Why do more men die by suicide?
There is a gender gap in suicide deaths in Hong Kong, and in most countries around the world. Double the number of men die by suicide in Hong Kong than women.
Firstly, it is complicated and there is rarely a singular reason someone decides to end their life. Suicide is a sensitive and complicated topic, and many factors contribute.
Here are some factors which help explain the gap in suicides between men and women.
Roles in Society
“It’s expected of you to just be able to deal with it”
For a long time society has pressured men to always be resilient. These social norms maintain a silence around mental health, leaving many men unable to share their true feelings when they are struggling.
Studies suggest that people perceive talking about thoughts of suicide as less acceptable for men than women (Fox et al., 2018). Adolescent men and boys have reported increased concerns about social disapproval regarding thoughts of suicide than adolescent women and girls (Stillion et al., 1999).
It is too simplistic to say that men don’t speak up.
However, it is true that they are less likely to access professional help.
A survey by The Mental Health Association HK found that 63% of men would not seek assistance from social welfare organisations or professionals due to concerns about being judged, perceived as weak, or feeling embarrassed.
Additionally, many respondents expressed a lack of knowledge about where to seek help or how to access support until their situations became severe and unmanageable.
Generally, men are more inclined to internalise their emotions. As many as 40% of men have never spoken to anyone about their mental health, despite over three-quarters experiencing common symptoms like anxiety, stress or depression.
When asked why they don't talk, the biggest reasons cited were:
‘I’ve learnt to deal with it’ (40%)
‘I don’t wish to be a burden to anyone’ (36%)
‘I’m too embarrassed’ (29%)
‘There’s a negative stigma around this type of thing’ (20%)
Substance abuse
Men are more likely to use alcohol and drugs to self-medicate. Men are nearly twice as likely as women to meet the criteria for alcohol dependence. Drinking alcohol and using drugs can deepen symptoms and increase impulsive behaviours.
Financial pressures
A study into masculinities in Hong Kong found that participants feel pressured to live up to society’s expectations of what it means to be an ‘ideal’ man. Most consider the model of a successful man to be wealthy, with a flourishing career and a happy family (The Women’s Foundation)
Life pressure can be intense, and that can play a role in men’s vulnerability to suicide. During financial downturns, rates of suicide increase, making men more at risk if they lose their jobs Chang et al., 2014; Law et al., 2011). In Hong Kong those who are not in employment are more than 15 times more likely to die by suicide (CSRP 2023).
Among men in the Asia Pacific region , unemployment or job-related stress is a more common trigger of suicide than for men in the other regions (Amagasa, 2005; Phillips, 2002). Circumstances such as gambling debts, job loss, and work-related factors are often acute stressors in the lives of men leading up to suicide (Amagasa, 2005; Phillips et al., 2002; Wong et al., 2010).
The Mental Health Association found that the most common sources of stress reported by male respondents were work, finances, health, and family and relationships.
Relationships
Findings from research focused on mid-life suicide risk (Agerbo, 2005) found partner bereavement (by suicide or another cause) created three times as high suicide risk for men (46.2%) compared to women (15.8%). Factors such as relationship breakdown and partner bereavement, while present among both men and women, increase suicide risk more significantly in men.
Lack of appropriate services
We know that less than 30% of people who die by suicide are in contact with mental health services in the 12 months before they die – the question is why?
Is it because the services aren’t there?
Or because when services are there they’re not tailored to the needs of the people who need them?
Or is it the long waiting lists? This leads to even greater inequality for the people who can’t afford to pay for private care.
In this blog we focus on comparisons between cisgender men and women, which reflects the majority of research on gender and suicide. However, it is important to recognise that suicide is a major concern among trans and non-binary people too (Bachmann & Gooch, 2018; Marshall et al., 2016), who experience a set of specific risk factors for suicide.
