The gender paradox of suicide
Today, Monday 10 October is World Mental Health Day. The overall objective of World Mental Health Day is to raise awareness of mental health issues around the world and to mobilize efforts in support of mental health[1].
I’ve used a gender lens to explore data related to global mental health and suicide rates, to explore how these have changed over the last 2 decades and to raise awareness to the gender paradox of suicide.
Depression is a key indicator for mental health[2] with an estimated 280 million people affected globally in 2019 equivalent to more than 3% of global population.
Looking at depression rates globally from 2000 to 2019 in table 1 below indicates a slight positive global trend. Female depressive disorder is declining from 4.45% in 2000 to 4.29% in 2019 (equivalent to a decrease of 4%) and male depressive disorder is declining from 2.93% in 2000 to 2.87% in 2019 (equivalent to a decrease of 2%).
What is very significant is the large discrepancy between female and male global depressive disorders as female depression disorder rate is almost twice as high as male depression.
Chart 1: Global depressive disorder as a percentage of population by female and male 2000-2019[3]
More than 700,000 people worldwide die from suicide every year, and suicide is the fourth leading cause of death among 15–29 year-olds globally[4].
The risk of suicide is closely linked to depression, and it is estimated that 60%[5] of people who die from suicide have had a mood disorder (e.g., major depression, bipolar disorder, dysthymia).
Looking at suicide rates globally from 2000 to 2019 in table 2 below indicates a significant positive global trend with female suicide rates declining from 9.1 out of 100,000 in 2000 to 5.7 out of 100,000 in 2019 (equivalent to a decrease of 37%) and male suicide rates declining from 16.6 out of 100,000 in 2000 to 12.6 out of 100,000 in 2019 (equivalent to a decrease of 24%). Suicide rates are declining among both sexes globally, but female suicide rates are decreasing at a more rapid rate compared to males.
Chart 2: Global suicides per 100,000 population by female and male 2000-2019[6]
Table 2 indicates that male suicide rates are more than twice as high as female suicide rates. This is counter intuitive to table 1 which shows us that female depression rates are twice as high as male, and we know that depression is a key determinant for suicide as described in the paragraph on depression. This seemingly converse relationship is part of what is known as the “Gender Paradox of Suicide”[7]. The most common explanation for the paradox is that men die by suicide more often than women, but women experience living with suicidal thoughts or behavior more often than men – put in other words men are more likely to die from suicide (which are generally more violent e.g., by firearms[8]) than women.
Fortunately, we see a positive trend over the last two decades with both depression and suicide declining globally. What we do however notice is that although the male suicide rate is declining, it is doing so significantly slower than female suicide rates. The same trend is occurring for depression rates.
Some interesting topics to further explore could be comparing the gender paradox of suicide across different world regions and explore underlying causes of changes in suicide rates. In the African region for example we are seeing a doubling of mental health problems since 1990 and suicide rates above the global average[9].
From a man’s personal point of view, I expect that an underlying reason for the gender paradox of suicide is that men are likely not to share suicidal thoughts. At the same time men are affected by breakdowns in relationships and work life to the point where men see these life circumstances as shameful which is connected to what I believe is a misguided mindset in many societies.
But what exactly is it about being male that creates this higher risk of death by suicide compared to women and how can we put gender adjusted global health strategies into place to address the underlying issues driving the gender paradox of suicide and by doing that help prevent loss of lives by suicide.
[1] https://www.who.int/campaigns/world-mental-health-day
[2] https://www.who.int/news-room/fact-sheets/detail/mental-disorders
[3]Source: Our World in Data
[4] https://www.who.int/news-room/fact-sheets/detail/suicide
[5] https://www.hhs.gov/answers/mental-health-and-substance-abuse/does-depression-increase-risk-of-suicide/index.html
[6]Source: data.worldbank.org
[7] https://cams-care.com/resources/educational-content/the-gender-paradox-of-suicide-how-suicide-differs-between-men-women-and-transgender-gender-diverse-individuals/
[8] https://www.verywellmind.com/gender-differences-in-suicide-methods-1067508
[9] https://news.un.org/en/story/2022/10/1129292
