This article appears in the November 2004 edition of the Catholic Medical Quarterly

A Major Public Health Problem

In this issue Dr. Bengt Safsten describes suicide as a crisis for the individual, for the family and the community. In this country it is a major public health problem. There were 5,910 suicides in the UK in 2001 and around 75 per cent of these were in males. Suicide accounts for 20% of all deaths among young people aged 15-24 and is the second most common cause among young people after accidental death. Since the beginning of the 21st century men appear to be more vulnerable than ever before with rates higher than women across all age groups. In the 25-44 range men are almost four times more likely than women to kill themselves. What causes this diversity?

The precipitating life events for women who attempt suicide tend to be losses or crises in significant family relationships. As with men it is more common among single women or those who are recently separated, divorced or widowed. Women, however, are more likely than men to have stronger social supports, to feel that their relationships are deterrents to committing suicide, and to seek psychiatric and other medical interventions.

In men, however, there is a tradition of being reluctant to talk about their problems or express their feelings. They are less likely to go to their GP's with them and present with physical problems which may not be recognised as a manifestation of mental distress. The concept of the 'new man' has left many feeling uncertain as to what is expected of them, particularly in terms of significant relationships. The increase in the proportion of unmarried men may be another factor. Indeed, research has suggested that marriage is a protective factor and that half the increase in young male suicides may be due to the smaller proportions of young men who are married.

Men, too, have suffered more severely than women from the shrinkage of traditional manufacturing jobs and it has been noted that those in unskilled employment are more likely to kill themselves compared with other men in the general population. Again although no direct link has been shown between unemployment and suicide unemployed men are two to three times more at risk than the general population. There may be a direct link with poverty.

Alcohol and drug abuse are common to both men and women and its alleviation occupies a leading role in the strategy of prevention.

In the face of rocketing levels of suicide in Ireland the hierarchy has issued a pastoral letter and written to every household in the country in an attempt to halt it. The bishops said a weakening of faith and loss of emotional support had been combined with efforts to remove the stigma of suicide from bereaved families, taking away the recognition that it was still 'an unthinkable option'.