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How to talk to someone you’re worried about

1. Pay attention

Any noticeable change in his behaviour is a warning sign your friend might not be doing well. These changes include:

Not texting or calling as much

Drinking more than usual

Appearing tired and distant

Talking about how much life sucks

Being more irritable or angry

2. Start a conversation

Choose a comfortable setting.

Over the phone

While driving in the car

Over drinks at a favourite hang out

While working on a project

Mention what you’ve noticed.

“I haven’t heard from you much these days. Is everything okay?”

Don’t blame or shame him.

3. Keep it going

Ask questions and listen to what he’s saying.

“The other day you said your life sucks… what’s that like for you?” Avoid instantly problem-solving.

Don’t make it seem like he’s overreacting, and don’t change the subject.

Back him up and acknowledge his feelings: “That sounds really hard.” If you’re still worried about him, ask: “Are you thinking about suicide?” ­­­If he says yes, don’t panic. Let him know you’re there for him: “Thanks for telling me. That’s really hard to do. Can you tell me more about it? I’m here for you.”



4. Stick to your role

You’re a friend, not a counsellor.

Who else has he told? Encourage him to reach out to others.

Call Crisis Services Canada together: 1-833-456-4566

Following the conversation, check in with him often.

If he has imminent plans to die, contact 911 and ensure he is not left alone.

Guys, how do you step up and support your buddies? Tell us in the comments!

To learn more about how to help someone who is thinking about suicide, consider taking a workshop offered by the Centre for Suicide Prevention, such as the safeTALK: suicide alertness for everyone half-day workshop, or the two-day ASIST: Applied Suicide Intervention Skills Training.

Download infographic

Why are men at risk of suicide?

Middle-aged men (40-60) die by suicide more than anyone else, including young people and women (Statistics Canada, 2019).

Men are often socialized not to talk about their emotions, and therefore, men as a group may mask their stress and deal with emotional pain through harmful behaviours and actions, and sometimes suicide, instead of seeking help (Ogrodnickzuk & Oliffe, 2011).

What to expect

This resource is an introduction to men and suicide. You’ll learn about statistics, warning signs, why men are more at risk, and how suicide can be prevented. You’ll also learn how to have a conversation with someone you’re worried about. If you know someone who is thinking about suicide, or if you’re thinking about suicide, call your local crisis line. In Canada, call 1-833-456-4566.

Statistics

Warning Signs

People thinking about suicide typically exhibit warning signs. Any significant change in behaviour may be a warning sign. Warning signs in men can look like:

Losing interest in hobbies or activities they normally enjoy Not showing up to events they used to enjoy Giving away items they value

Disconnecting from family and friends Texting, calling, visiting less often Being less present and engaged in conversation

Change in sleeping or eating patterns Sleeping more, even during the daytime, or being restless and having trouble sleeping Eating less and losing weight, or eating excessively and putting on weight

Drinking alcohol or taking drugs more than is normal for them

Irritability and anger

Risk-taking and ambivalence for the consequences

Emotion suppression – denying or not experiencing feelings and emotions

Offhand or uncharacteristic comments of hopelessness or expressing feelings of being a burden to others

Talking about wanting to die or to kill oneself

Looking for a way to kill oneself or already having a plan

(American Association of Suicidology, 2018)



Risk and protective factors

Even before a person displays warning signs, we can learn something about their suicide risk by considering different factors in their lives. We all have characteristics or traits that may contribute to or diminish our risk of suicide.

“Risk factors,” those factors that contribute to suicide risk, are always balanced by factors that build and maintain resilience, “protective factors.”

Risk factor – Reluctant to seek help: Men who are reluctant to seek help tend to bear the burden all alone. Everyone needs support from others at certain times in their lives. Protective factor – Tendency to look for support when it is needed: On the flip side, men who are more likely to reach out to someone when they’re struggling can find support more easily and can better cope with negative circumstances than those who do not. Risk factor – Hyper-masculine: Men who were raised with the idea that showing any sign of emotion is a “weakness” are more likely to hide their emotions, which can become overwhelming and may lead them to a point of crisis. Protective factor – Comfortable showing and expressing emotion: Men who have embraced their emotions and the importance of sharing them with others are better able to cope, as they are more likely to deal with their emotions before they become overwhelming. Risk factor – Socially isolated: Men who are socially isolated may feel less comfortable reaching out for help, because they don’t have loved ones close by. They may also have less people to ask for help and fewer people to notice that they are struggling and reach out to offer help to them. Men as a group are more likely than women to lose relationships over time, often because they prioritize career and financial success over relationships. Protective factor – Positive, supportive, and close relationships with family, friends, coworkers, etc: Relationships provide a safety net when men are thinking about suicide, because those people are there to offer help and to be asked for help. (Houle, Mishara & Chagnon, 2008; Ogrodniczuk & Oliffe, 2011; American Psychological Association, 2008)

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Risk Factors

There are certain factors that can place men at a higher risk of suicide than others.

Men as a group are at a higher risk for suicide because they tend to choose more lethal means of suicide. They’re also often socialized not to show or express emotion, leaving them with the idea that any show of weakness will diminish their “manhood.”

Men who have the following characteristics, behaviours, or circumstances may be at a higher risk of suicide:

Reluctant to seek help

Hyper-masculine (“suck it up” attitude, reluctant to show or express emotion)

Socially isolated (from friends and family or generally has no friends or contact with family)

Aggressive and impulsive

Risk-taking

Frequent alcohol or drug use that disrupts everyday functioning

Previous suicide attempt

(Houle, Mishara & Chagnon, 2008; Ogrodniczuk & Oliffe, 2011; American Psychological Association, 2008)

Protective Factors

Certain factors or circumstances can guard a person against thinking about suicide and increase their resiliency. These are some protective factors that can build resiliency in men:

Tendency to look for support when it is needed

Comfortable showing and expressing emotion

Positive, supportive, and close relationships with family, friends, coworkers, etc.

(Houle, Mishara & Chagnon, 2008; American Psychological Association, 2005)



The Gender Paradox

Men die by suicide more than women (3 times more often), but women attempt suicide more often than men (4 times more often). There are several reasons for this:

Men often use more lethal means of suicide than women

Men are less likely than women to seek help when they are struggling

Men are subject to the expectation that they will persevere through adverse situations or that they will follow through on decisions (including to die by suicide) and “get it done”

A man who is already feeling inadequate or “less than” (a man) because of suicidal thoughts is not only “not” going to seek help but also make sure he gets this (suicide) done right (Canetto & Sakinofsky, 1998).



Masculinity and suicide



Canadian society celebrates masculine qualities – and why not? There is much to be celebrated. However, sometimes these qualities can overwhelm and consume the men they define.

Masculine qualities, like feminine qualities, are neither positive nor negative in and of themselves, but the expectations they attract and the way they shape a person’s behaviour can affect the person’s wellbeing.

From an early age, for example, boys are often told to hold back their tears and men are told to “suck it up” when dealing with life’s pressures: “take it like a man.” Toughness and stoicism are expected; emotional vulnerability is seen as a blemish on their manhood.

These societal expectations may discourage men from seeking help when they encounter mental health adversities and instead can drive them to destructive coping strategies. This can put men at greater risk for increased substance use, risk-taking behaviours, anger and frustration, and, too often, suicide (Seager et al., 2014; Ogrodniczuk & Oliffe, 2011).



How can suicide in men be prevented?

As a society, we must get better at reaching out to men.

Partners and coworkers can be alert to the warning signs of suicide in the men in their lives. If a man is becoming more irritable, for example, this is a sign to his partner and coworkers that he’s struggling.

Individually, we can create a safe space, through open, non-judgmental conversation and gentle questioning for men to share and express emotions. If you’re worried about someone, reach out. See “How to talk to someone you’re worried about.”

We can model to everyone, children and adults, that emotions are not gendered, and that it is okay, and even necessary, to show and express emotion and ask for help when it’s needed. One way we can do this is by showing and expressing our own emotions and being honest when people ask us how we’re doing. We can also have more meaningful conversations with people by asking, “How are you really doing?” if we think they may be struggling.

Men need to know where they can find help – we as individuals can provide information to people we think may be struggling.

Workplaces can make the resources available to their employees easily accessible by communicating their existence and ensuring access is confidential. Find out more about what workplaces can do with our toolkit on workplace suicide prevention.

Doctors and others in the healthcare system can play a role in identifying men who may be thinking about suicide. As men may be less likely to directly discuss any issues they may be having, clinicians need to become adept at reading body language, tone of voice, and other physical cues to indicate that the man they’re speaking with may be struggling. Health professionals need to be better trained in detecting depression among men, which can often result in emotions such as anger or actions like excessive drinking (Ogrodnickzuk & Oliffe, 2011; Paraschakis, Michopoulos, Christoduolou, Koutsaftis & Douzenis, 2016).

What can men do?

Men can maintain life-saving social connections by prioritizing friendships and good relationships with their loved ones. They can participate in peer support programs at school, in the workplace, or in the community. Social engagement such as joining a sports team or a music group can create belonging and connectedness for men and prompt interaction with other men who have similar interests, experiences, or struggles.

Men who are struggling with thoughts of suicide may find that asking for and receiving help is not easy. Finding ways to lessen the intensity of these thoughts may take time. Be courageous. Be persistent – help is available.

Programs available for men by men

Tough Enough to Talk About It

This is a program for men working in trades, industry, and agriculture. The program features males who have dealt with stress, depression, suicidal behaviours, or loss from suicide.

Man Therapy

Man Therapy is an interactive website that encourages men to address their mental health and to seek help for themselves if necessary. Men can interact with a therapist, do a self-assessment, and get mental health tips. The website refers users to the National Suicide Prevention Lifeline (USA) and/or a list of professional mental health providers.

DUDES Clubs

DUDES Clubs are spaces that facilitate a participant-led community for men’s wellness, which prioritize supportive relationships, engagement in health care, and an Indigenous world view.

HeadsUp Guys

This is a website with information and resources to encourage help seeking among men at risk for depression and suicide.

Men’s sheds

Men’s sheds are community-based organizations that provide a safe and friendly environment for men to learn practical skills, develop new interests, work on meaningful projects (e.g., carpentry, restoring bicycles for a local school, gardening, art), connect with other men, and talk about their problems. Some Men’s Sheds incorporate visits from health care professionals and access to men’s health literature.

Recommended Reading

To gain a deeper understanding of the complexities of men and suicide, we’ve compiled a recommended reading list on the topic, which is available on our website.



Expert reviewers



John Oliffe, Professor, Canada Research Chair in Men’s Health Promotion, and Founder and Lead of the UBC Men’s Health Research Program

Paul Links, Professor, Psychiatry & Behavioural Neurosciences, McMaster University

References

American Association of Suicidology. (2018). Know the Warning Signs of Suicide. Retrieved from http://www.suicidology.org/resources/warning-signs

American Psychological Association. (2005). Men: A different depression. Retrieved from http://www.apa.org/research/action/men.aspx

Canetto, S., & Sakinofsky, I. (1998). The gender paradox in suicide. Suicide and Life-Threatening Behavior, 28(1), 1-23.

Houle, J., Mishara, B., & Chagnon, F. (2008). An empirical test of a mediation model of the impact of the traditional male gender role on suicidal behavior in men. Journal of Affective Disorders, 107(1-3), 37-43.

Ogrodniczuk, J.S., & Oliffe, J. L. (2011). Men and depression. Canadian Family Physician, 57(2),153-155.

Paraschakis, A., Michopoulos, I., Christoduolou, C., Koutsaftis, F., & Douzenis, A. (2016). Psychiatric medication intake in suicide victims: Gender disparities and implications for suicide prevention. Journal of Forensic Sciences, 61(6), 1660-1663.

Seager, M., Sullivan, L. & Barry, J. (2014). Gender-related schemas and validation of the male and female gender scripts questionnaire. New Male Studies: An International Journal, 3(3), 34-54.



Statistics Canada. (2019) Table 13-10-0392-01 Deaths and age-specific mortality rates, by selected grouped causes [CANSIM Database]. Retrieved 31 October 2019 from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310039201



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