More than loneliness: Why older men may be more vulnerable to suicide

From retirement and declining health to shrinking social circles, older men can face a combination of life changes that experts say may increase their vulnerability to suicide.

SINGAPORE: Day after day, it was the same routine for him after he retired. A swim each morning and watching television for the rest of the day.

Occasionally, he would bring his prized birds to a pet shop in Clementi, where he chatted with fellow bird enthusiasts over coffee.

“I think he felt that life in Singapore was very monotonous,” Joseph, his son, told CNA.

"He just kept saying there was nothing to do," he added.

At 85, Joseph’s father died by suicide.

Joseph's father was among a group that experts said deserves greater attention: older men.

According to Singapore’s latest suicide statistics released by the Samaritans of Singapore (SOS), older men accounted for three in four suicides among those aged 60 and above in 2024. Of the 120 deaths in that age group, 90 were men and 30 were women.

Across all age groups, men accounted for nearly two-thirds of the 441 suicide deaths recorded that year. Provisional data for 2025 show a similar proportion.

Experts say vulnerability in later life often stems not from a single event, but from a combination of life transitions - retirement, declining health, shrinking social circles and a reluctance to seek help.

WHEN WORK BECOMES IDENTITY

For many older men, work is closely tied to their sense of self.

Professor Paulin Straughan, director of the Centre for Research on Successful Ageing and sociology professor from the Singapore Management University, said traditional gender roles meant that many men devoted themselves almost entirely to paid work.

Over time, work became most men’s “total self”, Prof Straughan said.

“They are so overcompensated in their commitment to paid work that they leave insufficient time for building social networks,” she added.

The consequences often become apparent after retirement, when men whose lives have revolved around work suddenly lose the routines, structure and identity their careers once provided.

“If you don't spend time that is for nurturing your own hobbies, nurturing relationships, you're going to face an empty four walls when you retire because you didn't invest right in that preparation for retirement,” Prof Struaghan said.

Retirement is not just the loss of a job. For many older men, it can also feel like the loss of their role within the family.

Associate Professor Dr Helen Ko, a gerontologist from the Singapore University of Social Sciences (SUSS), said many older men were raised to see providing as their primary responsibility.

"There are a lot of men who tend to be expected to put food on the table, to be the breadwinner, to support the family," she said.

As a result, no longer working can affect their self-esteem and self-worth.

But experts said retirement does not have to mean losing one’s purpose.

Ms Loh Yan Zhu, head of programme for counselling and coaching at the Tsao Foundation, encourages older men to find meaning in life after retirement.

"One important shift we encourage is moving from being the family's material provider to becoming an emotional provider," said Ms Loh.

"While they may no longer support the household financially in the same way, they retain a vital role in offering encouragement, sharing life experiences, and strengthening family bonds,” she said.

PHYSICAL HEALTH TAKES ITS TOLL

For many older adults, growing older also means coping with chronic illness, pain and declining mobility. Beyond the physical challenges, experts said losing independence can erode a person's sense of purpose and control over their own life.

Dr Surej John, senior consultant and head of psychiatry at Khoo Teck Puat Hospital (KTPH), said that declining physical health is an important risk factor for suicide in later life, though it is rarely the sole cause.

"Chronic pain, disability, frailty, sensory impairment and progressive illnesses can lead to loss of independence, social isolation and a diminished sense of purpose," he said.

When physical illness is accompanied by depression, loneliness, bereavement or financial stress, suicide risk can increase significantly.

“The focus should therefore be on the whole person - not just the medical condition, but also how they are coping emotionally and socially,” said Dr John.

Dr Lim Boon Leng, a psychiatrist at Gleneagles Hospital, added that physical illness can also bring fears of becoming dependent on others.

"A man who says, 'I do not want to be a burden' or 'there is no point carrying on', may be expressing depression or suicidal thoughts, rather than merely commenting on his physical condition,” Dr Lim said.

“Research has consistently linked functional disability and several physical illnesses with suicidal behaviour, while loneliness and social isolation can further compound the risk”, he said.

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  ## SHRINKING SOCIAL WORLD

Strong social connections can help older adults cope with retirement, declining health and other life changes.

But many older men have relatively small social networks, making them more vulnerable to social isolation, said SOS deputy director Charlene Heng.

"What really makes it more tough compared to women is the social connection that is probably slightly more lacking,” said Ms Heng, adding that the latest statistics are a reminder that Singapore's population is ageing.

“Women are more socially connected and more willing to seek help,” she said.

Ms Heng said that many men's social networks are built around the workplace. But after retirement, those connections often fade if they are not intentionally maintained, leaving some older men increasingly isolated.

Loneliness is not just about living alone.

After retirement, Joseph's father lived with him, while his mother stayed with another son to help care for their grandchildren.

Outside his daily routine, he rarely socialised.

“Maybe he felt isolated. He didn't have a strong support system,” said Joseph, who only wants to be known by his first name.

Father and son spent most of their time together quietly watching television.

Joseph also encouraged his father to join activities at the community centre, such as karaoke or chess, in the hope that he would make new friends. But his father always declined.

“He was reserved, like a quiet man,” Joseph said. “He just wasn’t interested and didn't feel comfortable meeting new people.”

Experts said Joseph's father's experience illustrates a common misconception: that older adults who live with their families are protected from loneliness.

Ms Loh from Tsao Foundation said that the organisation is increasingly supporting older men who live with their families but still experience “emotional distress, role uncertainty and a deep sense of disconnection”.

She said: “A common misconception is that physical proximity equals emotional connection - that if an older man lives with his family, he is naturally protected from loneliness.

“In reality, living under the same roof without meaningful engagement can leave someone feeling isolated, unheard, or like an invisible burden.”

DEPRESSION CAN HIDE IN PLAIN SIGHT

Even when older men are struggling emotionally, the signs are not always obvious.

Dr Swapna Verma, chairman of the medical board at the Institute of Mental Health (IMH), said older men may also be less likely to talk openly about feeling low.

“Many men in this age group grew up in a generation where gender stereotypes and expectations of masculinity discouraged showing vulnerability,” Dr Verma said.

Dr Nur Farhan Alami, a geriatrician and founder of Alami Clinic, said untreated depression remains the biggest risk factor for suicide. Yet many older adults do not describe themselves as depressed.

Instead, they may lose their appetite, have trouble sleeping or appear forgetful.

Older people have “atypical presentations”, Dr Farhan said. “They may just have a lot of physical symptoms, but there's actually nothing physically wrong.”

They are just depressed, she said.

In some cases, depression can even resemble dementia.

Dr Farhan said older adults who suddenly appear forgetful or undergo a marked personality change may actually be experiencing "pseudodementia", where underlying depression affects concentration.

She recalled treating a senior who forgot the route home from a train station after years of walking it. His family feared he had dementia.

But after assessing him, Dr Farhan found that he was “deeply depressed” after coming under pressure from a new boss at work and had been unable to express what he was going through to his family.

Seeking help early and receiving treatment for depression, along with access to appropriate support and resources, can be protective against suicide, Dr Farhan said.

WARNING SIGNS

SOS’ Ms Heng said detecting warning signs can also be “particularly hard” for older men since some naturally prefer solitary activities or live alone, making it harder to tell when they are intentionally withdrawing from others.

People should also take suicidal comments seriously.

"There's no meaning in life. What's the point of living since I'm so old already? I'm useless," she said, citing examples of verbal warning signs that older adults may express.

They may also give away prized possessions, search for painless ways to die, withdraw from social interactions or stop responding to phone calls and messages.

An increase in substance use, such as alcohol, can also signal heightened risk and is more commonly observed in men, she added.

Dr Verma said the signs of depression or emotional distress in older adults are often similar to those seen in younger people, including social withdrawal, loss of interest in usual activities, changes in sleep pattern or appetite, low energy, or a noticeable behaviour change.

“The challenge is that these signs can be easy to dismiss,” Dr Verma said.

These warning signs are often dismissed as a normal part of ageing or attributed to life circumstances rather than signs that someone may be struggling.

Families may wrongly assume an older person simply prefers to keep to themselves or has less energy than before.

"Asking direct, caring questions about how they are coping, or whether they are feeling down, can help identify problems that might otherwise go unnoticed," she said.

Dr John from KTPH said that interactions with healthcare professionals provide opportunities to identify those who may be struggling.

“Every consultation is an opportunity to assess not only physical health but also emotional well-being,” he said.

Healthcare professionals should be alert to warning signs, which include poor self-care, repeated emergency attendances, medication non-adherence or expressions such as "I'm a burden" or "there's no point anymore”.

“Early recognition and timely referral can make a significant difference,” Dr John said.

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  ## WHAT CAN BE DONE

If older men experience emotional distress differently, experts said support must also be offered differently.

The pattern is reflected in SOS’s data. While women accounted for about one-third of suicide deaths in 2024, they made up 62.5 per cent of suicide-related calls and texts received by the organisation.

SUSS’ Dr Ko said outreach efforts should be designed around how men naturally build relationships.

"Women talk face to face but men talk shoulder to shoulder," she said, explaining that men often connect through shared activities rather than conversations.

Rather than expecting men to join traditional support groups, she said programmes centred on practical activities may feel more natural, allowing friendships and trust to develop over time.

Dr Ko pointed to the Men's Shed model as an example where older men meet regularly to work on practical projects and spend time together.

She said similar approaches could help reduce loneliness by creating opportunities for men to connect in ways they find more comfortable.

Ms Jennie Wan, director of mental health at Montfort Care, said her organisation has found that activity-based and skills-based programmes such as bike repair, carpentry workshops and social darts resonate more with older men.

"These give older men the chance to learn or apply practical skills, stay active, and share their knowledge and experience with others, including opportunities to mentor younger community members," said Ms Wan.

"What we noticed is that engagement improves significantly when men feel they're contributing rather than simply receiving help. It gives them a sense of purpose and camaraderie, which makes them far more likely to keep coming back."

Beyond community programmes, families also have a role to play.

Families should recognise that an ageing father or grandfather can feel profoundly lonely even when he is surrounded by people, said Gleneagles’ Dr Lim.

“Reaching him may require patience rather than interrogation, and empathy rather than immediate advice,” he said.

“Take the time to draw him into conversation, understand what he has lost, and help him feel that he remains valued, needed and connected to the family.”

Looking back, Joseph believes seniors need more reasons to stay engaged with life.

"You have to keep yourself busy,” he said. "You have to walk around, mix around friends ... you explore, you meet new people."

Where to get help:

National mental health helpline: 1771

Samaritans of Singapore Hotline: 1767

Singapore Association for Mental Health Helpline: 1800 283 7019

You can also find a list of international helplines here. If someone you know is at immediate risk, call 24-hour emergency medical services.