Preventing suicide: The basic mistake holding us back
THERE are two disturbing gender gaps in Australia.
We talk about the first one a lot. Women are paid less than men, and face far greater obstacles, particularly in the workplace. It's a serious and maddening problem, which you can read more about here and here.
The second gender gap is harder to discuss, but no less important.
Last year 3128 people killed themselves in this country. Three quarters of them were men.
To anyone involved in suicide prevention, that figure is horribly familiar, because it is similarly skewed every year.
"What we know is that three out of every four suicides are men. Eight suicides a day in Australia; six are men," says Glen Poole, Development Officer at the Australian Men's Health Forum and founder of the Stop Male Suicide project.
Mr Poole believes Australia, and indeed most of the world, has been "missing the point" in its efforts to stop men from taking their own lives.
As part of that, we are asking what more can be done, both by government and society in general, to help men avoid suicide.
Mr Poole says one of the biggest mistakes we make is to treat male suicide and female suicide as though they're the same.
"What we would like to see is government policies specifically targeting male suicide and female suicide in distinct and separate ways," he tells news.com.au.
"There's not enough of a gender focus. Pretty much all of the resources invested in suicide prevention are delivered in a gender neutral way, which may seem fair and egalitarian, but if we fail to take into account the differences between men and women, then we fail to put the focus and energy where it's most needed."
It sounds counterintuitive. Our instinct is to treat men and women as equals. But this is not an argument to help one more than the other; rather it is a plea to target support specifically to each gender more effectively.
For example, suicide prevention efforts often focus on people who have been diagnosed with a mental illness, or have attempted suicide before. A huge proportion of at-risk men fit in neither category.
That means they are often invisible to the mental health system.
"We are focusing a great deal of resources into supporting people who've previously attempted suicide, which is a very beneficial thing to do," Mr Poole says.
"However the vast majority of people who report attempting suicide are women. Mostly having attempted to overdose. Which often doesn't capture the men who have been contemplating suicide.
"Men are far more likely to die at the first reported attempt. We don't get a second chance."
Around 80 per cent of male suicides are not linked to any mental health diagnosis. Which begs the question - what are they linked to?
"Different types of life crises," Mr Poole says. "Relationship breakdown, work issues - whether that's stress at work or the stress of not having work - financial stress, for older men physical health issues, and other things such as bereavement, alcohol abuse, trouble with the law."
The key is to focus on helping men overcome those issues.
"Our conventional approach to suicide prevention, which is to encourage men to talk more about their feelings about their mental health, is missing the point," he says.
"Most men who end up taking their lives are dealing with life crises, not necessarily dealing with mental health issues that require a conversation about their feelings."
NATIONAL 24/7 CRISIS SERVICES
HOW DOES THE SYSTEM WORK?
The mental health system is extremely complex.
The federal government sets a national strategy, then works with other organisations and parts of the public sector to implement it.
"Funding is given to non-governmental organisations such as Lifeline and Beyond Blue," Mr Poole says.
"A lot of responsibility is put at the local level.
"There's a very professional and robust suicide prevention sector in Australia and a lot of good work going on."
There are even some signs, albeit fragmented ones, that at-risk men are starting to get the kind of support they need.
The federal government is spending $79 million, up until the 2020-21 financial year, on a range of national suicide prevention support activities and programs. Some of them specifically target men.
According to Mr Poole, all three programs have proven effective.
"A quarter of male suicides are linked to separation, so support groups like Parents Beyond Breakup are a form of suicide prevention," he says.
On top of that, the government is providing $1.23 billion to its Primary Health Networks across the country to plan out mental health and suicide prevention services at a regional level.
That funding covers 12 different suicide prevention trials, aimed at discovering which strategies work best. For instance, the Primary Health Network in rural South Australia will be holding a men's "Save Your Mates" forum series in February next year.
The government also funds a range of digital mental health services, which you can access through its online portal here.
And you have probably already heard of Headspace, which gives young men aged between 12 and 25 access to mental health support. That age group is particularly vulnerable to suicide, which accounts for a full third of deaths among people in their late teens and early twenties.
"The government is committed to reducing the number and impact of suicides in Australia, and ensuring the development of a better integrated mental health system that can support individuals when and where it is needed," a spokeswoman for the Department of Health told news.com.au.
"The Fifth National Mental Health and Suicide Prevention Plan has established a national approach to ensure better integrated mental health and related services in Australia. This includes services for men.
"Separately, work has begun on a National Male Health Strategy (2020-2030) which will focus on the mental and physical health of men and boys.
"Building on the 2010 National Male Health Policy, the strategy will identify what is needed to improve health outcomes, and provide a framework for taking action. It is being developed in consultation with key experts and stakeholders in male health and, importantly, the public will be invited to have a say through online consultation later this year."
The Productivity Commission has also announced an inquiry into Australia's mental health system that will look at its impact on the economy and to scrutinise the $9 billion spent a year by federal, state and territory governments.
Advocacy groups have welcomed the inquiry and said it had the potential to drive change.
But Labor's mental health spokeswoman Julie Collins said it shouldn't be used to delay action on mental health. She wants the government to adopt the National Mental Health Commission's target to reduce suicide by 50 per cent over 10 years.
A GLOBAL CHALLENGE
It's not as though Australia has a perfect model to follow. Other countries are struggling with the same challenges.
"Nowhere in the world that I know of has a government specifically targeting its suicide prevention policy at men," Mr Poole says.
"There's lots of good practice around the world and Australia's very good at learning through practice, but what no country is good at - that I'm aware of - is targeting suicide as a gendered issue."
Figures from the Bureau of Statistics reveal just how stark the problem is.
Australia's suicide rate has not fallen in the last decade. In fact, it has actually increased recently, leaping 9 per cent from 2016 to 2017.
Intentional self-harm is the 10th-highest cause of death among men, with a rate of 19.1 deaths per 100,000 people. It does not even rank in the top 20 causes of death for women, whose rate is just 6.2 deaths per 100,000.
They are grim numbers, though among OECD nations, Australia is actually better than average.
With more targeted help to both men and women, hopefully more lives will be saved.
If you or someone you know needs help, call Lifeline on 13 11 14 or visit its website.