Does Treating Men Like Robots Make Them Suicidal?
Men remain ashamed to use life-saving resources, as the permafrost of mental health stigma thaws too slowly. Males complete suicide at 4x the rate of womxn.
The midnight call
The fourth time the phone rang, I knew something was very wrong.
In the middle of the night, my sister was calling frantically while I was fast asleep in my apartment with my boyfriend. My mind raced through a disoriented roulette.
Why is she calling?
Something bad happened.
Who’s involved? What happened?
Is it our parents? Her spouse? A friend or a distant relative?
None of the above. It wasn’t what or who I pictured at all. At the moment she hurriedly, and with great desperation, explained what was happening, I instinctively held my breath. It was as though my body thought it could stop time.
I was panicked and shocked. It was a loved one who lived on the other side of the country — a young man.
The 988 hotline
The Federal Communications Commission (FCC) recently announced plans for the 988 National Suicide Prevention Lifeline. This free, nationwide service will be similar to 911, linking a national network of crisis centers instead of 911 dispatch centers.
It will be a lifesaver. The big problem is that it won’t begin until 2022.
the public relations campaign for the 988 line may itself serve a critical function ahead of the official 2022 launch — awareness
By the summer of 2022, mobile carriers like AT&T and Verizon must support the new number for free.
Ahead of that, FCC Commissioner Jessica Rosenworcel extols plans to publicize it as a means of reducing stigma. Will this campaign begin soon? If it does, its impacts could be immeasurable during the unknown number of months remaining in our pandemic lifestyles.
The male suicidality crisis
American men are four times more likely as women to complete suicide. Lethality influences this outcome — men comprise 79% of all domestic suicides. The pandemic has made this crisis worse and suicide prevention centers have seen a huge increase in calls.
As our routines have changed, fellow mental health professionals have emphasized the mental health risks of long-term isolation. Leisure activities are anything but stress-free and social gatherings are dramatically different. Friends and family are dying.
It’s a stressful time.
Many Americans are also now in full-blown financial crisis. Financial distress can wreak havoc on many areas of life. Work productivity. Personal identity (self-perception). Mental health functioning. And, yes — romantic relationships. Over 20 years of research shows fighting about finances is the result of partner(s) having coping problems at the individual level. This means if men struggle to cope, their relationship may also suffer.
Men are not robots.
Yet, even in 2020, men face a myriad of social barriers that deter them from accessing support or embracing self-care. Even asking for time off from work to cope or rest is stigmatized.
No one was ready for the unbelievable emotional tax of COVID-19. For those without strong social support, financial security, and other resilience buffers, the tax carries emotional compound interest and self-harm risks.
Queer youth, adult men, and non-binary individuals
Recent research shows gay, adult men exhibit different characteristics than non-queer men when contemplating suicide. They also struggle with different emotional experiences. Discrimination and homophobia influence both.
Suicide prevention efforts must embrace cultural humility and tailor strategies. Rather than using a universal intervention, transphobia, homophobia, and toxic masculinity must be acknowledged. These legacy factors exert social influence on these unacceptable realities.
Microaggressions have no place in psychotherapy. Diminishing systemic discrimination as a substantive influence on mental health is a textbook example of a microaggression.
Among America’s suicidal youth — suicide is the #2 cause of death for teens ages 15 to 19 — rates are disproportionately represented by queer youth.
Compared to heterosexual, cis-gendered teens, lesbian, gay, and bisexual youth are at least five times more likely to attempt suicide. In fact, the Trevor Project and national surveys point out that 39% of all LGBTQ youth had seriously considered a suicide attempt in the last year. Recent estimates on the size of the LGBTQ population, by contrast, is typically between 4 and 7% in the US.
The critical need for intersectional thinking is also evident in the elevated suicide risk for Black and Latinx queer youth versus white queer counterparts. Social stress (cultural norms within families, for example), stigma, and discrimination are possible explanations.
Among LGBTQ youth, one in four do not identify as binary — male or female. Suicide risk is escalated for this group as well, adding to the gay male and trans-male individuals at particularly high risk of suicide.
The Trevor Project symbolizes hope for change in youth while the 988 number will critically expand help among adults. The public relations campaign for the 988 line may itself serve a critical function ahead of the official 2022 launch — awareness.
Active-duty military
Veterans in treatment for Post-Traumatic Stress Disorder (PTSD) are at elevated risk of suicide. Within a year of beginning treatment at the Veterans Affairs (VA), those with PTSD died from suicide at a greater rate than civilians.
It’s notable that the Department of Veteran’s Affairs does run a Veterans Crisis Line. However, active-duty military men and womxn are frequently pressured to hide mental health issues.
It is not unheard of, in fact, for weapons to be confiscated for prolonged periods of time following a crisis event. While this caution is warranted, it’s clear why men and womxn in uniform worry about their military careers as collateral fallout.
Prevention has hardly been a historical focus. The Psychological Health Center of Excellence (Deployment Health Clinical Center) is an organization whose entire mission is advising military leadership on navigating post-suicide challenges among troops.
Sadly, this is not new news. For decades, The Pentagon has struggled to prevent suicides. Waves of periodic, programmatic interventions have risen and fallen with disappointing results. One was in 2012 when the Department of Defense realized suicide rates were the highest they’d been since the terrorist attacks of 9/11.
It’s unsurprising that military suicide rates are trending upward. In 2018, they hit a record high.
In August 2019, the VA and DoD cooperatively updated Clinical Practice Guideline for the Assessment and Management of Patients at Risk for Suicide. Using a multidisciplinary team of health scientists, this guide seems to earnestly attempt to honor the sacred obligation of protecting those who protect America.
Hotlines and loved ones
September is Suicide Awareness Month. It’s a good time to remind ourselves and those we love that we are enough.
The call I received in the middle of the night was terrifying — but I’m glad he called us because my story ends with gratitude for my training in counseling psychology. I knew how to assess suicidality risk, for knowing how to direct them toward a safety plan, and for knowing how to comfort my sister afterward.
I hope you will never need the crisis management resources, but you never know if you’ll get a call like mine at 2 AM. I am hopeful the new 988 hotline will improve access to mental health crisis support for men — and awareness they aren’t alone.
Annette Miller is the Cofounder and CEO of Enriched Couples, a financial therapy platform that uses psychology to guide couples through unifying their values, financial priorities, and future goals.
