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Why Macho Men Still Won’t Seek Out Help

In the Western United States, middle-aged men are self-reliant to a fault, which may partially explain the region’s soaring suicide rates.

By Kate Wheeling


(Photo: Sinan Ceylan/Flickr)

The suicide rate in the United States has been on the rise for almost two decades. One reason for that: men’s discomfort with therapy.

Between 1999 and 2014, the mortality rate for suicide climbed by nearly 25 percent. Men between the ages of 45 and 64 saw the largest percentage increase in suicide rates—43 percent—over that period. Middle-aged men now account for the majority of suicides; this grim trend has hit middle-aged, white men in the Western U.S. particularly hard. “With a suicide rate of 44 per 100,000, men in this age and geographical group have more than three times the risk of dying by suicide than the national average,” reports FiveThirtyEight’s Anna Maria Barry-Jester.

Men take their own lives at a rate far greater than women despite the fact that women are more likely to be diagnosed with depression and to attempt suicide (women tend to favor suicide methods with low success rates, like poisoning). An aversion to talk therapy may partly explain why. As Betsy Bates Freed and David Freed wrote in Pacific Standard in 2012, macho men — “those most invested in the belief that a ‘real’ man is self-reliant and strong to the point of physical invulnerability” — tend to avoid both physical and mental health care.

Avoiding treatment certainly plays a role in the West’s high suicide rate; out West, self-reliance is paramount, as Barry-Jester writes:

Local culture is a common explanation for the high rate in the West. In Wyoming, people call it the “cowboy-up” mentality — the get-your-shit-together, pull yourself up by your bootstraps, can-do attitude that they say is bred into children from a young age.

But it’s not just a reluctance to ask for help that leaves Western men vulnerable to suicide; it’s also access to firearms. Research has shown that higher accessto guns increases the risk of suicide.

“Reducing access to lethal means is one of the few tactics that has been shown to prevent suicide at a population level, either by making it more difficult to get a hold of a highly lethal method or by making that method less lethal,” Barry-Jester writes.

Both Wyoming and Utah are giving out gun locks in an attempt to create at least one additional barrier between suicidal thoughts and attempts. Suicide is often an impulsive act; the logic goes that even one extra obstacle might be enough to foil an attempt, but, according to Barry-Jester, it’s not clear yet if locks will be enough to meaningfully reduce risk.