MENZ Issues

Men Devalued in Suicide Strategy

Many people will have heard mention of the NZ Suicide Prevention Strategy but won’t be aware of exactly what it says, or that it was produced by the Ministry of Health and funded by our taxes. The Strategy was published in 2006 and is intended to be in place until 2016. Well, we all know that men suicide on average at about three times the rate that women do (actually, for some age groups it’s five to six times as much, and the figures will not include many other suicides made to look like accidents). No other population factor (e.g. age, race, socio-economic status) shows the large effect that gender does regarding risk of suicide (except for children under 10 years old who are understandably many times less likely to suicide than are all older age groups). But surprise, surprise, the Strategy contains not one single component specifically aimed at reducing male suicide or addressing the factors that lead men to suicide.

Almost every one of the Strategy’s seven goals contains a plan specifically related to reducing or managing Maori suicide, even though Maori to non-Maori suicide ratio (about 1.5) is much less than the male to female suicide ratio (3+). There are ten section headings in the Strategy report referring specifically to Maori suicide matters but exactly zero section headings specifically addressing men’s suicide matters. There are also sections devoted to Pacific suicide, Asian suicide, gay, lesbian and bisexual suicide, and migrant and refugee suicide, but not one devoted to men’s suicide.

Whoever wrote the Strategy appeared keen to ensure that no special recognition be given to men. Although mention is made that men suicide at about three times the rate of women, this is downplayed or its effect minimized through placement among other statements. For example:

It is evident in our data for suicide and hospitalisation for suicide attempt that some groups of New Zealanders do better than others. For example, young Maori men have higher rates of suicide than non-Maori men of the same age, Maori females have the highest rates of hospitalisation for suicide attempts, men die by suicide at approximately three times the rate of women, women are hospitalised for suicide attempts at approximately one and a half times the rate of men, and the most deprived geographic areas of New Zealand have much higher rates of suicide compared with the least deprived areas.

The section headed “Issues Relating to Gender” is incredible. Acknowledgement is made of higher suicide by men but the section then seeks to make it a non-issue. Firstly, it dismisses various explanations that had been suggested for high male suicide (though no mention was made of other realistic explanations such as the extent to which men, their roles and contribution have been denigrated under feminist ideology, the damage our family law causes to fathers’ relationships with their children, the fact that normal male responses to stress and threat have been painted as undesirable and in many cases made illegal). The section then tries to cast doubt on any link between gender and suicidality at all because women are said to be more prone to suicidal behaviour and to make more attempts. The “choice of method” is then put forward as the key gender difference, as though this has nothing to do with actual suicidality. The section then claims that the gender difference in deaths by suicide is reducing, so really, let’s just pretend gender isn’t important at all. Don’t believe me? Here’s the section:

Males die by suicide at a higher rate than females (see Figure 9). These findings have led to a number of speculations about the reasons for this. There have been suggestions that males may have a greater tendency to suicide than females because of gender differences in the prevalence of mental health problems (including schizophrenia, drug and alcohol abuse, externalizing behaviours and propensity to violence), cultural acceptability of male (as opposed to female) suicide, and psychosocial differences (including the protective role of children for females and male reluctance to seek help for emotional problems). These arguments linking gender with suicidality may be without foundation. In particular, studies in New Zealand and around the world have consistently shown that females are more prone to suicidal behaviour and make more suicide attempts than males.

The explanation for the higher rate of death by suicide for males may not lie with gender-related differences in tendencies to suicidal behaviour but, rather, with gender-related differences in the choice of method used, with females more likely to use overdosing and males more likely to use firearms, carbon monoxide poisoning and hanging. Furthermore, there is evidence in New Zealand that gender differences in suicide rates are reducing. The male to female sex ratio reached a peak in 1990-1992 (4.2 male deaths for every female death), then decreased to a ratio of 3.2 male deaths for every female death in 2001-2003 (Ministry of Health in press). This decline was largely explained by an increasing rate of hanging in younger women. These considerations suggest that it would be misleading to represent suicide as a “gender issue”. Rather, policies need to recognise that suicidal behaviour is an important issue for both genders and is expressed in gender-specific ways, with women making more suicide attempts and males more often dying by suicide.

In avoiding any special consideration for men (even though they are the most at-risk group for suicide), the Strategy’s logic twists and turns in order to place greater priority on women. It initially defines suicide not as suicide but also as attempted suicide, any self-harm and any thoughts about suicide, essentially treating women’s frequent suicidal gestures and even such things as self-cutting as equally important to men’s real suicide. (Oh well, they’re only men so who cares if they actually die?) The seven goals invented in the Strategy include one mainly relevant to women

3. improve the care of people who make non-fatal suicide attempts

but not one specifically relevant to male issues or needs. In addition, the “areas for action” statements proposed under each of the seven goals also include references to “suicide attempts” as if these are just as important as successful suicides in a suicide-prevention strategy, e.g:

promoting vigilance amongst families/whanau and friends of people who have made
suicide attempts to limit access to means of suicide

and

supporting people who have lost someone close to them by suicide, or who are affected by a suicide attempt

The Maori-specific “areas for action” were:

increasing, where appropriate, the role of cultural development as a protective factor
for Maori

increasing awareness and application of Maori models of health.

establishing partnerships with hapu, iwi, Maori providers and communities to assist mainstream services in their responsiveness to Maori.

promoting and supporting research to expand the evidence base for Maori suicide prevention

But not one “area for action” specifically related to men’s suicide was considered necessary, any need men might have being relegated to general statements about “other population groups”. How is it than men can be cast aside even in an area where they are without any doubt the most needy of any group? Likely, the Clark government of the day instructed the Ministry of Health to prioritize women and Maori, and possibly to cover up the male need in case it alerted the population to the state’s exploitation and abuse of men that surely must contribute to their suicide rates. Perhaps men have just always been seen as disposable (sent to war etc) and the Strategy simply continued that social norm. Perhaps the actual writer(s) of the Strategy were rabid man-haters. Who knows? We can only stand back and shake our heads in wonder. But what is clear is that NZ’s Suicide Prevention Strategy sees men being not as deserving as other people to be saved from suicide, and has little interest in the underlying reasons that men feel so worthless as to kill themselves in such large numbers.