Stop Blaming Men for Their Own Suicides (Part 1)

Stop telling men to be vulnerable. We already are, you’re just not listening.

(a lot of this article will be pulled from this article. Rob Whitley is a fantastic researcher and pioneer in men’s mental health. Please give his articles and work a read. Seriously.)

Suicide.

It's a hard and complex topic to talk about and one that disproportionately affects middle-aged men. Men between the ages of 26–55 are made up about 19% of the population but 40% of the suicide victims, a number that only seems to increase over time. Men, in general, have nearly 3.6x times the suicide rate of women, a figure that also seems to increase with time.

It’s heartbreaking.

Luckily, this has gotten an increasing amount of attention from mainstream news outlets and suicide researchers. People are finally starting the discussion about the gendered effects of suicide and more largely how men are systematically ignored by mental health services.

However, while many of these mental health campaigns are (probably) well-intentioned, they often stereotype men into silent, violent, self-destructive, and stubborn, implicitly or explicitly victim-blaming men for their own suffering.

Why Don’t Men Talk More

Australia, one of the few places that have attempted to address men’s health issues using male-centered strategies, has recently engaged in a national mental health campaign called ‘Beyond Blue’. One of the first things that they highlight on their webpage is the men’s “tendency” to “bottle things up”.

Similar rhetoric is echoed in the multiple men’s health articles and in the agenda of large psychological organizations such as the APA.

The more you look at institutions that claim to help men, the more their explanation becomes clear: if men talked more, they wouldn’t kill themselves.

The problem is, men often do come forward and often have experiences with front-line services and mental health professionals before their death.

A study done in the UK on the causes and context around suicidality by Middle-Aged Men found that about 91% of middle-aged men had been in contact with at least one front-line service or agency within 1 week to 3 months of death (on pg 4). 82% of those that were in contact with a front-line service encountered primary care services, 50% of which had been in contact with mental health services.

If 91% percent of middle-aged had been in contact with at least one front-line service or agency before taking their own lives, what does that say about the role of primary care and mental health agencies? What does that say about their inability to prevent men from harming themselves irrevocably?

To those who want to dodge public/shared responsibility, it says that men simply are too reticent in acknowledging their own pain and trauma. That men are simply slower than women to express their pain, or that men simply don’t engage with professionals in the “right” way (though this is closer to the truth).

In reality, while men on average do seem less keen to receive mental health advice, it’s clear that when they need care the most, they show up and don’t receive the care they deserve.

There’s plenty of evidence that depressive disorders are significantly underdiagnosed in men and that when “male-typical” symptoms, such as anger, irritability, substance abuse, etc, are included, the gap seems to disappear. The aforementioned bias affects rates of diagnosis of PTSD as well where while men experience more traumatic episodes (witnessing death, violent combat, fatal car crashes/accidents etc) than women do, they are diagnosed with PTSD less often, not because men don’t act any different after traumatic episodes (they do — notably becoming angrier and irritable), but because scales that measure PTSD don’t often factor in male-typical symptoms.

It seems that despite knowing how trauma affects men, we’ve completely neglected to make our psychometric tests more sensitive and inclusive to their experiences, and then wonder why men receive inadequate healthcare when they need it the most.

Psychology’s Toxic Masculinity Problem

Personally, I’m not a huge fan of the phrase “toxic masculinity”. As I’ve pointed out before, it's a highly nebulous term that means something completely different depending on the person, and when it’s used, its often implicitly or explicitly castigate men as something that men have to “unlearn”.

However, though doing some research on the topic of suicidality, depressive disorder, and PTSD, I get the sense that the very people who have might be likely to use the term “toxic” or “hegemonic” masculinity, are often at fault for applying these harmful gendered norms to their own practice.

In fact, toxic gendered expectations for men are likely the culprit behind psychology’s apparent bias against diagnosing men.

Frameworks for assessing psychological disorders are often based on a presumption that women are implicitly more “emotional” than men. While this is often looked at as a relic of the past where women’s emotionality was dismissed in the face of their competence, in a world where we aim to make it easier for victims to heal, the lingering influence “women as more emotional” just doesn’t work.

In fact, this presumption is so prevalent that included in major guidelines for assessing depression symptoms for Physicians (page 16)

You may be at risk for depression if you: … are female.

Yes, there are other gender-neutral items on the list, including dependency on alcohol and stressful life experiences, but the implication is clear to men and even clearer to physicians: men aren’t at risk for depression.

Conclusion

This is just the first of a series that I’d like to do covering some of the systematic biases, barriers, and problematic rhetoric surrounding men’s mental health. There’s so much to cover! especially in breaking down how we frame men’s mental health as a personal failing, rather than a systematic one and how that more generally fits into a picture of less empathy towards men and boys in general.

Part 2 will cover some of the social contexts of suicide and how the complexity of suicide is often reduced to “just talk more”.