Men in mind

The impact of untreated mental illness and globally disproportionate suicide rates in men is broad and profound. In recent years, male utilisation of mental health services has increased[1], owing to increased awareness, greater mental health literacy and a decrease in stigma. However, there is still a need to examine men’s experience with help-seeking and to develop accessible, appropriate and engaging treatment.

 

Getting men in the door

There is a complex and diverse range of factors that impact men’s mental health, which can be influenced by how they experience masculine social norms such as stoicism, strength, control and self-reliance. These attributes are helpful in certain scenarios and can be a protective factor for mental health and bolstering self-esteem. However, these same traits can cause distress, result in denial or avoidance of a problem, or manifest in behaviour such as irritability, anger, risk-taking and substance abuse.

Men have atypical symptoms of depression. Studies that use standard tests show lower rates of depression in men than women but when accounting for atypical, externalising symptoms, there’s parity in prevalence. The more men rigidly adhere to traditional social norms the more likely they are to be depressed and the less likely they are to seek help[2].

Some of the common barriers to men seeking mental health treatment include the belief that a lot of people feel sad and down, not knowing what to look for in a psychotherapist, and a feeling like they need to solve their problems themselves[3].

Many men feel like there’s a gender bias to therapy[4] and if they’re dissatisfied with previous therapy they have doubts about the effectiveness of future treatment, and an increased reluctance to disclose future distress[5]. Given that 50% of men who die by suicide have been in contact with mental health services prior to their death[6], looking at what happens once men seek help is critical.

 

Tailoring treatment

Gender-informed guidelines for the psychological treatment of females have been available for more than four decades but similar insights for working with boys and men have only been published in the last few years[7],[8]. Despite the delay, there’s now increasing focus on how mental health care can more effectively serve men and boys. This involves understanding the diverse economic, biological, developmental, psychological, and sociocultural factors that influence their mental health, how these intersect with their experience of masculinity and best-practice, male-appropriate treatment – something that’s not always taught at undergraduate or graduate levels.

Male-appropriate treatment recommendations include building on men’s strengths by employing action-oriented, skills-based worth, adapting language to be more male relevant, clarifying roles and goals, and focusing on building a collaborative therapeutic relationship[9].

Dr Zac Seidler is a clinical psychological, mental health researcher and Director of Mental Health Training at Movember. His research has focused on how to create mental health services that are effective for men and account for masculinity. This has manifested in Men in Mind – a world-first, online training program for mental health clinicians to help them better understand and respond to men’s distress and suicidality.

“I came into [my research] with all the same biases that everyone else has, which is that men don't seek help, men suck at talking about their emotions, men have an inability to describe their internal experience, and that explains the differences in prevalence rates and why there’s a huge suicide rate,” Dr Seidler says. “It became very clear, very quickly that that wasn't the case and that everyone seemed to be avoiding the issue here, which is that lots of men are seeking help, and no-one's looking at what they're being offered.”

However, it’s not just psychologists and psychiatrists that can benefit from this knowledge, but everyone involved in a multidisciplinary approach to mental health care. This includes GPs, mental health nurses, social workers, and allied health professionals.

Head to meninmind.movember.com to learn more about who you can take part.

 
 
References

[1] Harris, M. G., Diminic, S., Reavley, N., Baxter, A., Pirkis, J., & Whiteford, H. A. (2015). Males’ mental health disadvantage: An estimation of gender-specific changes in service utilisation for mental and substance use disorders in Australia. Australian & New Zealand Journal of Psychiatry

[2] Wong, Y. J., Ho, M. R., Wang, S. Y., & Miller, I. S. (2017). Meta-analyses of the relationship between conformity to masculine norms and mental health-related outcomes. Journal of counseling psychology

[3] Seidler, Z. E., Rice, S. M., Kealy, D., Oliffe, J. L., & Ogrodniczuk, J. S. (2020). What gets in the way? Men's perspectives of barriers to mental health services. The International journal of social psychiatry

[4] Mahalik, J. R., Good, G. E., Tager, D., Levant, R. F., & Mackowiak, C. (2012). Developing a taxonomy of helpful and harmful practices for clinical work with boys and men. Journal of counseling psychology

[5] Seidler, Z. E., Rice, S. M., Kealy, D., Oliffe, J. L., & Ogrodniczuk, J. S. (2020). Once bitten, twice shy: Dissatisfaction with previous therapy and its implication for future help-seeking among men. International journal of psychiatry in medicine

[6] Schaffer, A., Sinyor, M., Kurdyak, P., Vigod, S., Sareen, J., Reis, C., Green, D., Bolton, J., Rhodes, A., Grigoriadis, S., Cairney, J., & Cheung, A. (2016). Population-based analysis of health care contacts among suicide decedents: identifying opportunities for more targeted suicide prevention strategies. World psychiatry : official journal of the World Psychiatric Association

[7] American Psychological Association, Boys and Men Guidelines Group. (2018). APA guidelines for psychological practice with boys and men. Retrieved from http://www.apa.org/about/policy/psychological-practice-boys-men-guidelines.pdf

[8] Australian Psychological Society. (2017). Ethical guidelines for psychological practice with men and boys. 

[9] Beel, N., Brownlow, C., Jeffries, C., & du Preez, J. (2020). Counseling Men: Treatment Recommendations From Australian Men’s Therapists. The Journal of Men’s Studies

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