“Silence is the real danger in suicide,” says psychotherapist Mark Herman. It leaves people alone with their thoughts.
“In my experience, once somebody shares the fact they are thinking about suicide, there’s a connection to life ... and some kind of an unburdening.”
Talk therapies are generally recommended as a first-line treatment option for most people struggling with mental health.
However, too many men in crisis stay silent. The male predominance among deaths by suicide is an indicator of that. According to the latest provisional figures from the Central Statistics Office, there were 351 deaths by suicide in 2024, of which 289 were male and 62 female – a rate of 10.9 per 100,000 men and 2.3 per 100,000 women. A more complete set of statistics for 2021, incorporating late registrations, records 512 deaths of people by suicide in Ireland that year, unchanged from the number recorded in 2017. Over those five years, the proportion of deaths of people by suicide for males remained broadly similar, at about eight in 10, with the highest-risk age range in 2021 being 50-54 years.
READ MORE
A €2 million investment in new counselling supports for men recently announced by the Department of Health is aimed at helping to break the silence. Championed by the Minister of State with responsibility for mental health, Mary Butler, this initiative will be accompanied by a public campaign and promotion through GPs from the start of September. She has stressed that this is “recurring funding”, for measures that include more than 15,000 free counselling sessions to men each year.
However, accessibility and affordability are not the only barriers to men seeking any kind of talk therapy. Butler’s reference to the importance of men’s “specific needs and preferences” being taken into account when designing tailored supports acknowledges that, and there will be efforts to reduce stigma.
As the health and wellbeing manager with the Irish Men’s Sheds Association (menssheds.ie), Rebecca McLaughlin, says: “I wish it were as simple as the movies ‘If you build it, they will come’.” A clinical psychotherapist by training, she researched the challenges and barriers to older men engaging with counselling and therapy for her master’s degree.
“Even just a few generations apart, men present with very different views and perspectives, whether it’s on masculinity, the male role, gender, stigma and also engagements like therapy,” she says. Yet, consistent among men both young and old is a tendency to believe that seeking help challenges their masculine identity. Men of all ages present later and with more acute symptoms to mental health services.
The gender split among those attending Herman’s private psychotherapy practice in north Dublin is the opposite of the national trend, with about two-thirds of his clients being male. He suggests that men may gravitate towards a male counsellor, just as women may seek a female counsellor – in which case women will have a lot more choice. A 2018 survey by the Irish Association for Counselling and Psychotherapy showed its membership to be 78 per cent female.
“I think there is some kind of a comfort in talking to a man, in way of engagement but also in understanding of men’s issues,” says Herman. Yet it often still takes a woman to get a male client in the door. She may be his mother, partner, sister or, in cases of bereavement, a daughter.
“About half of my male clients seem to arrive by some kind of ‘proxy’,” he explains. A woman in the client’s life has encouraged him, or perhaps laid down an ultimatum, to seek help.
“Maybe some of those women have been to therapy themselves. It’s good; it’s a moving forward of that influencing.” The woman may be the one to engage initially with Herman, who must have contact from the man before anything is set up.
“I need to hear what he’s looking for, and I need to make sure he’s there of his own free will.” However, Herman can identify personally with this female nudging towards talk therapy.
“My wife, Maria, encouraged me to consider counselling for years, before my problems finally came to a head and I couldn’t sidestep them any longer. I remember being reluctant, but also knowing I probably should give it a chance. ‘Just a couple of sessions’, I told myself...”
Sharing with somebody who is non-judgmental brings not only relief but also clarity. A skilled listener can ask questions that will help the person move themselves forward
A former tech and business manager, he still finds it hard to say exactly how counselling helped him so much. “But I think that I got on well with my counsellor Phil, was able to trust him and that we worked well together, was the main thing.” He found it such a valuable experience that he did a degree in counselling and became, as he says himself, one of those “wounded healers” – people whose own painful experiences inspire and, arguably, better equip them to help others.
“This has been a long, vague path for me, but shows that hard times can offer us opportunities and lead to hope of fresh new things.”
Hope is a lifeline that can also be buried by silence. Yet, in general, men seem less likely than women to recognise the power of saying things about inner turmoil out loud, be that with a professional, partner or friend. Sharing with somebody who is non-judgmental brings not only relief but also clarity. A skilled listener can ask questions that will help the person move themselves forward.
“It’s not just talk. It’s also taking small steps,” says Herman.
In the thriving, 450-plus men’s sheds on this island, McLaughlin sees older men “upturning all the traditional negative stereotypes applied to them”, such as “men are hard to reach” and “men don’t talk”.
“What we experience is actually sharing and talking about health issues and problems,” she says. But, crucially, this is done “shoulder to shoulder” in the course of another activity, such as woodwork, gardening or some other community project.
“Each shed is run autonomously and has its own unique mix of three ingredients: people, place and purpose. Connection is the common factor – and a kettle, of course.”
[ New €1m fund for men’s sheds to help with heating and insuranceOpens in new window ]
The predominantly 60-years-plus age group drawn to the sheds grew up in a more entrenched culture of masculine silence around emotions. There is a huge leap from that to being expected to go into a room with a stranger and open up about their feeling, McLaughlin points out.
In her “wraparound” work with men’s sheds to facilitate workshops and other wellbeing initiatives, she has found that even the label “mental” health can be off-putting. Some older men have profoundly negative associations with the word, due to social, cultural and historical conditioning. To them it suggests, “there’s something wrong with you,” she says. “You were locked away; you were sent off; it was silence.”
Yet, for instance, a programme dealing with loss, devised post-Covid in conjunction with the Irish Hospice Foundation, has proved very popular. In some cases it has prompted men to come forward to look for further support, outside the walls of the sheds. “It’s like dropping a pebble in the pool. It creates a ripple effect and it opens up a dialogue.”
While welcoming Butler’s move to bolster men’s counselling, McLaughlin says the association would like to see more research about those in need of support who do not seek help.
“Is it around expectations? Is it about not having tailored supports for them? Is it about the language? Is it about misunderstanding of the role of the therapist? It’s very, very complicated to unpick.”
Echoing Herman’s comments, she says there also seems to be “quite a sensitivity to the age and gender of the therapist”. However, she adds, it’s only by asking men themselves will we get nearer to the answers about what would encourage them to look for mental health support. Meanwhile, the department has promised evaluation of the impact of the new funding.
Direct consultation paved the way for a new mental health programme for young Travellers, which is being rolled out with €100,000 this year from the funding announced by Butler, says John O’Brien, manager of the National Traveller Mental Health Service. This service, based in Exchange House in Dublin 1, is funded through the Health Service Executive’s National Office for Suicide Prevention. Research indicates that Traveller men are seven times more likely to die by suicide than the general population.
Part of the new project will be crisis-management training for Traveller adults, delivered by peers in their own community. The other part will be a six- to eight-week mental health programme for youngsters, with boys aged 15 to 18 being the key target group
Last year, among a Traveller population here of about 33,000 (based on Census 2022), “we recorded 37 possible deaths by suicide and 32 the year previous”, says O’Brien, “the youngest being 12, right the way up to a man in his 60s”.
In surveying young Travellers before the pilot project, one key finding was that they had all been exposed to suicide and death. The second was a prevalent lack of hope for their future, with a widespread sense that “people like me” don’t go to college, go into apprenticeships or get jobs. “So that’s where this programme is coming in,” says O’Brien.
“We asked the young people who would they turn to if they were worried, stressed or depressed or suicidal. Overwhelmingly they responded that they would go to their own parents or their own community, their peers. Professional support in the way of doctors or GPs, teachers, youth service workers, was way down the list.” That information was fed back to the adults through focus groups.
“There was a sense of pride within the adults that the children would go to them.” But there was also “a real sense of despair because the capacity isn’t there for them to deal with those issues”.
Part of the new project will be crisis-management training for Traveller adults, delivered by peers in their own community. The other part will be a six- to eight-week mental health programme for youngsters, with boys aged 15 to 18 being the key target group.
The approach contrasts with the traditional way of “middle-class, white professionals coming in to deliver projects – and I include myself in that cohort”, says O’Brien. The pilot programme was co-produced between professionals and community members and then delivered by a Traveller man and settled woman.
[ Mankeeping: why it’s bad for women and menOpens in new window ]
Stigma has been a historical factor in fewer men than women seeking counselling and psychotherapy, says Austen Donohoe, communications and digital marketing manager of MyMind (mymind.org), which will be funded to provide 5,000 free sessions targeted at men. Currently, two-thirds of clients using this early intervention service for mild to moderate mental health challenges are female. Last year, the breakdown was 62 per cent female, 34 per cent male, with other and undisclosed at 1 per cent each.
The average age for a MyMind client is 34, and the majority attend therapy for help with anxiety and stress. Many also seek assistance with other everyday issues such as self-esteem, loneliness and work/life balance.
“It is our hope that this new HSE funding will encourage more men to seek help sooner, with the mental health benefits for both them and their communities serving to help reduce stigma.”
According to MyMind’s mental health professionals, specialisations such as cognitive behavioural therapy work well for men by creating structure and teaching skills for managing mental wellbeing, reports Donohoe.
“Other specialisations like art therapy offer ways of communicating without relying on words alone. These approaches, and others, make therapy for men something that can be actively engaged in as a project for self-improvement.”
- Samaritans – samaritans.org – 116 123 – jo@samaritans.ie
