Mental Health Help-Seeking Behaviour in Men

Abstract

Despite significant advances in health care in recent decades, men do not appear to have benefited equally. Globally, men have a lower life expectancy than women (Thornton, 2019). Across a range of measures, men's general health is poorer than that of women (Mursa et al., 2022). Biological characteristics, occupational factors and health behaviours may all contribute to this gender-related difference; however, it has also been posited that the help-seeking behaviour of men plays a significant role (Sagar-Ouriaghli et al., 2020). It is widely assumed, across all age groups, that women are more likely to consult health professionals and use health services than men; however, rigorous gender-comparative evidence to back this assumption is lacking. In those studies that have been conducted, men have consistently been seen to have a greater reluctance to consult health professionals for health problems. This reinforces the presumption that men may often delay consultation for health-related problems, when medical conditions may become more advanced and potentially harder to treat. Interestingly, there appears to be very little gender differences between children and older adults, and non-consultation occurs most commonly in men aged between 16 and 60 years. In this age group, men experience poorer health outcomes than women in several areas, including mental health (Australian Institute of Health and Welfare, 2019). Evidence suggests, once again, that men are less likely to seek assistance for mental health problems than women, across race, age and social status (Seidler et al., 2016). Although mental health problems are extremely common, stigma is still attached to them, often making them difficult to talk about. Despite women and men experiencing stigma in response to help-seeking for mental health issues, there would appear to be gender-specific influences on men's reluctance to seek help. For men, non-consultation may also be linked to the mental distress and stigma that may result from the inability to perform in occupational and family roles, whilst coping with mental distress (Staiger et al., 2020). Non-consulting by men may be particularly problematic in this area, as mental health issues, like loneliness and chronic stress, may often be overlooked in males. Indeed, the mental and emotional health of men has been described as a 'silent crisis' (Affleck et al., 2018). Although the overall prevalence of mental disorders is lower in men than in women, men are less likely to access psychological support, like the National Health Service talking therapies service in the United Kingdom, than women (NHS Digital, 2021). Mental health problems regularly go untreated in men, despite public health concerns that depression and suicide are leading causes of death in men, with men more than three times more likely to die by suicide than women (Office for National Statistics, 2020). In addition, men are far more likely to sleep rough, go missing and become dependent on alcohol and drugs than women (Center for Behavioral Health Statistics and Quality, 2017). These trends should create a sense of urgency in identifying and supporting men who struggle with mental illness, so dangerous and unhealthy behaviours might be mitigated (Chatmon, 2020). More research is needed to drive identification, support and empowerment of men with mental health issues, as outlined by Tofthagen et al. (2022) in a review of men's experiences of self-harm. Despite considerable levels of interest, there is a shortage of nursing research that explores why males are less likely to seek help for mental health problems than females. When exploring the reasons why men do not seek help for mental health issues, masculine norms, such as being strong and in control, are commonly cited. These traditional gender roles of masculinity, including stoicism and self-reliance, can lessen the likelihood of men seeking support. Stereotypically, having mental health issues, like depressive illness, would appear to be in conflict with traditional views of masculinity, such as, lack of control, incapability and weakness. This belief was echoed by Mursa et al. (2022), who identified masculinity and feeling unwelcome as key barriers to preventive health care. Additionally, men have been known to trivialize or play down mental health symptoms, display difficulty disclosing issues, which in turn, can also inhibit their help-seeking behaviour (Sullivan et al., 2015). Symptoms of anxiety, distress and fear, need for emotional control, seeing symptoms as minor, and poor rapport and communication with healthcare personnel have also been outlined as obstacles to help-seeking in men (Seidler et al., 2020). Moreover, lower mental health literacy has been noted in men with mental health disorders (Lee et al., 2020), influencing the likelihood of them seeking help. Possessing higher levels of mental health literacy has been associated decreasing the impact of mental health probl