Franklin James Cook

U.S. Suicide Prevention Oblivious to Working-Age Men

In Policy, Research on May 11, 2009 at 4:02 pm

By Franklin Cook, SPNAC Editor

Men and Mental Health: Get It Off Your Chest,” a study just released by Mind, the leading mental health charity in England and Wales, deserves attention in the United States, where what is known about suicide and men lines up very well with what is known in Great Britain.

Here’s what the study, in which 2,000 men and women were surveyed about their mental health, says about men and suicide. These survey results explain some of the reasons why 75 percent of suicide fatalities are men in England and Wales (79 percent of suicides in the United States are men).

When it comes to risk factors and thoughts of suicide:

  • Men are twice as likely as women to have suicidal thoughts when they are worried (seven times more likely for men age 45 to 54).
  • Young men (18 to 24) are five times as likely to take recreational drugs when worried as young women, and almost twice as many men overall as women drink alcohol to cope with feeling down.
  • Almost twice as many men as women get angry when they are worried.
  • Forty-five percent of men think they could fight off feeling down by themselves.

When it comes to getting help:

  • Only one-fourth of all men would see their physician if they felt “low” for more than two weeks, and only 14 per cent of men age 35 to 44 would do so.
  • Men are half as likely as women to go to a counselor or therapist to talk about their feelings.
  • Men are also about half as likely to talk to friends about their problems as women, and only about three out of 10 men are likely to talk to a friend about feeling low (and young men are the most likely to tell a friend to “pull themselves together”).

The Mind report makes several specific recommendations that address the mental health and government institutions in Great Britain, and several more general recommendations that could be translated to U.S. suicide prevention efforts for men:

  • Commissioners of health services should identify the need for and plan accordingly for male-specific mental health services.
  • The criteria used by health professionals for diagnosing mental health problems should include all indicators of a condition, including the more traditional male symptoms of “acting out.”
  • Health professionals should take gender into account when discussing treatment options with men.
  • Employers should learn to recognise the symptoms of men’s mental distress and introduce mental well-being policies.
  • Core education/training and continuing professional development of health and social services professionals should cover the relationship between gender, sexuality, and mental well-being.
  • Race equality and the needs of black and minority ethnic men should be made a priority …
  • Commissioners of mental health services and public health professionals should take into account the different needs men can have at different ages and plan services accordingly.

Most importantly, the leadership of the suicide prevention movement in America ought to be asking (and answering) these questions:

  • Since four out of five U.S. suicide deaths are by men, what is being done to institute a public health strategy for suicide prevention that specifically targets that obviously high-risk group (including in the areas referenced by the recommendations above)?
  • Since nearly two-thirds of all suicides in the United States are by men between the ages of 20 and 64 (precisely during their working years), shouldn’t suicide prevention for those people be one of the highest health-care priorities for employers and the institutions supporting employees throughout the country (such as the Department of Labor and the AFL-CIO, just to name a few)?

These questions are–and have been for a long time–knocking about in the background of  discussions about suicide prevention in the U.S., but developing the strategic answers is on no one’s radar that I know of. Yet there are a number of realities that indicate the need and opportunity for action:

  • The National Strategy for Suicide Prevention marked its eighth year in existence on May 1st, and while it still is an excellent blueprint for the public health response to suicide in America, it is now unquestionably overdue for an overhaul.
  • The national coordinating body intended to help guide the suicide prevention movement that was called for in the NSSP (which was to be instituted by 2002, in fact) is still not in place (although the Substance Abuse and Mental Health Services Administration, SAMHSA, several years ago indicated it was taking steps to organize such a group under the name “Action Alliance”).
  • The lessons being learned from four years of community-level suicide prevention work targeting youth and college students with funding from the Garrett Lee Smith Memorial Act are ripe for translation into programs for suicide prevention across the lifespan.

If suicide prevention is to be effectively based on the public health model, then the highest number of individuals in the population identified as a group that is most affected by the malady ought to be reached through intensive preventative measures. The time for making suicide prevention a priority in the United States among working-age men has come.

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  1. The day after posting “U.S. Suicide Prevention Oblivious to Working-Age Men,” CNN moved a story titled “New Report Underscores Women’s Mental Illness Concerns.” It points to a publication from the U.S. Department of Health and Human Services’ Office on Women’s Health titled “Action Steps for Improving Women’s Mental Health” that “brings together the most recent research, resources, products, and tools on mental health issues in women and explores the role gender plays in diagnosing, treating, and coping with mental illness. It also points to resilience and social support systems as key factors in overcoming mental illness. The report outlines specific action steps for policy-makers, health care providers, researchers, and others to take in an effort to address the burden of mental illness on women’s lives and increase their capacity for recovery.”

    I could not find what I was looking for with a simple search, but it seems reasonable to assume that a similar publication has been published for men, which would reflect some of the government’s strategic thinking about men’s mental health needs (which would be one component of a larger strategy specifically related to suicide among working-age men). Which makes me wonder if my headline “U.S. Suicide Prevention Oblivious to Working-Age Men” was a bit strongly stated and should have been something more like “U.S. Suicide Prevention Not Yet Focused on Working-Age Men”?

    A good starting place for further exploration might be the Office of Women’s Health’s page focused on men’s health.


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