Category Archives: suicide

Men, Prisons, Separation and Suicide

Prison Population by Gender

Prison Population (England & Wales)

The average number of prisoners in England and Wales during 2016 was 85,348, comprising 81,494 men and 3,854 women (so 95.5% men). Disquiet in prisons has been much in the news of late. This post presents some bald facts about the joyous time prisoners are having. (Data relates to England & Wales unless noted otherwise).

I am no bleeding heart liberal (you may have noticed). But there is a point at which punishment gives way to inhumanity. And that’s assuming the man in question is actually guilty, which is becoming increasingly questionable.

Whilst I am addressing suicide in prison, I take the opportunity to make some observations about male suicide outside prison and its relationship with separation and domestic violence.

Contents

1. Suicide in Prison

107 men committed suicide in prison in 2016.

In the same year, 12 women committed suicide in prison – a very bad year for women prisoners. But the average rate of suicide in women’s prisons over the last 12 years has been 4 per year, or just under 1 per thousand of the women’s prison population. The current suicide rate for men is about 1.3 per thousand of the male prison population.

Thus, the claim in The Corston Report that, “Outside prison men are more likely to commit suicide than women but the position is reversed inside prison” is false. Whether inside or outside prison, men are more likely to commit suicide than women.

The prison suicide rate has doubled in five years – see Figure 1.

The justice ministry is reported as stating that the likelihood of self-inflicted death in custody is now 8.6 times higher than in the general population. In the UK population as a whole, the suicide rate is 18.2 per 100,000 for men and 5.2 per 100,000 for women (2012 data). Hence, a man in prison is 25 times more likely to kill himself than a free women.

Figure 1 click to enlarge

Fig1

2. Self-Harm in Prison

Women prisoners are frequently said to have a higher incidence of self harm. This is correct. In the year ending March 2016, 29% of female prisoners self-harmed, on average 6.7 times each, compared to 11% of male prisoners, an average of 3 times.

However, this disguises the scale of the problem with male prisoners. The numerical preponderance of male prisoners means that eight times more male prisoners than female prisoners self-harmed in the year to March 2016 (8,842 men cf 1,170 women).

Moreover, whilst the number of female prisoners self-harming has been decreasing over the last ten years, the number of men self-harming is rising steeply (Figure 2) – nearly doubled in ten years.

Similarly, whilst the number of incidents of women prisoners self-harming has been decreasing, the number of incidents of male prisoners self-harming is rising steeply (Figure 3) – doubled in the last six years.

These bald statistics on self-harm and suicide are symptomatic of a rapidly increasing degree of despair within overcrowded prisons. The number of incidents of self-harm exceeds the number of assaults on other prisoners, which in turn is four times higher than the number of assaults on prison staff.

Figure 2: Self Harming in Prison – click to enlarge

Fig2

Figure 3: Self Harming in Prison – click to enlarge

Fig3

3. Deaths in Prison

Do not imagine that suicide is the greatest cause of death in prison. The greatest is ‘natural causes’ – if anything can be said to be natural in prison. There were 354 deaths in prisons in 2016. This death toll has doubled in eight years. This reflects the ageing profile of the prison population, due in part to the burgeoning prison population of sex offenders. Many of these men have been convicted of historic sex offences, and hence are elderly, and sex offences attract lengthy sentences. Also, gaol is not the most healthy place to be. The result is a significant increase in the number of men dying of “old age” in prison. There is no such thing as dying of old age, though, is there?

The number of men over 60 in prison doubled in the decade to 2014. Even then the over 60s were the fastest growing prison age group.

Lovely, our society, isn’t it?

4. Who are these men in prison?

The British Academy report “A Presumption Against Imprisonment: Social Order and Social Values” tells us that,

  • 68% of prisoners were not in paid employment prior to being imprisoned
  • 59% of young offenders have learning difficulties or borderline learning difficulties
  • 47% of prisoners have no educational qualifications
  • 41% of male prisoners were permanently excluded from school
  • 27% of men in prison are victims of child abuse
  • 24% of men in prison were removed from their families and spent time in care
  • 15% of male prisoners were homeless prior to being imprisoned

According to the Prison Reform Trust, over half (54%) of prisoners have children under the age of 18 when they entered prison. This compares with only 13% – 19% of women prisoners who have children under the age of 18 when they entered prison.

The Social Exclusion Unit report, “Reducing re-offending by ex-prisoners”, notes that 43% of sentenced prisoners and 48% of remand prisoners loose contact with their families after entering prison.

Moreover, 22% of prisoners who are married on entering prison are divorced or separated whilst inside. That must be just peachy.

The isolation of men in prison from any meaningful contact with the outside world is crushing for many. Only about two-thirds of prisoners in local prisons and just over half of those in training prisons received the minimum statutory entitlement of two visits per month.

5. Outside Prison: Men, Separation and Suicide

Not surprisingly, parental separation has significant implications for the mental wellbeing of both affected parties (as well as the children). However there is evidence that men suffer particularly at this time due to lack of support. Partly this is due to women tending to spread their emotional capital more widely. At times of trauma, women can often fall back on emotional and practical assistance from mothers, sisters or female friends. Men, by contrast, tend to place all their emotional eggs in one basket. When that fails, they may have no reserve emotional resources to call upon. This is exacerbated by the parallel lack of support for men in the social services generally, and, of course, the crucifying meat grinder horror show that is the Family Court and its associated mechanisms of injustice. The following extracts illustrate some of the independent evidence which exists to underwrite the above contentions.

5.1 The Suicide Paradox

The total number of suicides in the UK is shown against year in Figure 4. The number of male suicides shows an upward trend, though the male suicide rate per 100,000 is roughly steady. The number of female suicides has decreased substantially, and the female suicide rate even more so. The female suicide rate per 100,000 was about 10 in 1980 but has dropped to about 5 now.

Women have a significantly higher reported incidence of mental health issues, including self-harm, than men and also a slightly higher rate of attempted suicide than men. But male suicides outnumber female suicides by about 3.5 times in the UK. The ratio is even worse in Wales, at about 4 (Figure 5).

This is the gender suicide paradox: if mental health indicators were indicative, women would be expected to commit suicide at greater rates than men. But the reverse is the case – and to a dramatic extent. This suggests that the causes of suicidality in men may involve exogenous factors more often than for women. In other words, mental ill-health may not always be the cause of suicide. Instead external factors may be a contributory, or dominant, reason for suicides – and this would appear from the data to be far more prevalent amongst men than women. We need to “look beyond male suicide as a mental health issue“. The feeling that life is not worth living after loosing one’s whole family may not register in our social systems as a mental health issue – but it may lead to death.

Figure 4: Number of Suicides in Whole UK by Sex – click to enlarge
Fig4

Figure 5: Ratio of Male to Female Suicide Rates in UK and in Wales click to enlarge

Fig5

In a Telegraph article, Glen Poole notes that,

All the research tells us there are multiple factors that make men of all backgrounds more vulnerable to suicide. They include exclusion from school, poor education, unemployment, low income, fatherlessness, relationship breakdown, separation from your kids, homelessness, imprisonment, substance abuse, being a victim of violence and abuse, mental health problems and a lack of male-friendly services.”

The next two sections explore a couple of these exogenous factors.

5.2 Male Suicide and Separation/Divorce

The best data-based evidence for a causal relationship between divorce or separation and an elevation in male suicide rate comes from studies in the USA. For example, the National Institute for Healthcare Research indicates that divorced people are three times as likely to die by suicide as people who are married. That it is specifically men who suffer from this elevated suicide risk is confirmed by the study of Augustine Kposowa, J Epidemiol Community Health 2000;54:254–261, Marital status and suicide in the National Longitudinal Mortality Study. The Abstract reads,

Divorced and separated persons were over twice as likely to commit suicide as married persons. Being single or widowed had no significant effect on suicide risk. When data were stratified by sex, it was observed that the risk of suicide among divorced men was over twice that of married men. Among women, however, there were no statistically significant differentials in the risk of suicide by marital status categories. Conclusions: Marital status, especially divorce, has strong net effect on mortality from suicide, but only among men.”

An updated paper by the same author (J Epidemiol Community Health 2003;57:993 Divorce and suicide risk) concludes,

Divorced men were over eight times more likely to commit suicide than divorced women. After taking into account other factors that have been reported to contribute to suicide, divorced men still experienced much increased risks of suicide than divorced women. They were nearly 9.7 times more likely to kill themselves than comparable divorced women. Put another way, for every divorced woman that committed suicide, over nine divorced men killed themselves.”

He goes on to speculate, following other authors, that,

while social, psychological, and even personal problems facing women are readily denounced, societal institutions tend to ignore or minimise male problems as evident in suicide statistics. For instance, in many jurisdictions in the US there seems to be an implicit assumption that the bond between a woman and her children is stronger than that between a man and his children. As a consequence, in a divorce settlement, custody of children is more likely to be given to the wife. In the end, the father loses not only his marriage, but his children. The result may be anger at the court system especially in situations wherein the husband feels betrayed because it was the wife that initiated the divorce, or because the courts virtually gave away everything that was previously owned by the ex-husband or the now defunct household to the former wife. Events could spiral into resentment (toward the spouse and “the system”), bitterness, anxiety, and depression, reduced self esteem, and a sense of “life not worth living”. As depression and poor mental health are known markers of suicide risk, it may well be that one of the fundamental reasons for the observed association between divorce and suicide in men is the impact of post divorce (court sanctioned) “arrangements”.”

As for the UK, a guest blog on the CALM web site (Campaign Against Living Miserably) has summarised the situation regarding men and suicide after divorce as follows (extracts only),

Divorce is difficult for everyone concerned, and a whole support network exists to help cushion the blow for some of those affected. For the wife and children there are usually endless offers of support from friends, family members and dedicated organisations, but it is still the case that comparatively few organisations exist to specifically help men cope with the often immense emotional and psychological trauma of getting divorced.

In today’s society the notion that men should simply get on with it and move on, still pervades but there is now startling evidence that many divorced men really do struggle to cope with the aftermath of a divorce…..As a result of resultant disconnection and loneliness they feel, and without the social acceptance of being able to ask for help, a significant number of divorced men are choosing to take their own lives.

Divorce and separation have long been connected to raised risk of suicide but another recent research report by the Samaritans in 2014 has found evidence that “this elevated risk appears to be greater for males compared to females.” The report also found that “separated men are twice as likely as separated women to have made plans about ending their lives.”

[Aside: It is worth noting that the above Samaritans report refers to the “causal association between relationship breakdown and suicide” in men, not mere correlation].

Often it is the divorced man who finds himself having to leave the marital home, particularly when children are to remain with their mother, which is more often than not the outcome from family break-ups.

Finding themselves alone, in reduced financial circumstances and no longer surrounded by their family, far too many men find themselves wondering how to cope with feelings of grief, loss and even rage. Alcohol, drugs and casual intimate relationships can often become a crutch providing instant euphoria, but failing entirely to address the deep seated problems. Worse than this, they can often lead to addictive behaviours and feelings of worthlessness and hopelessness afterwards, leading to a vicious cycle of desire, depression and low self-esteem. Such behaviour is well documented and can result in men becoming completely isolated and incapable of dealing with their situation, leading to severe depression and ultimately suicidal thoughts.

Since it is abundantly clear from the statistics that there is a significant rise in suicide rates for men following the breakdown of a relationship, then it is equally clear that more robust solutions need to be put in place to deal with the increased risk. There are no quick fixes, but steps need to be taken to make counselling, advice and practical resources more widely available for vulnerable men.”

A good article, apart from the last sentence. To materially disadvantage a man and then offer ‘counselling’ really won’t cut it. This problem will persist until either the operation of the family courts is changed radically to be more equitable, or men remove themselves en masse from the risks of partnering.

6. Men, Domestic Violence and Suicide

There is evidence that domestic violence is related to suicide, and that domestic violence has a greater impact on male suicide than on female suicide. Published data is still sparse, but emerging indicators are that male victims of domestic violence are more likely to kill themselves than female victims. Moreover, perpetrators of domestic violence also have a higher suicide rate – which is less surprising than it initially appears given that roughly half of domestic violence is reciprocal. Another emerging observation, as yet with little published support, is that male perpetrators are significantly more likely to kill themselves than they are to kill their partner. If true, it immediately follows that the number of male victims of domestic violence-related deaths inevitably exceeds the number of female victims, if suicides due to domestic violence are included.

Direct support for this corollary comes from the 2010 study by Richard Davis, “Domestic violence-related deaths“, Journal of Aggression, Conflict and Peace Research, Vol. 2 Issue 2, pp.44 – 52 which concludes,

When domestic violence-related suicides are combined with domestic violence homicides, the total numbers of domestic violence-related deaths are higher for males than females. This paper recommends that to understand the broad scope and tragic impact of domestic violence, further research is needed concerning domestic violence-related suicide.”

This is an extremely significant finding given the powerful influence that accusations of domestic violence have in determining the outcomes of Family Court cases. In the book “You Can Stop Male Suicide“, Glen Poole observes that,

UK government data suggests that male victims of domestic violence are 50% more likely to attempt suicide than female victims, while US researchers have found that men who were sexually abused in childhood are up to 11 times more likely to suicide…..Another form of abuse that men are more prone to is false allegations of physical and sexual assault. A recent survey of 30 victims of false allegations (24 men and 6 women) by the University of Oxford’s Centre of Criminology, found that over a quarter reported being suicidal.”