Shared perceived causes of suicide among young men and violence against young women offer potential for co-designed solutions: intervention soft-modelling with fuzzy cognitive mapping

Figures & data

Figure 1. Combined fuzzy cognitive map of categories affecting suicide of young men and violence against young women.

Legend: Blue boxes correspond to categories which appeared only in the map of causes of suicide of men in Botswana. Yellow boxes are categories that appeared only in the map of violence against young women. The grey boxes in the middle are categories both maps shared. Black arrows correspond to relationships coming from shared categories to the two main outcomes, and grey arrows come and go from the rest.

Table 1. Reduction in the activation level of nodes in the maps with six theoretical scenarios for removing the causal categories appearing on maps of both outcomes

	% reduction of baseline activation of other nodes if:
	No family Issues	No alcohol or drug use	No conflict in relationships	No men’s insecurity	No culture of violence	No financial difficulties
Nodes only present on the map about causes of suicide among young men
Suicide of young men	3.0	1.2	4.8	3.3	0.2	9.3
Unemployment	0.0	0.0	0.0	0.0	0.0	0.0
Badly treated by society	0.8	0.0	0.7	0.0	0.0	0.8
Being bewitched	0.0	0.0	0.0	0.0	0.0	0.0
Effective correctional services	0.0	0.0	0.0	0.0	0.0	0.0
Health problems	2.2	0.7	1.7	0.5	0.0	2.0
Lack of self-esteem and self-worth	1.8	0.4	0.5	0.1	0.0	2.4
Laws protecting children’s rights	0.5	0.0	0.0	0.0	0.0	0.0
Men do not discuss their problems or seek help	1.0	0.0	0.0	0.0	0.8	0.0
Men’s involvement in crime and consequences	3.6	1.5	1.9	1.3	0.8	8.7
Negative influence of friends and peers	0.0	0.1	0.5	0.1	0.0	2.0
Religion and spirituality	0.0	0.0	0.0	0.0	0.0	0.0
Nodes only present on the map about causes of violence against young women
Violence against young women	5.4	3.1	18.5	2.5	0.0	2.9
Male involvement	0.0	0.0	0.0	0.0	0.0	0.0
Transactional/intergenerational sex and related factors	2.7	0.1	3.6	0.2	0.0	4.1
Young women putting themselves at risk	0.0	0.0	0.0	0.0	0.0	0.0
Ethical behaviour/good choices	0.0	0.0	0.0	0.0	0.0	0.0
Women being disrespectful/not cooperative	0.2	0.1	6.7	0.2	0.0	0.3
Laws and customary laws	0.0	0.0	0.0	0.0	0.0	0.0
Teaching youth about violence- providing role models	0.0	0.0	0.0	0.0	0.0	0.0
Nodes present on both maps
Parenting or family issues	-	0.3	0.7	1.3	0.0	0
Alcohol and drug use	2.3	-	4.4	1.9	0.6	10.8
Conflict in relationships	3.2	0.8	-	2.9	0.1	3.9
Men are insecure and stressed	3.6	1.3	4.9	-	0.5	9.6
Culture of violence	0.1	0.4	0.1	0.0	-	1.6
Financial difficulties	2.7	2.7	5.4	2.1	0.0	-

Cells in grey are the top five reductions for each scenario.

Table

Name of the category\Category code		S01	S02	S04	S05	S07	S08	S10	S11	S13	S14	S16	S18	V01	V03	V04	V06	V07	V08	V11	V13	V02 S09	V05 S03	V09 S17	V10 S15	V12 S12	V14 S06
Suicide of men in Botswana	S01	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0
Unemployment	S02	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0
Badly treated by society	S04	0.2	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.1	0.2	0.0	0.2
Being bewitched	S05	0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.0	0.0
Effective correctional services	S07	−0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	−0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	−0.1	0.0	0.0	−0.1	0.0	−0.1
Health problems	S08	0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.0	0.0
Lack of self-esteem and self-worth	S10	0.3	0.0	0.0	0.0	0.0	0.0	−0.1	0.0	0.0	0.1	−0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.4	0.0	0.0
Laws protecting children’s rights	S11	0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.0	0.1	0.0	0.0
Men do not discuss their problems or seek help	S13	0.3	0.0	0.1	0.0	0.0	0.1	−0.1	0.0	0.0	0.1	−0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.1	0.2	0.2	0.0	0.0
Men’s involvement in crime and consequences	S14	0.3	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.1	0.2	0.0	0.1
Negative influence of friends and peers	S16	0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.0	0.0
Religion and spirituality	S18	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0
Violence against young women and girls	V01	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0
Male involvement	V03	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	−0.1	0.0	−0.1	0.0	0.0	−0.1	0.0	0.0	0.0	0.0	−0.1	0.0	0.0	0.0
Transactional/intergenerational sex and related factors	V04	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.2	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0
Young women putting themselves at risk	V06	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0
Ethical behaviour/good choices	V07	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	−0.1	0.0	−0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	−0.1	0.0	0.0	0.0
Women being disrespectful/not cooperative	V08	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.4	0.0	0.0	0.0	0.0	0.1	0.0	0.0	0.0	0.0	0.2	0.1	0.0	0.0
Laws and customary laws	V11	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	−0.2	0.0	−0.1	−0.1	0.0	0.0	0.0	0.0	−0.1	−0.1	0.0	−0.1	0.0	0.0
Teaching youth about violence- providing role models	V13	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	−0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	−0.1	0.0	0.0	0.0	0.0	0.0
Parenting or family issues	V02S09	0.5	0.0	0.0	0.0	0.0	0.1	0.1	0.0	0.0	0.2	0.0	0.0	0.4	0.0	0.1	0.0	0.0	0.0	0.0	0.0	0.1	0.1	0.2	0.4	0.0	0.2
Alcohol and drug use	V05S03	0.2	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.0	0.0	0.2	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.0	0.1	0.0	0.2
Conflict in relationship	V09S17	0.5	0.0	0.0	0.0	0.0	0.1	0.0	0.0	0.0	0.1	0.0	0.0	1.0	0.0	0.1	0.0	0.0	0.2	0.0	0.0	0.0	0.2	0.5	0.4	0.0	0.3
Men are insecure and stressed	V10S15	0.3	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.1	0.1	0.0	0.1
Culture of violence	V12S12	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.1	0.0	0.0
Financial difficulties WOMEN, mostly – OF THE VICTIM	V14S06	0.8	0.0	0.0	0.0	0.0	0.1	0.1	0.0	0.0	0.3	0.1	0.0	0.1	0.0	0.1	0.0	0.0	0.0	0.0	0.0	0.0	0.4	0.1	0.7	0.0	1.0

Table

Category	Factors from the maps about violence against women	Factors from the maps about suicide of young men
Suicide of men in Botswana		Suicide of men in Botswana.
Violence against young women and girls	Violence against young women (YW) and girls
Financial difficulties	Risk Young women live in poverty. Youth lack employment. Young women struggle to find ways to be financially independent. Financially dependent on boyfriend.	Risk Debts and financial problems. Fear of having to pay for child support. Fear of pregnancy-responsible payments. Financial lessons from parents. Financial pressure from family. Financial pressure from girlfriend. Good financial sense. Man has multiple children. Poor living standards. Reckless spending. Spending too much on friends. Spending too much on the partner. Loss of job. Unemployment.
	Protective Government economic empowerment programmes.	Protective Teach good financial sense. Having work.
Conflict in relationship	Risk Romantic/sexual relations at a young age. Young women lie about their age. Children mature at young age. Stealing from your partner. Partner has a child from a previous relationship. Men not accepting children from women’s previous relationships. Young women having multiple children, especially if children are from different partners. Low self-esteem. Men don’t accept being dumped. Not giving your partner attention while on social media. Conflict about phones (if she uses the phone or if she complains because he is using it). Taking and checking man’s phone. Hearing people talk about your partner and believing them. Men believe rumours about girls. Conflict with boyfriend caused by his friends. Not telling your partner you have an STI, and he finds out. Lack of trust in relationships. Young women lie a lot. Young women losing interest in relationship. Not respecting each other in a relationship.	Risk Cheating by partner. Cohabitation with partner. Confusion about sexual orientation. Denial of sex by partner. Girlfriend reveals his secrets. Men’s infertility. Multiple relationships (both the woman and the man). Pressure to support other children of the partner. Previous partners negatively influence new relationship. Rejection by woman/partner. Relationships at a young age. Sexual dysfunction.
	Protective Avoid keeping secrets from partners. Girls should not share the same man. Young women having fewer sexual partners. Avoid dating at a young age because women are more vulnerable and lack support. Giving the boyfriend more time and ignoring the phone. Everyone should keep their own phones (not snooping phones). Young women spending more time in church. Men should not believe their friend’s stories about their partners. Not letting other parties get between those in relationships. Partners trust each other in a relationship. Partners are faithful to each other. End relationships if there are problems, instead of cheating. Leave a relationship with an abusive partner. Good communication between couples. Couples go for counselling. Young women asking for help from government workers (counselling).	Protective Stop giving priority to girlfriends. Teaching young women not to be promiscuous.
	Poor communication. Fighting over money with your partner. Living with a man who does not provide enough money. Partner does not give you money. Young women having multiple partners. Young women not replying to men. Dating your partner’s friends. Youth (men and women) are promiscuous. Paying attention to other men – girl. Cheating on your partner. Male partner cheating and women complaining about that. Cheating/dumping because men are broke. Leaving partners for immigrant workers.
Parenting or family issues	Risk Leave school early so girls are not at school. Young women leave home. Leaving home young to live with a partner. Orphaned girls. Lack of support from parents. Lack of good parenting. Parents encourage transactional/transgenerational sex (usually the mother). Parents allow abuse on girls (because the man provides income). Parents do not pay attention to their children’s relationships – encouraging the girl to ask for more money or ‘catch more fish’. Vulnerable Girls. Uncles abuse YW girls. Mothers contrasting discipline (not disciplining girls). Conflict between siblings (male sibling is violent against female sibling). Children do not listen to their parents.	Risk Bad treatment by family. Being single parent. Death of parents. Deserting family. Discrimination by family. Domestic abuse of young men. Family does not provide support. Fear to communicate with father. Loss of support from parents. Misunderstanding in the family. Deserting family. Not listening to elders’ advice. Raised by single mothers. Unable to survive because they were spoilt.
	Protective Parents interfere in children’s relationships. Parents talk to children about relationships. Parents teach YW about contraceptives. Family elders refer to social workers and counsellors when girls suffer violence. Elders are strict with the youth. Mothers cooperating when disciplining girls. Parents do not cover up for children. The strict upbringing of girls.	Protective Elders advise young men on relationships. Engaged parents. Fathers form a close relationship with sons. Good parental guidance. Cooperative parenting. Family support.
Men are insecure and stressed	Risk Women should not go to the bar with their partners (can cause jealousy). Women refusing to come to boyfriend’s house (incites jealousy and suspicion). Male partners being very insecure. Stressed men are more aggressive.	Risk Anxiety. Depression. Lack of emotional control. Stress. Stress from losing court cases.
	Protective Counselling for stressed men.	Protective Emotional control.
Alcohol and drug use	Risk Alcohol abuse (both men and women). Drug abuse (both men and women). Drug and alcohol abuse during youth. Men drinking too much. Young women drinking too much alcohol. Women are disrespectful when drunk.	Risk Alcohol and Drug abuse.
	Protective Young women avoiding alcohol abuse. Youth do not use alcohol and drugs.	Protective No use of alcohol or drugs abuse.
Culture of violence	Risk Men are stronger than women. They learn violence at school (culture of violence and peer pressure). Bad influence/example from other men. Disrespect of women by men. Being a barren women (she becomes target because men want to prove they can make her pregnant).	Risk Men are violent. Violence against partner.
	Protective Accepting barren women	Protective Learn to communicate without violence.
Badly treated by society		Risk Badly treated by society. Bullying. Defamation of character. Discrimination due to poverty. Humiliation on social media. Men are not understood. Pressure from society. No awareness in society about the problem of suicide. Trivialise men’s problems.
Being bewitched		Risk Being bewitched.
Effective correctional services		Risk Calm approach by police to offenders. Equal treatment of men and women by police. No – Law more favorable to women. Make men and women equal under the law. Police and social workers’ intervention. Rehabilitation centre. Suicide awareness by police.
Health problems		Risk Health problems HIV Positive
Lack of self-esteem and self-worth		Risk Comparing themselves to peers. Comparing themselves to siblings. Competing with peers. Easily give up on themselves. Failure at school. Failure in life. Lack of progress compared to peers. Men showing off. Poor decision-making skills. Lack of self-discipline and self-respect.
		Protective Accepting your situation. Being hopeful and positive. Being self-dependent. Confident man. Encourage young men to be active. Having thick skin. Being self-dependent. Self-discipline and self-respect.
Laws protecting children’s rights		Risk Local chiefs (dikgosi) cannot overrule child protection laws. Rights hinder parental discipline. Softer laws for child rights.
Men do not discuss their problems or seek help		Risk Men do not share problems. Not using government support programs. Unable to communicate with friends.
		Protective Asking for advice from family. Asking for advice from friends. Conversations with community. Creating a safe place for young men. Encourage young men to attend kgotla meetings. Guidance and counselling. Men’s groups. Asking for relationship advice. Seeking professional counselling. Seeking professional help.
Men’s involvement in crime and consequences		Risk Crimes like rape and murder. Criminal acts and consequences. Fear of arrest after a crime. Fear of arrest/pressure after committing murder. Fear of being arrested after rape.
		Protective Law fearing man.
The negative influence of friends and peers		Risk Being used/abandoned by friends. Gangster groups. Lack of support from peers. Poor advice from friends.
		Protective Choosing friends wisely.
Religion and spirituality		Risk Encourage young men to attend church. Spiritual interventions.
Male involvement	Risk Boys grew up in a female-headed family (women struggle to teach the boy how to be a man. The older boy disrespects his mother because he did not have limits).
	Protective Male involvement in sexual education (fathers talk to girls about using sex for money). Fathers are good role models to boys. Good parenting with male involvement. Men involved in discussing sexual issues. Upfront talking to boys about sex (find a direct way to talk about sex).
Transactional/intergenerational sex and related factors	Risk Sleeping with older men. Taking money from older men. Using men as a source of income. Prostitution. Taking alcohol from a man and running away.
Young women putting themselves at risk	Risk Girls should respect their bodies by not wearing revealing clothes. Women put themselves in a risky situation by walking alone at night. Girls are going after men with cars (getting into a risky situation). Sex with strangers. Young women dressing provocatively.
Ethical behaviour/good choices	Protective Girls should evaluate their choices. Youth should make ethical choices (girls and boys). Youth should value their relationships. Youth should stand up for themselves. Youth should be true to themselves.
Women being disrespectful/not cooperative	Risk Men’s agenda is always sex. Young woman trying to control the relationship. Disrespecting your co-habiting partner. Women are disrespectful of ex-partners when they find new partners. Young women using disrespectful words. Failure to show up for appointments/dates. Disrespect towards men. Young women talking nonstop. Young women must be humble – avoid upsetting/confronting their partner. Girls refusing to wear what their partner wants. Men do not want to be corrected/contradicted. Refusing to do basic chores. Young women not allowing their partner’s relatives to visit/not attending to them well. Women leave their kids alone, and then their partner gets angry at them. Women go to bars and their kids follow them. Women not letting their partners choose their friends. Young women love money (only care about money). Young women refusing sex with their partners. Making young women leave at night when they refuse sex – women are put in a risky situation. Women reject men’s advances.
	Protective They should stop giving excuses for not having sex. Accept your partner as he is. Young women should respect their parents and stay at home.
Laws and customary laws	Risk Men are not taken seriously if they report violence by a woman.
	Protective Chiefs should have the power to protect co-habiting women. Chiefs should be strict about how young women should dress. Chiefs should be strict about neglectful parents. Bars for older men should not let young women enter. Return to arranged marriages. Bring back initiation schools. Bringing back culture in the community and respecting it. Strong legislation against violence. Assistance from the police. Men do not want to be arrested (fear of law). Arrest old men having sex with underage women. Law must be equal to men and women – men’s abuse should be taken seriously. Government to punish parents who neglect children/bad parenting. Government to be strict on young people who leave their homes.
Teaching youth about violence- providing role models	Risk Lack of male role models
	Protective Youth clubs that will educate them about violence. Men groups. Youth must listen to elders’ advice. More communication about sex. Chiefs teach youth about violence. Chiefs and other male leaders should lead. Government to teach about violence.

Table

	t0	t1	t2	t3	t4	t5	t6
Suicide of men in Botswana	1	0.969	0.921	0.911	0.909	0.909	0.909
Unemployment	1	0.500	0.500	0.500	0.500	0.500	0.500
Badly treated by society	1	0.540	0.524	0.523	0.523	0.523	0.523
Being bewitched	1	0.485	0.492	0.492	0.492	0.492	0.492
Effective correctional services	1	0.507	0.504	0.504	0.504	0.504	0.504
Health problems	1	0.589	0.558	0.556	0.555	0.555	0.555
Lack of self-esteem and self-worth	1	0.495	0.505	0.504	0.503	0.503	0.503
Laws protecting children’s rights	1	0.515	0.508	0.508	0.508	0.508	0.508
Men do not discuss their problems or seek help	1	0.542	0.523	0.522	0.522	0.522	0.522
Men’s involvement in crime and consequences	1	0.705	0.648	0.641	0.640	0.640	0.639
Negative influence of friends and peers	1	0.493	0.501	0.501	0.501	0.501	0.501
Religion and spirituality	1	0.500	0.500	0.500	0.500	0.500	0.500
Violence against young women and girls	1	0.881	0.808	0.794	0.791	0.790	0.790
Male involvement	1	0.500	0.500	0.500	0.500	0.500	0.500
Transactional/intergenerational sex and related factors	1	0.500	0.518	0.514	0.514	0.514	0.514
Young women putting themselves at risk	1	0.475	0.488	0.488	0.488	0.488	0.488
Ethical behaviour/good choices	1	0.500	0.500	0.500	0.500	0.500	0.500
Women being disrespectful/not cooperative	1	0.550	0.540	0.537	0.536	0.536	0.536
Laws and customary laws	1	0.500	0.500	0.500	0.500	0.500	0.500
Teaching youth about violence- providing role models	1	0.500	0.500	0.500	0.500	0.500	0.500
Parenting or family issues	1	0.527	0.522	0.521	0.520	0.520	0.520
Alcohol and drug use	1	0.725	0.675	0.666	0.664	0.663	0.663
Conflict in relationship	1	0.781	0.714	0.702	0.700	0.699	0.699
Men are insecure and stressed	1	0.956	0.890	0.880	0.878	0.877	0.877
Culture of violence	1	0.535	0.523	0.522	0.522	0.522	0.522
Financial difficulties WOMEN, mostly – OF THE VICTIM	1	0.895	0.843	0.829	0.826	0.825	0.825

Data availability statement

The data supporting this study’s findings are available with the publication.