Dr Amy Chandler, CRFR research associate, talks about some of the issues being raised in her project, Alcohol Stories, a study of middle-aged men, alcohol, mental health, self-harm and suicide.
This is a very much a ‘work in progress’ blog – reflecting on recent statistics on suicide in the UK, and thinking through how this relates to issues I am addressing in a new research pilot project.
New figures released by the UK Office for National Statistics show that suicides among men have risen, with levels now the same as in 2011 – a potential reversal of what had been a downward trend. Rates among younger men are often highlighted, since suicide in men aged 15-29 is the leading cause of death. These latest figures show that suicides among older men, aged 45-59, are now higher than any other age group.
I am currently at the start of a pilot project, funded by Alcohol Research UK, which is using biographical methods to study the life-stories of men in this older age group. The study will focus especially on men’s accounts of the complex interplay between alcohol use, self-harm, suicidality, and mental health.
The men I am speaking to are in some ways ‘lucky’ – they are all being supported by community-based mental health and substance use support services. Despite this, their accounts (so far) highlight difficulties they have faced in accessing and using support at various points across their lives. News stories about the latest suicide statistics were accompanied by coverage of one particular suicide, with a bereaved family keen to highlight what they see as limitations in current mental healthcare provision in the UK. The story of Martin Strain was, sadly, familiar when I read it – elements of his struggle are reflected in the accounts of the men I have spoken with so far. In particular, Martin’s history of drug and alcohol misuse is said to have resulted in him being denied access to one-to-one psychiatric support. This highlights a significant challenge in tackling mental ill health in general, but especially for men, who are more likely to turn to alcohol to manage distress.
Around 50% of deaths by suicide occur in the context of alcohol use; and those who are alcohol dependent are at increased risk of suicide. Despite this, those identified as having alcohol use problems are – like Martin Strain – in some cases, diverted away from psychological support, into alcohol use services. Unless appropriate community based support is available (which is patchy, and will be reliant on the whims of local authority funding), people who have both mental ill-health and alcohol problems may not receive any kind of ‘joined up’ support. One of the issues I am investigating in the current study is the extent to which mental health is supported by substance use services; and conversely, how well alcohol misuse is responded to by mental health services.
In a limited way, I will also be exploring the role that community based support can have for men, who are often framed as ‘hard to reach’ and ‘hard to engage’. Yet clearly, some are reached, and some do engage – how do men account for this? In particular, I will be building on existing research which has examined the accounts that men provide when they engage in potentially ‘un-masculine’ practices, such as accessing a talking therapy. Studies have suggested that there are important differences between men in how they deal with such issues: with some men more able than others to frame ‘talking’ or ‘connecting’ with others as a responsible reaction to depression and thoughts of suicide (Oliffe et al 2011).
Additionally, I am looking at the way in which men themselves talk about their use of alcohol in the context of mental ill-health. Not all suicides are related to alcohol, and not everyone who uses alcohol will have problems with mental health, self-harm, or suicide. Already, variations are emerging in how men talk about alcohol use, and this study will provide useful insights into the diverse ways in which alcohol and mental health are understood.
Contact Amy by email.