Stephen “tWitch” Boss took his own life earlier this week, and millions took to social media to mourn the tragic loss. Many commented on how it seemed like he had it all—fame from his long-time tenure as the Ellen Degeneres Show DJ, an All-Star stint on So You Think You Can Dance, a gorgeous wife, Allison Holker Boss, as well as three beautiful children. Jarringly, he is pictured looking blissful in TikTok videos posted just days, and weeks, before his suicide, dancing with his wife and decorating the Christmas tree with his kids.
According to the CDC, men make up 49 percent of our population—but account for half of suicides. We askedGregory Scott Brown, MD, a psychiatrist who contributes to Men’s Health, and Wizdom Powell, PhD, MPH, Chief Social Impact and Diversity Officer, Headspace Health, to answer our questions about men, mental health and suicide—including Black men in particular. Plus, how to tell when someone is in crisis—and how to get them help.
Why do men account for such a disproportionate amount of suicides?
Gregory Scott Brown, MD: Depression is one of the primary risk factors for suicide and women are diagnosed with depression about twice the rate of men. This doesn’t mean that men are at low risk, but they are getting professional help, and they are not being diagnosed. Some reasons include stigma, masculinity expectations, and the fact that men just don’t do to the doctor as often as women do.
Recent research is showing that suicide rates are rising more rapidly in the African-American population—why do you think this is?Gregory Scott Brown, MD: There are some people who feel more comfortable seeking treatment from a therapist who looks like them. This is problematic for Black Americans because only about 4% of psychologists and 2% of psychiatrists in the United States are Black, so access to care may be even more limited for Black men. It’s important for patients to understand that their therapist or doctor does not have to look like them in order to provide good care.
Wizdom Powell, PhD: Suicide rates have been rising among Black people, particularly youth and young adults. According to experts, suicide research has focused mostly on White populations, leading to gaps in our understanding of suicide among Black populations. Research also suggests a myriad of socioeconomic factors are at the root of rising rates of suicide in Black males, including experiences of racism, bias, and discrimination—both in healthcare systems and in society. Further, there are significant gaps in the availability of culturally responsive, high-quality, and affordable, preventive mental health care in our nation.
What effect has the pandemic had on suicide rates?
Wizdom Powell, PhD: The nation’s suicide rate in 2021 increased for the first time in two years with the largest spike seen among males ages 15-24. Provisional data released in 2021 showed a 4 percent rise in suicides compared to rates compiled in September 2022. While it is difficult to clearly pinpoint exact factors contributing to this increase, evidence on suicide risk factors affirms that depression, family history of suicide, physical illness, childhood trauma and more adverse lived experiences play a role. There are additional factors that may also increase suicide risk like ready access to guns in the home, job loss, and the death of loved ones during the COVID-19 pandemic. Social media has also been referenced as a possible contributor to spikes in adolescent suicide.
Can depression look different in men than in women?
Gregory Scott Brown, MD: Yes. Depression in men can present more as irritability then sadness. Men who are depressed can become edgy and snap at their partners, the may tend to isolate more and just want to be left alone. You also see depressed men drinking more or abusing other illicit substances. Other more general signs of depression are changes in appetite (over-eating or eating less), changes in sleep (too much or too little), fatigue, restlessness or feeling sluggish, feeling less interested in the things you used to enjoy, feeling of guilt or worthlessness, depressed mood, or thoughts about suicide.
What are some signs that someone is in crisis—signs that they are at risk for suicide?
Wizdom Powell PhD: We don’t often get ‘signs’ that a person is at risk for suicide. Many people who commit suicide do so without letting on they are thinking about it or planning it. The decision to commit suicide might be made just minutes or hours before that act. With that said, there are some, often subtle, signals:
- The presence of suicidal behavior: Talking about or taking actions related to ending one’s own life. Suicidal thoughts and behaviors should be considered a psychiatric emergency
- Increased substance use/misuse
- Dramatic mood swings
- Impulsive, aggressive, or reckless behavior
- Social withdrawal
- Sleeping too little or too much
- Talking about suicide: Statements like “I’d be better off dead” or “If I see you again…,”
- Seeking the means: Trying to get access to guns, pills, or other objects that could be used in a suicide attempt.
- No hope for the future: Feelings of helplessness, hopelessness, and being trapped, or believing that things will never get better.
- Self-loathing: Feelings of worthlessness, guilt, shame, and self-hatred.
- Getting affairs in order: Giving away prized possessions or making arrangements for family members.
- Saying goodbye: Unusual or unexpected visits or calls to family and friends; saying goodbye to people as if they won’t be seen again.
The truth is that men and boys often have a more difficult time accessing and describing their emotions. This is something clinician-scientists describe as ‘normative male alexithymia’. It is often the case that some Black males may suffer in silence because they can’t find the words to describe the inner turmoil they confront. Also, there are significant gaps in the availability of culturally responsive, high-quality, and affordable, preventive mental health care in our nation.
What should you do if you or someone you love is contemplating suicide? We know that for those suffering a high-profile suicide can lead to “copy-cat” tragedies.
Wizdom Powell, PhD: If you think someone is at immediate risk of self-harm, here are commonly referenced steps you can take:
- Call 988 or your local emergency number.
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.