Till death do us part a real risk for men The Weekend Australian 28 June 2003

The Australian
28 June 2003

The Weekend Australian
28 June 2003, Page C14

Till death do us part a real risk for men
By John Stapleton

Breaking up is hard to do. But for some Aussie men it can be deadly.

John Stapleton reports.

The country's leading research facility for men's health is urging
general practitioners to be more aware of the poor health and high suicide
rates among separated men.

Co-director of the Men's Health and Information Resource Centre at the University of Western Sydney Professor John MacDonald says while it is notoriously difficult to get men to go to a doctor, many GPs are
strategically placed to help when troubled men come knocking.

While last week's announcement by Prime Minister John Howard to
overhaul custody laws and move towards a presumption of joint custody after
separation may go some way to resolve the problem, health professionals are now being urged to look for the danger signs in their male patients.

Statistics suggest separated Australian men are up to six times more likely to suicide than separated women, although this depends on the age group.

The latest Australian Bureau of Statistics report reveals that in the prime divorce age bracket - of 25 to 44 years - suicides remain stubbornly high, or are increasing. This age group of men accounts for almost 50
per cent of all suicides.

"GPs, along with other professionals, are well equipped to help play an important role," Professor MacDonald says.

"The sources of stress belong in the social domain and often in the legal domain. But if the doctor has a list of relevant agencies that can help, some legal agencies rather than medical, for example, then such a GP
would be bringing a holistic service to his clients.

"That would be the doctor acknowledging what we call the 'social
determinants of health'."

Professor MacDonald says several doctors are now asking what they
could do to make their services more accessible to men.

"Even when doctors are referring men on to counsellors or other
agencies, it is important that such services are male-positive."

He points out that many community health services don't deal with men
at all unless they are in crisis, for example for drug and alcohol
problems.

"Most of the medical profession would accept that there are very few
services directed at men," he says.

"We would definitely like to see more male-friendly services."

Geoffrey Greene, federal director of the Shared Parenting Council of
Australia, a representative body of more than 20 fathers and family law
reform groups, says general practitioners are usually the first place
where fathers suffering through the process of separation present.

"Make no mistake, losing your children is one of the single most
distressing experiences any person can go through," he says.

"Doctors need to be aware that if their patients are experiencing
separation or divorce they are at high risk of suicide. Even if they
are not suicidal they can present with symptoms of stress or stress
disorders. GPs must look at the potential risk factor of suicide ... just
prescribing an antidepressant is not going to solve the problem."

Mensline Australia manager Terry Melvin says the emegency help line is
managing to answer only one-in-four of the deluge of calls to the
commonwealth-funded service.

"Clearly from our experience, men dealing with family and relationship
breakdown deal with a range of physical and mental health issues," he
says.

"We find callers on the line with high levels of anxiety and stress,
depression, and risk of suicide or self-harming behaviour," he says.

"Six per cent of our callers are men who are either threatening
suicide or where the suicide is actually in progress.

"We find that there is a spillover effect into their working lives and
research conducted by Mensline has shown high absenteeism, conflict
with their peers, inability to concentrate and the potential for industrial
accidents.

"There is often a high use of drugs and alcohol as men struggle to cope
with the loss of daily contact with their children and the loss of the
relationship.

"The level of stress increases when they have to deal with the (legal)
system.

"Many men feel alienated from community health services. GPs and all
health workers need to be better educated to understand that the
system in which men are raised undermines their ability to seek help at these
times of crisis.

"The fact that some of these men are walking into a doctor's surgery
is, in itself, a major plea for help.

"To shunt them through in five minutes and give them an antidepressant
pill is the wrong way to deal with them.''

One step being advocated by a new generation of health workers is to go
where the men congregate - into their workplaces, clubs and pubs.
Educationalist and board member of Suicide Prevention Australia Julian
Krieg is running a pilot program called Alive and Well for the Central
Wheat Belt Division of General Practice in Western Australia.

Their slogan is: "Blokes that know going where blokes are".

Mr Krieg says the program was developed as an important alternative to
GPs giving men antidepressants.

Instead, Alive and Well has developed a simple message: "Before things
get too much, talk to a mate."

"A lot of it is stepping back into our humanity and recognising that we
have these issues going on inside us, which we can solve quickly if we
can talk between us, bloke to bloke.

"The analogy we use is a car accident. The reality is that when we come
across a car accident, we refer people to the appropriate support
mechanisms. Very few drive past.

"If we supplied better basic first-aid for each other we would have
better results."

Mr Kreig says many separated men were "falling through the cracks" of
the health system.

"There are support mechanisms for the wife and kids, but the blokes are
expected to carry on, doing the provider thing. There is no approach
that recognises these blokes are, in reality, heart broken.

"The blokes are saying, "it's over. I've failed at my job, my life, my
marriage." A lot of these men do present to GPs but the GPs quite often
miss the symptoms."

He says this is because men do not report they are in trouble but that
they are having trouble sleeping.

"The reality is that the man is not sleeping because he is stressed
out of his brain.

"It is a matter of raising our whole awareness, through GPs, hospitals,
the court system. "When people are going through a divorce there are
critical things going on. The whole spectrum of care needs to recognise
that separation and divorce is a time of risk.

"The emerging men's groups message is powerful, and will make a
difference, but it is about all of us. We have to accept the primary
care for each other."



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