The Crisis of Our Sons' Mental Health

Murder and Suicide

When a boy drives down the serpentine road of mental health, feeling depressed and isolated because he feels no one who knows the real him loves him, no one needs him, and there's no hope of that changing, he may one day find a cliff and drive off. That choice may be direct, as with suicide, or it may be indirect, as in a school shooting. School shootings are homicides that are also suicides — even if the boy doesn't end his own life literally, for all practical purposes, his life is still ended.

The rate of mass shootings has tripled since 2011. We blame guns, violence in the media, violence in video games, and poor family values. Each is a plausible player. But our daughters live in the same homes, with the same access to the same guns, video games, and media, and are raised with the same family values. Our daughters are not killing. Our sons are.

The murder-suicide combination of school and other mass shootings is largely young white boys' way of driving off the cliff at the end of mental health's tortuous road. Consider three of the most notorious white male shooters: Adam Lanza (Sandy Hook), Elliott Rodgers (UC Santa Barbara), and Dylann Roof (Emanuel African Methodist Episcopal Church in Charleston).

The National Academy of Sciences reports that the increase in suicide among white males led to as many white males' lives lost to suicide as have been lost to AIDS. (Only Native Americans commit suicide at rates similar to whites; Hispanics and Asian Americans commit suicide at about one-third the rate of whites — about the same rate as the African American population.)

African American males, by contrast, stick with murder and being murdered. Thus, while only 6 percent of the overall population, black males make up 43 percent of murder victims. More black boys between ten and twenty are killed by homicide than by the next nine leading causes of death combined.

Suicides increase as the pressures of the male role and hormones increase. Before puberty, the suicide rates among males and females are about equal. However, between ten and fourteen, boys commit suicide at almost twice the rate of girls.

Between fifteen and nineteen, boys commit suicide at four times the rate of girls; and between twenty and twenty-four, the rate of male suicide is between five and six times that of females.

The Connection Between Masculinity and Suicide

You have probably seen pictures of men in the Great Depression jumping from tall buildings, falling faster than the stock market, only to be spread out on the sidewalk below, lost to their world and loved ones. Worth less, men considered themselves worthless. Thus, at the height of the Depression, 154 men committed suicide for each 100 women.

Yet by 2015, in good economic times, boys and men were committing suicide three and a half times more often than women.

Is this because females are inherently better at handling stress? Perhaps not. When men and women are exposed to similar pressures to perform, as among men and women in the military, the female suicide rate soars almost as high as the male rate. But men, like Brad, are prone to doing it differently.

In 2016 Brad returned from his third tour of duty in Afghanistan with a reasonable amount of economic security. But he felt like a stranger to both his wife and himself, and quickly alienated his children with his temper. His PTSD and the tension at home left him feeling like a burden. One day, after losing his temper again, Brad bought his wife her favorite flowers and their children the newest PlayStation, gave his wife and kids especially long and loving hugs and kisses, and took out the older of the family cars. He said he was going shopping; instead, he sped quickly down a curved road and "skidded" off a cliff.

Looking back, Brad's widow "knew" he had committed suicide

— "After he'd 'lose it' he'd always say he was worth more as an insurance policy than a husband and dad." But because he had faked it as a car accident so the family could get the insurance, he wasn't counted as a suicide.

Since both young and old men are often more motivated to commit suicide when they feel their loved ones will benefit more from their money than themselves, they have a need to cover it up so that insurance will pay. So although more veterans commit suicide each year than were killed in the wars in Iraq and Afghanistan, even that staggering number is probably a vast underestimation of the true suicide rate of male veterans, as well as older men, who are also, as we'll see in part V, more prone to feel they are worth more to their family dead.

The Incarceration Nation Versus the Prevention Nation

There is probably no better evidence of the increase of the boy crisis as a mental health problem than the fact that the US jail and prison population increased by more than 700 percent between 1973 and 2013. Of that population, 93 percent are male and are disproportionately young. 700% Increase in Prison Population (93% Male), 1972–2013

The American Psychological Association (APA) calls the United States "incarceration nation." Why? We are 5 percent of the world's population with almost 25 percent of the world's prisoners. The APA estimates half of those prisoners have mental health problems.

We often allow that the disproportionate percentage of young black men in prison may reflect our racism, but rarely contemplate whether, since the other half of "black men" is "men," that it may also reflect our sexism. Might the 700 percent increase in the 93 percent male prison population in the last half century mean that the way we our raising our sons in the last half century is leading to a deterioration in their mental health? Addressing that question would be preventive. To date, our prison debate has focused on rehabilitation versus incarceration, rather than prevention versus imprisonment. And just as this hurts African Americans more than any other race, it hurts our young men more than our young women.

Less Boy Crisis, Less Budget Crisis: Mental Health Pays the Taxes

Can we afford to focus on preventing imprisonment? We can't Afford not to. Prison spending has increased at five times the rate of spending per grade school student. Even in progressive California, twenty-three new prisons have been built for every one new college since 1980.

In addition to the immeasurable grief and self-blame among family and friends, suicide has an estimated economic cost to the United States of $44 billion a year. And suicide is only the tip of the mental health iceberg. For childhood mental disorders alone — predominantly affecting our sons — the United States now spends a quarter trillion dollars annually.

We pay taxes to rebuild what mentally unhealthy boys destroy. Prevention cultivates mentally healthy sons who pay taxes. The less our boy crisis, the less our budget crisis. Investing in turning our "incarceration nation" into a prevention nation will cost us less — in every way.

The Crisis of Our Sons' Physical Health

Being male is now the single largest demographic factor for early death.

— Randolph Nesse, Director of the Center for Evolution and Medicine at Arizona State University

In Nesse's summary assessment of a study of premature deaths in twenty countries, in which he found that "being male is now the single largest demographic factor for early death," the word "now" is important. It is only now that boys and men under fifty are twice as likely to die as girls and women the same age. That is a greater life-expectancy gap than at any time since World War II.

Your son's increased vulnerability can also be detected in the change in his sperm count. Boys today have sperm counts less than half of what their grandfathers had at the same age. And the problem is getting worse. The average sperm count in the United States continues to drop 1.5 percent every year.

"May You Live Until 120" ... or Not

When Jews traditionally wish for others to live to 120 (inspired by the Torah, in which Moses was said to live to 120), their wish includes their sons. But your son's reality makes that much less likely for him than for your daughter.

Our sons, husbands, and fathers die at a younger age from fourteen out of fifteen leading causes of death.

The disease that gives your son a predictably shorter life is the outcome. Our expectations for him as a male contribute to the cause.

The "Death Professions": Your Son's "Glass Cellar"

Every day, 150 workers die from hazardous working conditions. And 92 percent of them are male.

The less formal education and more children your son has, the more likely he is to feel he'll help his family live a better life by risking his own life working in what might be called "the death professions."

Why? To receive the "death professions bonus." Jobs like crab fishing in Alaska (think Deadliest Catch), working on an oil rig, in a coal mine, as a lumberjack, long-distance driver of a semi (or eighteen wheeler), as a welder a hundred feet above a bridge, as a cab driver at night in an inner city, as a pilot of a small plane dropping pesticides, as a roofer, or a construction worker — they all pay more money than safer, similarly low-education jobs. In exchange for this "death professions bonus," millions of dads with less education risk their lives to give their children options they don't have. And tens of thousands of single young men try to save up enough to make themselves attractive as a future dad.

Most of us take for granted how the home we live in was created at the risk of the lives of young men. For example, the wood in your home likely began its journey with young lumberjacks risking their lives as loggers. The trees they felled were then hauled by long-distance truckers (another hazardous profession) to a site near to what would become your home. On their way, the truckers repeatedly stopped for fuel extracted by other men who had risked their lives on oil rigs (as in Deepwater Horizon). And the wood was ultimately used by construction workers and roofers — who, in the United States, die at the rate of one per working hour.

A friend of mine was a firefighter. He and his wife, both Mormon, had eight children. One day, when my friend was in his early fifties, his wife, in tears, called to tell me he had died of lung cancer from the chemical-laden fumes he had ingested over the years. Few parents realize, as they proudly watch their son don a firefighter's uniform, that in hazardous professions, death after the job takes twelve times as many of our sons' lives as death on the job. Hazardous occupations on the job are merely the smoke; occupation-remnant diseases — such as black lung disease among miners — are the fire.

In aggregate, these jobs might be thought of as "glass cellar" jobs — all-male, because it is almost exclusively our sons who are willing to risk death so their family will have a better life.

"Bigorexia" and Obesity

While your daughter may suffer from anorexia or bulimia, your son is more prone to respond to the pressures he feels with bigorexia or obesity.

Jonathan was a freshman when his older brother, a junior, was making a name for himself as their high school's lead wrestler. After his brother introduced him to a teammate, his brother casually revealed that the teammate had later laughed that he and his brother were like the two guys in the movie Twins — his brother like the Arnold Schwarznegger character, and him more like Danny DeVito.

The reference haunted Jonathan. He knew he couldn't bridge the height gap, but he set out to make sure no one ever saw him as the short weakling again. He began lifting weights, ultimately working out obsessively and taking massive quantities of supplements. Proud of his progress, but still feeling unable to match his brother, he began taking steroids. He was soon abusing them.

Jonathan suffered from bigorexia, the body dysmorphia that occurs when a young man like Jonathan continues working on his physical strength, often temporarily magnifying it with steroids, in the hope that it will fill the black hole of his psychic wound. Just as the cultural ideal of thinness blinds many friends and parents of anorexic girls to their suffering and need for help, so our respect for male muscle blinded Jonathan's friends and parents to his suffering and need for help.

And bigorexia has further complications: if your son is preoccupied with body image, he is also more vulnerable to binge-drinking and overuse of drugs.

While Jonathan's psychological struggle was marked by muscle mass and motivation, the struggle of Jonathan's friend Austin was marked more by fat mass and lack of motivation. When Jonathan's motivation stepped up, Austin couldn't keep up and just gave up. Taking refuge in video games and eating, for Austin the presence of online friends couldn't compensate for his feelings of exclusion by real-life friends, and led to obesity and depression.

While the rate of obesity among adolescent girls has stabilized, the rate for our sons is increasing. Aside from their physical health, this damages both our sons' psychological security, and our nation's global security: a third of young men are not fit for military service owing to obesity and other physical and mental problems. And this problem extends to other professions on which our security depends: 70 percent of firefighters and 80 percent of police officers are also obese or over-weight. The US has the highest rate of overweight males among all major countries.

Whether through bigorexia or choosing the death professions, our sons, like our daughters, are often responding to what they feel will give them more approval and respect. For example, in the same way that many guys are attracted to quasi-anorexic girls, so many of our daughters find themselves attracted to firefighters, marines in dress uniform, football players in padded uniforms, and winners in other sports that put our sons' lives at risk.

The Crisis of Our Sons' Economic Health

The challenge for your son's grandpa was grandpa's job going nowhere; the challenge for your son is his job going elsewhere. Your son is more likely to seek a job in a sector that is being increasingly outsourced overseas — as with computer technology and manufacturing, as well as online jobs. Your daughter is more likely to hold jobs in stable sectors that are more recession proof, like health and education, both of which are 75 percent women.

Half the 6.5 million US jobs lost since the 2009 recession were in manufacturing and construction. In contrast, personal care and home health aides are projected to be the fastest-growing occupations, and women are predicted to fill the majority of these new jobs.

In addition to outsourcing, something else has changed since grandpa's day. If grandpa wasn't educated, he probably supported his family with his muscle. But your son will enter an economy that has made a transition from muscle to mental — or from muscle to microchip. For example, many of the nation's approximately 1.7 million truck drivers are predicted to be largely replaced by trucks that drive themselves, such as those currently being tested by Uber-owned Otto.

The implications for your son? Over the last forty years, the median annual earnings of a boy with just a high school diploma dropped 26 percent. Without that diploma, his chance of being unemployed during his prime working years (twenty-five to fifty-four) is 20 percent, almost 400 percent greater than the average.

If your son plans to live in an urban area, he'll likely live in one of the 147 US cities in which young women under thirty haven't just caught up to their male peers, but now outearn them (by an average of 8 percent). In only three cities do young men earn as much or more. And single women are now buying their own homes at two and a half times the rate of single men.

If your son is heterosexual, these transitions lead to a bigger problem, one which may be tough to hear. But I promised you I would be straightforward so that our solutions can be built on your son's real vulnerabilities.

Every Kiss Begins with Kay ... Still

You've heard the ad for Kay Jewelers, "Every kiss begins with Kay." Translation: a diamond for a kiss. Or, every kiss begins with pay.

Is this still true today? Yes. On a survey on splitting the bill on a first date, 72 percent of women responded that the man should pay the full bill. Moreover, 82 percent of the men agreed.

If your son and a woman who wants children take a liking to each other and make a mutual decision to have dinner, he may fear that if he asks for "equal pay for equal pleasure" when it comes to paying the check, he increases his likelihood of being rejected as a cheapskate. The message he hears is "no money, no honey."