Pilot Programme for stressed/distressed men. BMC Family Practice, 17, 13. https://doi.org/10.1186/s12875-016-0410-6
Cleary, A. (2012) ‘Suicidal action, emotional expression, and the performance of masculinities’. Social Science and Medicine, 74 (4):498-505.
Quinnett, P., Hindman, J. & Spencer-Thomas, S. (2010) Man Up! Suicide prevention among working aged men. A pre-conference session at the American Association of Suicidology’s Annual Conference in Orlando, FL.
Machlin, A., King, K., Spittal, M., & Pirkis, J. (2014). The Role of the Media in Encouraging Men to Seek Help for Depression or Anxiety.
Robertson, J. M., & Fitzgerald, L. F. (1992). Overcoming the masculine mystique: Preferences for alternative forms of assistance among men who avoid counseling. Journal of Counseling Psychology, 39(2), 240–246. https://doi.org/10.1037/0022-0184.108.40.206
Sierra Hernandez, C. A., Oliffe, J. L., Joyce, A. S., Söchting, I., & Ogrodniczuk, J. S. (2014). Treatment preferences among men attending outpatient psychiatric services. Journal of Mental Health (Abingdon, England), 23(2), 83–87. https://doi.org/10.3109/09638237.2013.869573