Expert has chosen to ignore the reality of male suicide

ON Wednesday last, a letter appeared on the Letters to the Editor page of this newspaper from Dr Katherine Brown, MB, MRCPI, …

ON Wednesday last, a letter appeared on the Letters to the Editor page of this newspaper from Dr Katherine Brown, MB, MRCPI, MRCPsych., Consultant Psychiatrist, criticising my recent column about the manner in which the phenomenon of male suicide has been ignored by Irish society. I welcome letters about my column, however critical, and rarely respond to them directly.

But the letter by Dr Katherine Brown, MB, MRCPI, MRCPsych. (hereinafter referred to as "Dr Brown"), rather than engaging with the issues I had raised, attacked me on the basis that I was doing a "disservice" to those at risk of suicide and families bereaved "in such tragic circumstances". Dr Brown described my approach as "unhelpful" and asserted that it might serve to "alienate those individuals, in particular young men, who are at risk".

It would be more helpful, wrote Dr Brown, "to focus on all the relevant issues as they are known relating to suicide in young men and highlight the availability of services, both statutory and voluntary, that are there to help such people".

This is a tactic which has been adopted before by those who find my writings uncomfortable. Rather than deal with the substance of the argument, better by far to suggest that the writer is being irresponsible or worse. This approach has a twofold purpose: to alienate the reader from the writer and to facilitate the reinterment of the subject under the nearest carpet. My article of two weeks ago was mostly about the failure of Irish media to draw attention to the fact that the overwhelming majority of suicide victims are male. I have written other articles on the general subject of suicide, including one of my earliest contributions to this newspaper in 1990, a two-part series on the subject.

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As a result of those articles, I was invited to address a seminar of Samaritan volunteers. In these and other articles, I have written about many aspects of suicide, focused on all the relevant issues relating to suicide in young men and highlighted the availability of services, both statutory and voluntary, which are there to help such people.

The point I made in my recent column, with which Dr Brown made no attempt to engage, could be summarised as follows: in the most recent period for which suicide figures are available, i.e., the months of July, August and September 1998, 88 per cent of suicides were by males. This, by any standards, is an astounding figure. But, despite the fact that this information is readily available from the Central Statistics Office, no journalist, apart from myself, has seen fit to mention it.

Neither has any specialist in the subject of suicide, any clergyman, any politician or any other public figure chosen to draw attention to it.

Purporting to refute my argument about the studied attempt by this society to ignore the phenomenon of male suicide, Dr Brown stated that "the late eminent Dr Michael Kelleher" wrote an editorial in the British Journal of Psychiatry in September 1998 "discussing youth suicide rates in the Republic of Ireland and particularly addressing the issues relevant to young men". I fail to see how this undermines my argument about male suicide being ignored by Irish media and society.

I had the height of respect for Dr Kelleher and spoke to him on several occasions, quoting his views frequently. But I doubt he would have asserted that an article in the British Journal of Psychiatry amounted to, or obviated the need for, a serious engagement by Irish society with the catastrophic increase in the numbers of suicides by young men.

I AM not an expert on suicide. I am a journalist doing my job in drawing public attention to issues of importance. I have tried to do this by researching this subject, by talking to experts and people active in the area, and by observing both changing trends and the societal responses to these.

I ask the question again: why is there such a reluctance to engage with the fact that the vast majority of suicide victims are male? This is surely something which transcends semantics about whether an article in an obscure British journal amounts to a full and proper public debate. Why, when I seek to raise this issue, am I bludgeoned by those whose responsibility it is to have this subject brought to light? The reason, as I stated in my last article, is that suicide is an issue which most irrefutably challenges one of the dominant ideologies of this society: the simplistic belief that women are oppressed and men oppressors.

Dr Brown sought to question my observations concerning the general patterns in suicide and parasuicide, implying that there is no gender dimension to this dichotomy. In his book, Britain on the Couch, Dr Oliver James baldly states: "Women have been consistently more likely to attempt suicide than men". We know from the figures that men are far more likely to succeed in killing themselves. Close to the truth of this matter is the fact that women have an understanding with society which allows them to send warning signals, whereas men do not. Female depression and the associated phenomenon of parasuicide are not the same phenomenon as male suicide; the first exists in a public context of help and listening, the second in a public context of indifference and denial.

The phenomenon of male suicide is profoundly linked to the paradoxical position of men in modern societies - to the fact that, while led to believe they are members of the dominant sex, many men, in their private experience, feel relatively powerless compared with women. I am happy again to quote the late Dr Kelleher, who in March 1990 told a gathering at St Patrick's Hospital in Dublin: "When an individual takes his own life it is not simply, as the Stoics thought, a personal statement; it is also a comment on the individual's social environment.

"With each death by suicide the question of responsibility should be considered. A society that can face questions such as: to what extent did the individual contribute to his own demise?; to what extent did his environment precipitate his death or fail to protect him from it?; to what extent was the treatment given to him inadequate for his needs?; and to what extent did society itself, including the formative forces of his youth, lead him to death by his own hand later?; is on the right pathway to better social and mental health".

Rather than seeking to rubbish my admittedly layman's understanding of the subject, it might be useful if experts like Dr Brown, who follow Dr Kelleher's illustrious footprints, sought to tease out in public what is, to the most cursory observation, a fairly consistent and worsening overall pattern of women threatening to kill themselves and men actually doing so.