As part of my university degree, I was required analyse why there is a significant difference between the suicide completion rates between males and females. It was a critical analysis essay, so the writing style somewhat different to my usual.
"Critically evaluate at least three of the existing explanations of the fact that, world wide and in Australia, youth suicide rates differ significantly between males and females"
It has been well documented that in Australia and across the world, youth suicide rates differ between genders, with significantly more suicide attempts made by women and paradoxically more suicide completions made by men (Bjerkest, Romundstad & Gunnell, 2008; Liemkuhler, 2003; Curtright & Fernquist, 2003; Groholt, Ekeberg, Wicherom & Haldorsen, 1999). Studies have suggested that the suicide completion ratio could be approximately three to one (M:F) globally, with the largest ratio being six to one (M:F) in America (Curtright & Fernquist, 2003: Groholt, Ekeberg, Wicherom & Haldorsen, 1999).
For the purpose of this essay, youth constitutes the ages between 15 and 25. Suicide is defined as an individual’s intentional actions for the purpose of, and resulting in, the loss of their own life (Kring, Davison, Neale, & Johnson 2007). A literature review yielded some possible explanations as to why there is a gender difference in suicide rates.
The first explanation is based around the relative reluctance of males, compared to females, to seek help for depression and suicide related problems and concerns (Groholt, et al, 1999; Bjerkest, et al 2008). The second explanation arises from the greater levels of negative stigma attached to male depression and suicide than to female depression and suicide (Pompili, Macinelli & Tatrelli, 2003; Liemkuhler, 2003; McAndrew & Garission, 2007). The third explanation for differences between male and female suicide rates is the more violent methods of suicide attempts used by males compared to females (Bradivik, 2007; Liemkuhler, 2003; Motto & Bostrom, 1997). This essay will critically evaluate these three explanations, including how they individually and collectively impact upon the levels of male to female suicide completion rates.
How an individual handles depression and thoughts of suicide can have a dramatic influence upon their outcomes. Research has suggested that there is a relative reluctance in males, compared to females, to seek help for depression and suicide related problems and concerns (Groholt, et al 1999; Bjerkest, et al 2008). This leads to the questions of why is there a difference in help seeking behaviour and how does this the difference in help seeking behaviour contribute to the differences in suicide levels of males and females? Possible causes of the gender difference in help seeking behaviour could be due to a culture of minimal male expressiveness, the effects of gender stereotypes and the effects of alcohol abuse amongst male youth (Liemkuhler, 2003; Groholt, et al 1999; Oie, Foong & Casey, 2006).
The consequence of help seeking behaviour could be seen to reduce control and autonomy, suggest incompetence and increase dependency, all of which are contradictory to the actions of a stereotypical male (Liemkuhler, 2003). This contradiction may subsequently result in males not seeking help even when they become aware of depressive or suicidal thoughts. Supporting this suggestion a study by Bennett, Ambrosini, Kudes and Rabinovich (2005) on youth depression levels, found that there was little difference in depressive symptoms or severity levels between genders. Furthermore, Bennett et al (2005) found that there was no gender difference in the number of thoughts of suicidal behaviour. This finding suggests that while both males and females have similar levels of depression and suicidal thoughts, females are more likely than males to seek help, possibly because help seeking is believed to be a more feminine quality (McAndrew & Garission, 2007).
When confronted with depressive or suicidal thoughts many male youths may turn to alcohol, as a compensation for their relative reluctance to seek help or support (Oie et al 2006; Groholt, et al 1999). Alcohol may have the effect of producing inhibition or potentiating existing impulsivity. Studies have shown that greater levels of alcohol consumption can lead to increased levels of depression and subsequent suicide, particularly in males (Oie et al, 2006; Stack, 2000). However the reliability of these findings can be questioned as it may be unclear if the depression resulted in the individual abusing alcohol or if alcohol abuse resulted in the depressive symptoms. Additionally, there may be problems in obtaining representative data regarding the presence of alcohol in suicide completions. This could be because the appropriate tests may not have been performed within the needed time frame to get an accurate result (Oie et al, 2006).
For males, suicide completions could be seen as the last avenue of control, thus maintaining a male stereotype, whereas female suicide attempts may be seen as a desperate attempt to seek help, which is fitting for the female stereotype. (Groholt, et al 1999; Liemkuhler, 2003; Bjerkest, et al 2008). This adherence to maintaining stereotypes could in part help to explain the gender differences in suicide rates of youths. The paradoxical relationship that there are significantly more female suicide attempts, but more suicide completions by males, could also be a result of the reluctance of males to seek help. This subsequent lack of communication of depressive and suicidal related issues may result in an under reporting of suicide attempts by males as doing so would infer a loss of control and vulnerability which is contradictory to the male stereotype (Liemkuhler, 2003; Bjerkest, et al 2008).
In relation to the reluctance of males to seek help, a further explanation of the differences in suicide rates could be the greater levels of negative stigma attached to male depression and suicide than to female depression and suicide. Research has suggested that while as a whole, the act of suicide is looked down upon, suicide in males is especially stigmatized (Pompili et al, 2003; Bjerkest et al, 2008). For the purposes of this essay, stigma will be defined the phenomenon where an individual has a particular quality and is subsequently discredited by society for having the quality (Pompili et al, 2003).
Evidence for gender differences in the level of stigma regarding suicide comes from a study regarding the beliefs about the methods and causes of suicide. McAndrew and Garrison (2007) found that given the same explanation for the reasoning behind a suicide, participants were significantly less sympathetic to male victims than the female victims. This relationship held regardless of the gender of the participant. Bjerkest et al (2008) and Liemkuhler (2003) similarly suggests that there are greater levels of stigma regarding depression and suicide placed upon males then females however evidence supporting these suggestions is mixed (Biddle, Gunnell, Sharp & Donovan, 2004; Bogner & Gallo, 2004).
It has been suggested that the media may play a role in creating the stigma related depression and suicide, implying that depression is not a true illness compared to normal, organic illness (Pompili et al, 2003). This could have the effect of people suffering from these issues to not seek help, as the act of seeking help would draw attention to their stigmatised quality. However both males and females are exposed to basically the same media experience, but as discussed, the levels of help seeking behaviour are different (Liemkuhler, 2003). Thus, it could be seen that the stigma of depression and suicide may not be strong enough to impede female help seeking behaviour. Whereas with males the added negative stigma may effectively compound the impediments of gender stereotypes on help seeking behaviour.
The level of violence of the method of suicide could have a dramatic impact upon the success of the suicide attempt. One possible explanation for the significantly more suicide attempts made by females compared to the significant amount of suicide completions made by male is the violence of the chosen method of suicide (Bjerkest etal, 2008). Research has found that the fatality rate of suicides made by violent means (firearms, hanging or railway behaviour) to be 70 to 90%, compared to the overall fatality rate of all suicide attempts to be around 13% (Miller, Hemenway & Azreal, 2004). However these figures, and other figures relating to suicide may be questionable as there could be an issue of underreporting due to the stigma attached to suicide behaviour, the effects of male stereotypes or the effect of family members attempting to protect the victim’s memory (Bradvik, 2007; Liemkuhler, 2003).
Research has shown that generally males choose more violent methods of suicide than females, with the typical male method of choice, a firearm or hanging and the typical female’s method of choice, a drug overdose (Groholt et at, 1999, Motto & Bostrom, 1997). In addition, research has shown that for repeated suicide attempters, males generally begin with violent methods, or subsequently change to more violent methods for the repeated attempts, whereas females generally begin with and remain with non violent attempts (Bradivik , 2007).
There have been some suggestions as to why males choose more violent methods then females. One possible reason could be that males are typically more violent by nature (Groholt et at, 1999). Along a similar vein, gender stereotypes suggest that violent methods of suicides fit the male stereotype, while less violent methods such as an overdose fit the female stereotype (Liemkuhler, 2003; Groholt et at, 1999). In support of this suggestion, McAndrew and Garrison (2007) found that there is a prevailing belief that males will use violent methods of suicide. However a question is rased regarding if the stereotype/belief that males use more violent suicide methods then females came from the observation that males use violent methods, or if the stereotype/belief contributes to males using more violent methods.
The inclination for males to choose more violent methods, even after repeated attempts, could help to explain why there are significantly more male suicide completions then female suicide completions. Additionally, taking into account that males typically choose more violent suicide methods, and that violent suicide methods have a very high fatality rate may help to explain the disproportionate levels of suicide attempts made by females to males (Groholt et at, 1999, Motto & Bostrom, 1997; Miller et al 2004). The intent of male and female suicide attempts may be the same, but due to the fatality of the choice of suicide method, more males complete suicide then females (Bradivik, 2007). This may have the effect of leaving the female suicide attempters alive to preform repeated attempts, compared to the males who would typically complete the suicide on the first attempt, thus not being able to perform repeat attempts (Groholt et at, 1999; Motto & Bostrom, 1997; Bradivik, 2007).
In conclusion, this essay has critically evaluated the explanations for the gender differences in suicide rates. The relative reluctance of males compared to females to seek help for depression and suicide related problems and concerns was discussed. This difference may arise due to differences in male and female stereotypes. Help seeking could be seen as congruent to the female stereotype, whereas for males it may imply a loss of control, incompetency and dependency. Alcohol may be used as a substitute for help seeking behaviour in males. The negative stigma of suicide, in particular male suicide was also discussed. For males, the stigma may compound their reluctance to seek help.
Effectively adding to the pressure against help seeking that is present in the male stereotype. For females, the stigma may not be great enough to inhibit their help seeking behaviour. Finally the violence of the method of suicide was discussed in relation to explaining the gender difference in suicide rates. Males typically choose more violent, and subsequently more fatal methods, then females. This could result in more males completing suicide on their first attempt, leaving females to attempt suicide again. Thus possibly explaining why there are significantly more female suicide attempts and yet significantly more suicide completions by males.
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