Mental illness in men, and how physicians can prevent suicide in males

by Sujatha Prabhakaran, MD

Suicide is arguably the most preventable cause of death. It is also a tough thing to talk about.  But talk we should, because suicide costs Americans a lot.  In 2000, self directed violence cost $1 billion in medical costs and $32 billion in lost productivity.  Self-directed violence affects men and women of all racial/ethnic groups. However, as highlighted in the 2011 CDC Health Disparities and Inequalities report males take their own lives at nearly four times the rate of females and represent 78.8% of all U.S. suicides.

One reason this imminently preventable cause of death and illness occurs is mental illness stigma. This stigma exists despite the fact that over a quarter of Americans in a given year might be diagnosed with a mental illness.  Men are particularly susceptible to stigma.

Efforts focused on helping peers and friends of people with mental illness are one of the ways that stigma can be addressed.  An example of this is the SAMSHA website, “What a difference a friend makes.”  The website is geared toward people living with mental illness and their peers.  One of my favorite portions of the website are couple of ad spots obviously geared toward men and their friends.  They each feature two “guys” doing guy things and start with the statement, “What do you do if your friend is dealing with mental health problems?” and follow with the answer, “Everything you’ve already been doing”  They bring home the point that your relationships with your friends do not need to change if one of them has a mental illness.

In addition to public health efforts, physicians can also work directly to reduce stigma and thus this health disparity.  As a believer in social justice, addressing health disparities is an area I have passion for.  But I am sometimes underwhelmed by my power to influence some of the broad factors that affect health such as motor vehicle safety, lack of education, and poor housing.  As physicians my say may have more weight than those of other voters when it comes to addressing factors like these.  But I would never tout myself as an expert in any of these areas, so my opinions should probably be taken with a grain of salt.

However, as physicians, we have particular power to lead by example.  If physicians were more open about their own experiences with mental illness, it would reduce the stigma surrounding these diseases.  Despite the negative press we get some times physicians have a lot of power to do good.  People still admire and respect their physicians.   It isn’t so hard to admit that you’re like someone you admire.

Sujatha Prabhakaran is a physician who blogs at Progress Notes.

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