Men in pain find it hard to seek help


Four times more men than women take their own lives and suicide prevention groups need to address that, writes CAROL RYAN

IT IS ONE AREA in which men won’t be happy to be over-represented. Ireland’s suicide statistics show a glaring imbalance between the sexes. Of the 486 deaths from suicide in 2010, 386 were men and 100 were women; a 4:1 ratio that has been evident for decades. Is enough attention given to the fact that men make up more than 75 per cent of suicides?

This is not just an Irish problem. The same pattern is seen all over the world except in China. Researchers have tried to tease out the reasons men are so much more vulnerable to suicide.

One theory is that recent economic and social changes (particularly changes in traditional gender roles) are affecting men more than women and have led to the spike in male suicide rates seen in Western countries since the 1970s. The way boys are reared may also be to blame. Restrictive rules about what is and isn’t “masculine” are drilled into young boys at home and in the school yard, making it harder for men to talk about their problems.

A theme that keeps emerging in male suicide is that even in the depths of despair, some men have kept their pain hidden from family and friends and never asked for help. The ideal man is still supposed to be a rugged individualist who solves his own problems and hides his vulnerabilities.

If men get the message from a young age that problem sharing is not masculine, the “seek help” message of most suicide prevention campaigns is likely to fall on deaf ears. Countries that have aggressively targeted male suicide recognise this and try to work around it.

The Choose Life suicide prevention campaign in Scotland has reduced the male suicide rate by 15 per cent since 2000 with a wide-ranging campaign specifically aimed at men. It teamed up with the Scottish Football Association to design sports themed slogans such as “There is no substitute for life” and “Help a friend stay in the game”, which encourage men to look out for each other.

Another campaign for US war veterans who have a very high suicide rate uses the slogan, “It takes the courage and strength of a warrior to ask for help”. It may not be subtle but the campaign chips away at the idea that seeking help is “unmanly”.

National suicide prevention campaigns in Ireland are largely gender neutral but surely if men are most at risk, campaigns should be targeting them. Phil Mac Giolla Bhain, author of Preventable Death: The Scandal of Male Suicide in Modern Ireland, says we are ignoring the fact that suicide is mainly a killer of men. He calls current suicide prevention campaigns “about as focused as putting up posters advertising cervical cancer screening in men’s toilets”. It is a tough stance, but there does seem to be growing awareness that male suicide needs attention.

Dr Anne Cleary, from the UCD Department of Sociology, says that while successive governments have given a great deal of attention to suicide, a more “gender sensitive” angle is needed. As some men won’t spell out that they are in difficulty, it is important that health professionals are trained to spot signs that a man is in trouble.

“AE is absolutely crucial in identifying people who are in need because that is where they will often turn up. A gender sensitive approach is to know that there are quite a lot of men who will not come in and say, ‘I have a problem’, they are going to present in different ways. They might come in with an overdose, or it is well known that some of them might crash their car or do something reckless. It is really important they are assessed by people who are specialist in picking up this kind of thing”.

She also found in her research into male suicide that counselling methods may need to be looked at. “Men don’t really like the psychotherapy approach, the talking. Maybe it is true that psychotherapy, counselling, and talking suits women more at this time . . . they like approaches that are a little bit sharper, shorter, more focused on problem solving,” she says.

Former director of the HSE National Office for Suicide Prevention (NOSP) Geoff Day points out that while more could be done, the NOSP is involved in several male-focused suicide-prevention initiatives.

It is funding a Crosscare project to train two Traveller men to work in suicide prevention within their community where male suicide rates are seven times the national average. Another cross-Border project being co-funded by the NOSP and the Public Health Agency in Northern Ireland is looking at best practice in working with men in the area of suicide prevention.

“Some of the general campaigns do target men because they target both sexes but there is a need to have something targeted just at men. This is very slow-burn stuff, it is not going to happen quickly because we have years of stigma about men being macho to overcome, but I think there is a willingness for men now to realise they need to open up”. He says there is no single solution to male suicide but that campaigns for specific groups of men (such as men in rural areas or younger men) might be more effective than a “one size fits all” approach.

In 2006, the NOSP published The Male Perspective which gives a glimpse of young Irish men’s outlook on life. The study is an important step in trying to find out why Ireland has one of the highest rates of male youth suicide in the world. One of its recommendations is that suicide prevention and research should have a gendered focus. The study found 12 per cent of the men interview-ed had a problem in the past year for which they needed professional help but didn’t seek it, while 60 per cent agreed that “the lot of the average man is getting worse in Ireland”.

The research also showed that mothers are an important source of support for young men: 60 per cent said they would turn to their mothers when they needed to talk, compared with 37 per cent who seek out their fathers.

“It is interesting. We assume that men want to talk to men, but actually the reverse seems to be true, quite often they want to talk to women. We want to try and encourage men to be listeners too,” says Day.

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