Monday, 29 June 2015

Preventing Male Suicide

A new study by the Black Dog Institute (Australia) release this week has examined the reasons for male suicide and the measures that can be taken to intervene and prevent action to move beyond ideation. As men account for 80% of all suicide deaths, enhanced intervention has the potential to greatly reduce the number of deaths by suicide.

The research, funded by Beyond Blue (Australia) from donations to the Movember fund raising program, was conducted through one-to-one interviews with 37 men who had attempted suicide and 47 family members or friends. The key findings of the study were:
1. There are clear gender and sociocultural differences associated with male suicide;
2. There are core risk factors which lead men down specific pathways to suicide;
3. There is a need to develop corrective interventions;
4. Suicidal behaviour may be reduced by addressing common risk factors and supporting changes to men's decision-making as they approach acute states of ideation;
5. Men often don't seek help until the latter stages of suicide ideation and that is more likely to be with family and friends;
6. Those close to men experiencing suicide ideation need a greater understanding of the signs and symptoms and to develop skills in intervention practices.

The signs and symptoms of men at risk of developing suicidal thoughts and ultimately act on them may include and failure to identify stress, uncommon sadness and emptiness and demonstrate instead activities of numbing (alcohol and drugs), risk (gambling, violence), defensiveness (anger, aggression), or avoidant behaviours (social withdrawal). All of these will be present as an enhanced masculinity, often in relation to women.

The common risk factors for men were identified as a period of depressed or disrupted mood, unhelpful conceptions of masculinity often associated with stoic beliefs and values, social isolation, avoidant or negative coping strategies and at least one but often many personally meaningful stressors. These factors are characterised as a downward spiral of repetitive thinking which makes them vulnerable, which leads to a period of planning until they reach a point which is described as "a time to die".

"Men repeatedly reported that a greater understanding by loved ones of the signs and symptoms of suicidal thinking was crucial in keeping them safe."

Distraction and practical and emotional support, although not long term solutions, provided respite for men's thinking and even more importantly, for those at a criical stage. This often took the form of physical activity which had a high adrenaline component. Being motivated of their responsibility to others or helping others proved a useful distraction.

A large number of the participants in the study reported unsatisfactory experiences with those services intended to provide them with assistance, including community health programs and mental health professionals, despite the fact that these same services ultimately played a vital positive role.

Preventative strategies for men not a critical stage included a reminder of the effect of their suicide on family and friends and practical help in managing risk factors, particularly stressors. Regular contact with people they respect and trust will help men vent their feelings and develop better coping methods.

"This research has the potential to be highly influential in the development of appropriate responses to men experiences suicidal thoughts, both through health services but more importantly through the personal support of friends and family."

On a personal basis, this report rings so true, it is a clarion bell in an otherwise dark world of guilt and shame: a treatise which exemplifies my own experience. Whilst its findings will no doubt ring true in most parts of the world, as Australian research, it holds even greater authenticity in its own country.

I have stood in the desperate shoes of the man with nowhere to go. My first suicide attempt came at just sixteen, taunted by the secret of a sexual assault I dare not share for fear of my throat being cut. When the demons tracked me down thirty years later, I tried the final solution four times, convinced each time that my family would be better off without me.

However, by then, I had support structures in place. I had escape valves: a wife who watched for signs, a doctor who understood the serious consequences of not being thorough and a psychologist who helped me select the keys to the songs of a better future. Even then, even with many of the pressures tuned to a lower key, I still couldn't best the threat to the belief my father had instilled in me, that stoicism was an expectation. It was there in the stories most treasured by Australian men: the ANZACS, the heroes of the Burma railway, the glorious sportsmen who won when all was lost. This was every Aussie boys birthright and terrible, unalterable destiny.

One broke instead of bending.

Slowly I learned of my misplaced addiction to a legend never intended for such personalised application. Better still, I discovered I had the greatest courage of all: the courage to stay alive and fight the demons off until a new dawn. Writing was my distraction  and whilst my body had aged beyond usefulness to play sport, my experience and unquenched thirst for the games young men play placed in me in exactly the right place to speak of their great virtues. In doing so, I helped engender other men into a greater sense of themselves as warriors united by the bonds of shared experience. As tides turned for individuals, we all learned that the strength of the bonds of mateship could hold one unsteady on their legs until that same courage for survival infected them.

"I have stood in the desperate shoes of the man with nowhere to go."

Instead of succumbing I have lived to fight for other men's days. I have been the listener, the emotional support, the distractor. I have had my courage ratified and discovered the purpose which my own dark experiences gifted me, even at their worst.

This report has told me what I already know but it tells others what they need to know. Read it. Understand it. Learn what you need to learn: how to listen, how to distract, how to support men in crisis and beyond. If you ask the question - RUOK - be prepared for the answer, for the real work starts there, not with the initial enquiry.

To read a full copy of the report, follow this link to "What Interrupts Suicide Attempts in Men: A Qualitative Study."

If you or someone you know is experiencing suicidal thoughts, contact your GP immediately or if the risk is too immediate, call Lifeline 13 11 14 or Mens Helpline 1300 78 99 78 at any time, 24/7.