Childhood Trauma and Suicidality in Scottish Men
Pictured: Men’s SHARE service users attend weekly support groups. Photo reproduced with permission and consent.
The Men’s Suicide, Harm, Awareness, Recovery and Empathy (SHARE) Project is run by Health in Mind in Midlothian, Scotland. It provides emotional and social support to men in the local community who are at risk of suicide. The project works in partnership with the Dalkeith Citizen’s Advice Bureau (CAB), which offers financial and practical support to service users. This holistic approach allows men to take the time to reflect on and prioritise the different aspects of their psychological wellbeing.
As an active member of the project’s steering group committee whilst undertaking my Doctorate in Clinical Psychology, I witnessed first hand the incredible and life-saving work of the SHARE project. Men bravely shared their histories with me and I was struck by the many stories of negative childhood experiences, including abuse and trauma that these men had faced.
Taking a keen interest in the men’s narratives, I started reading around the topic. I quickly discovered that little is actually known about the reasons why men in particular become suicidal despite statistics suggesting that they are the most at risk. The World Health Organisation, for example, estimates that men account for three-quarters of all completed suicides and those aged 45-49 are nearly twice as vulnerable as the wider male population. It seemed obvious to me that better understanding the causes of male suicidal behaviour would be critical to reducing suicide rates in this high risk population. Indeed, understanding pathways to suicide can inform suicide prevention. So, I set out to work with the SHARE project to conduct research that would help to develop our knowledge and understanding of male suicidality.
The study aimed to explore the relationship between childhood trauma and suicidality. It looked specifically at the role that social inhibition and difficulties managing emotions play in this relationship. The study was novel insofar as it focused on a sample from a socio-economically deprived part of Scotland. Evidence suggests that men from lower socio-economic demographics in higher-income countries are particularly under-researched and under-represented in the research despite bearing the highest risk of suicide.
In total, 86 men who accessed the SHARE project over a five-month period took part in the study. They completed four questionnaires: the first looked at their experience of childhood trauma (physical, sexual, emotional abuse and neglect); the second measured their interpersonal difficulties including social inhibition; the third looked at their difficulties in managing emotions and the final one assessed their suicidal thoughts and feelings.
The results showed that higher ratings on the childhood trauma questionnaire predicted higher score on the measure of suicidality i.e. the greater the degree of childhood abuse, the greater the level of suicidality. This demonstrates the possible negative collateral and compounding effect of childhood trauma. The study also showed that childhood trauma may predict suicidality within the context of emotion management difficulties and high levels of social inhibition. Suicide is clearly a multifactorial phenomenon that is the result of a complex interaction between numerous factors. This novel study showed that difficulties managing emotions and interpersonal difficulties (being socially inhibited) are part of this complex picture.
The findings of the study could potentially help shape guidance on suicidality and enhance clinical practice. Firstly it is important for organizations to identify the presence of early childhood trauma, emotion regulation difficulties and social inhibition when assessing men who are at risk of suicide. Thereafter, targeting social isolation and treating emotion management difficulties as possible interventions to reduce active suicidality in this population is imperative. Offering men emotional and social support is strongly advocated in order to directly address and reduce active suicidal thoughts or feelings.
With these results and conclusions in mind, it is not surprising that services such as the Men’s SHARE project are so successful. The project adopts a prevention and intervention approach, offering weekly support groups and one-to-one sessions that focus on the emotional, social and practical needs of men who at risk of suicide. It is a testament to Men’s SHARE that the men whom the project supports often recount how the project has kept them alive and more importantly, has helped them to live well despite their adverse childhood experiences.
Special thanks to John Murphy (Health in Mind), Julie Podet (Dalkeith CAB) and the service users of the Men’s SHARE Project for their time and contribution. For more information on the Men’s SHARE project, please visit here.
This article was first published on the Male Psychology Network website in 2018.
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Dr Charlotte Lemaigre, Clinical Psychologist, works with Southwark Integrated Psychological Therapies Team (IPTT) and Wandsworth Consortium Drug and Alcohol Service (WCDAS). Email.