The Silent Burden: Help-Seeking for Mental Distress Among Suicidal Male Secondary School Students in Aotearoa. An Analysis of Large-Scale Survey Data

Background: Adolescent males in Aotearoa report high rates of suicidal ideation and attempts but limited help seeking. The extent to which suicidal males access school based and other help is poorly understood. Aims: To explore help seeking, characteristics associated with help seeking difficulties and barriers to help among males who reported suicide ideation and or attempts ('suicidality').

Methods: Secondary data analysis from the Aotearoa Youth19 Rangatahi Smart Survey and affiliated School Health Services Leader Questionnaire. I analysed mental health help-seeking in the last 12 months from school and other sources, among adolescent males (n=3466). Primary analyses were for males reporting any suicidality (n= 545). Secondary analyses were for males reporting suicide attempts (n= 145). Results: 16.5% of adolescent males reported suicidality with higher prevalence among Māori (18.5%) and Pasifika (18%), those with depressive symptoms (56.8%), from high deprivation neighbourhoods (18.9%) and low decile schools (18.7%), and those experiencing frequent bullying (36.6%) or recent ethnic discrimination (25.9%). Most suicidal males (73.4%) sought help from their peers rather than formal sources (21.7%). In-school help-seeking was low (19%) but higher for those with depressive symptoms (22%), and exposure to frequent bullying (32.1%). Many suicidal males (37.6%) reported difficulties getting help, and commonly reported self-reliance (45.9%), and embarrassment (40.6%) as barriers to accessing help. Conclusion: It is crucial for those invested in enhancing adolescent wellbeing to explore avenues through which help is extended to suicidal males who do not seek professional assistance. Exploring pathways including through peers, family and active outreach should be prioritised.