Suicide: Lessons from the tragic death of Shane Tuck

shane tuck suicide

Michael Tuck is one of my heroes.  A seven-time premiership-winning legend of the Hawthorn Football Club who played a record four hundred and twenty-six (426) senior games for the club between 1971 and 1991. He is also a father that recently lost a son, Shane Tuck — an AFL legend in his own right — to suicide from the impact of mental illness.

No parent should ever have to bury their child and no family should have to endure the gut-wrenching pain and anguish that comes from losing a loved one to suicide stemming from the darkness[1] — the black dog[2]— the mental illness commonly known as depression. Yet they do so with such regularity and a level of predictability that is frightening.

Will it ever stop?

The stats

There is no escaping the numbers.

Globally, while females are more likely than males to experience depression and anxiety[3], the incidence of men committing suicide is disproportionately higher[4].  In fact, men in Australia are three (3) times more likely to die by suicide than women[5] which is significantly higher than the global average[6].

The stark reality is that every day in Australia, six (6) men die by suicide[7] and there is evidence to suggest that they are far less likely to seek help for mental health conditions than women.

Men seeking help

The 2007 National Survey of Mental Health and Wellbeing study found that only 27.5% of males with a mental disorder and recent symptoms had accessed services for their mental health problems compared with 40.7% of females.[8]

Michael Tuck is quoted[9] as saying that:

‘A lot of men think they’re all right and they’re actually not, and the best help they can get is telling people actually how bad they are, and not saying, ‘I’m all right, I’m all right.’

MICHAEL TUCK

Another AFL great, mental health sufferer and advocate, Danny Frawley[10], once observed[11] that:

‘Manning up in the past was to suffer in silence, manning up now is to put your hand up.’

DANNY FRAWLEY

These observations highlight a general unwillingness of men to discuss their problems and represent one of the most significant reasons for the disparity that exists for men vis-à-vis the incidence of depression and suicide. The other significant contributor to this disparity is the social stigma which attaches to mental illness and suicide.

Stigma

Stigma is a significant issue in mental health: it lowers people’s self-esteem, makes symptoms more severe and limits help-seeking behaviours.[12]

One of the most common fallacies regarding depression, and a significant source of stigma, is that mental health problems are caused by personal weaknesses. Yet there are no shortages of examples of high-profile people, including sporting stars — people that society regards as strong, courageous, robust, and almost unstoppable — that have suffered and fallen victim to the impact of the illness.

Australian society idolises their sporting stars, often with good reason. They are the elite, a cut above the rest, the chosen few and representative of the values that define us as a nation – grit, determination, and a commitment to never giving up no matter the adversity.

Shane Tuck was a sporting star — a “tough midfielder”[13] — that typified the characteristics of a true champion. He was admired, respected, and loved by teammates, family, friends, and fans alike. But he was also human and susceptible, as we all are, to the inherent frailties that come with that and the complexities that pervade depression as a disease and recognised illness.

In a previous blog, I stated that ‘stigma will always exist for as long as you have ignorant, prejudiced, and poorly behaved people in the world.[14]‘ Communication is one thing and vital but to be truly effective – to encourage men to speak up more – the stigma must be consigned to history.

Beyond Blue report that the two most effective approaches to reducing stigma are education and contact (including personal contact with people with depression and anxiety).[15]  There is no doubt that depression and suicide are uncomfortable subjects to talk about and are often avoided, perhaps partly due to the inherent complexities of the illness.

Depression is complex

Depression is a complex condition. Its causes are not fully understood[16], remain mostly unknown,[17] and vary according to individual circumstances.[18] Research suggests that depression may result from a complex interaction of social, psychological, environmental, and biological factors[19] (including genetics).[20] These factors influence the prevalence[21] of depression, evidencing the existence of some common trends among countries globally.[22]

Although the exact reasons why depression manifests are unclear,[23] risk factors are well- known.[24] For example, people who have gone through adverse life events (unemployment, bereavement, psychological trauma) are more likely to develop depression[25] and potentially contemplate suicide.

While the reasons for people experiencing depression and its incidence vary, it does not discriminate.[26] It does not matter how old you are.[27] A woman or a man.[28] Married or single. An adult or a child.[29] Nor does it care where you live,[30] what you do for work, where you went to school, college or university,[31] where you come from,[32] or whether you are rich, poor, famous or infamous (or a combination of these).[33]

It follows that we should not be at all surprised that depression will make an appearance in our lives, or the life of someone we know, at some time during our existence on the planet.

We are all vulnerable.

The full-time siren – the important message

Today, information may be accessed faster and more reliably than at any other time in history. There is a plethora of it available at our disposal, and it is easy to obtain. There is, therefore, no plausible excuse for not seeking to know something about depression and suicide prevention. Educating ourselves about these topics and, if circumstances permit, having a conversation with someone suffering, or that has suffered, from the illness facilitates understanding and is a good place for us all to start.

Lives depend on it.

It is entirely fitting and appropriate that the final words on this subject, at least for the present purposes, and a parting message to all men, are left to Michael Tuck[34] – may Shane Tuck rest in peace:

‘It’s not a weakness, it’s just to express yourself with honesty and don’t try to cover up things.’

MICHAEL TUCK

© 2020. Robert Nicholls. All Rights Reserved.

Featured image: Michael Hahn / Shutterstock.com


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NOTES

[1] Leonard Cohen referred to the illness as the ‘darkness’ in his song by the same name released in 2012.

[2] This was the term Winston Churchill purportedly used to describe his own depression, https://www.blackdoginstitute.org.au/.

[3] In all countries, the median estimate for the prevalence of depression is higher for women than for men. For example, Australia (M: 3.64%, F: 5.57%); Canada (M: 2.98%, F: 4.95%); New Zealand (M: 3.21%, F: 4.68%); United Kingdom (M: 3.29%, F: 4.12%); United States (M: 3.53%, F: 6.09%); World (M: 2.73%, F: 4.12%). Source: Ritchie, H. and Roser, M. (2020). Mental health. Published online at OurWorldInData.org. Retrieved on 16 April 2020 from https://ourworldindata.org/mental-health [online resource]; Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2017 (GBD 2017). Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME).

[4] ABS National Survey of Mental Health and Well-Being: Summary of Results, 2007 (2008), p.27. See also Source: Ritchie, H. and Roser, M. (2020). Mental health. Published online at OurWorldInData.org. Retrieved on 16 April 2020 from https://ourworldindata.org/mental-health [online resource]; Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2017 (GBD 2017). Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME).

[5] Australian Bureau of Statistics (2019). Causes of Death, Australia, 2018: Intentional self-harm, key characteristics, cat. no. 3303.0.

[6] In 2017, World (M: 13.89 deaths per 100,000, F: 6.28 deaths per 100,000); Australia (M: 17.35 deaths per 100,000; F: 4.97 deaths per 100,000). Source: Ritchie, H. and Roser, M. (2020). Mental health. Published online at OurWorldInData.org. Retrieved on 16 April 2020 from https://ourworldindata.org/mental-health [online resource]; Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2017 (GBD 2017). Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME).

[7] Australian Bureau of Statistics (2019). Causes of Death, Australia, 2018: Intentional self-harm, key characteristics, cat. no. 3303.0.

[8] 4326.0 ABS National Survey of Mental Health and Well-being: Summary of Results, 2007 (2008), p.44.

[9] Michael Tuck, ABC News, 22 July 2020, Shane Tuck’s father Michael urges men to talk about their mental health after former Richmond player’s death, retrieved on 24 July 2020 from https://www.abc.net.au/news/2020-07-22/shane-tuck-father-michael-former-richmond-player-mental-health/12479298

[10] Danny Frawley was killed tragically in a car accident on 9 September 2019. He was just 56 years old.

[11] SBS News Australia (2019). ‘Seek help’: Wife of Danny Frawley makes emotional statement about mental health, 16 September 2019. Retrieved on 27 July 2020 from: https://www.sbs.com.au/news/seek-help-wife-of-danny-frawley-makes-emotional-statement-about-mental-health  

[12] Sastre, R.M., et al. (2019). Instruments to assess mental health-related stigma among health professionals and students in health sciences: a systematic psychometric review. Journal of Advanced Nursing; 75: 9, 1838-1853.

[13] The Age (2020). ‘A really good friend’: Tigers mourn Shane Tuck, 20 July 2020. Retrieved on 26 July 2020 from: https://www.theage.com.au/sport/afl/former-richmond-player-shane-tuck-dies-aged-38-20200720-p55ds6.html

[14] Nicholls, R. (2020). Mental health stigma – it’s everywhere!, 22 June 2020, at https://robertnicholls.online/mental-health-stigma-its-everywhere/

[15] Beyond Blue Ltd, Information Paper – Stigma and discrimination associated with depression and anxiety, August 2015.

[16] Munro, M. and Milne, R. (2020). Symptoms and causes of depression, and its diagnosis and management. Nursing Times [online], vol. 116, no. 4, pp. 18-22. Retrieved on 9 April 2020 from https://www.nursingtimes.net/roles/mental-health-nurses/symptoms-and-causes-of-depression-and-its-diagnosis-and-management-30-03-2020/.

[17] Dr Grohol, J. M. (2016). Depression, 27 January 2020. Retrieved on 23 April 2020 from https://psychcentral.com/depression/.

[18] Norman, I. and Ryrie, I. (2018). The art and science of mental health nursing: Principles and practice. London: Open University Press. See also, Munro, M. and Milne, R. (2020). Symptoms and causes of depression, and its diagnosis and management. Nursing Times [online], vol. 116, no. 4, pp. 18-22. Retrieved on 9 April 2020 from https://www.nursingtimes.net/roles/mental-health-nurses/symptoms-and-causes-of-depression-and-its-diagnosis-and-management-30-03-2020/.

[19] World Health Organization (2020). Depression fact sheet. Retrieved on 9 April 2020 from https://www.who.int/news-room/fact-sheets/detail/depression; Australian Health Ministers (2009). Fourth National Mental Health Plan – an agenda for collaborative government action in mental health 2009-2014. Retrieved on 16 April 2020 from http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-f-plan09-toc; Munro, M. and Milne, R. (2020). Symptoms and causes of depression, and its diagnosis and management. Nursing Times [online], vol. 116, no. 4, pp. 18-22. Retrieved on 9 April 2020 from https://www.nursingtimes.net/roles/mental-health-nurses/symptoms-and-causes-of-depression-and-its-diagnosis-and-management-30-03-2020/.

[20] Elwood, J. et al. (2019). A systematic review investigating if genetic or epigenetic markers are associated with postnatal depression. Journal of Affective Disorders, vol. 253, pp. 51-62. However, it must be noted that there is no one gene linked to depression: Munro, M. and Milne, R. (2020). Symptoms and causes of depression, and its diagnosis and management. Nursing Times [online], vol. 116, no. 4, pp. 18-22. Retrieved on 9 April 2020 from https://www.nursingtimes.net/roles/mental-health-nurses/symptoms-and-causes-of-depression-and-its-diagnosis-and-management-30-03-2020/.

[21] Research has demonstrated that age, gender, education level, employment status and stage of the life-cycle are individual factors which may influence the prevalence of depression and, in terms of gender, the incidence of suicide from country to country, region to region: Ritchie, H. and Roser, M. (2020). Mental health. Published online at OurWorldInData.org. Retrieved on 16 April 2020 from https://ourworldindata.org/mental-health [online resource].

[22] In all countries, the median estimate for the prevalence of depression is higher for women than for men. For example, Australia (M: 3.64%, F: 5.57%); Canada (M: 2.98%, F: 4.95%); New Zealand (M: 3.21%, F: 4.68%); United Kingdom (M: 3.29%, F: 4.12%); United States (M: 3.53%, F: 6.09%); World (M: 2.73%, F: 4.12%). Source: Ritchie, H. and Roser, M. (2020). Mental health. Published online at OurWorldInData.org. Retrieved on 16 April 2020 from https://ourworldindata.org/mental-health [online resource]; Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2017 (GBD 2017). Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME).

[23] Munro, M. and Milne, R. (2020). Symptoms and causes of depression, and its diagnosis and management. Nursing Times [online], vol. 116, no. 4, pp. 18-22. Retrieved on 9 April 2020 from https://www.nursingtimes.net/roles/mental-health-nurses/symptoms-and-causes-of-depression-and-its-diagnosis-and-management-30-03-2020/.

[24] WHO (2012). Risks to mental health: An overview of vulnerabilities and risk factors; Ritchie, H. and Roser, M. (2020). Mental health. Published online at OurWorldInData.org. Retrieved on 16 April 2020 from https://ourworldindata.org/mental-health [online resource].

[25] World Health Organization (2020). Depression fact sheet, 30 January 2020. Retrieved on 9 April 2020 from https://www.who.int/news-room/fact-sheets/detail/depression.

[26] Munro, M. and Milne, R. (2020). Symptoms and causes of depression, and its diagnosis and management. Nursing Times [online], vol. 116, no. 4, pp. 18-22. Retrieved on 9 April 2020 from https://www.nursingtimes.net/roles/mental-health-nurses/symptoms-and-causes-of-depression-and-its-diagnosis-and-management-30-03-2020/; World Health Organization (2020). Depression fact sheet, 30 January 2020. Retrieved on 9 April 2020 from https://www.who.int/news-room/fact-sheets/detail/depression; Ritchie, H. and Roser, M. (2020). Mental health. Published online at OurWorldInData.org. Retrieved on 16 April 2020 from https://ourworldindata.org/mental-health [online resource].

[27] Ritchie, H. and Roser, M. (2020). Mental health. Published online at OurWorldInData.org. Retrieved on 16 April 2020 from https://ourworldindata.org/mental-health [online resource].

[28] Ibid.

[29] Kessler, R.C. and Bromet, E.J. (2013). The epidemiology of depression across cultures. Annual Review of Public Health, no. 34, pp. 119-138.

[30] Ritchie, H. and Roser, M. (2020). Mental health. Published online at OurWorldInData.org. Retrieved on 16 April 2020 from https://ourworldindata.org/mental-health [online resource].

[31] Ibid.

[32] Ibid.

[33] Hoebel, J. et al. (2017). Social inequalities and depressive symptoms in adults: The role of objective and subjective socioeconomic status. PLoS ONE, vol. 12, no. 1, e0169764.

[34] ABC News Australia (2020). Shane Tuck’s father Michael urges men to talk about their mental health after former Richmond player’s death, 22 July 2020. Retrieved on 27 July 2020 from: https://www.abc.net.au/news/2020-07-22/shane-tuck-father-michael-former-richmond-player-mental-health/12479298

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