No Country for Middle-Aged Men? An Intersectional Approach to Explore Sources of Psychological Distress and Patterns of Seeking Support among Middle-Aged Men Considered ‘At Risk’ of Suicide in Ireland

In many high-income countries, the rate of suicide is highest among middle-aged men. Despite this, few studies have explored the factors that underpin psychological distress and support-seeking among this cohort. This qualitative study used an intersectional approach to account for the plurality of middle-age masculinities and to offer deeper insights into middle-age men’s mental health experiences. Focus groups and interviews were conducted with nine demographic groups of middle-aged men considered ‘at risk’ of suicide in Ireland (n=34). Data collection and data analysis were informed by the principles of grounded theory. A master code list and conceptual maps were developed from which four themes emerged. Theme 1 Reconciling Increasing Expectations with Diminishing Capacities to Achieve at Middle-Age captures various tensions that emanated from expectations on men to have acquired mastery of various gendered norms by middle-age that coincided with a reality of different manifestations of middle-aged vulnerability as well as large scale societal change in Ireland. Theme 2 Isolation at Middle-Age broadly describes a sense of loneliness at middle-age as a result of narrowing social circles, a lack of social outlets, relationship breakdown and living alone. For those men who experienced discrimination, prejudice or racism, their isolation tended to be more deep-rooted and multifaceted and was a particular source of psychological distress. The notion of a ‘double burden’ was central to Theme 3 Barriers to Support Seeking, and encapsulated men’s sense of shame in having to ask for help and ‘failing’ to manage their own problems. Theme 4 Catalysts for Change & Strategies for Improved Self-Care highlights what were seen as the foundations of good mental health for middle-aged men, as well as the value of educational programmes and social contact. The use of an intersectional approach in this study fostered a deeper understanding of the blended identities and wide range of mental health experiences of middle-age men which have informed training and resources currently being implemented under the auspices of ‘Connecting for Life’, Ireland’s strategy to reduce suicide.