Part 2

            In Part 1, I shared my challenges with depression, the fact that the suicide rate for males is so much higher than it is for females, and how these realties have impacted men and their families. Here we will look more deeply into the underlying causes and potential solutions to this world-wide problem.

The Most Underappreciated Fact About Men and Why Males Are the Risk-Takers

            Dr. Roy Baumeister is one of the world’s leading social scientists. Understanding his work can better help us understand a lot about why men are the way they are and specifically why men are the risk-taking gender.

            Baumeister is the author of more than thirty books and four hundred scientific articles. In his groundbreaking book, Is There Anything Good About Men? How Cultures Flourish By Exploiting Men, he says,

“If evolutionary theory is right about anything, it’s right about reproduction. Nature will most favor traits that lead to success at reproducing. But for thousands of years, men and women have faced vastly different odds and problems in reproducing. On this basic task, women faced good odds of success, whereas men were born to face looming failure.”

            Given that all humans are mammals, there is a basic biological fact of life. It is the female who carries the baby in her womb and will always be 100% sure that any offspring carry her genes. Males can never be 100% certain, hence the truism, “mother’s baby, father’s maybe.” Further, through evolutionary history more females than males reproduced.

            Dr. Baumeister tells us that

“Of all the people who ever reached adulthood, maybe 80% of the women but only 40% of the men reproduced. Or perhaps the numbers 60% versus 30%. But one way or another, a woman’s odds of having a line of descendants down to the present were double those of males.”

            Baumeister goes on to say,

“That’s a stunning difference. Of all humans ever born, most women became mothers, but most men did not become fathers.”

The result is that throughout human history men became the risk-takers, competing with other men to be chosen by a woman to mate with him. Some successful males (think Genghis Kahn) fathered hundreds of children. Some men stuck out completely.

            Women’s motto became: “Life has handed you a good thing; don’t blow it. Play it safe.”

            Men’s motto was the opposite: “The odds are against you. Better take your chances.”

            Says Baumeister,

“That’s why we are descended from playing-it-safe women and risk-taking men.”

Help-Seeking vs. Risk-Taking, The Empathy Gap, and Implications for Male Suicide

            My father didn’t seek help with his depression until he was forced to do so and the help available at the time was inadequate. This is still true for many men today.

“Perhaps it is not surprising that, if there are large gender differences in risk-taking and protective behavior,”

says Dr. Martin Seager who we met in Part 1,

“there will also be correspondingly large gender differences in help-seeking. An individual or group that is more likely to take risks to protect others is also by definition less likely to seek help or self-protection.”

            As my father found, he was not only driven to take risks to work in a challenging profession in order to take care of his family, but this indication was supported and encouraged by the society at large.

“The evidence also indicates that society is correspondingly calibrated to expect this difference and is consequently less empathic towards male death and injury,”

says Seager.

“If this is the case, then it must follow logically that men will be on average more driven than females to take their own lives because of:

              a. A greater instinct to ignore personal safety and confront danger

              b. A greater instinct to protect others (and greater shame at failing to do so)

              c. A lower sense of entitlement to receive help or protection from others.”

Towards a More Scientific and Effective Approach to Reducing Male Suicide

            Dr. Seager’s approach offers importance guidance for clinicians as well for men and their families.

By simply allowing archetypal gender differences to be researched, understood, and honored, gender-specific solutions to male suicide can indeed be found. Here are some important points:

• Carl Jung talked of archetypal patterns evolved within the human species and shared within a “collective unconscious.”

• Jung’s thinking was clearly influenced by ancient Chinese conception of “Yin” and “Yang” in which femininity (one aspect of “Yin”) is seen along with masculinity (one aspect of “Yang”) as complementary system of opposites within the natural universe.

• Dr. Seager proposes the following simple and practical instinctual, evolutionary-based, male archetypes:

1. Fighting and winning.
2. Providing and protecting.
3. Maintaining mastery and self-control.

• These archetypes contribute to a sense of masculine identity, honor and strength. To the extent that a man feels these elements are missing, he will feel the opposite of masculine shame and failure.

            My own experiences and research has convinced me that men’s inherent proclivity to maintain emotional self-control helped men be successful hunters during the millions of years humans were hunter-gatherers. Men needed to fight potential threats from other men in order to protect our families. Men needed to take-risks in order to compete with other men in our own tribes so that we would be chosen by women. These evolutionary-based instincts are built-in and though they don’t control our behavior, we still make individual choices, they cannot be ignored.

            Calling masculinity “toxic” or blaming the “patriarchy” just serves to divide and alienate us. We create more conflict between left and right, males and females, Republicans and Democrats, Us and Them. We need more bridges not more walls.

            I met the internationally acclaimed scholar, futurist, and activist, Riane Eisler shortly after her book, The Chalice & the Blade was published in 1987. We have been friends and colleagues ever since. She said,

“Underlying the great surface diversity of human culture are two basic models of society. The first, which I call the dominator model, is what is popularly termed either patriarchy or matriarchy—the ranking of one half of humanity over the other. The second, in which social relations may best be described as the partnership model. In this model—beginning with the most fundamental difference in our species, between male and female—diversity is not equated with either inferiority or superiority.”

Why an Archetypal Approach to Male Depression and Suicide Works Better

            For some clinicians, men’s innate desire to fight and win, to protect women and children, and to control our emotions, are seen as “toxic” or “harmful.” They try and encourage men to change and express themselves in different ways. Dr. Seager’s approach is different:

            “If we assume that men on average are more likely than women to be driven to ‘fight, protect’ and ‘retain mastery/self-control,’ then it is clear that trying to encourage men collectively to ‘open up, be vulnerable’ and ‘seek help’ potentially violates deep-rooted masculine instincts. Such an approach may even increase a sense of masculine shame and failure.”

            Dr. Seager concludes that we have a choice between two divergent approaches:

• Socially challenging and reconstructing masculine behavior and masculinity itself as a negative stereotype through educational methods with the aim of teaching males to seek help and share emotions more openly (i.e. change masculinity).

• Changing the social attitudes and responses of society towards men and boys to create more empathy for masculinity as a positive part of the human spectrum, while providing male-friendly services for men and boys that both honors the male archetype and offer new and better ways of expressing it (i.e. change society).

            In advocating for the second of the two approaches, Dr. Seager says,

“I am saddened that our profession seems to be no better than the rest of society in being blind to the fact that men and boys also have needs and problems arising from their gender. Raising this subject always incurs unreasoned resistance and even at times hostility. This in itself shows the need to keep promoting the issue.”

            My father was fortunate to have survived a health-care system based on the first approach that never worked for him, he finally found his way to one that accepted his inherent drive to take risks in support of his family. I wrote about his journey in my book, My Distant Dad: Healing the Family Father Wound and an article, “My Father’s Stay at God’s Hotel: A Slow-Medicine Approach to Healing Mental Illness.”

The Moonshot For Mankind: Male-Positive Programs For Men and Their Families

            I launched MenAlive in following the birth of our first son, Jemal, on November 21, 1969 and our daughter Angela, on March 22, 1972. Fifty years ago, there were very few programs that focused on men’s mental, emotional, and relational health. Now there are many. Three years ago I invited a number of colleagues who I knew were offering new and effective approaches for helping men to join me in creating a central hub for the thousands of organizations that are now available.

            Come visit us at our website, MoonshotForMankind.org. Here are a few of the organizations that have joined our movement:

            ManTherapy.org: Man Therapy is an evidence-based, decades-long, multidisciplinary effort to break though stigma, improve help-seeking behavior and reduce male suicide. And they’ve got the stats to back it up. Learn more here.

            MenLiving.org: MenLiving delivers programs and experiences to help create a world of healthy, intentional, connected men who can heal and thrive. Learn more here.

            Men and Boys Compassion Initiative (MBCI) is an international movement to help men and boys cultivate their compassionate selves. This also requires the cultivation of courage and wisdom to heal the male crisis of disconnection.

            You can learn more about the work of Martin Seager at the Centre For Male Psychology.

            We need more programs for men that are evolutionary-archetypally informed. You can learn more at MenAlive.com and MoonshotForMankind.org. If you like articles like these, I invite you to become a subscriber.

By Taylor Sisk

JELLICO, Tenn. — In March 2021, this town of about 2,000 residents in the hills of east Tennessee lost its hospital, a 54-bed acute care facility. Campbell County, where Jellico is located, ranks 90th of Tennessee’s 95 counties in health outcomes and has a poverty rate almost double the national average, so losing its health care cornerstone sent ripple effects through the region.

“Oh, my word,” said Tawnya Brock, a health care quality manager and a Jellico resident. “That hospital was not only the health care lifeline to this community. Economically and socially, it was the center of the community.”

Since 2010, 149 rural hospitals in the United States have either closed or stopped providing in-patient care, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. Tennessee has recorded the second-most closures of any state, with 15, and the most closures per capita. Texas has the highest number of rural hospital closures, with 25.

Each time a hospital closes there are health care and economic ripples across a community. When Jellico Medical Center closed, some 300 jobs went with it. Restaurants and other small businesses in Jellico also have gone under, said Brock, who is a member of the Rural Health Association of Tennessee’s legislative committee. And the town must contend with the empty husk of a hospital.

Dozens of small communities are grappling with what to do with hospitals that have closed. Sheps Center researchers have found that while a closure negatively affects the local economy, those effects can be softened if the building is converted to another type of health care facility.

In Jellico, the town owns the building that housed the medical center, and Mayor Sandy Terry said it is in decent condition. But the last operator, Indiana-based Boa Vida Healthcare, holds the license to operate a medical facility there and has yet to announce its plans for the building, leaving Jellico in limbo. Terry said local officials are talking with health care providers that have expressed interest in reopening the hospital. That’s their preferred option. Jellico does not have a Plan B.

“We’re just in hopes that maybe someone will take it over,” Terry said. Meanwhile, the nearest emergency rooms are a half-hour drive away in LaFollette, Tennessee, and across the state line in Corbin, Kentucky.

An hour and a half away in Fentress County, the building that once housed Jamestown Regional Medical Center has been empty since June 2019, when Florida-based Rennova Health — which also previously operated Jellico Medical Center — locked it up.

County Executive Jimmy Johnson said Rennova’s exit from Jamestown was so abrupt that “the beds were all made up perfectly” and IV stands and wheelchairs sat in the halls. About 150 jobs evaporated when the center closed.

Rennova still owed Fentress County $207,000 in taxes, Johnson said, and in April the property was put up for auction. A local business owner purchased it for $220,000. But Rennova was granted a year to reacquire the building for what it owed in back taxes, plus interest, and did so within a few days.

Abandoned hospital buildings dot the map in central and east Tennessee. But in the western part of the state, two communities found uses for their empty buildings, albeit not in reopening hospitals.

Somerville, about an hour east of Memphis, lost its hospital, Methodist Fayette, in 2015. Its parent company, Methodist Le Bonheur Healthcare, donated the building to the town and threw in $250,000. The building is now a satellite campus for the University of Tennessee-Martin.

The conversion was pushed along by the town leveraging other funding. Bob Turner, Somerville’s city administrator, said both the town and the county matched Methodist’s quarter-million dollars toward the renovation. In its first year in Somerville, the university raised another $125,000. Tennessee’s governor then matched that $875,000 in his state budget.

Somerville is now in the seventh year of a 10-year agreement with the university, which rents the building from the town.

“We have a building, an asset, that’s probably worth $15 million,” Turner said. “It’s a four-year university right here in the heart of Fayette County.”

Mendi Donnelly, Somerville’s community development director, said the county is still in desperate need of a hospital, but “we’re thrilled that we were able to make lemonade out of our lemons.”

Ninety miles to the northeast, in rural Carroll County, Tennessee, another shuttered hospital found new life.

The closing of McKenzie Regional Hospital in 2018 was a blow to the local economy. But Baptist Memorial Health Care, which operates a hospital in nearby Huntingdon, bought the assets — including the building, land, equipment, and ambulance service — and subsequently donated the building to the town of McKenzie.

Cachengo, a technology company, ultimately took over the space. Because of hospitals’ electrical infrastructure, the site was a perfect fit for a business like his, said Ash Young, Cachengo’s chief executive. Young said Cachengo is now looking into repurposing abandoned hospitals across the country.

Jill Holland, McKenzie’s former mayor and a local-government and special-projects coordinator for the Southwest Tennessee Development District, believes the town can become a technology hub.

“It’s opening a lot of doors of opportunity for the youth in the community,” Holland said.

Back in Jamestown, the vacant hospital is “deteriorating,” said Johnson, the county executive. “It could have been used to save lives.” Rennova did not respond to a request for comment.

The University of Tennessee Medical Center opened a freestanding emergency room elsewhere in Jamestown, sparing residents a half-hour drive to the closest ER. Johnson believes the old hospital building could serve the community as housing for those who are homeless or as a facility to treat substance use disorder.

Brock, the health care quality manager, thinks things will get better in Jellico, but the community has had its hopes dashed more than once.

Brock believes a freestanding emergency room could be a viable solution. She urges her community to be responsive to “a new day” in rural health in America, one in which a hospital must focus on its community’s most urgent needs and be realistic about what that hospital can provide.

“Maybe it is just the emergency room, a sustainable emergency room, where you could hold patients for a period of time and then transfer them,” Brock said. “And then you build upon that.”

She added, “There are options out there.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Previously Published on kffhealthnews.org

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