Why Is Suicide Rate High in Men? Causes and Prevention

Introduction and Research Design

The central research question guiding this study is: Why is suicide high in men? To answer this question, a multi-method research design was employed. A systematic literature review was conducted first, followed by qualitative research in the form of semi-structured interviews. The themes identified from the literature were then assessed and compared against the qualitative results to reinforce the overall findings.

The literature review was conducted across three databases using defined inclusion and exclusion criteria to refine the search. A thematic analysis was subsequently conducted to identify recurring themes from prior studies and to assess the strengths and weaknesses of existing scholarly work. The qualitative component consisted of semi-structured interviews with men who had previously attempted suicide, conducted in the presence of a psychological specialist. The aim was to gain an in-depth understanding of the participants' mental states and the motivations behind their suicide attempts. The themes derived from the qualitative research were then used to corroborate and strengthen the findings from the literature review.

For the systematic literature review, three databases were selected — Embase, Medline, and CINAHL — to identify peer-reviewed articles most relevant to the research question. The review was confined to six papers to enable a systematic, rigorous, and wide-ranging approach to evidence critique through thematic analysis. The thematic analysis helped extract key themes from the texts, which were later used to evaluate the qualitative research findings.

For the qualitative component, semi-structured interviews were conducted with men who had previously attempted suicide. The interviews took place in the clinic of a psychiatric specialist who was a professional acquaintance, and all participants were his patients who had received counseling and had since recovered from their symptoms. The results from the interviews were used to corroborate the themes identified in the systematic literature review, thereby strengthening the paper's conclusions.

The following keywords were used to conduct the online database search: suicide in men, high rate of suicide in men, men committing suicide, factors leading men to suicide, suicidality in men, male suicide, male intentions for suicide, masculinity and suicide in men, depression and suicide in men, substance misuse and suicide in men.

Articles were considered eligible primarily because they were relevant to the research question — namely, exploring the reasons for the high rate of suicide among men. Articles related to women's suicide or to family members affected by men's suicidal inclinations were excluded, as these populations fall outside the scope of the current research.

Articles published before 2015 were also excluded so that only recent scholarship would be considered, providing insight into contemporary factors contributing to male suicide. An additional search strategy involved examining the reference lists of selected articles to identify further relevant sources. This extended search opened new investigative dimensions — for example, illuminating the fact that men with depression often do not seek medical help.

Systematic Literature Review

More than 100 articles were retrieved when the keywords were entered into the databases, but only six met the inclusion criteria and were selected for review. The systematic literature review is presented below in chronological order to allow a comprehensive view of the scholarly research and to set the foundation for the thematic analysis discussed in the following section.

Shand et al. (2015) aimed to assess the factors that interrupt men's suicidal behavior and prompt high suicidal risk. The survey results showed that men exhibited signs of depression and wanted support without explicitly asking for it.

Dragisic et al. (2015) searched for the association between suicide and substance abuse using a questionnaire method, examining the mediating roles of hereditary factors, legal problems, and personality traits. Statistical results showed a significant relationship between suicide and substance abuse, with hypersensitivity and psychotic disorders also prevalent.

Keohane and Richardson (2018) explored the role of masculinity in help-seeking behavior around depression and men's willingness to offer psychological support to those at risk. A focus group study revealed three themes suggesting that masculinity plays a dominant role in seeking and accepting help during distress, and that this dynamic can shape patterns of suicide prevention in men.

Conejero et al. (2018) investigated recent findings on suicidal thoughts among older adults and the risk factors that drive them toward suicide. A PubMed literature search revealed that stress, psychological distress, and social isolation are the main causes of suicidal thoughts and should be actively addressed.

Esang and Ahmed (2018) investigated whether substance use increases suicide risk in men. Their results revealed that substance use and alcoholism impair judgment and disrupt cognition under stress, leading to suicidal attempts.

King et al. (2020) investigated the relationship between suicidal inclination in young males and conformity to masculine norms. A cohort study design revealed that Australian young men who strongly conform to masculinity may be at high risk for suicidal ideation and elevated rates of suicide.

Thematic Analysis of the Literature

The thematic analysis of the literature review identified three distinct themes explaining the high rate of suicide in men. Some of these themes corroborated the facts and statistics introduced earlier in the paper.

The first theme is toxic masculinity and the tendency toward suicide. Young males are at the highest risk of committing suicide, yet they do not portray themselves as vulnerable since they consider themselves the stronger gender. For this reason, they do not express feelings of stress or depression, and they do not seek help. Adherence to social norms of masculinity can strongly affect men's mental health and is a key factor in the development of suicidal tendencies.

The second theme is depression, considered another chief reason men are driven to suicide. Stress, anxiety, and mental disorders play a central role in bringing men to a point of helplessness where they perceive suicide as a last resort. A large body of research has shown that post-traumatic stress disorder among military men has caused suicide attempts, clearly indicating that men are highly affected by depression. This connects directly to the first theme: strict adherence to masculine norms discourages help-seeking, which in turn elevates depression levels and ultimately raises the risk of suicide.

The third theme is substance misuse. Men who are dependent on alcohol and drugs are at elevated risk of committing suicide. Substances such as opioids, marijuana, and cocaine disrupt normal behavior, and the psychotic disturbances they cause increase the likelihood of suicide. Substance misuse is frequently accompanied by stress, and as drug intake increases, so does the number of suicide cases among men.

Conclusion and Recommendations

After the thematic analysis of the systematic literature review and a thorough qualitative analysis with semi-structured interviews from seven men who had attempted suicide — all under the care of a psychiatric specialist — it is clear that the identified themes and qualitative observations are mutually reinforcing. The first theme of the systematic literature review, toxic masculinity, emerged as a critical barrier. The suppression of emotions acted as a pressure valve with nowhere to release, building until men perceived suicide as their only exit from distress. Men typically have friends and social networks; however, gender norms around masculinity lead them to regard seeking support in stressful situations as inappropriate, causing them to prolong their suffering. This harms their mental health considerably, as male role expectations within society remain high. The negative implications for their mental wellbeing also affect those living around them, underscoring the urgent need for men to mobilize their social networks.

Social isolation in times of stress was one of the most significant factors contributing to suicidal inclination and attempts among the men studied. Because they do not wish to appear feeble, they refrain from expressing themselves openly to friends or family. As mood distortions and anxiety increase, they withdraw further. The respondents in the current study reflected this pattern, though the two married young men did share their worries with their wives — suggesting that trusting relationships provide a meaningful protective factor. Had the other participants regularly vented their difficulties to someone they trusted, they might have avoided deepening social isolation and ultimately the suicide attempt itself.

Social isolation, reinforced by masculine norms, can be considered another critical pathway leading to suicide in men. Men believe that seeking help challenges their gender identity and invites social stigma. They consider themselves diminished if they accept physical or psychological services for their mental health. As the primary providers for their families, they also fear social shame at work if colleagues learn of their mental state. Consequently, their masculinity feels constantly at risk, restricting emotional expression and making them increasingly vulnerable. Stress accumulates silently until it erupts in the form of a suicide attempt of which no one around them has been forewarned.

The theme of substance abuse was also visible in the qualitative results: some men were beginning to engage with drug use or alcohol. It is well established that people who misuse substances are significantly more likely to commit suicide than those who do not. Overdose of drugs or medications was the method chosen by the older adult participants — a pattern consistent with the broader literature. Addicts experience emotional disturbances and rely on substances to achieve temporary mental relief; however, as dependence intensifies, emotional and behavioral problems worsen, psychological control deteriorates, and the likelihood of violent or impulsive behavior increases. Hypersensitivity under the influence of substances renders men more susceptible to uncontrolled, violent thoughts that can lead to suicide. Preventing substance abuse is therefore a critical component of any male suicide prevention strategy.

Following this close analysis of the factors contributing to high male suicide rates, several recommendations for prevention are offered. It would be highly beneficial if troubling behaviors in men were promptly detected by those closest to them — parents, siblings, friends, or partners. Warning signs such as mood changes and increasing social withdrawal should be monitored carefully on a regular basis so that further drastic steps, particularly suicide attempts, can be prevented.

Mood regulation techniques and psychosocial therapies can help prevent the psychological disorders that underpin suicidal ideation in men. Psychological support can equip men with coping strategies and emotional management skills. Nursing and healthcare professionals should be aware that families and friends play key roles in intervention and in providing consistent support throughout the recovery process. Demonstrating compassion, care, and genuine attention can shift men's attitudes toward life, help normalize daily routines, and encourage greater openness about their struggles. Families and friends can help restore social connections and remain actively present for at-risk men, protecting their self-esteem during traumatic periods — whether involving financial loss, bereavement, or unemployment. Lifestyle factors such as a balanced diet, regular exercise, and reduced smoking or alcohol consumption also contribute to mood improvement.

Future research should explore how having a trusted confidant — whether a partner or a close friend — functions as a life-saving factor in suicide prevention among men. The inability to share one's burdens was a major reason stress escalated to the point of suicidal ideation and attempts among the participants. Feeling connected to society, and actively developing communication strategies with friends and family, appears essential at every life stage, including old age. Redirecting men's attention when they experience social isolation due to stress, and fostering environments in which having a friend or partner to confide in is normalized, could serve as powerful interventions for reducing the unacceptably high rate of suicide among men.

Conejero, I., Olie, E., Courtet, P., & Calati, R. (2018). Suicide in older adults: Current perspectives. Clinical Interventions in Aging, 13, 691–699. https://doi.org/10.2147/CIA.S130670

Dragisic, T., Dickov, A., Dickov, V., & Mijatovic, V. (2015). Drug addiction as risk for suicide attempts. Materia Socio-Medica, 27(3), 188–191. https://doi.org/10.5455/msm.2015.27.188-191

Elbogen, E. B., Lanier, M., Montgomery, A. E., Strickland, S., Wagner, H. R., & Tsai, J. (2020). Financial strain and suicide attempts in a nationally representative sample of US adults. American Journal of Epidemiology, 189(11), 1266–1274.

Esang, M., & Ahmed, S. (2018). A closer look at substance use and suicide. The American Journal of Psychiatry Residents' Journal, 13(6), 6–8.

Keohane, A., & Richardson, N. (2018). Negotiating gender norms to support men in psychological distress. American Journal of Men's Health, 12(1), 160–171.

King, T. L., Shields, M., Sojo, V., Daraganova, G., Currier, D., O'Neil, A., King, K., & Milner, A. (2020). Expressions of masculinity and associations with suicidal ideation among young males. BMC Psychiatry, 20. https://doi.org/10.1186/s12888-020-2475-y

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Shand, F. L., Proudfoot, J., Player, M. J., Fogarty, A., Whittle, E., Wilhelm, K., Hadzi-Pavlovic, D., McTigue, I., Spurrier, M., & Christensen, H. (2015). What might interrupt men's suicide? Results from an online survey of men. BMJ Open, 5.

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Question 1: Was your suicide attempt an act of impulsivity, or was it planned?

Question 2: If it was planned, what led you to have suicidal thoughts?

Question 3: What methods or ways did you choose?

Question 4: What circumstances imposed suicidal thoughts — that is, what were you going through, and how did you feel about it?

Question 5: Did you seek any help when you first sensed that something was bothering you?

Question 6: Who did you reach out to, and did they help?

Question 7: If you did not seek help, what hindered you?

Question 8: Did you try to find solace in other directions when you were mentally distressed — such as smoking, drinking, or substance abuse?

Question 9: How do you feel now — should you have done it, or could you have adopted other ways to manage your stressors?

Note: Questions 1, 2, and 9 are not graphically represented, as all respondents provided identical responses to these questions.