Josephine Gardiner reports on research into why depression seems to drive more boys than girls to suicide.
Adolescent girls appear to be leaving boys behind in the struggle to adapt to the uncertainties of life in the late 20th century, research suggests.
A spate of recent statistics indicate that boys in their mid to late teens and early 20s are almost twice as likely to commit suicide as they were 20 years ago, while the suicide rate for girls of the same age has declined by 23 per cent over the same period.
Boys are also increasingly susceptible to depression, which has traditionally been regarded as a female affliction.
These findings have prompted various investigations into possible causes and some of the results were published last week to coincide with World Mental Health Day.
One of these, Young Men Speaking Out, a study commissioned by the Health Education Authority and carried out by the London University Institute of Education, paints a bleak picture of modest, old-fashioned aspirations snuffed out prematurely by harsh economics. The report also questions the value of counselling, conventionally regarded as a panacea for all social and mental ills: most of the interviewees said that "talking about it just winds you up even more".
A team led by Professor Peter Aggleton talked to 160 16 to 20-year-old boys from around Britain contacted through homeless projects, probation hostels and sports clubs.
Although some of them could be counted as particularly vulnerable, Professor Aggleton insists that a broad range of social backgrounds was encountered. "We excluded university students and concentrated on the broad mass of young men," he said.
He admits that the survey was small scale and cannot be seen as representative, but points out that what the boys are saying is remarkably consistent across the group. "These boys are not asking for the moon; they want somewhere to live, a job or a college place, and a relationship that works. "
These are ambitions, as the report points out, that differ little from those likely to have been expressed by their fathers and grandfathers at a similar age. As one 20-year-old said: "I'd like to see myself set up somewhere in a little flat, a little bedsit or something like that and just do something with my life like get another girlfriend."
What separates them from their forebears is the difficulty, or perceived difficulty, in achieving these goals when housing and jobs are scarce. Girls have fewer problems because their expectations are less rigid and they are more prepared to adapt to reality and to share problems, he suggested.
"One of the big things for teachers is how to prepare boys for uncertainty - they have to strike a balance - to avoid exposing them to unrealistic expectations without damping enthusiasm," said Professor Aggleton. Depressed boys, unlike girls, were highly unlikely to seek help from a doctor, thus making suicide more likely.
"It's still not seen as manly to admit to problems. The only reason they'd go to a GP is if they had a sports injury," he said. The study also found that, contrary to the stereotype, young men would far rather "lose face" than become involved in violence.
The study recommends that youth clubs, arts and sports centres and adult education have a more valuable role to play than counselling in preventing hopelessness and suicide among young men.
Meanwhile, at a conference on suicide organised by the Dorset Health Commission, an investigation into the backgrounds of young male suicides - "psychological autopsies" - came to similar conclusions. Depression, unemployment, drug abuse and family breakdown are all factors, said Dr Peter Hardwick, a consultant in child and adolescent psychiatry. "Of course these stresses are also faced by many young people who do not self-harm. It is how these stresses are perceived that is the important issue."
Dr Hardwick, like Professor Aggleton, also found that males were still more reluctant to discuss problems, although "talking about feelings does not immunise men from committing suicide; the romantic poet Shelley died by his own hand". Among other recommendations, Dr Hardwick calls for more awareness of mental health problems in schools and training for teachers in how to handle those at risk.
Dr Eric Fombonne, senior lecturer in child psychiatry at the London Institute of Psychiatry, is leading a study of international suicide trends, trying to identify links with social changes and "find the mechanisms that lead people into such a fatal spiral of despair".
An increasing tendency to commit suicide began among young males in the United States in the 1960s, spread to most European countries in the Seventies, but did not show up dramatically in Britain until the early Eighties, hitting Scotland before England. For girls, the rates move up and down across Europe. Dr Fombonne says: "There seems to be no consistent pattern for girls."
He says that existing evidence does not support the idea that unemployment could be a factor in young male suicides. "Over the past 30 years rates for suicide and unemployment have run in opposite directions."
An analysis of 10,000 records of children and adolescents referred to the Maudsley Hospital between 1970 and 1990 revealed that an increased likelihood to commit suicide was paralleled by an increase in abuse of drugs, he says.