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Male suicide: status, society and a big unspoken issue

Male suicide: status, society and a big unspoken issue
Promoted by Male suicide: status, society and a big unspoken issue

By Colin Hawes, Claims & Medical Underwriting Manager – UK Employee Benefits, Generali

Suicide prevention probably doesn’t appear at the top of the priority list, if at all, when it comes to developing a wellbeing strategy.

It’s an issue that’s rarely discussed in public, or private for that matter, so you could be forgiven for thinking that it’s not a very big issue at all. But when you consider that men aged 20 – 49 in the UK are more likely to die from suicide than prostate cancer or coronary heart disease, its relevance becomes a lot more apparent.

In December, the Office for National Statistics published its latest data on suicides in the UK, based on 2016 registrations. It found that after many years of increases, suicide among men and women had fallen by 3.6% from 2015 – 2016: the largest decrease seen since 1995 – 1996. The current age-standardised annual suicide rate for the UK is 1.6 per 10,000 for males and 0.5 per 10,000 for females.

The fall in the number of suicides is welcome. But there’s a long way to go yet considering every week around 84 men in the UK take their own lives, as highlighted by the male suicide prevention charity Calm (Campaign Against Living Miserably) in its ‘Project 84’ campaign.

Of the 5,965 suicides registered in 2016, a total of 4,508 were male and 1,457 female. In other words, men account for three quarters of all suicides in the UK, and have done since the early 1990s.  Men aged 40 – 44 had the highest age-specific suicide rate at 24.1 per 100,000.

How can employers help?

Most companies probably have the tools to help already in place, in terms of Employee Assistance Programmes (EAPs) and other routes to talking therapies, plus stress resilience training and methods to de-stigmatise mental health issues. The problem is that these valuable resources – in particular, EAPs - are incredibly under-utilised.

Through effective communications and a culture shift, this could and should change. Employers are arguably best placed to provide a foundation of mental health support, alongside struggling public sector services.

As outlined by the Samaritans in its report Men, Suicide and Society “Confidential services which allow men to raise emotional difficulties spontaneously, rather than in a pre-planned way, are important and obviously emerging mobile phone and internet technologies have a part to play in this”.

What’s the government doing?

The money spent on suicide prevention by the government – in terms of mental health support at least – stands at a fraction of what’s spent on other leading causes of death. Overall, the charity Mind finds that while £160m is spent nationwide annually on encouraging people to stop smoking, £108m on anti-obesity programmes, and £76m on increasing physical activity, only £40m is spent on mental health, within which suicide prevention is just one problem.

At the same time, mental health problems cost the UK an estimated £100bn a year through lost working days, benefits, lost tax revenue and the cost of treatment, and account for 23% of the total burden of disease cost in the UK, according to Mind.

Although the government pledged a £1.3bn plan to improve mental health services, clinical commissioning groups and frontline services are not yet feeling any benefit after years of cuts and critics suggest that planned improvements will only scratch the surface, according to an article in The Guardian.

Why are men in mid-life more vulnerable?

Although there are no certainties with regards to reasons why, numerous studies now reveal certain common characteristics of victims.

Evidence from the Samaritans suggests that contributing factors and experience include: relationship breakdown, bereavement, socio-economic factors and mental health problems. All of these things affect women too of course so why should suicide rates be significantly higher among men?

It’s suggested that the rise in the rate of male suicides since the 1990s might have something to do with men’s changing role in society.

Research finds that, even today, men attach greater importance to job status and income. A report by Calm entitled Masculinity Audit 2016 found that 80% of men aged 35-44 consider their job to be “very important” or “important” to their self-esteem, while 42% still believe they should be the main breadwinners in their household. Only 13% of women felt the same, in spite of the fact that many women are now more financially independent.

The gender paradox

Men are also believed to be more naturally impulsive than women, meaning they are more likely to act rashly on suicidal feelings, according to the Samaritans. They’re also far less likely to seek formal emotional support, compared to women. When they do, it is at the point of crisis.

The Samaritans suggests that men currently in their mid-years are the “buffer generation” and are “struggling to cope with major social changes”.

It states: “…caught between their traditional silent, strong and austere fathers, who went to work and provided for their families, and the more progressive, open and individualistic generation of their sons. They do not know which of these two very different ways of life and masculine culture they should follow”.

An academic study published by the Medical University of Vienna in 20151 interviewed male suicide survivors, plus their family and friends. It concluded: “Rather than expressing or identifying with feelings such as stress, sadness and emptiness, men typically demonstrate numbing (e.g. alcohol and drugs), risky (e.g. gambling, violence), defensive (e.g. anger, aggression) or otherwise avoidant (e.g. social withdrawal) types of coping behaviours relative to women. Furthermore, a positive correlation is observed between higher adherence to masculine norms and a higher likelihood of experiencing depressive episodes.”

Intervention & prevention

The study found that avoiding or reversing this downward spiral involved behavioural strategies that broke up routine and boredom, increased social contact, rewarded self-esteem (e.g. performing altruistic acts) or returned individuals to relationships or activities that they had previously enjoyed, or which had positive impacts on them: for example, exercise, healthy diet, reduction in drug or alcohol use.

EAPs and the type of tailored mental health pathways provided with group income protection can help in all of these regards. As can a workplace culture that normalises stress and distress. Combined with public health services and community groups that assist in male suicide intervention and prevention, it is hoped that more men at risk receive the support and protection they need.

1 What interrupts suicide attempts in men: A qualitative study, Medical University of Vienna (June 2015) http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0128180#abstract0

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