Suicide

NOTE: Trigger warning on this post and the links.

A few weeks ago, there was a superb Panorama program on the BBC looking at the prevalence of middle-age, male suicide. On the back of that, I have read the Samaritans men, suicide and society report, which makes for quite difficult reading. That is the reason it has taken me so long to put this posting together, as the report is quite long and hard going.

I would warn people that the program and the report are very difficult to read and watch, and are not recommended for those who might find them upsetting.

The starting point was that the incidence of suicide among middle-age men shown a notable peak. Where most other groups have shown a decline, this group hasn't and is either bucking the general downward trend, or moving upwards. There is a problem with this demographic, and this program and report try to address the reasons behind this. I will attempt to provide some summary of these - although summarising 130 pages of report into one post is not simple! Which is one reason that this is such a long post.

The core reason identified was a problem with men losing their grasp on what it meant to be a man, a crisis in terms of their masculinity. This can come in a range of ways, and it is likely that multiple challenges occur at once. And masculinity is in crisis, not that this is necessarily a bad thing (or necessarily a good thing), but it is does have an impact on people.

One of the significant challenges is when men lose their jobs. In fact, this is probably the major factor in a masculinity crisis. Men still have a sense that in working, they do what they are expected to do, what they are supposed to do. However much we talk about the importance of people irrespective of their employment status, there are still many - of any gender, but especially males - for whom they see their definition in terms of their work. As a society we still define people by their work position and status. While "housewife" or "full-time mother" are perfectly valid and acceptable, "house-husband" and "full-time dad" are not so acceptable. Men who do not have an acceptable work title can feel like they are less than true men, that their masculinity is compromised.

A related aspect is that work in the UK - and the west as a whole - has changed over the last 50 years or so. Many of the more manual, physical typically male jobs has diminished - something that Mrs Thatcher can take some significant blame for. What this means is that, for some, the loss of a physical job can mean that they have to take an office job, or a "soft" job, something that they feel is less manly. Once again, this can lead to a sense of loss of manhood of masculinity. For men in middle age, they are unlikely to achieve a role that has anything that they can feel redeems their sense of self-worth. It is more likely to be a menial job - one that is probably demeaning whoever does it, but for someone trying to find purpose and meaning through their work, this is even worse.

I should point out that this perception is not necessarily true - their friends and family do not necessarily feel that they are "less of a man". That is not relevant in this case, because it is the potential suicides perception of their role, their position, rather that the truth. What the report makes clear is that perception is of primary importance, because it is the perception of an individual about their situation that may drive them to a suicidal act. Suicidal behaviour is driven by feelings and beliefs, not by objective truth.

It is also worth saying that the changes in employment and in the entire job situation has been exacerbated in the last few years, under the Tory government. As unemployment increases, and as unemployment is increasingly stigmatised by the government, this makes the likelihood of middle-aged men taking their own lives higher. Although the precise cause-and-effect is hard to define, and there are plenty of counter-examples, government policies that stigmatise the unemployed while making satisfying work harder to get, will lead to more deaths.

There are also changes to the functions of child-rearing in the family over the last 50 years or so. What was once the preserve of women became something that was expected to be shared between both genders. And yet, when relationships break up, it is often the men who are separated from their children, and this becomes traumatic. Having made the efforts to open up, show emotion, become openly emotionally attached to their children (something that seems obvious, but was not the case a number of years ago), they are suddenly torn away from this. The sense of loss, of failure, can be serious. This is especially true when combined with a perceived failure to fulfil the other fatherly expectation of earning the money to keep them. The inability to be a father in any more than the genetic sense can be very disheartening.

There is another related aspect here, that of the break up of relationships - something that is far more prevalent today than it has been. At a time when men might be very focussed on work, and would have expected to be supported at home, they find that this support is not there. Middle age is when many men find that work challenges are at their highest, often because they are pushing to get their final promotion, the final role in their working life, which is probably the hardest to get. It may be that the children are growing up and they are looking forward - either positively or negatively - to them not being at home any more. It is often a time when they realise that work will not provide everything in their lives, and so they are looking for something more out of life - and so to have what is for many their only non-work contact removed can be devastating.


The other side of this problem is that men deal with problems, stress, depression, suicidal thoughts and anything else in different ways to women (and those currently in middle age deal with things differently to the younger men). This part is rather more personal, because I do recognise most of this myself.

Firstly, we don't talk very well. Talking therapies - which are the mainstay of support and assistance for many people suffering disillusionment about life. Talking does not necessarily mean formal counselling - the report makes it clear that many women will talk about their problems in informal ways as well. Younger people are also better at talking. The particular group looked at do not have this outlet. What is more, men are generally better at hiding their feelings (and at not reading or seeing the real state of other people), meaning that sometimes men will take their own lives while even those closest to them were sure there was nothing wrong. Even when pressed, men are often dismissive of their own feelings and thoughts. Talking, in some form, is often the first step toward acknowledging the problems people are facing, and finding ways around them. Men are notoriously bad at going to doctors for "trivial matters", which is another place that problems can be identified early. So many of the early ways to identify problems are not ones that men take, and so early identification is lost - one suspects that this early identification, however precisely it occurs, saves many lives.

The second issue is that men often self-medicate. This can be with alcohol, work, activity, all sorts of things. By medicating ourselves, by actions that numb the pain, this serves to delay the crisis, rather than make an actual difference. Also, we have a tendency to keep our feelings in, not talk about them, but bury them. The result is that, at some point, this is liable to explode. Some (often minor) issue serves as the trigger, which can lead to a crisis, and can push someone to suicide. This introvert approach to dealing with problems can lead to a crisis causing a suicide attempt. The self medication can also be thrill seeking, risk taking, and this does mean that men often use more serious methods for suicide attempts than women.


Finally, historically, I did wonder whether some of the changes in our society have caused this peak to "appear", rather than "grow". When more of this demographic worked in industrial roles, I wondered whether some of the "industrial accidents" were actually suicides. What has actually changed is that they are now being classified appropriately. This means that the problem is not actually a recent one, but something that has been recently identified against the significant reduction in other suicides.

Conclusions? mainly that this is a problem, and telling this demographic to "talk to someone" is not necessarily helpful. Being prepared to listen is important, and an understanding that just being there for people is sometimes so important. Some of lifes events, that are often blandly dismissed as being "unfortunate", can have, for some people, very significant impact. For many, it is some minor issue that finally breaks them. and the loneliness that is associated with this is tragic.