I used to think that death by suicide is uncommon; that it could only happen to others, but not to me or my entourage; that I would never be put in a position of experiencing the loss of someone I love, or to feel incapable of helping a suicidal friend.
The truth about suicide hit me hard when I joined the Lebanese Red Cross.
I remember first being dispatched to a patient who had overdosed on Advil pills. Then, to a man who had shot himself, ending his life in a lonely hotel room. Followed by a person who threw himself from his balcony, and a young man who hung himself while his parents were in the adjacent room.
All were men.
Each scene more horrific than the other.
Each emergency leaving me tired, drained, helpless.
But still, I used to think to myself “this won’t happen to me, my family or my friends”
… until it did.
Mental health problems and suicide are some of the public health subjects that are still taboo in the Arab World and Lebanon. These polemics tend to have a greater negative effect on men. In fact, suicide in men has been described as a “silent epidemic” because of its high incidence and simultaneous lack of awareness. So why is suicide more prominent in men?
In Lebanon, a person completes suicide every 60 hours. The security forces reported 1,366 cases of suicide over the last 11 years, averaging 2.4 cases per 100,000 people (Shartouni, 2021). However, we expect this number to be underreported, partly due to the lack of proper documentation of death certificates, but also because some families prefer changing the cause of death rather than experiencing the stigma associated with suicide.
Although females are more likely to show suicidal behavior and attempts, males are more likely to complete suicide (Tsirigotis, K. 2011.). In Lebanon, the latest studies show that 66% of suicide victims were males, making males almost twice as likely to commit suicide. This gender difference in suicide rates may be attributed to several factors.
First, in Lebanon and other Arab countries, there is still a stigma associated with mental health problems. In many communities, this subject brings “shame” or “3ayb” to the family of the sick individual. Therefore, the Lebanese tend to express their emotional concerns through somatic or physical complaints, as these are more socially acceptable. As a result, people suffering from common mental disorders such as depression may manifest symptoms such as stomach aches or migraines, making them more likely to visit their family doctor rather than a mental health professional.
This is especially true for men who are exposed to a tremendous amount of pressure and stigma since their youngest age and who are expected to keep a controlled figure that may be disrupted if they seek professional help. Therefore, males are usually unwilling to get help when they are distressed, and rather choose to stay silent and battle it alone. In fact, it has been shown that, in the year before suicide, only 35% of males sought medical attention from a mental health practitioner, compared to 58% of females. This gap is a good representation of the effect of gender stereotyping and societal pressure on what an individual’s masculinity should or shouldn’t look like. This gender-based problem has severe consequences on the life of thousands of men around the world.
High suicide rates in men are also related to socioeconomic factors such as income, employment, and social status. Men, especially in the Arab world and in Lebanon, are still expected to be the main, and sometimes sole, breadwinner and provider of the household. This gender-related stereotype puts a great amount of stress on the man’s life and may be a factor in the development of mental health problems. This major stressor is worsened by the current economic crisis witnessed in Lebanon that has pushed more than half of the population into poverty. Many are not able to provide for their parents, kids, and families because of the inflation that has devalued the Lebanese currency and the extraordinary rise in unemployment. The emotional toll of this stressor pushes many into major depressive episodes, that can eventually lead to suicide, especially if left untreated.
In a country where the weekly therapy consultation costs more than the national minimum wage, which is currently around 60 USD per month, mental health services have become an unthought-of luxury that cannot be afforded by most (Atoui, M. 2021). The average price of a consultation in an out-patient clinic is 250,000 LBP but can reach 450,000 LBP in some private clinics. Medication can also cost anywhere between 20,000 LBP and 500,000 LBP. Unfortunately, insurance and the CNSS rarely cover psychiatry consultations and do not cover the cost of psychological therapy.
Finally, alcohol misuse can increase the risk of suicide by up to 8 times. Men are more likely to abuse alcohol and are therefore more likely to commit suicide (Dan, B. 2011). In many cases, men consume alcohol as an unhealthy coping mechanism for their untreated psychiatric problems. The drug can lower the person’s inhibition just enough for him to act on their suicidal thoughts. This proves that our gendered community and the stigma that exists around mental illnesses, especially for men, push the victims deeper in their distress, increasing their chances of alcohol abuse and attempted and/or completed suicides.
The reason behind this “silent epidemic” is greatly due to the gender-based stigma that pressures boys and men to stick to stereotypical standards instead of communicating their feelings, embracing their weaknesses, and seeking help.
Although some initiatives are being taken to help people in emotional distress, not enough awareness is being raised and many communities are still oblivious to the effect of the stigma associated with masculinity on the mental health of men. It is crucial for the Lebanese government, alongside the help of NGOs, the Lebanese security forces, healthcare personnel, and educational establishments to introduce plans that will ensure safe and sustainable changes that lead to a decrease in the suicide rate.
Atoui, M. (2021). Mental health crisis on the rise: A pandemic of a different kind. Flip the Script.
Bilsker. D, White, J. (2011). The silent epidemic of male suicide. British Columbia medical journal. https://www.researchgate.net/publication/286692266_The_silent_epidemic_of_male_suicide
Chahine, M., Salameh. P, Haddad, C., Sacre, H., Soufia, M., Akel, M., Obeid, S., Hallit, R. & Hallit, S. (2020). Suicidal ideation among Lebanese adolescents: scale validation, prevalence, and correlates. BMC Psychiatry.
Hedegaard, H., Curtin, S. & Warner, M. (2020). Increase in suicide mortality in the United States, 1999 – 2018. NCHS Data Brief. U.S. Department of health and human services.
Shartouni, R. (2021). Lebanon witnesses suicide case every 60 hours: Study. AA. Retrieved from
Tsirigotis, K., Gruszczynski, W., & Tsirigotis-Woloszczak, M. (2011). Gender differentiation in methods of suicide attempts. Medical Science Monitor, 17(8). https://doi.org/10.12659/msm.881887
WHO. (2019). Suicide. Retrieved from