American men are often taught to be tough, self-sufficient, and “masculine”. For many of us, that means “toughing it out” and not seeking out help, not showing signs of “weakness”, and certainly not getting help with mental health. Men make up 49.6% of the U.S. population and struggle with mental health problems like bipolar disorder, schizophrenia, depression, and anxiety at similar rates to women. In fact, with 46.6 million Americans struggling from a diagnosable mental illness at any given time, some 15.1% of all men have a mental health disorder. Yet, men face difficulties in diagnosis, treatment, and recovery that impede their ability to seek out help.
Difficulty in Getting a Diagnosis
Many men simply never receive a mental health diagnosis. This is partially the fault of those men not going to a doctor or to seek out help. Patriarchal ideas of masculinity and toughness can make you feel like asking for help is weak. Men consistently and detrimentally fail to seek out help. Suicide is responsible for 1.5% of all male deaths, but only 55% of male suicide victims have had contact with a mental health provider. That’s critical considering mental health treatment can and does improve mental health and happiness.
At the same time, men are also less likely to be diagnosed at all. Men who do go into a doctor’s office are more likely to be told to wait it out, to exercise, or to “man up”. Some studies show that men are 20-31% less likely to be given a prescription for mental health problems. Many are significantly less likely to be forwarded to a mental health care provider at all. These problems relate to a combination of stigma and lack of emotional and mental health literacy in men.
Mental Health Literacy
Many boys are raised to be “tough”, “manly”, and to avoid talking about their feelings. Men are raised to like certain things, taught that emotions are “feminine”, and pushed into avoiding rather than dealing with and coping with emotions. This leads to adults who still feel things but lack the vocabulary to adequately describe or communicate about those feelings. This can lead to feelings of isolation and disconnection. It can also result in a lack of diagnosis, because the patient doesn’t have the words to adequately explain what’s wrong or what’s going on.
What does this look like in practice? Men are more likely to focus on physical symptoms of mental illnesses such as fatigue, body aches, headache, eye strain, etc. This can easily lead to a misdiagnosis, as doctors don’t even consider that depression or anxiety might play a role. This means men’s mental health treatment should have components of education and learning, where men learn to acknowledge, discuss, and voice their feelings in healthy and clear ways.
Stigma and Gender Roles
Men face considerable pressure to conform to gender norms and roles. Men are providers, strong, dependable. When men believe their value lies in their ability to conform to these roles, they cannot normally admit to a mental illness or seek out help without giving up their sense of self value. This problem worsens as it extends into a network of caregivers, where doctors, nurses, and psychiatrists might buy into it as well.
Fear of Seeking out Treatment – Men might avoid seeking out treatment for fear of being seen as weak. This also extends into treatment. Men are less likely to open up, be honest, or truly engage in therapy because they don’t want to be perceived as weak. Some fears include fear of losing a job, fear of losing identity, and pressure to support or provide for a family or loved ones.
Lack of Diagnosis – Some medical professionals may be reluctant to give men prescriptions for anxiety, depression, or panic attacks because they aren’t part of what those people see as “masculinity”. This can contribute to instances where men are told to toughen up, to deal with it, and to man up. These types of attitudes from mental healthcare and healthcare professionals contributes to stigma and to the men they are supposed to treat leaving treatment. It also contributes to higher incarceration rates for mentally ill men, as those men do not receive the treatment they were seeking.
Alternative Coping Mechanisms – Many men turn to alternative coping mechanisms such as self-medicating with drugs and alcohol rather than seeking treatment. This means that men are more likely to develop a mental illness further before seeking treatment. It also means they are more likely to be incarcerated or enter the judicial system as a result of mental illness and substance abuse impacting choices and behavior. This makes men more difficult to help when they do move into treatment. In fact, men are over 300% more likely to be diagnosed with a drug or alcohol addiction than women are.
Tackling these concepts in treatment can be difficult, simply because many of them must be broached before men go into treatment. Healthcare providers can start by normalizing images of mentally ill men, working to reduce stigma, and changing the approach to treatment. Providing male-only treatment, so that men’s insecurities, problems, and specific issues allows mental healthcare providers to tackle those issues. This cannot be done in a mixed-gender space. For example, men may feel unable to open up about problems that make them appear “weak” in front of women. These issues are better tackled in male-only spaces, with peers who can share that they feel the same way, but without women.
Traditional gender roles often isolate men, physically and emotionally, from their male and female peers. Homophobia often results in men failing to build any kind of platonic physical contact with male peers. Strict ideas about relationships results in men not having female friends. Men are less likely to seek out emotional intimacy, to develop close bonds with non-romantic partners, and less likely to give and receive emotional support with friends. The result? A man in his 20s is about 12% more likely to be lonely than women. In his 40s, that escalates to almost 50%.
This is further exacerbated by the fact that many American men simply don’t know how to take care of themselves in a fulfilling way. Most men leave the home with no idea how to take care of basic necessities like laundry, cooking simple meals, or taking care of the home. Without self-care habits, many worsen symptoms of depression and mental illness by simply not taking care of themselves.
Mental health treatment must tackle these problems by integrating life skills and self-care into treatment. Men should leave treatment with a strong understanding of how to cook for themselves, how to keep their home clean and pleasant, and how to take care of their body so that they feel good, mentally and physically.
Differences in Mental Illness Expression
Most medical professionals are well aware that men and women express mental health disorders in different ways. Men are prone to different mental illnesses, express mental illnesses in different ways, and discussing those issues in different ways. It’s critical for mental health providers to understand those differences and to look at mental illness from a biological perspective when building treatment.
Should Mental Health Treatment be Gender-Based?
Men’s mental health can be significantly different from women. Men often feel that it isn’t worthwhile for them to seek treatment. They often feel as though they don’t “need” help and that they are manly enough to get through things on their own. They face different social stigma and pressure than women. Most research strongly suggests that most or all mental health treatment benefits from dividing by expressed gender. This means that it is best for men to enter a men’s gender-specific mental health treatment program, designed around the unique needs of men.
There’s nothing to be ashamed about if you’re struggling with mental health. Waiting or failing to get help can complicate treatment, complicate your disorder, and result in developing secondary disorders like substance use or PTSD. It’s crucial to approach your problems head on, to resolve them, and to get better, so you can move on with your life. While there is a lot of stigma surrounding mental health and treatment, getting help eventually requires much more strength and dedication than not doing so ever will.
If you’re ready to get help, join the Gooden Center for a free tour of our men’s mental health facilities. We offer a men’s only program, so you get the personalized care you need, with classes and therapies designed around male problems and needs. Call us at 800-931-9884 to learn more.