A while back, residents of the complex where I used to live were rattled when the body of a very successful dentist who had taken his own life was discovered in his home.
Weeks later, his neighbours still murmured about how his suicide came completely out of the blue. What could have caused the dentist to take his own life, they wondered? He had it all, they said — a great job and the good fortune of a loving family. The rumours swelled until his family revealed that he had suffered from acute depression. But how, the neighbours asked, and when?
Why are the signs of depression in men not quite the same as those in women? Men are known to socialise less and often are not as open to talking about their feelings. They also tend to avoid medical care and this includes mental healthcare.
Women’s health over the years has become a priority for governments globally. For example, many more women are aware of breast cancer and know how to detect a lump and visit a doctor before it’s too late.
Sadly, for men, not as much medical care awareness exists, although they also face acute health issues. Research shows that men often die earlier than women, one reason being that they commit suicide more often than women.
Male suicide risk is linked to a lack of male healthcare responsiveness. Many men suffer untreated mental conditions. Labelled a silent epidemic, more than half a million men take their own lives globally — that’s one every minute, says the Men’s Foundation of South Africa.
The World Health Organisation (WHO) found that close to 800 000 people die because of suicide every year — one person every 40 seconds. Around 804 000 suicides occurred worldwide in 2012, representing a suicide rate of 11.4 per 100 000 people — 15.0 for males and 8.0 for females.
According to the WHO: “Suicide is a global phenomenon and occurs throughout the lifespan. Effective and evidence-based interventions can be implemented at population, sub-population and individual levels to prevent suicide and suicide attempts.
There are indications that for each adult who died by suicide, there may have been more than 20 others attempting suicide.”
In South Africa the female suicide rate per 100 000 population in 2016 was 5.1 and 21.7 for males.
Globally, suicides account for 50% of all violent deaths among men.
Research shows that depression is acknowledged to underlie more than half of suicides, yet the treatment rates for males suffering from depression is relatively low.
Unfortunately, according to the WHO, “suicide all too often fails to be prioritised as a major public health problem, despite an increase in research and knowledge about suicide and its prevention”.
Concerns about masculinity are deeply entrenched within traditional societal myths about how men should behave and respond to their problems.
Gary Barker, in the survey The Man Box: A Study on Being a Young Man in the US, UK and Mexico (2017), explains that trying to be a “real man” affects mental health. Barker found that “men with more restrictive ideas about manhood are more likely to think about suicide than young men, who aren’t so stuck in the man box”.
Men are unable to “recognise negative or troubling emotions, and don’t seek help or talk about them”.
There is a stigma against those who seek help for suicidal behaviour, says the WHO. And if they do seek help, many health systems and services fail to provide timely and effective assistance.
According to a report in The New York Times, there is a “general crisis of mental healthcare; people are not receiving the medical care they need”. The proposed solution is “better therapies, more effective antidepressants and greater access to treatment”.
Some studies, such as ‘Why Is the Suicide Rate Higher in Men Than in Women?’ by Emma Poynton-Smith (2015) suggests that the answer may lie in the difference of the methods employed to commit suicide — men choose more lethal methods.
Poynton-Smith found that “men may also express their depression differently to women, meaning they are more likely to behave impulsively — including [committing] suicide”.
But, fundamentally, the suicide rate has increased, even as more people are seeking treatment for depression and anxiety and even as treatment for those conditions has become more widely available.
An additional explanation seems necessary.
Behavioural scientist Clay Routledge writes: “Critically, studies indicate that it isn’t enough to simply be around or even liked by other people. We need to feel valued by them, to feel we are making important contributions to a world that matters.”
The question then that needs to be answered is: How do we manage to find meaning and purpose in our lives? Routledge suggests that there are various ways, but the psychological literature suggests that close relationships with other people are our greatest existential resource.
Palesa Lebitse is a liberal feminist who regularly writes for the M&G.