Our "political difficulty"Peter Vogel asks why we are so reluctant to confront the epidemic of male suicide, and suggests some ways we could better meet men's needs.In November of last year a suicide conference was held on the N.S.W. Central Coast, the area of the highest suicide rate in Australia and one of the highest in the world. One quote in the subsequent newspaper report of the conference caught my attention: the Director of the Australian Institute for Suicide Research and Prevention described suicide as a "delicate, politically difficult" crisis. What makes this issue "politically difficult" is that it is MEN who are dying. If the problem were child abuse, or violence against women, there would be no political difficulty; the problem would be real and the need for action obvious. Political correctness dictates that men are doing just fine, merrily going about their daily toil of exploiting women and abandoning their children. This fantasy does not sit well with the fact that in one small geographic area alone one man every day is feeling so unsupported and desperate that he takes his own life. Averaged across all age groups, males kill themselves at four times the rate of women. In 1993, more males died from suicide than in road accidents. I'm sure there are many reasons why male suicide has reached epidemic proportions. One factor is that men do not seek help as readily as women. Men's low utilisation of services is often used to reject calls for providing more services. Some men don't seek help because they believe that a man should solve his problems by himself, some simply don't know where to turn for assistance, and others fear that "the system" is designed to help women, not men. There are also many men who do seek help when they feel overwhelmed by their difficulties. My anecdotal experience has been that for many of this group, just when their need is the greatest, the system fails them most dramatically. Although male suicide is generally presented as a problem of young males, suicide rates actually peak in middle age. The highest risk group is men after relationship breakdown. A Queensland study last year showed that on relationship breakdown, more than 12 men kill themselves for every woman who kills herself. This may be attributable in part to the much greater likelihood that the male partner loses his children, home and often his job after divorce. Whatever the reason, men in this situation must certainly be considered highly "at risk", yet health services do not target this group. Funding and services are available for youth and for women, but with the demise of Carmen Lawrence's Men's Health Policy, the only safety-net for middle-aged men is what self-help groups can provide on a voluntary basis. I was contacted recently by a man whose wife had left him, taking his child with her. Mark was distraught and frightened by thoughts of ending it all. He wanted a suggestion where he could get some counselling. He had called the Family Court and got the distinct impression that the person on the other end of the phone thought he must be the cause of his wife leaving, and was not at all sympathetic. He had no money, so a private therapist was out of the question. The community health service where he lives has a policy of not counselling people over relationship difficulties. They would refer him to Relationships Australia, which costs $20 to $85 per session, and which offers a "Survivors of domestic violence" support group for women, but not for men. I suggested a GP I know who would bulk-bill. I don't know what the outcome was. Various counselling services have policies that militate against men obtaining help. Community health service policies of not counselling people with relationship problems are particularly alarming since data from men's phone line services show that relationship issues account for most calls. One man whose mental and physical health had suffered due to being emotionally abused by his boss was refused counselling by a community health service on the grounds that the matter was pending as a worker's compensation case. Another man who was being abused by his ex-wife was refused counselling by the Family Court because she had taken out a protection order against him. No NSW government health agency is permitted to counsel men seeking help with their own violence. One would think that these policies, which discriminate almost exclusively against men, would be in breach of anti-discrimination laws, but apparently these laws are themselves discriminatory. Men who are suffering violence from their partner or ex-wife are particularly isolated and neglected. Andrew had left a violent relationship taking his daughter with him, with his wife's agreement. He hoped that the violence would stop once they were gone, but it hadn't. He feared for his daughter's safety when she went to stay with her mother. His ex-wife was also violent to him on handovers. He wanted to speak to a counsellor who could help him work out a resolution, and I suggested the domestic violence hotline would be a good place to start. Andrew was reluctant to make the call, fearing that he would not be believed, but was happy for me to make an enquiry on his behalf. I called the Department of Community Services Hotline, only to be told that they could not offer advice because the couple was no longer living together. I subsequently acquired the DOCS domestic violence policy documents which clearly states that domestic violence is defined as violence against women by men. It also states that domestic violence does extend to post-separation situations. So Andrew's reluctance was well placed. I am pleased I made the call on his behalf. I can only wonder what effect such a fob-off might have on a man who has reached the end of his tether. While preparing a submission to a government enquiry last year, I interviewed a number of men about their experiences of various counselling services. Their comments help explain why so many men treat "the helping professions" with great suspicion. One man reported his experience of a counselling session requested by the Family Court: I was worried from the outset that the court had already decided I was a demon and the outcome of the report was a foregone conclusion. When I arrived for the appointment, in the waiting room there was a cartoon someone had stuck on the wall. It showed a skeleton - holding a handbag to show it's female - sitting on a bench. The caption said 'Waiting for a good man'. This didn't make me feel real welcome. A custodial father fighting to retain custody: The counsellor spent 10 minutes listening to my side of the story and two hours listening to my ex. It was sickening how plain she made it that she believed my son belongs with his mother; the fact that I've been the primary caregiver for years seemed to annoy her. She wanted to know what was wrong with me to want to have custody. Men who have experiences of discrimination such as these naturally have very negative opinions of the worth of counselling. Furthermore, as one of the men quoted above said: If a mate is having problems with his marriage, my advice to him is to keep right away from counsellors - they'll only make things worse for you. The full extent of our incompetence at dealing with men in crisis was brought home to me dramatically last year with the suicide of a man, who lived not far from me. I doubt that Robert even made the suicide statistics, since he killed himself by driving into a tree. He had been deeply depressed for a long time, believing that no one cared about him. Six months before his death he had an experience which confirmed that his perception was not wrong. One night, a concerned neighbour had heard him crying and screaming that he was going to kill himself. Not knowing what else to do, she called the police. The next thing Robert knew his house was surrounded by police armed with rifles, fierce dogs, and floodlights. The street was cordoned off, in what the news reports for the next 10 hours described as a siege situation. Robert armed himself with a kitchen knife and was determined to kill himself before the police got him. When he was eventually captured, he was taken to the police station and then released to find his way back home. This was the best response the police could manage. A desperately sad and isolated man was offered no help - in fact it would be hard to conceive of a response more likely to pour fuel on the fire. I have not gone out of my way to seek out evidence of our neglect of men's needs for societal support through times of crisis. Suicide prevention is not an area of particular expertise for me. I am not a psychologist, or a researcher, but it is clear to me that it's time to confront this "delicate, politically difficult" crisis. Some names in this article have been changed to preserve anonymity.
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