Reprinted from "Men's" issue of Visions Journal, 2005, 2 (5), p. 15-16
Whenever I am asked to give an educational presentation about suicide, there is typically a well-defined moment when the learners in the audience get very focused and quiet and become particularly engaged with the material. It is when I show the graph that compares rates of suicide among young males with the rates among young females. With one glance at this slide- which shows that young males are killing themselves three to four times as often as females-participants immediately understand that suicide among young males is a very serious concern.
To put some of these numbers into perspective, consider the following. There were a total of 430 suicides among males ages 15 to 24 in Canada in the year 2000, a rate of 20.2 per 100,000.1 Among females of the same age there were a total of 112 suicides or 5.5 per 100,000. Consistent with the pattern observed in other developed nations, Canada witnessed a dramatic rise in youth suicide rates between the 1950s and the 1980s, with much of this increase accounted for by suicides in young men.2
Closer to home, there were 20 suicides (13.9 per 100,000) among males ages 15 to 19 in British Columbia in the year 2003 compared with five suicides (3.7 per 100,000) among females of the same age.3 The vast majority of male suicides in this age group were by hanging or firearm, which may partially explain their elevated rates since these methods are almost always lethal. Finally, 75% of all suicides in the province of BC are among males. As the participants in my educational presentations inevitably ask: What is going on here?
Risk Factors for Youth Suicide
Suicide is complex and most researchers and mental health practitioners agree that, in order to understand suicide, we need to recognize that there are multiple sources of risk occurring at many different levels. The following are some of the most wellestablished risk factors for youth suicide:4
mood disorders, substance use disorders and cooccurring disorders
previous history of suicidal behaviour
family history of suicide
current life stressors
exposure to sensationalized media reports of others' suicidal behaviour
having access to the lethal means for suicide (e.g., firearms, medication)
An understanding of suicide among Aboriginal youth must also recognize the damaging consequences of historical and political practices such as colonization, governmentsponsored policies of assimilation and residential schooling.5
In addition to recognizing these common risk factors for youth suicide, how might we come to understand young males' particular vulnerability to suicide?
Understanding Male Vulnerability to Suicide
A recent cross-country comparison of several industrialized nations examined the relationship between rates of youth suicide and specific social and cultural variables. These variables included quality of life, social attachment, and measures of individualism (e.g., personal freedom and control).2
Rates of suicide among males in these countries were strongly linked to levels of individualism. The authors suggest that this could be one possible factor accounting for the dramatic rise in male suicide rates in the past 50 years. These authors go on to suggest that common markers of "progress" in industrialized nations (e.g., materialism, mobility, individualism) are not always balanced with a corresponding commitment to social obligation and tradition. This may be particularly so for "newer" industrialized countries like Australia, New Zealand, United States, and Canada, all of which have witnessed a tripling of their youth suicide rates since the 1950s.
It is not clear from this study why the "costs" of individualism might be greater for young males than females in terms of increased risks for suicide. The authors, however, suggest that the failure of these Western societies to provide appropriate sources of social identity and attachment, while at the same time promoting unrealistic expectations of personal freedom and autonomy, might be contributing factors. It is possible that this combination of expectations and social circumstances may be more of a hazard for males than females.
Another study examined the issue of help-seeking among young males. This is of particular relevance in understanding suicide risk among males since we know that males tend to access formal mental health services less often than females.6 Based on a series of in-depth interviews with white, middle- class, American male high school students, researchers identified a series of key themes that may help shed some light on why young men are reluctant to seek help during times of emotional distress.6
A core issue for these young men was "the pressure to fit in," which often precluded them from asking for help for fear they would be perceived as weak. This was coupled with a desire to maintain a strong masculine image of success and independence.
Suggestions for making services more available and attractive to males included high-level soci-etal change, normalizing males' efforts to seek and receive help, and helping males find opportunities to experience a sense of purpose and empowerment.
While we must continue to recognize and respond to individual-level risk factors for youth suicide (e.g., recognize and treat depression), studies suggest that we must also understand the role of broader social influences in the emergence of suicidal behaviour among males. Both studies suggest there may be an important role for mental health promotion programs that actively cultivate realistic expectations for the future, promote selfawareness and a strong cultural identity, foster healthy social attachments, and enhance helpseeking among young males. In other words, if we want to develop effective youth suicide prevention programs then we must intervene with young people and their social contexts.
About the authorJennifer is Assistant Professor on contract in the School of Child and Youth Care at UVic. She has been a clinical counsellor at Vancouver Coastal Health Authority's SAFER Counselling Service and Director of the Suicide Prevention Information and Resource Centre, Department of Psychiatry, UBC
World Health Organization. (2004). Suicide statistics. Retrieved December 20, 2004, from www.who.int/mental_health/prevention/suicide/suicideprevent/en
Eckersley, R. & Dear, K. (2002). Cultural correlates of youth suicide. Social Science and Medicine, 55, 1891-1904.
British Columbia Vital Statistics. (2003). Unpublished suicide statistics. Victoria, BC: British Columbia Vital Statistics.
Gould, M., Greenberg, T., Velting, D. et al. (2003). Youth suicide risks and preventive interventions: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 42(4), 386- 405.
Mussell, B., Cardiff, K. & White, J. (2004). Promoting the Well-Being of Aboriginal Children and Youth. Chilliwack, BC: Sal'i'shan Institute.
Timlin-Scalera, R., Ponterotto, J., Blumberg, F. et al. (2003). Grounded theory study of help-seeking behaviours among white male high school students. Journal of Counseling Psychology, 50(3), 339-350.