Men must learn what it takes to ask for help
Gerry Hassan
The Scotsman, February 11th 2012
The Scottish suicide figures reported in ‘The Scotsman’ this week illustrate that we have a deep, challenging set of problems as a society.
‘British Journal of Psychiatry’ research revealed that the Scottish male suicide rate was 31 per 100,000 compared to 17 per 100,000 south of the border. It showed an increasing problem with 15-34 year old men in particular.
This alarming story can be used to suggest something pre-determined about Scotland, painting a predictable picture about Scottish society and lifestyles with negative and damaging connotations.
The reality is complex. Alana Atkinson, head of the Choose Life anti-strategy strategy pointed out that there has been a 14% decline in the number of people committing suicide in the last nine years.
There is a positive story in this, of Scottish progress and saving lives, as well as a more worrying account, of a widening gap between Scotland and England, along with the suicide rates of specific groups, such as young men.
The journal article suggested that the reasons for the gap between the two nations might be found in socio-economic factors such as deprivation, unemployment and insecurity, along with lifestyle behaviours such as drinking and drug taking. Atkinson commented that, ‘We can’t say for sure why there continues to be more suicide in Scotland than the rest of the UK.’
Different national cultures and experiences affect suicide rates. The highest suicide rate in the world per head according to the World Health Organisation (WHO) is Lithuania, and six of the top ten nations are former Soviet countries. There is a Nordic effect. Nordic countries have high suicide rates; WHO figures put Finland 15th in the world per head, Sweden (30th), Norway (34th), Denmark (35th) and Iceland (39th); the UK ranked 61st.
We know the turbulent changes that post-Soviet societies have been through with their ‘shock therapy’ structural changes and mass privatisations. We can also factor in the Nordic experience of their climates and lack of sunlight.
There needs to be accurate, reasoned coverage of these challenging issues which avoids sensationalism and simplification. Public health research has identified ‘the Glasgow effect’ and wider ‘Scottish effect’ which shows that many poor health outcomes from life expectancy to inequalities are not just about poverty and socio-economic factors.
‘The Glasgow effect’ has attracted international interest because the nature of health in Scotland’s biggest city is just in parts so appalling and shaming on all of us. However, ‘the Scottish effect’ also needs to be not forgotten, charting as it does the discrepancy between Scotland and England since 1981 in relation to mortality, and posing that this is not just about class and material factors.
Researchers have surmised that the missing factors at a Scottish level are likely to be about culture and the psychological effect of deindustrialisation on our society, the cumulative collective harm inflicted on us by those huge changes of 30 years ago which parts of Scotland, individuals, places and communities, have never since recovered from.
It is possible that a similar set of effects may be found with Scotland’s suicide figures, with the gap between Scotland and England being shaped by more than simple socio-economic factors and lifestyle choices which can be more easily measured.
Maybe the way we talk about these fundamental issues does not help. I was struck upon looking at ‘The Scotsman’ online comments in relation to the paper’s coverage of the Scots suicide rates that many had been moderated and deleted. It was clear from the comments remaining that these opinions were simplistic and determinist about why we have such problems.
Most were from people making sweeping, over the top observations about Scotland and its relationship with England holding this responsible for our suicide rate and suggesting that political change and from some, that independence would change this.
Two observations flow from this. First, we cannot make simple assumptions about Scotland and how it gets on with England in relation to this area. Yet at the same time Scotland’s relationship with England could possibly have some kind of impact negatively on some people in terms of their well-being and feelings of powerlessness. That though is a set of issues which needs to be handled and expressed with the utmost sensitivity.
Second, the sort of victimhood and persecution complex remarks displayed by some exasperate the problem because they deny nuance and subtlety. Perhaps even more importantly they close down and silence the human element. In amongst the deleted comments, there were powerful, brave, honest accounts of families who have lost a close loved one, a partner, brother, sister and child.
This is the Scotland we need to give voice to. While government and voluntary services matter and have to have proper funding, part of the problem is cultural, and part of the solution is cultural.
We have long needed to have a cultural revolution in Scotland, of opening up, shaking up and loose Scottish society, institutions and attitudes, and become a bit more liberated, liberal and less closed. The truth is that in the last couple of decades we have actually come a long way from the repressed, straightjacket society which many of us grew up with and which affected our childhoods, families and friends.
This was a Scotland of telling people off but not talking about emotions, relationships, hurt, doubt and love. There was a religious propensity not to articulate these issues, but there was also a wider Scottish stoicism born of some of the huge challenges people faced in large parts of the country such as the widespread poverty of the 19th and early part of the 20th century.
This is a world which is slowly fading and weakening, but we have still to uncritically and unapologetically embrace a different way of being, of saying it is alright to be vulnerable, to cry, to show you have doubts or need help and advice.
There is the challenge for some Scottish men, many of whom have not had the insight, skills or desire to be open, or admit they might need support. While many think this is about older Scots men, the figures show that for a variety of reasons, young men are one of the groups most struggling. We were once a society shaped by a certain granite masculinity and men as heroes and warriors; now it is a bit less clear.
We have to embrace the multi-faceted nature of modern life as a cause for celebration as well as a challenge. Some Scots still want to see the world in simple terms, and overstress the role of politics and political change as the solution, rather than look deeper.
Somehow after the retreat of religion, the task is to create our own Scots self-help guide to emotional literacy, of what it means to be a contemporary Scottish man and woman in today’s world.