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Book Reviews

Suicide in Men

How Men Differ From Women in Expressing Their Distress. David Lester, John F. Gunn III, and Paul Quinnett (Eds) (2014) Springfield

Charles C Thomas.

Winstead, Daniel Keith MD

Author Information
The Journal of Nervous and Mental Disease: October 2015 - Volume 203 - Issue 10 - p 811
doi: 10.1097/NMD.0000000000000373
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This is a companion piece to the senior editor’s previous book titled Why Women Kill Themselves (1998). Early on, it is noted that more women make non-fatal suicide attempts whereas men are more frequently successful in their suicidal endeavors. Following an overview, various factors are investigated in some detail. These include “Male Depression and Suicide,” “Fatal Loneliness…” the role of drugs and alcohol, the role of testosterone and “Men, Guns and Suicide.” Special populations are also explored to include male athletes, male soldiers, gay men, and creative men.

Roughly 70 pages (of 358) are devoted to suicide in other cultures. Although this adds some perspective to an otherwise Western-Centric outlook on the problem, this is by no means a comprehensive review. These chapters are used to illustrate that “hegemonic masculine roles play a major role in men’s suicidal behavior.”

Some 50 pages then did deal with prevention of suicide in general and in particular in men. However, the editor’s note in their chapter titled “Final Thoughts” that men do not develop adequate support networks nor do they routinely seek help for their distress when under duress. These factors plus the fear of stigma often prevent men from seeking mental health interventions.

Various suicide prevention programs are described and discussed, but none have a proven impact in men. A notable exception is the program utilized by the United States Air Force Suicide Prevention Program. This program utilized by the USAF was the QPR program. Question, Persuade and Refer (QPR) was developed by Paul Quinnett in 1985 and is described as a “proprietary gatekeeper training program.” Chapter 25 explores the use of QPR in a community college setting and the data support the usefulness of this strategy especially with men.

A separate technique (“MATES”) was studied in the construction industry in Australia. Detailed analyses of data for the Queensland Mates in Construction (MIC) program showed evidence “to support the social validity and effectiveness of MIC for improving suicide and mental health awareness, help seeking behavior, and treatment engagement”. Suicide risk for construction workers in Queensland was shown to be reduced by these methods.

In conclusion, this is a comprehensive text on the topic of suicide in men and should be essential reading for anyone in the mental health field for the business of suicide prevention.

Daniel Keith Winstead, MD

Robert G. Heath Professor and former Chair

Department of Psychiatry and Behavioral Sciences

Tulane University School of Medicine

New Orleans, LA


The author declares no conflict of interest.

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