Lessons in male suicide

What's the issue?

In Australia, males die by suicide at higher rates than females. Data from the Australian Bureau of Statistics shows that in 2023 a total of 2,419 men died by suicide (18.0 deaths per 100,000 population) compared to 795 women (5.8 per 100,000).1 The rates of help-seeking from men is also lower than women.2

How people and services engage with men experiencing suicidal thoughts and behaviours is vital to the prevention of suicide.

What was done?

In 2022 Suicide Prevention Australia released, Male Suicide Prevention Principles to assist Australia’s suicide prevention approaches in meeting the needs of men.3

This research article reflects on the content of the report and shares specific information for psychologists and research in clinical practice in Australia.

What was found?

Male suicide is influenced by interacting factors predominately centring on ‘masculinity’. Masculinity can encompass a range of social, behavioural, cultural and religious traits that influence how males think and act – including suicidal thoughts and behaviours.

1. The role of gender and masculinity influence health beliefs and willingness to seek support

In Australia, males are often exposed to masculine norms which include stoicism and self-reliance. These masculine norms can impact health beliefs including those related to mental health and suicide, and can be a barrier to help seeking.4,5

Masculine norms:

  • Have been linked to suicidal ideation and suicide deaths6
  • Can influence men to choose more lethal means to suicide7
  • Can increase aggression and risk-taking behaviours
  • Can influence men to internalise distress and is a barrier to help-seeking
  • Can encourage men to confront risk and fear, and deal with issues in self-destructive and risky behaviours
  • Can influence men not to talk about suicide and problems for fear of this communication being seen as a feminine trait and against masculine norms.7

2. Males who die by suicide often experience a mental health concern or use alcohol and other drugs

The researchers share that 21.4 per cent of Australian males aged over 16 experience mood disorders, anxiety disorders and/or substance use problems each year.8

The research also shows that 63 per cent of males who died by suicide lived with a mental health or behavioural disorder.9

  • A clinical barrier to supporting males is that the criteria used to identify mental health concerns are not male specific and therefore males' distress may go unidentified.10
  • Males have higher rates of substance misuse which can influence risk-taking behaviours, including suicidal behaviours.8

3. Social connections and family protect males against suicide

  • The research shows that males often prefer self-reliance than seeking support from social connections and professional services.11
  • Social connections and family are important protective factors for males against suicide.12
  • Data shows that 14.8 per cent of males who died by suicide had been separated or divorced, 11.7 per cent had problems with partners, and 7.8 per cent were experiencing legal problems.13
  • Males from minorities (LGBTIGQ+, Aboriginal and Torres Strait Islander males, older males) can face additional stressors from stigma and discrimination and have higher levels of social thoughts, behaviours and attempts.14

4. Males prefer self-reliance over professional support services

  • Males often delay seeking help. Suicidal thoughts and behaviours can be severe before professional help is involved.15
  • Males often prefer self-reliance for problems over accessing professional services.
  • Males' previous experiences with health systems can be a barrier to help-seeking and the type of help offered doesn’t always meet males' needs and expectations.16

Advice for psychologists in research and clinical practice in Australia

  • All males will require unique and different support from clinical and community support services. A one-size fits all approach to male suicide prevention in clinical practice does not meet the needs of males.17
  • Psychologists should aim to support males to regulate emotions and teach them how to express their needs in ways that will lead them to further support, or to access support when needed.
  • Psychologists should promote healthy coping strategies where possible away from alcohol and other drug use and encourage social connections and communication with others around challenges.18
  • Therapy that allows males to navigate the process on their terms, and gives them control, can be most effective to support males experiencing suicidal thoughts and behaviours. In addition, therapy that incorporates masculinity in positive ways can support males experiencing suicidal thoughts and behaviours.

Why are the findings important?

Low help-seeking behaviours have been linked to increased suicidal thoughts and behaviours.15

Understanding the factors that may drive low help-seeking in males such as self-reliance, stoicism and stigma, and how these are associated with masculinity, can help us to respond to males' needs and provide services and support that best serve males.

Notes

1

Australian Bureau of Statistics (2024). Causes of Death, Australia. Available from https://www.abs.gov.au/statistics/health/causes-death/causes-death-australia/latest-release#intentional-self-harm-deaths-suicide-in-australia

2

Burgess P, Pirkis J, Slade T, Johnston A, Meadow G, Gunn J. Service use for mental health problems: Findings from the 2007 national survey of mental health and wellbeing. The Australian and New Zealand Journal of Psychiatry 2009; 43(7), 615–623.

3

Suicide Prevention Australia. Male Suicide Prevention Principles Suicide Prevention Australia. 2022. Available from SPA_Male-Suicide-Prevention-Report_2022_FINAL.pdf

4

Connell R. Masculinities (2nd ed.) Allen & Unwin. 2005.

5

Courtenay H. Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Social Science & Medicine 2000; 50(10), 1385–1401. https://doi.org/10.1016/S0277-...(99)00390-1(99)00390-1.

6

Pirkis J, Spittal M, Keogh L, Mousaferiadis T, Currier D. Masculinity and suicidal thinking. Social Psychiatry & Psychiatric Epidemiology 2017; 52(3), 319–327.

7

Mergl R, Koburger N, Heinrichs K, Székely A, Tóth M, Coyne J, Quintão S, Arensman E, Coffey C, Maxwell M, Värnik A. What are the reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four European countries. PLOS ONE 2015; 10(7), e0129062.

8

Australian Bureau of Statistics. National study of mental health and wellbeing. ABS. Canberra.

9

Australian Institute of Health and Welfare. Psychosocial risk factors & suicide. Australian Insitute of Health and Welfare 2023.

10

Oliffe JL, Ogrodniczuk JS, Bottorff JL, Johnson JL, Hoyak K. “You feel like you can’t live anymore”: Suicide from the perspectives of Canadian men who experience depression. Part Spec Issue Men Masculinities Suicidal Behav. 2012 Feb 1;74(4):506–14.

11

Beyond Blue. Men’s social connectedness. Hall & Partners. 2014.

12

Milner A, Page A, Morrell S, Hobbs C, Carter G, Dudley M, Duflou J, Taylor R. Social connections and suicidal behaviour in young Australian adults: Evidence from a case-control study of persons aged 18–34 years in NSW, Australia. SSM - Population Health, 2015(1), 1–7.

13

Australian Institute of Health and Welfare. Psychosocial risk factors & suicide. Australian Institute of Health and Welfare, 2023.

14

Balakrishnan K, Haregu T, Hill A, Young J, Armstrong G. Discrimination experienced by sexual minority males in Australia: Associations with suicidal ideation and depressive symptoms. Journal of Affective Disorders 2022; 305, 173–178. https://doi.org/10.1016/j.jad....

15

Calear A, Batterham P, Christensen H. Predictors of help-seeking for suicidal ideation in the community: Risks and opportunities for public suicide prevention campaigns. Psychiatry Research 2014; 219(3), 525–530. https://doi.org/10.1016/j.psyc...

16

Seidler Z, Wilson M, Toogood N, Oliffe J, Kealy D, Ogrodniczuk J, Rice S. Pilot evaluation of the men in mind training program for mental health practitioners. Psychology of Men & Masculinities 2022; 23, 257– 264. https://doi.org/10.1037/men000...

17

Bennett S, Glasgow U, Zortea T, Dickson A, Richardson C, Glasgow U. Male suicide risk and recovery factors: A systematic review and qualitative meta synthesis of two decades of research. Psychological Bulletin 2023; 149(7–8), 371–417. https://doi.org/10.1037/bul000...

18

Englar-Carlson M, Kiselica M.Affirming the strengths in men: A positive masculinity approach to assisting male clients. Journal of Counseling & Development 2013; 91(4), 399–409.

Study information

Authors

  • Kylie King
  • Adriel Burley
  • Zac Seidler
  • Greg Armstrong
  • Lakshmi Vijayakumare

Study originally published

9 October 2024

Read the full paper

Translated on Life in Mind

11 December 2024

Population group

Citation

King K, Burley A, Seidler Z, Armstrong G, Vijayakumar L. What psychologists need to know about men and suicide. Australian Psychologist 2024; 59(6), 487–495. https://doi.org/10.1080/00050067.2024.2404116