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Six years ago, my brother committed suicide. He was 28 years old.
Tragically, suicide is not as rare as one might think. In 2016, according to World Health Organization (WHO) global data for the past year, an estimated 793,000 people worldwide were killed by suicide. Most were men.
In the United Kingdom, the suicide rate among men is the lowest since 1981 – 15.5 deaths per 100 000 inhabitants. But suicide remains the leading cause of death among men under 45 years of age. A marked split between the bades remains. For British women, the rate is one third that of men: 4.9 suicides per 100 000 inhabitants.
It's the same in many other countries. Compared to women, men are three times more likely to commit suicide in Australia, 3.5 times more in the United States and more than four times more in Russia and Argentina. WHO data show that nearly 40% of countries have more than 15 suicide deaths per 100,000 men; Only 1.5% have such a high rate for women.
The trend is old. "As long as we record this information, we notice this disparity," says psychologist Jill Harkavy-Friedman, vice president of research at the American Foundation for Suicide Prevention, a health organization that supports suicidal people.
Suicide is an extremely sensitive and complex problem that has a multitude of entangled causes – and the very nature of death by suicide means that we can never fully understand the reasons for it.
Nevertheless, as mental health awareness grows, the public becomes more aware of potential contributing factors. One of the persistent issues, however, is the gender gap. This seems particularly important given that rates of depression diagnosis are generally higher among women.
Women are also even more likely than men to attempt suicide. In the United States, for example, in the United States, adult women reported a suicide attempt 1.2 times more often than men. But suicide methods in men are often more violent, which makes them more likely to be completed before anyone can intervene. Access to means is a determining factor: in the United States, for example, six in ten gun owners are men – and guns are responsible for more than half of all suicides.
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Men can also choose these methods because they are more inclined to carry out the act. A study of more than 4,000 hospitalized patients who self-injected revealed, for example, that men had higher suicidal intentions than women.
Why do men struggle – and what can be done about it?
Risk factors
A key element is communication. It is too simplistic to say that women are willing to share their problems and that men tend to bottle them. But it is true that for generations, many societies have encouraged men to be "strong" and not to admit that they are struggling.
It often starts in childhood. "We tell the boys that the boys are not crying," said Colman O'Driscoll, executive director of operations and development at Lifeline, an Australian charity providing 24-hour help in crisis and emergency situations. suicide prevention. "We condition boys from an early age not to express their emotions because expressing emotions is to be 'weak'."
Mara Grunau, Executive Director of the Center for Suicide Prevention in Canada, explains how we talk to our children and encourage them to communicate with each other: "Mothers talk a lot more with their daughters than boys … and they share and identify feelings, "she says more." We almost expect women to be emotional. "
But men may be less inclined to admit when they feel vulnerable, either to themselves, their friends or a GP. They may also be more reluctant than women to see a doctor. A British study from the British Medical Journal found that primary care consultation rates were 32% lower for men than for women. (Counseling rates for depression, as measured by the prescription of antidepressants in patients, were 8% lower in men than in women).
"Men are less likely to use mental health help," says Harkavy-Friedman. "It's not that men do not have the same problems as women – but they're a little less likely to know that they're suffering from stress or mental health issues exposing them to a greater suicide risk ".
If a person is not even aware that they have an illness that makes them sad, they are less aware that nothing can be done to help them. According to Harkavy-Friedman, only one-third of those who commit suicide are in mental health treatment.
Dangerously, rather than seeking help through the usual channels, some men may try to "heal themselves".
"There is usually an increase in alcohol and drug use among men, which may well reflect the distress they feel – but we know that it worsens the problem of suicide," he said. Harkavy-Friedman.
Indeed, men are almost twice as likely as women to meet the criteria for alcohol dependence. But drinking can worsen depression and increase impulsive behavior and alcoholism is a known risk factor for suicide.
Other risk factors may be related to family or work. For example, when the economic downturn leads to an increase in unemployment, the number of suicides generally increases – usually 18 to 24 months after the downturn. A 2015 study found that for every 1% increase in unemployment, there was a 0.79% increase in the suicide rate.
Having to worry more about one's finances or trying to find a job can exacerbate mental health problems for anyone. But there are also elements of social pressure and crisis of identity. "We have been raised all our lives to judge ourselves against our peers and to succeed economically," said Simon Gunning, CEO of Campaign Against Living Miserably (Calm), a UK-based, award-winning charity that is dedicated to suicide prevention in men. "When there are economic factors that we can not control, it becomes very difficult."
There can also be a spiral effect. In the United States, for example, health insurance is often related to employment. If someone is treated for depression or addiction, they may lose care when they lose their job.
A feeling of loneliness is another risk factor, as physician Thomas Joiner writes in his book Why People Die by Suicide. This can manifest in all areas of life. The seemingly prosperous professional who has given priority to career advancement at the expense of everything else, including social relationships, can end up "at the top of the pyramid alone," Grunau says.
Of course, it is important to remember that if an external factor can precipitate suicidal behavior in someone already in danger, this is never the only cause.
"Millions of people are losing their jobs, we almost all have lost a relationship and we do not end up dying of suicide," Harkavy-Friedman said.
Possible solutions
There is no simple solution for such a complex problem. But a number of programs, policies and non-profit organizations are making progress.
In Australia, for example, mental health and suicide prevention groups are attempting to change the cultural paradigm. An initiative that has gained ground is RU OK? day, which encourages people to support those who struggle with life by starting a conversation. Another approach is the "shoulder-to-shoulder principle" of encouraging men to talk while they are busy, such as watching football or cycling. Mates in Construction, a training and support program, educates the industry on high suicide rates and shows construction workers how they can contribute to the solution.
Overall, the focus is on "allowing men to talk about how they feel – and this is recognized as a sign of strength," O'Driscoll said.
Technology also presents new options. Everyone may not want to discharge their burden to another person, even through a hotline. But artificial intelligence, such as chatbots, could allow a vulnerable person to communicate and get the help that she needs without fear of being judged.
Another strategy is to focus on the impact of a suicide on loved ones. The Calm campaign project, 84, named to represent the 84 men who commit suicide each week in the UK, highlights the devastation. This may counteract some men's feeling that "it's the" right "thing to get out of the equation," Gunning says. He emphasizes: "Staying is always an option."
Other solutions simply consist of making suicides more difficult to complete. After setting up barriers on Clifton's suspension bridge in Bristol, England, for example, a study found that the number of deaths due to jumping over a bridge was halved – and nothing was wrong. Indicated that suicides caused by leaps from other sites in the area had increased.
Nevertheless, much remains to be done.
O'Driscoll compares the attention often given to the reduction of road accidents rather than the prevention of suicide, even if suicide makes more victims. In Australia, for example, the overall suicide rate in 2015 was 12.6 per 100,000 – the highest rate in more than 10 years – compared to 4.7 per 100,000 for road deaths.
Additional research is also needed. "Clearly," says Harkavy-Friedman, "there are differences between women and men in our biology, our hormonal structure and how our brains develop and function." But men and women are often studied together, and despite attempts to control statistical differences, that's not enough. She thinks we need to study men and women separately.
But there are positive signs. Harkavy-Friedman notes a huge change on the professional side, recalling that early in his career it was difficult to get a document on suicide accepted because it was thought that it was impossible to prevent the suicide, she said. Now, we know that it's wrong.
She also emphasizes that the government is more involved than ever. On the occasion of World Mental Health Day in 2018, the British government announced the appointment of its premier of suicide prevention. "The UK has been ahead of the game, at every stage of the process," she said, adding that she felt that the suicide rate in the UK had decreased because a national strategy had been implemented.
For Grunau too, the situation is definitely improving. "We are seeing momentum never seen," she says. "We can talk about suicide and people continue to flinch, but they are more willing to have the conversation."
This has had positive effects, as shown by the decline in the number of suicides in the United Kingdom. Yet that is not enough. All life lost to suicide – whether a man or a woman – is a life too many.
If you or someone you know is involved with this story, here are some resources that can help you.
In the United Kingdom and Ireland:
the Samaritans are open 24 hours a day. Call 116 123 or write to [email protected]
The campaign against the miserable life (Calm) offers support to men. Call 0800 58 58 58 from 5:00 pm to midnight every day or visit their webchat page here.
In the USA:
If you are in crisis, please call National suicide prevention lifeline at 1-800-273-TALK (8255) or contact the Crisis text line by texting TALK to 741741.
In Australia:
Call Safety rope the 13 11 14 or chatting on the Internet, every night seven days a week.
In Canada:
If you are in crisis, call 1-833-456-4566 (4357) or call 45645. For more information on suicide prevention, visit the Suicide Prevention Center.
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