Why Suicide Rates Are Higher in Men: Causes and Prevention

Introduction and Background

Suicide can be considered a serious mental health crisis that requires intervention before tragedy occurs. It is imperative to recognize the warning signs in a person who is under stress or experiencing depression so that prompt help can be provided (Casarella, 2020). Family and friends are often the first to notice these signs, as the person frequently gives hints to those close to them before committing such an act. Globally, the suicide rate in men is approximately double that of women (Ritchie, Roser & Ortiz-Ospina, 2015). This paper aims to explore why this rate is higher in men, using a systematic literature review followed by a qualitative research analysis to validate the themes identified in the literature.

Statistics from 2017 revealed that the suicide rate for men was 3.5 times higher than that of women in the same year (Kennard, 2020). The demographic group most affected is middle-aged White men, who accounted for 70% of all male suicides; however, the risk is even greater among men of older ages. Reports have indicated that men tend to choose more lethal methods when attempting suicide, although women have been observed to have a greater rate of attempts overall.

The neurobiology underlying suicidal behavior involves a complex interplay of brain structures and alterations in brain functioning. Low concentrations of 5-HIAA (a serotonin metabolite) is one recognized factor, as depression and anxiety in men are associated with this neurochemical imbalance. Such conditions impose lasting effects on the family members and friends of men who die by suicide. It is most likely that men who attempt suicide experience a significantly diminished quality of life and feel unable to envision an alternative.

Methodology and Search Strategy

The research question guiding this study is: Why is suicide more prevalent in men?

A multi-method research design was employed. First, a systematic literature review was conducted, followed by qualitative research using semi-structured interviews. The themes identified from the literature were then assessed and compared with the qualitative research results. The literature review was conducted across three databases using predetermined exclusion and inclusion criteria to ensure rigor. A thematic analysis was subsequently conducted to identify recurring themes from prior studies, allowing for an evaluation of the strengths and weaknesses of existing scholarship. The qualitative component consisted of semi-structured interviews with men who had previously attempted suicide, conducted to gain an in-depth understanding of their mental states and the motivations behind their attempts. The themes derived from the qualitative research were used to corroborate and reinforce 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 refined to six papers, enabling a systematic, rigorous, and wide-ranging critique of the evidence through thematic analysis. The thematic analysis extracted recurring themes from the texts, which were later used to inform the evaluation of the qualitative research. For the qualitative component, semi-structured interviews were conducted with men who had previously attempted suicide. The interviews took place in the presence of a psychiatric specialist in his clinical setting. The participants were his patients who had received counseling from the same doctor and had since recovered from acute symptoms. The results from the interviews were used to corroborate the themes identified in the systematic literature review and to provide additional supporting evidence for the paper's conclusions.

The following keywords were used to conduct the extensive literature search: suicide in men, high rate of suicide in men, men committing suicide, factors leading men to suicide, suicidality in men, male suicide, and male intentions for suicide.

Selected articles were considered eligible primarily because they were directly relevant to the research question — that is, they explored reasons for the high rate of suicide in men. Articles focused on female suicide or on family members affected by male suicidal behavior were excluded, as neither population was the focus of this study. Articles published before 2015 were also excluded so that only recent research would inform the analysis of contemporary factors contributing to male suicide. An additional search strategy involved examining the reference sections of selected articles to identify further relevant sources, opening new dimensions of inquiry. For example, this extended search illuminated the finding that men who suffer from depression frequently do not seek medical help.

Systematic Literature Review

More than 100 articles were identified when the keywords were entered into the databases; however, only six met the inclusion criteria and were selected for review. The systematic literature review is presented below in chronological order, providing a comprehensive overview of the scholarly research on male suicide.

Player et al. (2015) aimed to examine the factors contributing to suicide among at-risk men and the role of families in suicide prevention. One-to-one interviews and a focus group study revealed five major themes related to mood distortions in men and offered suggestions for how behavioral detection and care could improve prevention efforts.

Keohane & Richardson (2018) explored the role of masculinity in help-seeking behavior among men with depression and their willingness to provide psychological support to those at risk. A focus group study revealed three themes, suggesting that masculinity plays a dominant role in determining whether men seek and accept help in times of distress — a dynamic that can shape patterns of suicide prevention.

Conejero et al. (2018) investigated recent findings on suicidal ideation among adults and the risk factors that contribute to suicide attempts. A PubMed literature search concluded that stress, psychological distress, and social isolation are the primary causes of suicidal thoughts and should be targeted in prevention efforts.

Sargeant, Forsyth & Pitman (2018) examined suicide epidemiology among men in Greenland, drawing comparisons with other demographic groups in Denmark and Greenland. An extensive literature review found that Greenlandic men aged 15–24 had the highest prevalence of suicide, with young men more prone to suicide than women or any other male age group.

Kootbodien et al. (2020) scrutinized suicide death rates and trends in South Africa from 1997 to 2016. Death registration data showed that more men died by suicide than women, and that the average years of potential life lost (YPLL) were higher among men than women.

Rosso et al. (2020) evaluated the factors associated with violent suicide attempts, specifically among patients with bipolar disorder. Statistical results indicated that male gender was significantly associated with the use of violent methods in suicide attempts.

Conclusion and Recommendations

After the thematic analysis of the systematic literature review and a thorough qualitative analysis involving semi-structured interviews with seven men who had previously attempted suicide — conducted under the supervision of a psychiatric specialist — it is evident that the themes from the literature and the findings from the interviews are mutually reinforcing.

The first theme concerned the predominance of suicide in men over women, with young men aged 10–35 being the most at-risk group. This was reflected in the interview sample, in which five of seven participants fell within this age bracket. Another theme was the use of violent methods. The literature review found that men frequently employ methods such as self-inflicted cutting, jumping from heights, or hanging. Three of the seven young adult participants confirmed the use of lethal methods in their attempts, consistent with this finding.

Social isolation was identified as one of the most significant contributors to suicidal ideation and attempts among men. Because men do not want to appear fragile, they suppress their feelings and gradually withdraw socially as mood disturbances and anxiety increase. While two of the married respondents did share their concerns with their wives, the other five did not seek any outlet. Had these men been able to consistently confide in someone they trusted, they may have been able to avoid the progression toward social isolation and, ultimately, suicide.

Closely related to social isolation is masculinity, which functions as a structural barrier to help-seeking. Men who equate emotional expression with weakness, and who fear social stigma at work or among peers if their mental health struggles become known, become increasingly restricted in their emotional lives. Stress accumulates silently until it erupts in the form of a suicide attempt that leaves those around them completely unprepared.

Older adult men — generally those aged 65 and above — constitute another high-risk group. The presence of two older adults in this sample, both struggling with chronic illness and social disconnection, underscored the particular vulnerability of this population. Prior research further confirms that men without spouses are at elevated risk of social isolation and subsequent suicide attempts, as bereavement and social exclusion are strongly associated with suicidal ideation in older adults.

Based on these findings, the following recommendations are offered. Early detection of warning signs by those closest to at-risk men — parents, siblings, friends, or spouses — is essential. Behavioral changes such as mood alterations and increasing social withdrawal should be monitored consistently so that further deterioration can be prevented.

Mood regulation techniques and psychosocial therapies are effective tools for preventing the psychological disorders that frequently precede suicidal behavior. Psychological professionals can teach men coping strategies and emotional regulation skills. Healthcare and nursing professionals should recognize that family members and friends are crucial allies in the intervention process. Demonstrating compassion, offering consistent attention, and providing emotional care can help men re-engage with life and gradually open up about their difficulties. Social reintegration — staying active and maintaining relationships with at-risk men — can help preserve their self-esteem during periods of financial hardship, bereavement, or unemployment. Attention to physical health, including a balanced diet, regular exercise, and reduction in smoking or alcohol use, also supports mood regulation.

Future research should further investigate the protective role of social connectedness — particularly having a trusted confidant — as a life-saving factor in male suicide prevention. The inability to share one's emotional burden was one of the most consistent explanations for escalating stress and eventual suicide attempts among the participants in this study. Men of all ages should be encouraged to form and maintain meaningful relationships in which they feel safe expressing their difficulties. Particular attention should be paid to helping older men develop new social connections and active communication channels with family and friends. Diverting men away from social remoteness by fostering these connections may be among the most effective strategies for reducing the disproportionately high rate of suicide in men.

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Kootbodien, T., Naicker, N., Wilson, K. S., Ramesar, R., & London, L. (2020). Trends in suicide mortality in South Africa, 1997 to 2016. International Journal of Environmental Research and Public Health, 17(6), 1850.

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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 imposed suicidal thoughts? That is, what circumstances were you going through, and how did they make you feel?

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

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

Question 7: If you did not seek help, what prevented you from doing so?

Question 8: Did you seek solace in other ways when you were mentally distressed — such as smoking, alcohol, or substance abuse?

Question 9: Looking back, do you feel the attempt was justified, 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 the same responses to these questions.