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Final Report: Men’s Experiences with Suicidal Behaviour and Depression Project Page 47 of 50
factors identified during Phase 1 are significant to this population, especially given that they clearly
resonated with the much larger online survey sample.
A clear message arising from both Phase 1 and Phase 2 is that Men want others around them to
notice changes in their behaviour, and correctly ‘interpret’ these changes (e.g. changes in mood,
social withdrawal) as indicative of a spiralling mood, or an increased risk of suicidal behaviour. In
addition, Men reiterated that successful intervention depended on being asked multiple times
whether they were OK, and that they valued hearing repeatedly that people around them cared.
During Phase 1, Family and Friends reported the warning signs they generally witnessed were
destructive, externalising, and numbing behaviours, such as aggression, risk taking and substance
use, while during Phase 2, Family and Friends noticed reductions in self-care and losing interest in
‘pretty much everything’ . However, in addition to these signs, Family and Friends noticed attempts
by men to re-engage with their family. Family and Friends reported that they often wanted to help,
but were often unsure how to respond to men’s warning signs. There is clearly great need for
interventions that address these gaps in knowledge and communication, particularly in light of the
fact that Men reported needing repeatedly to be asked how they are and be told how much they
were valued and loved by people close to them whom they already trusted and respected.
Awareness raising and education are needed to assist the community in general as well as the Family
and Friends of Men who are at-risk of suicide to better recognise the signs of suicidality in men.
Education that focuses on how to better recognise signs of suicidality in men, paired with training on
how to respond to these signs and intervene effectively during times of suicidal crisis should be
prioritised. Training should emphasise the varied and broad range of warning signs exhibited by
different men at different stages of suicidality, and not just focus on traditional symptoms of a
depressed mood. This would include increased awareness of common ‘externalising’ and risk-taking
behaviours exhibited by men during the pathway to suicide. As men tend not to ask for help,
assistance is needed to guide family and friends on how and when to approach a man at-risk, what
to say, when to refer to a mental health professional, and how to manage the situation if the latter is
against his wishes.
In addition to involving family and friends in suicide prevention with at-risk men, health
professionals play an important role in recognising the warning signs, and taking action to prevent
and interrupt a suicide attempt. They are uniquely placed to intervene with men who present with
anger and externalising behaviours, such as in clinics, hospitals and in general practice. Consultations
with practicing clinicians on the best way to incorporate findings from this research into practice are
an essential step. For example, identifying appropriate times to conduct suicide assessments, based
on non-traditional warning signs identified here may help to prevent men from proceeding further
down a self-harm pathway. Likewise, clinicians are appropriately positioned to help men in crisis
develop skills to better cope with mental health issues. Men reported that they had developed few
skills in experiencing, tolerating and communicating emotions, and this directly led to engaging in
other unhelpful coping strategies. Isolation exacerbated their low moods, and propelled them
further down the pathway. Better skills training for men in emotion identification and regulation
could assist them to choose alternative and more helpful strategies to manage their mood, and to
limit the extent of their distress.
Men and Family and Friends who participated in this research endorsed very similar dissemination
strategies: high profile men talking in the mainstream media about their experience of depression
and suicidality; an ad campaign directed at men, using social media to distribute information, and
having a central online source of information about depression and suicidality. Men and Family and