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Men and Suicide Risk
Men die by suicide four times as often as women in the US, three times in the UK. The easy read is that men feel worse. Here's what you didn't know you didn't know: women attempt more often. Men reach for methods that kill. A gun kills nearly nine attempts in ten; pills kill fewer than two in a hundred Conner 2019, and half of people act within ten minutes of deciding Deisenhammer 2009. What saves a life is distance from that gun.
Condition Evidence Strong Chapter Psychology

The method is the whole story. Women attempt more; men die more because a firearm is almost always fatal and pills usually are not 1. A gun in the home roughly triples the odds that someone living there dies by suicide 2. After a first handgun purchase the raised risk shows within a month and lasts years, all of it firearm suicide; the gun adds a fast lethal option rather than replacing a slow one 3.

The window is short. Among people who survived a serious attempt, nearly half acted within ten minutes of deciding 4; about one in four deliberated under five 5. Drinking in the hours before raises the odds of an attempt roughly sevenfold 6. Add depression and an alcohol use disorder and lifetime risk runs near one in six 7.

The move that matters is temporary. When a man in the house is in a hard stretch, get the fast method out of reach for a while.

The good outcome is invisible.

  • That week: almost nothing changes. He goes to work; the drawer is just empty. That is the point; the bad ending never arrives.
  • That month: the acute crisis dissolves the way most do, through sleep, time, and contact, while a first appointment gets room.
  • Years out: when Britain switched off toxic town gas, suicides fell about 30% and stayed down, with no substitution to another method 11. One household's version is one man still alive.

Where it lands hardest: divorced men carry over twice the rate of married men, with no matching rise for divorced women 13. Job loss, a custody ruling, and a parent's death are brief spikes. The person with the most leverage is whoever holds a key to his house.

The fine print โ€” when to skip it, and what people get wrong

The substitution myth: "if he really wants to, he'll find a way." Block one method and most people wait out the impulse; town gas, pesticide bans, and bridge barriers all cut total deaths 9.

What sinks the conversation: the yes/no ask ("you're not thinking of hurting yourself?") almost forces a no 12. Ask concretely: is the gun locked up these days? And restrict means before starting an antidepressant, which takes weeks.

References
  1. 1Conner A, Azrael D, Miller M (2019). Suicide case-fatality rates in the United States, 2007 to 2014: a nationwide population-based study. Annals of Internal Medicine. link
  2. 2Anglemyer A, Horvath T, Rutherford G (2014). The accessibility of firearms and risk for suicide and homicide victimization among household members: a systematic review and meta-analysis. Annals of Internal Medicine. link
  3. 3Studdert DM, Zhang Y, Swanson SA, et al. (2020). Handgun ownership and suicide in California. New England Journal of Medicine. link
  4. 4Deisenhammer EA, Ing CM, Strauss R, Kemmler G, Hinterhuber H, Weiss EM (2009). The duration of the suicidal process: how much time is left for intervention between consideration and accomplishment of a suicide attempt? Journal of Clinical Psychiatry. link
  5. 5Simon TR, Swann AC, Powell KE, Potter LB, Kresnow M, O'Carroll PW (2001). Characteristics of impulsive suicide attempts and attempters. Suicide and Life-Threatening Behavior. link
  6. 6Borges G, Bagge CL, Cherpitel CJ, Conner KR, Orozco R, Rossow I (2017). A meta-analysis of acute use of alcohol and the risk of suicide attempt. Psychological Medicine. link
  7. 7Wilcox HC, Conner KR, Caine ED (2004). Association of alcohol and drug use disorders and completed suicide: an empirical review of cohort studies. Drug and Alcohol Dependence. link
  8. 8Grossman DC, Mueller BA, Riedy C, et al. (2005). Gun storage practices and risk of youth suicide and unintentional firearm injuries. JAMA. link
  9. 9Yip PSF, Caine E, Yousuf S, Chang SS, Wu KCC, Chen YY (2012). Means restriction for suicide prevention. The Lancet. link
  10. 10Sale E, Hendricks M, Weil V, Miller C, Perkins S, McCudden S (2018). Counseling on Access to Lethal Means (CALM): an evaluation of a suicide prevention means restriction training program for mental health providers. Community Mental Health Journal. link
  11. 11Kreitman N (1976). The coal gas story. United Kingdom suicide rates, 1960-71. British Journal of Preventive and Social Medicine. link
  12. 12Addis ME, Mahalik JR (2003). Men, masculinity, and the contexts of help seeking. American Psychologist. link
  13. 13Kposowa AJ (2000). Marital status and suicide in the National Longitudinal Mortality Study. Journal of Epidemiology and Community Health. link
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