A new qualitative study suggests that a sole emphasis in suicide prevention on encouraging men to ‘talk’ about their mental distress can be ineffective.
A new study published in the journal of Critical Public Health challenges commonplace assumptions about suicidality in men. Recently, a popular explanation for an increase in suicide among men is their inability to talk about their problems.
These mainstream understandings of male suicidality consider the barriers to vulnerability for men given the expectations of masculinity. However, Amy Chandler, a critical suicidologist at the University of Edinburgh, finds in her research that this discourse around masculinity and suicide may actually exacerbate these issues.
Chandler’s work “seeks to ‘unsettle’ the suggestion – embedded in many public mental health campaigns – that if men only talked more, they would die by suicide less.”
Chandler notes that emphasizing ‘talking’ in public mental health campaigns may be distracting from the societal and systemic contributors to “the desire to die,” notably financial hardship and drug and alcohol addiction. Further, she suggests that reproducing a discourse that intertwines masculinity and the “inability to talk” may inadvertently undermine women’s articulations of distress and suicidality, casting them as “too emotional.”
Suicidality is a challenging public health issue. Men die by suicide more frequently than women almost everywhere in the world. Unfortunately, suicide interventions often fail and sometimes appear to exacerbate the issue, especially when interventions take a “screen and intervene” approach, often prescribing antidepressants to those deemed “at risk.”
Many countries have turned toward public health approaches. Some of these campaigns address “toxic masculinity” in an attempt to get men to break free from the idea that they must be silent about mental and emotional pain and encouraging them to talk to people about their problems. It is such campaigns that Chandler investigates critically in her analysis.
Utilizing qualitative methodologies and narrative-informed analysis, Chandler explored the link between men’s inability to talk about their problems with their suicidality. Over six months, ten middle-aged men (34-61 years old) were interviewed about their previous suicidality, self-harming behaviors, and drug/alcohol addiction. All participants were cis-gender men.
Of course, “the idea that men as a group find it hard to talk about problems or emotions was routinely raised by interviewees,” which corresponds with the mainstream assumption that men when given the opportunity to talk, benefit from sharing their experiences. However, interviewees also spoke to the contrary, arguing that they may benefit from staying silent in certain instances because of perceived societal or self-stigma.
The interviews also revealed that the context of ‘talk’ is crucial–who are the men supposed to talk to? And what are they supposed to talk about?
Some interviewees spoke to an unproductive, even harmful relationship with their therapist and the mental healthcare system. Alternatively, several men spoke to the importance of men-only services in their recovery and improvement in their mental wellness.
It was also unclear whether it was the ‘talk’ of suicide, specifically, that helped or if the improvements derived from the social bonds and human connection may have been forged in other ways. Chandler suggests that despite the ameliorative effect these men-only services have had on recovery, they may also reaffirm “a notion that some topics can only be discussed with other men and can be withheld from family members and intimate partners.”
“Indeed, the community-based service men accessed was praised for the role workers took in supporting men with all aspects of their lives – including accessing benefits and housing.”
Similarly, public mental health campaigns promote the idea that “not talking” ought to be perceived as weakness rather than emotionality. However, Chandler challenges this reframing of talking as ‘strong’ and ‘courageous,’ as it reinforces problematic notions of masculinity.
On the one hand, despite the attempt by campaigns to reframe disclosing one’s struggles as ‘courageous’ or ‘strong,’ there remains an insidious incentive for men to remain silent to retain their power and privilege.
“In some contexts, some men may indeed lose status, privilege or power by admitting ‘weaknesses or shameful aspects of their experiences.”
On the other hand, despite the many benefits that come with ‘talking,’ no amount of verbal disclosure of shame, guilt, or sadness can address the social drivers of suicide, including a stable income, a place to live, and meaningful work.
“Rather than a focus on ‘talk’ as a response to suicide among men, suicide prevention initiatives might instead seek to engage more broadly with economic and housing security, access to non-stigmatizing welfare/disability support, robust programs promoting gender equality, easy access to well-resourced community-based services in relation to mental health and substance use,” Chandler writes.
“Each of these is, of course, much more complicated and politically sensitive than encouraging men to ‘talk more about their problems, but without addressing these concerns, I would suggest that focusing on ‘talk’ will be ineffective at best.”
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Chandler, A. (2021). Masculinities and suicide: unsettling ‘talk’ as a response to suicide in men. Critical Public Health, 1-10. (Link)
There has never been a time in which men have had more encouragement to be lachrymose and emotionally incontinent, and yet suicide rates are going through the roof. Perhaps keeping a stiff upper lip is under-rated.
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The results of talking about your own suicidal thoughts are dependent on the culture and person you are revealing them to. In our modern society the most likely result is you are pressured/coerced to take deadly drugs that worsen outcomes and you get stigmatized as mentally ill and dangerous.
The most common response is being told do get addicted to drugs followed by being treated differently.
Talking about suicide isn’t helpful when doing so is likely to cause the people around you to make your life worse. It becomes a self fulfilling prophecy. You reveal suicidal thoughts and people’s behavior causes more stress and emotional suffering.
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Men and women should not speak to “professionals” or anyone else for that matter, unless it is your closest confidant or your dog.
Men and women should be able to speak in safety, but there is NOTHING safe about strangers combined with one’s intimate disclosures.
I can only encourage everyone to look around for a trustworthy community or support system.
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“On the other hand, despite the many benefits that come with ‘talking,’ no amount of verbal disclosure of shame, guilt, or sadness can address the social drivers of suicide, including a stable income, a place to live, and meaningful work.”
Overall, an excellent analysis. And this part sums it up nicely.
I would only add that for most women, these exact same factors apply. Talk therapy does not fill hungry bellies, provide a roof over one’s head, meaningful contribution to the community in which one lives (whether employment or volunteer), or good medical care. Therapy can be helpful for processing trauma, working through difficult family dynamics, growing beyond emotional survival, etc. But it should not be seen as a panacea for fixing the vicissitudes of modern life in which people need tangible assistance to get back on their feet or else to have alternative means of survival if one becomes disabled.
Bottom line is we are all negatively impacted by bootstrap culture. Even the relatively well off and able bodied live with the stress of knowing that an unexpected medical bill or other disaster can wipe out everything they’ve worked hard for and that there is likely no one to catch them.
I appreciate the emphasis on men here because I think men have been endlessly harangued to talk about their problems as if that alone will fix them. But I think we can learn and extrapolate from this that while women more readily talk about what’s bothering them, that alone does not necessarily lead to improved outcomes when opportunities for tangible assistance are scarce.
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Great article and great comment from you, kindredspirit. I am assuming that by ‘bootstrap culture’ you mean the toxic hyper-individualism that is promoted by Western capitalist-oriented governments.
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Capitalism pits people against each other on an individual level as well as a systemic level with all the ways we are labeled and grouped and tallied and, ultimately, divided. But it’s often unfortunately individual level behavior that reinforces the systemic harm. The social contract and safety net have been obliterated. Competition and judgment rules because it’s every person for himself and we all sort of know that.
And I’m only talking about westerners generally – the US and it’s big allies. So many more around the world are negatively impacted by US government policies, military actions, economic sanctions and trade pollution.
My position is generally anarchasocialist or Left Libertarian.
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I remember reading an article about a psych resident suggesting a suicidal homeless women who had been repeatedly raped take some SSRI’s to help her depression. Psych has conditioned everyone to blame environmental factors on defective brains that need a chemical fix. No wonder suicides are increasing. The drugs won’t fix the actual problem and when the problem occurs again the person feels even more hopeless, shamed and defeated.
The reason men have higher suicidal rates is because men use guns more for their suicide attempts. Women are actually more likely to attempt suicide but their methods are less likely to cause death.
Somehow men using more deadly methods of suicide has been blamed on men not talking enough.
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Interesting article, as for me it calls into question the fact that mental health norms may be overly skewed towards female paradigms (in medicine it’s usually the reverse).
Also smuggles in a more supra-individualistic political perspective which the U.S. for one needs (in my opinion).
In any case as Nietzsche said: “Some people talk about themselves as a way of avoiding themselves.”
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Good work.
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Nobody wipes a tear from their eye in peer groups when men (or women) share their most intimate tragedies – because this would be disrespectful. These groups are independent and self supporting, and know how to deal with the private reality of life.
Most ‘Professional Mental Health Support’ is now at a level of pure duplicity.
Any one telling tales in an independent Peer Group would be pointing the finger at themselves for attending the Peer group to begin with. So confidentiality is fairly secure.
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The popularisation of the ‘talk about it’ solution to mental distress is just another result of the neoliberal political philosophy adopted by the governments (of all parties) in the US and the UK. Blaming men’s (and women’s) problems on their reluctance to talk about their mental health is so much cheaper for our governments than tackling the causes of the problems – ludicrously high housing costs, insecure employment contracts, wages that are too low to live on, lack of social services, etc, ad infinitum. It’s just another version of the ‘if you fall sick, it’s your own fault’ narrative that lets governments off the hook when it comes to funding the basics of an equitable society.
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Now we’re not even supposed to talk about it. We’re supposed to take drugs and hope that we feel better, without even consideration of the actual source of our distress.
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Why talk about how life is so shitty it’s making you miserable when the “expert” will simply tell you it is all the fault of your brain and give you drugs?
It is less painful to avoid being gaslit and victim blamed and not share the environmental factors bothering you. You’ll get the same drugs either way.
I think a lot of psychs don’t recognize that they’ve conditioned people not to tell them their life problems. This then reinforced the myth that it is caused by a faulty brain because the environmental factors are actively avoided.
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I read a study one time where they sent volunteers into a residential treatment facility for teen youth with a handful of reasonable but kind of personal questions. Over 80% of the youth revealed a trauma history to these complete strangers surveying them. Yet less than 20% had their trauma history documented in their logs! So either the youth were more willing to trust a complete stranger than one of the staff they see daily, by a factor of 4, or else the staff never bothered to ask them, or considered their revelations so irrelevant they didn’t even warrant a log entry. I thought it said a whole lot about what “treatment” constitutes today.
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Samantha et al:
How and why does the thinking become parsed as “good conscious” to the exclusion of unconscious? For the thinking of Edinburgh, the cultural norms by which one is learning along with the whole world, vis-i-vis even this website, seemingly would require us to pause, to reflect and try to understand where our tracking within keeps our outlook skewed?
(If you are enjoying running the race, then how to improve, when layers of trauma have been occupying space within our memories?)
Will look forward to the discussion.
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“the social drivers of suicide, including a stable income, a place to live, and meaningful work.”
I would also add social connection to that list. Acceptance, genuine respect, ect. But that’s a topic unto itself. And feels like a bit of a nitpick. This article is SPOT ON about looking to external effects as contributing factors to mental distress. That point needs to keep being pushed. It’s not opinion, it’s fact.
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I agree For most social connection is very important for emotional well being. Psychiatry and talk therapy in many ways make social connection harder.
Being professionally marked as having a defective brain, where you are considered so dangerous you need less rights than criminals makes people want to avoid you. People believing you lack insight because your brain is broken means they are less likely to listen, consider your opinion/feelings, or view you as an intellectually valid human being.
Being told to “seek help” and “take drugs” by friends and family prevents connection from happening in the first place. It also discourages future connection because doing so can result in being called ill, and being told you’re the problem. It is also not safe to talk because you can be forcibly drugged and detained based on your thought.
The drugs also reduce socialization. The main purpose of stimulants is to make kids stop socializing and playing and get them “working” In the Ham D depression scale someone who stops sharing and telling the psych about their negative mood, even if the mood is the same, has a larger benefit than what the most pro-drug flawed studies claim the short term benefits of the drugs are. Neuroleptics cause massive sedation and impairment.
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the mental health industry is destructive and deadly, on both individual and social levels. to that end, I personally do not care to talk to a “professional,” nor do I care to take their neurotoxins. Having survived “treatment,” by the grace of God, my personal approach is to avoid mental health, inc. and also encourage others to do the same. and then…
as many other posters have pointed out, suicide is a social problem, not a psychological or psychiatric one. This has been evident since the 19th century, when Durkheim did a (now classic) study on suicide. and yet…
perhaps -not- surprisingly, mental health, inc. demands more and more funding to “treat” more and more individuals suffering from the fall out of social and economic problems…
and instead of dealing with the core problems — the woes of neoliberalism, social disintegration, the collapse of many families and communities, on and on and on — the powers that be are all too happy to jump on the “mental health awareness” bandwagon. and why shouldn’t they be?
providing daily bread, adequate housing, health care, legal rights, and fostering the (re)development of community are all potentially do-able…
but not under the current neoliberal nightmare, not even under a patched up neoliberal system. some data has indicated that the level of inequality and stratification in the US, in particular, is damaging to people all over the socioeconomic spectrum. how could it not be? perhaps, one day this society — and others, too — will see real, meaningful change towards a society that is more humane, less sick and sickening. in the meantime…
mental health, inc. is providing a band-aid, I guess. not for the people “in treatment,” but we/they are not the problem, after all. my concern is that the latest epidemic of “mental health” will never be stopped, not even contained; rather, this ‘epidemic’ seems to have the potential to grow and grow, ensnaring more and more people in psych slavery. 🙁
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