In most developed countries, death by suicide is more common in males than females, at around a three times higher rate (Lengvenyte et al, 2021; Turecki et al, 2019; Fazel et al, 2020). Despite the disparity in rates of suicide, research and subsequent interventions have not led to significant advancements in the ability to predict suicide, nor adequately intervene.
A review of qualitative studies from Bennett et al (2023, previous Mental Elf blog) highlighted that understanding masculine norms may be a key factor in male suicide prevention. Within this, interpersonal disconnection, isolation and loneliness, and interpersonal challenges and dysregulation were highlighted as key themes that had been reported throughout the literature. Many of these related to relationship troubles or breakdowns. A second systematic review, exploring these associations quantitatively, had similar findings (Richardson et al, 2021, previous Mental Elf blog) suggesting the absence or breakdown of a romantic relationship may be a risk factor for future suicide risk.
This blog summarises a recent systematic review (Wilson et al, 2025) aiming to synthesise evidence on associations between relationship breakdowns and the risk of suicidal ideation, suicidal attempt and death by suicide in men.
Could relationship breakdowns be a risk factor for suicide in men?
Methods
The authors used several databases (APA PsycInfo, Embase, MEDLINE, CINAHL, Scopus, Web of Science, ProQuest Central) to search for papers investigating suicidal ideation, attempted suicide or death by suicide in men following a relationship breakdown. Wilson et al searched for papers after the year 2000 to explore contemporary evidence. Searches were updated in October 2023 to ensure evidence was up to date.
Studies were included if they met the following eligibility criteria:
- Were of any methodological method or study design conducted in any country
- Were conducted in men (inclusive of transgender men) or had gender specific analyses
- Reported associations between indicators of relationship breakdown and suicidal ideation, suicide attempt, or death by suicide
- Were published in a peer-reviewed journal in English (unpublished literature not included in review)
Two tools were used to assess the quality of the studies included; one for quantitative methods (National Heart Lung and Blood Institute) and the other for qualitative studies (Critical Appraisal Skills Programme). Full-text screening, data extraction and study quality were performed by one author only, with dual screening conducted for 30% of the total records at the title and abstract level. Authors of each paper were contacted to establish eligibility or provide additional data, where necessary.
Three separate random-effects meta-analyses were conducted, one for each outcome (lifetime suicidal ideation, lifetime suicidal attempt, death by suicide). A number of sub-group meta-analyses were also performed. Narrative synthesis was also used to describe the studies, as well as possible moderating variables investigated in the studies.
The review followed relevant reporting guidelines and the protocol was preregistered on PROSPERO (CRD42022360410).
Results
75 studies (population = 106,719,740) met inclusion criteria, with 29 studies (population 103,732,942) having sufficient data to be included in the meta-analysis. Studies were mostly cross-sectional (43%) and utilised quantitative methods (93%). Findings from each meta-analysis can be seen in the table below:
| Outcome | Number of studies (effect estimates) | Results |
| Suicidal Ideation | 5 (7) | Separated or divorced men were 1.64 times more likely to report suicidal ideation relative to married men.
Pooled odds of suicidal ideation among separated/divorced men in Asian cultures did not differ significantly from separated/divorced relative to married men in Western cultures. |
| Suicidal attempt | 8 (8) | Divorced men were 1.73 times more likely to attempt suicide relative to married men.
When looking at studies that combined divorced men and separated men, there was weak evidence that the pooled odds of lifetime suicide attempt increased compared to married men. Whilst there was strong evidence for association when examining unadjusted estimates, there was weak evidence for associations when including just estimates with adjustment for sociodemographic variables and at least one indicator of psychiatric morbidity with odds attenuated towards the null. Odds of suicide attempt among separated/ divorced versus married men did not differ between Asian and Western cultures. |
| Death by suicide | 22 (56) | Divorced men were 2.82 times more likely to die by suicide than married men.
In comparison to married men, younger divorced men were more likely to die by suicide than older divorced men. Adjusting for a range of confounders attenuated the associations for divorced men versus married men. Divorced men in Asian cultures were 4.18 times more likely to die by suicide than married men, greater than those of divorced men in Western cultures, who had 2.56 times greater odds of suicide. Separated men were 4.82 times more likely to die by suicide relative to married men. Younger separated men (≤34 years) exhibited over eight times the odds of suicide relative to their married counterparts. Separated men were 1.96 times more likely to die by suicide relative to divorced men. |
Additionally, younger age (≤34 years), less than tertiary education, and lack of employment; the recency of relationship breakdown; and psychological factors including loneliness and isolation, preexisting mental illness and underlying vulnerabilities, and shame and emotion dysregulation were found to be possible moderating factors of the associations in some of the studies the authors identified.
The available evidence suggests relationship breakdowns are associated with suicidal behaviours in men.
Conclusions
The authors conclude that:
This study solidifies intimate relationship breakdown as a clear vulnerability marker for suicide in men. Subgroups of men navigating relationship distress and dissolution appear to experience a disproportionate likelihood of suicide, particularly younger and acutely separated men, alongside divorced men in Asian culture.
They add that:
Ultimately, the end of a relationship should never mean the end of life, and the normative inevitability of relationship breakdown demands attention as an all too-common circumstance of suicides among men.
The end of a relationship should never mean the end of a life.
Strengths and limitations
One of the major strengths of this review is that they conducted a meta-analysis to synthesise the study findings, and that they did this for a number of different sub-groups, although some did have limited numbers, reducing the robustness of the evidence.
Likewise, a strength of this review is that it includes papers of all methodology types, and does not limit to specific geographic regions. However, it does restrict to studies only written in English. Suicide rates are highest in low- and middle- income countries (World Health Organisation, 2025), where English is less likely to be spoken, and by limiting to studies in English, it is likely papers have been missed from countries where the burden of suicide is highest. The vast majority of studies included in this review are from high-income countries; this may also be due to a lack of evidence available. Whilst not a limitation of the review but of the available evidence, there were few studies included on transgender men, and the role relationship breakdowns play in suicidal behaviors in this population.
In addition, only one author conducted the majority of the screening and extracting processes; it is recommended that two reviewers do this to ensure all possible studies are included. Because of this, some studies may have been missed.
The review mostly includes studies from high-income countries, limiting the generalisability of these findings to other settings.
Implications for practice
This review has highlighted the increased risk of suicidal behaviours in men following a relationship breakdown, suggesting it could be an area for intervention development and implementation. The authors offer implications for suicide prevention and future research.
However, whether population-based approaches should be designed to focus on men in the whole population after they have suffered a relationship breakdown is questionable. How would they be identified? How would they be targeted? And would the benefit outweigh the inevitable cost of this approach?
Instead, developing skills and promoting coping mechanisms and resilience for challenging aspects of life could aid in suicide prevention after a relationship breakdown, but also after many other significant life events. This could be offered via school-based educational programmes.
The review also suggests normalising healthy adjustment to relationship breakdown among men could be achieved by public health campaigns, as well as improving help-seeking behaviours in this population. If men do seek help post relationship breakdown, clinicians and other healthcare providers should be aware the risk this has for suicidal behaviours, and clinical interventions could be developed for these instances.
In terms of future research, the authors suggest further exploring the moderating effects of different variables, both quantitatively and qualitatively. This would allow for the identification of specific groups of men most at risk following a relationship breakdown, indicating groups that could be targeted via interventions. The need for longitudinal data to explore these interactions quantitatively is highlighted, alongside the need for qualitative studies to understand the complexity and variability of the research question. In addition, there was a clear lack of evidence (either due to availability or via the search strategy) from low- and middle-income countries. The impact of relationship breakdowns may be amplified in these countries as divorce and relationship breakdowns are often more stigmatised e.g. it is illegal in the Philippines, or due to greater financial insecurity in these settings, meaning the breakdown has greater practical and emotional consequences. Stigma of mental health problems may further reduce help-seeking behaviour in men highlighting the need for culturally-sensitive interventions.
How will men experiencing a relationship breakdown be identified and targeted in whole-population approaches? Instead, we should focus on fostering resilience which can help buffer the effects of a relationship breakdown as well as other distressing life events.
Statement of interests
No conflicts of interest.
Links
Primary paper
Wilson, M. J., Scott, A. J., Pilkington, V., Macdonald, J. A., Rice, S. M., Oliffe, J. L., & Seidler, Z. E. (2025). Suicidality in men following relationship breakdown: A systematic review and meta-analysis of global data. Psychological Bulletin.
Other references
Bennett, S., Robb, K. A., Zortea, T. C., Dickson, A., Richardson, C., & O’Connor, R. C. (2023). Male suicide risk and recovery factors: A systematic review and qualitative meta-synthesis of two decades of research. Psychological Bulletin, 149(7-8), 371–417.
Critical Appraisal Skills Program. (2018). CASP qualitative checklist. https://casp-uk.net/casp-tools-checklists/qualitative-studies-checklist/
Fazel, S., & Runeson, B. (2020). Suicide. The New England Journal of Medicine, 382(3), 266–274.
Lengvenyte, A., Conejero, I., Courtet, P., & Olié, E. (2021). Biological bases of suicidal behaviours: A narrative review. European Journal of Neuroscience, 53(1), 330–351.
National Heart Lung and Blood Institute. (2021). Study quality assessment tools. https://www.nhlbi.nih.gov/health-topics/study-quality-assessmenttools
Richardson, C., Robb, K. A., & O’Connor, R. C. (2021). A systematic review of suicidal behaviour in men: A narrative synthesis of risk factors. Social Science & Medicine, 113831.
Turecki G, Brent DA, Gunnell D, et al. Suicide and Suicide Risk. Nature Reviews Disease Primers 2019 5:1. 2019;5(1):1-22
World Health Organisation. (2025). Suicide. https://www.who.int/news-room/fact-sheets/detail/suicide
