The uncomfortable truth: why do more men than women commit suicide?

The hangover of the "stiff upper lip" years leads directly and frighteningly to the deaths of hundreds of men in the UK. What can we do about it?

 

In 1997, a book by Marc Etkind called ...Or Not To Be: A Collection of Suicide Notes enjoyed quiet but firm success: quiet, because the buyers themselves often expressed feeling "uncomfortably morbid" about its purchase, even when they left online reviews; firm, because apparently this sort of morbid voyeurism is part and parcel of human nature. Staunch belief in this ubiquitous enjoyment of the gruesome and tragic is presumably why the book’s own editor referred to its content as "pornography".

But there are other reasons why people might have clamoured for the contents of Kurt Cobain’s last adieu to the world, or Sylvia Plath’s final explanation for a life of steady masochistic decline. Suicide is one of the most frightening and persistent occurrences in the world. It goes against everything we know about biology and those "natural" instincts which are apparently programmed towards survival. Its continued appearance across all strata of our own society, and all societies resident on our planet, utterly destroys the idea that we can ever centrally control, provide or quantify happiness. We might see patterns in suicidal behaviour periodically emerge - the dramatic spike in people taking their lives in the UK and US during the recession, for instance, certainly indicates a connection with financial hardship - but many, many suicides remain inexplicable. An extremely common response amongst family members who have lost loved ones to suicide is, "I don’t understand why". And so this undeniable interest in the suicide notes of others - those prized letters which, statistically, are hardly ever left - can be seen as a collective exercise in self-protection as well as straightforward morbidity. Reading the notes of others might arm us with some preventative measures, we reason. It might elucidate the mechanics of human drives turning in on themselves. It might even help us to eventually purge suicide from our global community altogether. 

That’s exactly what a research team at Cincinnati Children’s Hospital had in mind when they compiled "the world’s largest collection of suicide notes" and released the news to the North American media last month. One man, a professor of paediatrics called John Pestion, claimed in USA Today to have read all 1,300 of them in his quest to produce tools for diagnosing an individual’s true suicide risk. Whether the team will be successful remains to be seen, but for western societies, the issue is pressing. According to ONS, suicide is now the single biggest killer of young men in England and Wales; in recent years, it has more than once outstripped the number of deaths from road traffic accidents and assault combined.

Which brings us to the uncomfortable truth: that suicide has a clear gender bias. It is an event with a male face, although the specific affliction behind it is murkier. There are certain populations which suffer from the highest rates of all, such as prisoners and those from lower socioeconomic backgrounds. "But what exactly do we achieve when we shift our focus to these?" says Jane Powell, head of the male suicide prevention charity Campaign Against Living Miserably (CALM.) "The simple, numerical fact of the matter is that men are dying by their own hand far more than women. We need to tackle that immediately."

Jane Powell is a practical woman with a practical viewpoint. She was brought in as a freelancer to develop an anti-suicide pilot project for men in Manchester in 1997; she had no personal connection with suicide, but the issue quickly became her vocation. When she was asked to wind the pilot up, she decided to develop CALM into a fully fledged independent national charity instead. And she sees nothing strange in the idea of a woman heading up a charity that specifically targets male suicide: the numbers and the people spoke for themselves, she says, and she was in the right place at the right time. She wasn’t willing to walk away.

In many ways, an increased risk of suicide for men can be seen as that old foe, the patriarchy, backfiring on itself. Rigid binary structures of gender have led to a cultural expectation that men won’t voice depressive feelings or problems with anxiety, preferring instead to suffer in silence until the suffering becomes unbearable and they remove themselves resignedly from the fold. This conflation of emotional turmoil with weakness combines toxically with social stigma surrounding mental health. Often, the idea of a psychiatric visit literally becomes a fate worse than death.

"Men don’t want a diagnosis or an introduction to the mental health system," says Powell, simply, "so what’s the point in campaigning to get them to accept a label? In the here and now, we provide initiatives that acknowledge and normalise depressive feelings in men. We point them towards our helpline. We don’t insist that the man in question has to see his GP. We address the suicidal urge without implying that we might introduce him to a world of further prejudice; that’s how we prevent a man from killing himself. Of course we work to break down destructive expectations about traditional masculinity - but we’re pragmatic when someone is in the throes of a suicidal episode." In other words, she picks her battles.

Feminism, Powell believes, has progressed massively in terms of female expression in the last 40 years - she personally recalls once being refused a job for wearing trousers. Assertiveness is now a virtue for the "career woman" rather than a perversion of the "sweet, meek" housewife - and, indeed, trouser suits are the norm - but the parameters of the male identity have remained comparatively narrow. This blinding hangover of the "stiff upper lip" years leads directly and frighteningly to the deaths of hundreds of men in the UK (a number that, according to Powell, is climbing in certain age ranges.) While Powell might see this as feminism forgetting her brothers, however, it seems more likely that "male" attributes, with all their attached prestige, are easier to assimilate than those "female" ones which stink of instability and inferiority.

Whatever the reason, people die. And initiatives like CALM - which attempt to frame suicide as something that ‘everyone considers’ rather than a thought which, when voiced, could lead you straight into a hospital bed - are making practical differences. Young male suicide rates during their years of operation have dropped by 55 per cent in Merseyside alone. Discussions about mental health stigma and sexism desperately need to be further explored, but the technique over at CALM is working, and it’s working in difficult conditions. The general erosion of gender barriers, however, must be a society-wide effort - and until it is, Powell believes that we will continue to lose men in their droves.

Interestingly, the suicide note itself is one of the only aspects of the act which seems entirely isolated from the sex of the deceased. Men and women are equally likely (or unlikely) to leave behind written accompaniments to their untimely shuffling off the mortal coil - which range from the outright harrowing to such dark comedy as George Eastman’s "Dear friends: my work is done. Why wait?" Faced with the numbers, addressing suicide seems daunting - but a lot can be done through the day-to-day challenging of gender expectations. 

Because, ultimately, we all have a responsibility to give those like Eastman a reason for the waiting.

If any of the content of this story affects you, the Samaritans are available to talk 24 hours a day, 365 days a year.

Kurt Cobain in 1993. Photograph: Getty Images
Holly Baxter is a freelance journalist who writes regularly for The Guardian and The New Statesman. She is also one half of The Vagenda and releases a book on the media in May 2014.
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Metro mayors can help Labour return to government

Labour champions in the new city regions can help their party at the national level too.

2017 will mark the inaugural elections of directly-elected metro mayors across England. In all cases, these mayor and cabinet combined authorities are situated in Labour heartlands, and as such Labour should look confidently at winning the whole slate.

Beyond the good press winning again will generate, these offices provide an avenue for Labour to showcase good governance, and imperatively, provide vocal opposition to the constraints of local government by Tory cuts.

The introduction of the Mayor of London in 2000 has provided a blueprint for how the media can provide a platform for media-friendly leadership. It has also demonstrated the ease that the office allows for attribution of successes to that individual and party – or misappropriated in context of Boris Bikes and to a lesser extent the London Olympics.

While without the same extent of the powers of the sui generis mayor of the capital, the prospect of additional metro-mayors provide an opportunity for replicating these successes while providing experience for Labour big-hitters to develop themselves in government. This opportunity hasn’t gone unnoticed, and after Sadiq Khan’s victory in London has shown that the role can grow beyond the limitations – perceived or otherwise - of the Corbyn shadow cabinet while strengthening team Labour’s credibility by actually being in power.

Shadow Health Secretary and former leadership candidate Andy Burnham’s announcement last week for Greater Manchester was the first big hitter to make his intention known. The rising star of Luciana Berger, another member of Labour’s health team, is known to be considering a run in the Liverpool City Region. Could we also see them joined by the juggernaut of Liam Byrne in the West Midlands, or next-generation Catherine McKinnell in the North East?

If we can get a pantheon of champions elected across these city regions, to what extent can this have an influence on national elections? These new metro areas represent around 11.5 million people, rising to over 20 million if you include Sadiq’s Greater London. While no doubt that is an impressive audience that our Labour pantheon are able to demonstrate leadership to, there are limitations. 80 of the 94 existing Westminster seats who are covered under the jurisdiction of the new metro-mayors are already Labour seats. While imperative to solidify our current base for any potential further electoral decline, in order to maximise the impact that this team can have on Labour’s resurgence there needs to be visibility beyond residents.

The impact of business is one example where such influence can be extended. Andy Burnham for example has outlined his case to make Greater Manchester the creative capital of the UK. According to the ONS about 150,000 people commute into Greater Manchester, which is two constituency’s worth of people that can be directly influenced by the Mayor of Greater Manchester.

Despite these calculations and similar ones that can be made in other city-regions, the real opportunity with selecting the right Labour candidates is the media impact these champion mayors can make on the national debate. This projects the influence from the relatively-safe Labour regions across the country. This is particularly important to press the blame of any tightening of belts in local fiscal policy on the national Tory government’s cuts. We need individuals who have characteristics of cabinet-level experience, inspiring leadership, high profile campaigning experience and tough talking opposition credentials to support the national party leadership put the Tory’s on the narrative back foot.

That is not to say there are not fine local council leaders and technocrats who’s experience and governance experience at vital to Labour producing local successes. But the media don’t really care who number two is, and these individuals are best serving the national agenda for the party if they support A-listers who can shine a bright spotlight on our successes and Tory mismanagement.

If Jeremy Corbyn and the party are able to topple the Conservatives come next election, then all the better that we have a diverse team playing their part both on the front bench and in the pantheon of metro-mayors. If despite our best efforts Jeremy’s leadership falls short, then we will have experienced leaders in waiting who have been able to afford some distance from the front-bench, untainted and able to take the party’s plan B forward.