MEN,
SUICIDE
AND
SOCIETY
Why disadvantaged men in
mid-life die by suicide
Research report
MEN,
SUICIDE
AND
SOCIETY
Why disadvantaged men in
mid-life die by suicide
Research report
MEN,
SUICIDE
AND
SOCIETY
Why disadvantaged men in
mid-life die by suicide
Research report
Rhiannon Evans, Brendan Kennelly, Olivia Kirtley, Graham Moore,
Foreword
CONTENTS
Executive summary 1
Introduction 4
Summary of findings 8
Explanation for the high risk of suicide in disadvantaged men in mid-life 21
Implications for policy and practice 26
Gender, relationship breakdown and suicide risk:
a systematic review of research in western countries
Rhiannon Evans, Jonathan Scourfield and Graham Moore 36
Men, suicide and society: the role of psychological factors
Olivia Kirtley and Rory O’Connor 57
Men, suicide and society: an economic perspective
Brendan Kennelly and Sheelah Connolly 73
Male suicide in mid-life: linking private troubles and large social process
Julie Brownlie 91
Exploring the role of masculinities in suicidal behaviour
Amy Chandler 111
Biographies 126
Executive summary
This report seeks to explain why men of low socio-economic position in their mid-years are
excessively vulnerable to death by suicide and provides recommendations to reduce these
unnecessary deaths.
The report goes beyond the existing body of suicide research and the statistics, to try and
understand life for this group of men, and why they may come to feel without purpose,
meaning or value.
The key message from the report is that suicide needs to be addressed as a health and gender
inequality – an avoidable difference in health and length of life that results from being poor and
disadvantaged; and an issue that affects men more because of the way society expects them to
behave. It is time to extend suicide prevention beyond its focus on individual mental health
problems, to understand the social and cultural context which contributes to people feeling
they wish to die.
Approach
Samaritans commissioned five leading social scientists to review evidence and theory in psychology,
sociology, economics and gender studies. The report takes as given that mental health problems
play a role in most suicides.
Psychological and personality factors
Some personality traits and ‘mind-sets’ contribute to the development of suicidal thoughts,
including the belief that you must always meet the expectations of others; self-criticism; brooding;
having no positive thoughts about the future and reduced social problem-solving ability. These traits
can interact with factors such as deprivation, and triggering events such as relationship breakdown
or job loss, to increase suicide risk.
Masculinities
Masculinity – the way men are brought up to behave and the roles, attributes and behaviours that
society expects of them – contributes to suicide in men. Men compare themselves against a
masculine ‘gold standard’ which prizes power, control and invincibility. When men believe they are
not meeting this standard, they feel a sense of shame and defeat. Having a job and being able to
provide for your family is central to ‘being a man’, particularly for working class men. Masculinity is
associated with control, but when men are depressed or in crisis, they can feel out of control. This
can propel some men towards suicidal behaviour as a way of regaining control. Men are more likely
to use drugs or alcohol in response to distress.
1 Samaritans 09/2012 Men, suicide and society
Relationship breakdown
Relationship breakdown is more likely to lead men, rather than women, to suicide. Men rely more
on their partners for emotional support and suffer this loss more acutely. Honour is also part of
masculinity, and to be ‘disrespected’ in front of others by the actions of their partner (infidelity or
abandonment) may lead to shame and/or impulsive reactions, perhaps to punish ex-partners. Men
are more likely to be separated from their children and this plays a role in some men’s suicides.
Emotional lives and social disconnectedness
The way men are taught, through childhood, to be ‘manly’ does not emphasise social and emotional
skills. Men can experience a ‘big build’ of distress, which can culminate in crisis. Men in mid-life are
dependent primarily on female partners for emotional support. Women help them to recognise their
own distress, provide them with care and encourage them to seek help. Women maintain close
same-sex relationships across their lives, but men’s peer relationships drop away after the age of 30.
Women are much more open to talking about emotions than men of all ages and social classes.
Male friendships tend to be based on companionship through doing activities together. The ‘healthy’
ways men cope are using music or exercise to manage stress or worry, rather than ‘talking’. Men are
much less likely than women to have a positive view of counselling or therapy. However, both men
and women make use of these services at times of crisis.
Men in their mid-years today
Mid-life has traditionally been viewed as the prime of life. However, there is evidence of mental ill-
health and a dip in subjective wellbeing among people in their mid-years, compared to young and
older people. Problems with relationships and employment during mid-life are experienced
intensely, because by this life-stage, people have typically invested a great deal in work and
relationships and the possibilities for making changes in these areas are limited.
Men currently in their mid-years are the ‘buffer’ generation – caught between the traditional silent,
strong, austere masculinity of their fathers and the more progressive, open and individualistic
generation of their sons. They do not know which of these ways of life and masculine cultures to
follow. In addition, since the 1970s, several social changes have impacted on personal lives, including
rising female employment, increased partnering and de-partnering and solo-living. As a result, men
in mid-life are increasingly likely to be living on their own, with little or no experience of coping
emotionally or seeking help on their own, and few supportive relationships to fall back on.
Socio-economic position
There are systematic socio-economic inequalities in suicide risk. Socio-economic position can be
defined in many ways – by job, class, education, income, or housing. Whichever indicator is used,
people in the lower positions are at higher risk of suicide. As you go down each rung of the social
ladder, the risk of suicide increases, even after taking into account underlying mental health
problems. There is debate over precisely how low social position increases suicide risk. Suggestions
include having many more adverse experiences, powerlessness, stigma and disrespect, social
exclusion, poor mental health and unhealthy lifestyles.
Unemployment in the UK is higher among men than women. This is related to the decline of
predominantly male types of employment, such as manufacturing. Men have also been affected by the
2 Samaritans 09/2012 Men, suicide and society
general trend towards irregular work patterns, insecure or temporary work and self-employment, and
the current recession.
Conclusions
Suicide is an individual act, the tragic culmination of mental health problems, feelings of defeat,
entrapment, that one is worthless, unloved and does not matter. However, these feelings are
produced within a specific social, economic and cultural context. This report shows that there have
been a number of significant changes in society over the last 50 years – the shift from repressive pre-
war to liberal post-war culture; changes to the roles of men and women and to the structures of
families; economic restructuring and the decline of traditionally male industries. The impact of these
processes has not been uniform across society; they pose challenges in particular to the group of men
currently in mid-life, and these challenges are exacerbated when men occupy low socio-economic
positions. The social context means this group of men is likely to experience multiple risk factors for
suicide, interacting in devastating combination. They have seen their jobs, relationships and identity
blown apart. There is a large gap between the reality of life for such men and the masculine ideal.
Recommendations
Samaritans calls on national government, statutory services (such as health, welfare, employment
and social services), local authorities and the third sector to take action to reduce suicide in
disadvantaged men in mid-life. Our recommendations are:
1 Ensure that suicide prevention strategies include explicit aims to reduce
socio-economic inequalities and gender inequalities in suicide.
2 Inform suicide prevention measures with an understanding of men’s beliefs,
concerns and contexts – in particular their views of what it is to ‘be a man’.
3 Enable inter-agency working to address the multiple difficulties experienced by
men in mid-life, through clear allocation of responsibility and accountability for
suicide prevention at local level.
4 Support GPs to identify and respond to distress in men, recognising that GPs are
the most likely formal source of help to be consulted by this age-group.
5 Provide therapies which address the specific psychological factors associated with
suicide – particularly, for men, social and emotional skills, managing stress and the
expectations of others.
6 Develop innovative approaches to working with men that build on the ways men
do ‘get through’ in everyday life.
7 Join up alcohol and drugs strategies and services with suicide prevention, recognising
the links between substance misuse, masculinity, de
MEN,
SUICIDE
AND
SOCIETY
Why disadvantaged men in
mid-life die by suicide
Research report
MEN,
SUICIDE
AND
SOCIETY
Why disadvantaged men in
mid-life die by suicide
Research report
MEN,
SUICIDE
AND
SOCIETY
Why disadvantaged men in
mid-life die by suicide
Research report
Rhiannon Evans, Brendan Kennelly, Olivia Kirtley, Graham Moore,
Foreword
CONTENTS
Executive summary 1
Introduction 4
Summary of findings 8
Explanation for the high risk of suicide in disadvantaged men in mid-life 21
Implications for policy and practice 26
Gender, relationship breakdown and suicide risk:
a systematic review of research in western countries
Rhiannon Evans, Jonathan Scourfield and Graham Moore 36
Men, suicide and society: the role of psychological factors
Olivia Kirtley and Rory O’Connor 57
Men, suicide and society: an economic perspective
Brendan Kennelly and Sheelah Connolly 73
Male suicide in mid-life: linking private troubles and large social process
Julie Brownlie 91
Exploring the role of masculinities in suicidal behaviour
Amy Chandler 111
Biographies 126
Executive summary
This report seeks to explain why men of low socio-economic position in their mid-years are
excessively vulnerable to death by suicide and provides recommendations to reduce these
unnecessary deaths.
The report goes beyond the existing body of suicide research and the statistics, to try and
understand life for this group of men, and why they may come to feel without purpose,
meaning or value.
The key message from the report is that suicide needs to be addressed as a health and gender
inequality – an avoidable difference in health and length of life that results from being poor and
disadvantaged; and an issue that affects men more because of the way society expects them to
behave. It is time to extend suicide prevention beyond its focus on individual mental health
problems, to understand the social and cultural context which contributes to people feeling
they wish to die.
Approach
Samaritans commissioned five leading social scientists to review evidence and theory in psychology,
sociology, economics and gender studies. The report takes as given that mental health problems
play a role in most suicides.
Psychological and personality factors
Some personality traits and ‘mind-sets’ contribute to the development of suicidal thoughts,
including the belief that you must always meet the expectations of others; self-criticism; brooding;
having no positive thoughts about the future and reduced social problem-solving ability. These traits
can interact with factors such as deprivation, and triggering events such as relationship breakdown
or job loss, to increase suicide risk.
Masculinities
Masculinity – the way men are brought up to behave and the roles, attributes and behaviours that
society expects of them – contributes to suicide in men. Men compare themselves against a
masculine ‘gold standard’ which prizes power, control and invincibility. When men believe they are
not meeting this standard, they feel a sense of shame and defeat. Having a job and being able to
provide for your family is central to ‘being a man’, particularly for working class men. Masculinity is
associated with control, but when men are depressed or in crisis, they can feel out of control. This
can propel some men towards suicidal behaviour as a way of regaining control. Men are more likely
to use drugs or alcohol in response to distress.
1 Samaritans 09/2012 Men, suicide and society
Relationship breakdown
Relationship breakdown is more likely to lead men, rather than women, to suicide. Men rely more
on their partners for emotional support and suffer this loss more acutely. Honour is also part of
masculinity, and to be ‘disrespected’ in front of others by the actions of their partner (infidelity or
abandonment) may lead to shame and/or impulsive reactions, perhaps to punish ex-partners. Men
are more likely to be separated from their children and this plays a role in some men’s suicides.
Emotional lives and social disconnectedness
The way men are taught, through childhood, to be ‘manly’ does not emphasise social and emotional
skills. Men can experience a ‘big build’ of distress, which can culminate in crisis. Men in mid-life are
dependent primarily on female partners for emotional support. Women help them to recognise their
own distress, provide them with care and encourage them to seek help. Women maintain close
same-sex relationships across their lives, but men’s peer relationships drop away after the age of 30.
Women are much more open to talking about emotions than men of all ages and social classes.
Male friendships tend to be based on companionship through doing activities together. The ‘healthy’
ways men cope are using music or exercise to manage stress or worry, rather than ‘talking’. Men are
much less likely than women to have a positive view of counselling or therapy. However, both men
and women make use of these services at times of crisis.
Men in their mid-years today
Mid-life has traditionally been viewed as the prime of life. However, there is evidence of mental ill-
health and a dip in subjective wellbeing among people in their mid-years, compared to young and
older people. Problems with relationships and employment during mid-life are experienced
intensely, because by this life-stage, people have typically invested a great deal in work and
relationships and the possibilities for making changes in these areas are limited.
Men currently in their mid-years are the ‘buffer’ generation – caught between the traditional silent,
strong, austere masculinity of their fathers and the more progressive, open and individualistic
generation of their sons. They do not know which of these ways of life and masculine cultures to
follow. In addition, since the 1970s, several social changes have impacted on personal lives, including
rising female employment, increased partnering and de-partnering and solo-living. As a result, men
in mid-life are increasingly likely to be living on their own, with little or no experience of coping
emotionally or seeking help on their own, and few supportive relationships to fall back on.
Socio-economic position
There are systematic socio-economic inequalities in suicide risk. Socio-economic position can be
defined in many ways – by job, class, education, income, or housing. Whichever indicator is used,
people in the lower positions are at higher risk of suicide. As you go down each rung of the social
ladder, the risk of suicide increases, even after taking into account underlying mental health
problems. There is debate over precisely how low social position increases suicide risk. Suggestions
include having many more adverse experiences, powerlessness, stigma and disrespect, social
exclusion, poor mental health and unhealthy lifestyles.
Unemployment in the UK is higher among men than women. This is related to the decline of
predominantly male types of employment, such as manufacturing. Men have also been affected by the
2 Samaritans 09/2012 Men, suicide and society
general trend towards irregular work patterns, insecure or temporary work and self-employment, and
the current recession.
Conclusions
Suicide is an individual act, the tragic culmination of mental health problems, feelings of defeat,
entrapment, that one is worthless, unloved and does not matter. However, these feelings are
produced within a specific social, economic and cultural context. This report shows that there have
been a number of significant changes in society over the last 50 years – the shift from repressive pre-
war to liberal post-war culture; changes to the roles of men and women and to the structures of
families; economic restructuring and the decline of traditionally male industries. The impact of these
processes has not been uniform across society; they pose challenges in particular to the group of men
currently in mid-life, and these challenges are exacerbated when men occupy low socio-economic
positions. The social context means this group of men is likely to experience multiple risk factors for
suicide, interacting in devastating combination. They have seen their jobs, relationships and identity
blown apart. There is a large gap between the reality of life for such men and the masculine ideal.
Recommendations
Samaritans calls on national government, statutory services (such as health, welfare, employment
and social services), local authorities and the third sector to take action to reduce suicide in
disadvantaged men in mid-life. Our recommendations are:
1 Ensure that suicide prevention strategies include explicit aims to reduce
socio-economic inequalities and gender inequalities in suicide.
2 Inform suicide prevention measures with an understanding of men’s beliefs,
concerns and contexts – in particular their views of what it is to ‘be a man’.
3 Enable inter-agency working to address the multiple difficulties experienced by
men in mid-life, through clear allocation of responsibility and accountability for
suicide prevention at local level.
4 Support GPs to identify and respond to distress in men, recognising that GPs are
the most likely formal source of help to be consulted by this age-group.
5 Provide therapies which address the specific psychological factors associated with
suicide – particularly, for men, social and emotional skills, managing stress and the
expectations of others.
6 Develop innovative approaches to working with men that build on the ways men
do ‘get through’ in everyday life.
7 Join up alcohol and drugs strategies and services with suicide prevention, recognising
the links between substance misuse, masculinity, de
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