Suicide in men: Rethinking masculinity to battle the silent struggle

Previously, RMIT psychologists called for collective action to prevent suicide among adolescents on World Suicide Prevention Day (10 September) and highlighted safe practices when talking about suicide on World Mental Health Day (10 October). 

To conclude this series of dialogues on suicide, this International Men’s Day (19 November), RMIT researchers address the social factors that increase men’s risk of suicide and discuss how fostering positive masculinity can promote men’s mental wellbeing.  

Warning: This article discusses matters related to suicide. If you find this content distressing, please stop reading and, if needed, reach out for support via the hotlines at the end of this article.

Why are men more at risk of suicide?

For decades, psychologists have been puzzled by what is known as the “gender paradox in suicide”: although men die by suicide at significantly higher rates than women, they often report fewer suicidal thoughts and attempts. In Vietnam, the male-to-female suicide ratio is approximately 2.7 to 1, reflecting a pattern also observed globally. Why does this gender gap persist? 

Research has offered some explanations. “Men die by suicide more than women because they often opt for more lethal and violent methods such as hanging, which increases the risk, while women more often attempt suicide through poisoning or overdose, which allows more time for rescue,” said Ms Vu Bich Phuong, Associate Lecturer in Psychology at RMIT Vietnam.

Not only do men and women differ in suicide rates, but they also show significant differences across several suicide-related measures, such as suicide literacy and help-seeking intentions when experiencing suicidal thoughts. 

“For example, in my recent study, male adolescents knew significantly less about suicide facts than their female counterparts. When asked to rate their likelihood of seeking help if they had suicidal thoughts, their responses were also more complex and polarised: they reported both a high intention to seek help and a high intention not to seek help from anyone,” Ms Phuong said.

“This suggests that many young men start to experience internal conflict around help-seeking as early as during adolescence: they may recognise the importance of getting support yet feel constrained by social norms that equate vulnerability with weakness. This may be related to the deep influence of toxic masculinity”, Ms Phuong said. 

In other words, rigid social expectations for masculinity can backfire on men themselves. “In many societies including Vietnam, there are clear, sometimes strict, expectations of how men should behave. Phrases such as ‘boys shouldn’t cry,’ ‘men must be tough,’ or ‘only girls show emotions’ still circulate in everyday conversations”, says Mr Duy Le, Associate Lecturer in Psychology at RMIT Vietnam. 

“When masculinity is interpreted in a rigid way, it can discourage emotional expression and self-care. Boys may not learn how to manage emotions in healthy ways, which can lead to emotional difficulties later in life”, Mr Duy said.

The issue with rigid, traditional masculinity is twofold. “Researchers have found that conforming to toxic masculine ideals – such as aggression or a ‘playboy’ lifestyle – is linked to higher suicidal ideation,” Mr Duy notes. “At the same time, the difficulty of living up to these ideals can cause deep distress, including depression and suicidal thoughts. Sometimes, even offering help to men is misinterpreted as questioning their capability. It is a painful double bind.”

What can we do to help? 

In the face of such deep-rooted struggles with gender norms and social expectations, it can be hard to know how to help young men deal with suicidal thoughts. “The key is to rethink masculinity and educate boys and men in ways that promote healthier, more balanced understandings of male strengths,” says Dr Gordon Ingram, Senior Lecturer in Psychology at RMIT Vietnam. “You can be strong without breaking.”  

One way of doing this is to flip the script and point out that for men, a behaviour like help-seeking requires a lot of inner strength and courage. “Often, reaching out to others for help can feel hard. But what it really means is you’re taking action and taking control of your life, rather than passively doing nothing about your problems and letting them multiply,” Dr Ingram says. 

“And just like going to the gym, it gets easier over time.” The key is to give advice that fits well with masculine virtues – the positive side of traditional masculine norms – rather than putting young men off by going against the grain and painting all masculinity as toxic. 

As well as strength and courage, masculine virtues include task-oriented qualities like mastery and perseverance, along with more social concepts such as protectiveness, assertiveness, responsibility, and honor. “Research on positive masculinity is still in its infancy.” 

But anti-suicide interventions may have more success with teenage boys and young men if they speak to them in terms of male virtues than if they imply that males need to become more like females, in areas like expressing feelings and seeking help from others,” Dr Ingram said.

To put these principles into practice, Dr Ingram offers several concrete recommendations for parents and teachers:

• Praise more masculine seeming virtues as well as more feminine ones: talk about the value of inner strength, courage, and perseverance, as well as kindness, empathy, and diligence.

• Actively listen to boys and validate them when they share their feelings; but don’t push them if they don’t seem comfortable. Creating a safe place for them to feel comfortable can help them talk.

• Don’t compare boys’ and girls’ behaviour (“Look, the girls are all sitting quietly while the boys are messing around!” or “Why can’t you be more like your sister?”) as this reinforces gendered peer group distinctions and can make boys feel pathologised.

• Similarly, try to discourage boys and girls from maintaining separate “gendered spaces” in school, as this can mean that a boy (or girl) who doesn’t fit in with most same-sex peers has fewer “safe spaces” to go to.

• Give your teenage son plenty of opportunities to bond with male friends over fun activities that they all enjoy. They will naturally learn to support each other as they explore male friendship and competition together. 

By raising awareness about male suicide, acknowledging men’s silent struggles, and embracing positive masculinity, we can tackle the troubling rate of suicide in men and create a society where mental health is for all.

If you experience significant distress or suicidal thoughts, call 115 for emergencies (nationwide), or 1900 1267 for help from the Ho Chi Minh City Psychiatric Hospital. For more sustainable support, reach out to mental health services at nearby hospitals and clinics.