Issue link: https://maltatoday.uberflip.com/i/1544495
13 maltatoday | SUNDAY • 19 APRIL 2026 FEATURE Malta, 80% of suicides are men. never asked for help Later, sicker, angrier Donatella Agius is a psychi- atrist. She says that what Paris describes as the "waiting, the delay, the crisis that arrives be- fore the conversation does", is what she sees in clinical prac- tice, over and over again. Men come in later than wom- en. By the time they do, things are worse, she says. "There is this mentality that a man can- not show his weaknesses; he cannot cry. So, the moment they feel depressed, they tend to become much more suicidal than women. For them, seeking help feels like failure." And it does not always look like depression when a man walks into the clinic. It looks like anger, irritability, some- one who seems fine until he is not. She explains: "When you see that anger, there is often an underlying anxiety beneath it that is not immediately visible. What presents as irritability or aggression can actually be root- ed in something much deeper." What the numbers say In 2015 alone, 29 of the 36 re- corded suicides were men. The pattern repeated itself across every subsequent year. Research into local suicide deaths between 1995 and 2018 found the highest-risk profile was male, aged 30 to 60, single or separated, unemployed or a pensioner. A separate analysis of police reports covering 359 deaths between 2003 and 2017 found that only 19.2% of those who died had ever been in con- tact with national mental health services. Richmond Foundation's 2025 figures show the same gap in who uses services. Of 1,324 cli- ents using the Healthy Minds Talk therapy service, 791 were women and 467 were men. The helpline took 4,056 con- tacts—2,301 from women and 1,687 from men. Olli, the foun- dation's chat platform, was used by 614 women and 421 men. The only service where the numbers are roughly even is the free therapy programme, which covers 38 women and 37 men. What boys are taught Paris says boys are taught to toughen up and move on; not to display emotion and not to cry. But being emotional is in and of itself seeking help, he insists. "It is something which boys and men are sometimes forced to unlearn as they grow up, which makes it more difficult to relearn when they're older," he says. Agius has no qualms about where the root cause of the problem with men is. "It is the way children are being raised. The values, the beliefs. That is the culture. These mentalities are being pushed onto them from childhood." She is also tired of the idea that awareness campaigns have done their work. "I'm still en- countering stigma with regard to treatment," she says. People believe psychiatric medication means addiction or sedation. Jokes about Mount Carmel Hospital are common enough that she raises them unprompt- ed. "If you have a chest infection and you need to be admitted to the hospital, you go. It is the same thing with mental health but many do not consider it the same as physical illness," she says. Paris acknowledges medica- tion was hard to start at 15. Harder still, over a decade later, is accepting that he still needs it. "I've been taking medication and doing therapy for a good 12 years, and I still have moments and periods where it gets worse. Even just the fact that I still need to take medication and still need to go to therapy; a lot of these things can be difficult to cope with when I'm not do- ing very well." Agius sees this play out clin- ically. A man arrives and feels like a failure for being there. That feeling sits on top of what- ever brought him in. "So, they are depressed, and then every step of the process, seeking help, attending a clinic, taking medication, continues to deep- en their depression." What would actually change things A new acute psychiatric unit is planned within Mater Dei Hospital. Whether it will make it more accessible to men who currently do not seek help is a different question. Agius keeps returning to the need for straight-talking pub- lic individuals, who can re- count their own experiences not through vague references to hard times, but actual accounts: 'I was unwell, I got help, this is what it looked like.' "It is only then that society can say it is acceptable to share my vulnerabilities; it is acceptable to seek help," she says. Paris ends with a word of ad- vice: "When your friend men- tions he's going to start thera- py, instead of making a face or thinking why, just have a good conversation about it and don't be judgmental. That's really what it comes down to, loving one another and being kind to one another." If you are struggling with mental health issues, you can contact the Richmond Foun- dation helpline on 1770, Cri- sis Resolution Malta on 9933 9966, the FSWS support line on 179, or speak to a profes- sional online at kellimni.com. The national mental health helpline is available on 1579. All services are free and avail- able 24/7. If you are in imme- diate danger, call 112. Left to right: Donatella Agius and Matthew Paris More than four in every five suicides in Malta are men. Most of them never spoke to anyone about their mental health struggles—not a doctor, not a therapist, not a friend (File Photo)