No apologies for returning to the issue of mental health as it constitutes about 15% of my workload and is still severely under-resourced, given the scale of the problem. The recent focus on youth suicide has been entirely appropriate but there is also an alarming trend in self-harm in older men, and as my practice ages I am privy to some really distressing stories of hopelessness in this age group.
What is happening to older men that causes them to want to take their own lives? Nobody knows the answer so I can only contribute some personal opinions. Studies show a consistent link between functional disability and suicidality. It is possible that men, in particular, struggle with decreased activity and “uselessness”. If their identity has been defined by what they do, then losing that function can damage self-esteem and meaning. Whereas women might be protected by their capacity to have relationships not necessarily based on function, men often need to be doing something to connect with others. The loss of the activity may mean the loss of the friendship as well. If you add in a decline in mobility and independence, and possibly loss of a partner, there can be lot to adjust to.
In addition, the males of my generation and older are often not able to express their emotional needs or know how to meet them. If you went to the “suck it up” school of psychological development it’s a bit hard to flat out admit that you need help. This contrasts with the millennials who will rock up to a consultation and tell me not only what their mental health diagnosis is but also what medication I should give them.
I like to discuss with older men the rough developmental idea of “learning, earning and returning”. This says that we spend the first third of our lives learning, i.e., training in a career and other skills. Then the second third earning, necessarily, to establish a social and economic base. And then, if all goes well, older men and women can move into a stage of “returning”. This means becoming a resource of experience, wisdom and support to the next generations. As physical energy and capability wane, as they will, there is still the opportunity to engage with others in a way which is meaningful and rewarding. So older guys, don’t give up. There is someone who needs you, just to be you.