Suicide in Men: How men differ from women in expressing their distress

Suicide is a complex problem, and doesn't have simple causes or solutions. One of the complexities is the higher numbers (often much higher) of men than women who die by suicide in all countries, except China. This is despite universally higher numbers of women who attempt suicide. In most populations higher numbers of women also meet the criteria for diagnoses of depression and anxiety disorders.

Suicide in Men is an internationally orientated volume that explores the possible explanations for higher rates of death by suicide in men, and it also looks at a range of related issues around male suicide. Chapter topics include the relationship between suicide and loneliness, depression, drugs and alcohol, risks and protective factors, athletes, armed forces, gay men, other cultures (including Chinese, Ugandan and Palestinian men), suicide bombers and creativity. Towards the end of the book there are also chapters on what may work in prevention programmes.

In all there are 17 contributors to this book, with the bulk of the writing coming from the three editors. Most of the chapters are written in academic style, reading like literature reviews, with very tentative conclusions and the ubiquitous phrase of most academic papers: "more research is needed...".

At times the academic caution, formality and provisos makes the reading a little hard going, and also rather dry, feeling a little removed from the tragic and heart-wrenching subject matter. A few chapters, however, do have a more human touch (the chapter on fatal loneliness, for instance), some take a more theoretical analysis and several argue for complete paragdigm shifts in suicide prevention for men.

Overall, this is not a book that will attract a more general readership, but is likely to be of great interest to those working or studying in the field of suicide prevention and mental health services with a gender focus. While the book is focussed on suicide in men, it of course make comparisons with women's experiences, and considers many of the sub groups within men. So it could also be a useful resource for anyone with an interest in population approaches to suicide.

Unfortunately for an Aotearoa audience there is no chapter looking specifically at indigenous male experience and suicide within a colonising European origin culture.

I believe this book is an extremely valuable resource for those who want to discover the depths and limits of what we know about suicide in men as well as some emerging answers for successful approaches to prevention. The numbers of men globally who die by suicide must be one of the major and and more tragic public health problems today, but the impression from this book is that it is also possibly one of the less recognised and researched ones, too.

Reviewed by Hugh Norriss, director of policy and development, Mental Health Foundation