We need to move beyond just awareness to address male suicide

September is Suicide Prevention Awareness Month, and the statistic that will be repeated most often is that men account for nearly 80% of suicides in the United States. That number is now widely known. What is much less clear, to advocates and state officials alike, is what a government is supposed to do with it.

Maryland is a working example of how a governor’s voice created room for programming, how that programming supported institutional commitments, and how those commitments made upstream regulatory action easier to defend. This is a model other states can borrow and build upon.

What the headline number leaves out

A great deal has been done to raise awareness of male suicide in recent years, but awareness alone is not a solution. The four-in-five figure has also become a talking point, and in some hands it gets used as a grievance rather than as a policy problem. It hides a second pattern that matters more for designing programs.

Women and girls attempt suicide at substantially higher rates than men and boys. In the most recent National Youth Risk Behavior Survey, 8% of female high school students reported an attempt in the past year, compared with 5% of male students. Maryland’s own Youth Risk Behavior Survey and Youth Tobacco Survey shows the same pattern, with female students significantly more likely than male students to report persistent sadness or poor mental health. Both things are true at the same time. Girls and women report more distress and attempt more often, and men and boys die more often, largely because of the lethality of the means they use.

This does not mean one group deserves more attention than the other. It means the two patterns point to different places to intervene. A response built around distress that gets expressed, disclosed, and brought to a provider will not reach a population that expresses less, discloses later, and often never gets to a provider at all. That is a question about how services are designed, not a question about who is suffering more, and arguing about the latter is much of what has kept this conversation stuck.

Creating the permission space

Governor Wes Moore has spent the past year putting his own voice behind male mental health. He signed a proclamation recognizing Men’s Health Month in June. In July, he published an op-ed in STAT News arguing that men’s health is about more than clinical care, and that upstream factors like the share of male teachers and men’s participation in national service belong in the same conversation as crisis response. He signed a proclamation for Suicide Prevention Awareness Month that specifically named the needs of men and boys.

Listed out like that, these look like symbolic acts. What they actually do is create the permission space for the work that follows. When the governor says it out loud, staff can prioritize work that has historically been taboo or underdiscussed. Most of what I discuss later in this piece was easier to authorize because of the governor’s public commitments. That is where the less newsworthy, yet equally important work gets done.

Meeting boys and men where they are

One key aspect that permission bought was with the approach to the 988 Suicide and Crisis Lifeline. The Lifeline is one of the state’s most significant suicide prevention resources, and how much good it does depends on whether the people least likely to ask for help know it is there. Maryland’s Behavioral Health Administration has expanded its 988 outreach strategy to include not only what is communicated, but where and how messages reach populations that may be less likely to seek help through traditional behavioral health channels. So the state has bought attention in the places where men and boys already are, such as sporting events and via video games.

This is ongoing work rather than a September campaign, which is what makes the partnerships possible in the first place. At the Ravens home opener, Governor Moore joined Movember, the leading international men’s health organization, to launch Supporting Young Men & Boys, a guide the Maryland Department of Health developed with the organization. It gives families, mentors, and community members practical information on recognizing distress, encouraging help-seeking, and connecting young men to support.

Later in September, Lt. Governor Miller joined the African American Male Wellness Agency and Movember to bring together roughly 300 Black men at M&T Bank Stadium for Real Men Real Talk, a conversation about mental health and help-seeking, as part of a three-day Baltimore Men’s Wellness Day offering free health screenings across the city. This work matters because 988 is only as effective as the continuum of care behind it, and recent research suggests a crisis line does only as much good as the services a caller can actually get to afterward.

Building something that lasts past the administration

Programming that depends on particular staff being enthusiastic about it tends to end when those staff move on, so part of the work is writing the focus into documents that outlast them.

The governor’s Commission on Suicide Prevention is finalizing its 2026–2028 State Plan, which identifies men and boys as a population warranting targeted prevention approaches and recognizes problem gambling and digital environments among emerging issues relevant to Maryland’s suicide-prevention landscape. State plans are not exciting documents. They are, however, what an agency points to when it needs to justify a budget line three years from now.

Maryland received an award from SAMHSA through the Garrett Lee Smith State and Tribal Suicide Prevention Program to support intervention and postvention work. The application intentionally addressed the differences in how men and women express suicidality, with that work plan now being finalized. Unlike a proclamation, federal grants commit states to specific activity for extended periods of time, with reporting attached, so the work survives a change in staff or leadership.

Upstream policy is mental health policy

Some of the state actions that look least related to suicide prevention are among the most important for young men’s mental health.

Maryland has moved aggressively on prediction markets. Maryland Lottery and Gaming Control Agency issued cease-and-desist orders to Kalshi, Robinhood, and Crypto.com in April 2025, finding their sports event contracts indistinguishable from sports wagering under state law. The governor has also barred state employees from betting on nonpublic government information. Although these regulatory actions were not undertaken solely as suicide-prevention measures, they intersect with a broader public-health concern: problem gambling is associated with significant behavioral-health harms, including elevated suicide risk. Roughly half of men aged 18 to 49 have an active betting account, 15% of Marylanders who bet on sports in the last year met the criteria for “disordered gambling,” and some studies suggest that one in five people with a gambling disorder attempt suicide.

The same logic applies to the Kids Code, effective October 2024, which requires online services likely to be accessed by minors to default to the highest privacy settings, avoid dark patterns, and refrain from data practices contrary to a child’s best interests. Maryland’s 2024-25 survey found most middle and high school students on social media multiple times a day. That finding is part of why the administration published the Digital Wellness Playbook with the Child Mind Institute, now in the curriculum with the Boys and Girls Clubs of Maryland and presented to youth stakeholders across the state.

What other states can use

For states thinking about similar work, the order of operations matters more than any single item on the list.

• Start with the governor’s voice. A public statement from the top turns targeted programming from a political risk into an administration priority, which is what can free up agency capacity.
• Follow the population. Reaching men who avoid clinical settings means buying attention at ballparks, on streaming platforms, in union halls, and at gaming conventions.
• Get it into the permanent documents. State plans and federal grant applications carry the focus forward past any one administration.
• Treat upstream regulation as prevention. Gambling and youth online safety policy reach the same population earlier.

Not every step requires creation of a new standalone program or appropriation; some can be integrated into existing grants, state plans, partnerships, regulatory authorities, and prevention infrastructure.

In 2024, Maryland registered one of the lowest suicide rates in the country, seventh lowest by age-adjusted rate according to the CDC, and that has been true for longer than this administration has been in office. It would be dishonest to attribute it to recent work. The more useful point is that a low rate does not sustain itself, and holding onto it takes real effort aimed at a population most systems miss.

What drives an individual to suicide is rarely reducible to a single answer, and there is a real limit to what any government can do. But the limit sits considerably further out than naming the problem, which is where much of this field has stopped. Awareness was once a genuine contribution. It is now the floor.

If you or someone you know is struggling, call or text 988 to reach the Suicide and Crisis Lifeline.

Disclosure: the author supports Maryland’s Young Men and Boys Initiative as a Senior Policy Fellow in the Governor’s Office for Children and sits on Maryland’s Governor’s Commission on Suicide Prevention.

Patrick Bourke

Patrick Bourke is a senior policy fellow at the American Institute for Boys and Men and serves in Maryland’s Governor’s Office for Children, where he works to address challenges facing young men and boys across the state.