Background: Suicide bereavement is associated with higher risks of suicide and mental health problems. Impacts may vary for men due to gender differences in grief and coping styles. Men, already at higher risk of suicide mortality and less likely to seek help, are underrepresented in suicide bereavement research in Australia and internationally.
Aim: The systematic review investigates the impacts of suicide bereavement on men, particularly on psychosocial outcomes including suicidal behaviour and mortality, mental and physical health problems, substance use, and work-related problems. By doing so, this review enhances our understanding of suicide bereavement in men, and may inform adequate support for this population in this country.
Research team: the research team includes researchers with lived experience of suicide who have been involved in the design and throughout all aspects of the study. The research team met on a regular basis to minimise researcher bias.
Methods: Following PRISMA guidelines, we systematically searched the peer-reviewed literature in Medline, Embase, Emcare, PsycINFO, and Scopus. We found 33 studies (23 quantitative, 8 qualitative, 2 mixed-methods), encompassing 29 samples, published between 1995 and 2022. We employed narrative synthesis methods. Quantitative results were categorized based on comparison groups: non-bereaved men, or women bereaved by suicide.
Results: Compared to non-bereaved men, suicide-bereaved men showed increased risks of suicide mortality, mental health problems (PTSD, mood, anxiety disorders, and self-harm), psychiatric hospitalisation, and substance use disorders. They had higher rates of all-cause mortality, certain physical health problems, unemployment, and work absences. Compared to suicide-bereaved women there were no clear differences in suicidal behaviours, but suicide-bereaved men generally had fewer mental health issues and higher substance use compared to suicide-bereaved women. In qualitative studies, men reflected on the role of gender norms in restricting emotional expression.
Conclusion: Men bereaved by suicide are at higher risk of suicide, mental health problems, and some physical health conditions than non-bereaved men and experience different risks of many psychosocial outcomes compared to suicide-bereaved women. Influences of gender norms on their grief and emotional expression are evident. This review highlights the importance of considering masculine identity and norms in postvention support practices and policy, and the need for further research on the intersection of these impacts with other factors including culture and sexuality.