Cited by 146Gender Roles and Identity StudiesMental Health Treatment and AccessPsychology and Mental Health

The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index; none of the 18 sources its claims cite is checked for support yet.

Masculinity and Help-Seeking Among Men With Depression: A Qualitative Study

Open access

Abstract

Background: Many studies indicate that men are more reluctant to seek help for mental health problems than women. Traditional ideas of masculinity are often seen as a cause of this phenomenon. However, little is known about the diversity of experiences during the processes of help-seeking and service use among men with depression who have already utilized mental health services. This study aims to explore men's experiences and attitudes toward depression, help-seeking, and service use in order to develop gender-sensitive services. Methods: Narrative-biographical interviews were conducted with men treated for depression (n = 12). Interview topics included individual experience with depression, help-seeking behavior, and mental health service use. Transcripts were analyzed using qualitative content analysis. Results: Before seeking treatment, men's help-seeking behavior was negatively affected by internalized masculine norms. However, findings indicate a change of attitudes toward depression after mental health service use. Men with depression emphasized a salutogenic perspective toward mental health problems and critically reflected on masculine norms. The positive function of men-only groups were described as key for successful service use. Conclusions: Men with depression reported experiences toward help-seeking and service use on four different levels: (i) attitudes toward depression, (ii) perception of societal views on depression, (iii) experiences within the family context and (iv) experiences with mental health services. Interventions to reduce the stigma of being “unmanly” and to improve men's capacity to cope with being unable to work should be developed. Peer-led men-only groups may increase participants' self-esteem and assist in disclosing weaknesses. In the context of GPs' mediating role, training for health professionals concerning the impact of masculine norms on mental health is recommended.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In narrative-biographical interviews with 12 men treated for depression, internalized masculine norms initially inhibited help-seeking, but service use was retrospectively linked to critical reflection on those norms and a salutogenic view of depression. Men-only peer groups were described as key enablers of disclosure and successful service use.

Key findings

  • Before treatment, men reported trivializing symptoms, individualized problem solving, hiding depression due to masculine norms, and avoiding help to protect career options; these categories had 10, 7, 7, and 6 quotations respectively.
  • After service use, many described changed attitudes toward mental health problems (11 quotations) and a salutogenic perspective (10 quotations), seeing depression as an important life experience or wake-up call and reflecting critically on masculine norms.
  • Stigma was prominent: being assessed as incapable of coping (12 quotations), stigma toward help-seeking and having depression (12), stigma toward inability to work (10), and stigma of being unmanly (8); some also perceived growing acceptance (8).
  • Family and service experiences were mixed: loss of empathy in the family (14 quotations), partners’ emotional support (21), service users’ social support (14), group counseling for men (15), and familiarity of peer-led men-only groups (11); 11 of 12 participants were currently utilizing mental health services.

Methods

  • Qualitative study nested in the mixed-methods MenDe project; this article reports a third-step re-analysis of 12 narrative-biographical interviews with men treated for depression, recruited inside and outside healthcare settings in Southern Germany. Inclusion criteria were male, aged 18–64, diagnosed or self-identified as having depression, and sufficient German language skills; exclusions were organic mental disorder, dementia, anorexia with BMI <17, addiction, and bipolar disorder or schizophrenia.
  • Interviews were conducted March–June 2018 by a male researcher (TS), lasted 27–133 min (mean 75 min), and covered depression experience, help-seeking, service use, illness theories, social consequences, coping, and masculinity.
  • Transcripts were analyzed using qualitative content analysis: deductive categories from the research question and theoretical background, inductive codes from the material, and refinement into themes. Coding was done independently by three researchers (MSt, SK, TS), with discordant coding discussed in a qualitative research group until consensus; MAXQDA 12 was used.

Limitations

  • The paper states that participants had used mental health care services prior to the study, so findings only refer to men who had successfully sought help and cannot explain reasoning in men who never sought help. It also states the small sample size and participants’ high age (mean = 52) prevent revealing age-related differences in help-seeking attitudes and behavior.
  • The paper notes the interviewer was male and that male participants might answer in gender-specific ways, for example by staging themselves as “real men” who never lost control; a qualitative research group with multiple perspectives discussed this bias critically.
  • Evident from the text: all participants were recruited in Southern Germany and the sample was predominantly married (9 of 12), limiting transferability beyond this context.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3389/fpsyt.2020.599039

Cites

30 of 30 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 18 cited sources checked · 0 supported · 0 flagged

Show all 53 claims

  • It may state two separate claims as one. 18
  • Probably not a substantial claim. 16
  • The quote only partly states this claim. 1
30 of 30
  • The paper relies on this without support.

    There is a lack of knowledge on how men's specific needs in cases of depression are addressed by mental health services.

    “Beyond this, there is a lack of knowledge on how men's specific needs in cases of depression are addressed by mental health services.”
  • The paper relies on this without support.

    The impact of norms concerning traditional masculine roles for men with depression who have already utilized mental health services is unclear.

    “Moreover, the impact of norms concerning traditional masculine roles for men with depression who have already utilized mental health services is unclear.”
  • The paper relies on this without support.

    More evidence is needed to develop mental health services based on the experiences of men with depression.

    “On the other hand, more evidence is needed to develop mental health services based on the experiences of men with depression.”
  • The paper relies on this without support.

    Many studies provide a one-dimensional understanding of mental health behavior among men with depression, including reduced service use.

    “Despite emerging evidence for the diversity of men's experiences of help-seeking and service use, many studies provide a one-dimensional understanding of mental health behavior among men with depression, including reduced service use.”
  • The authors state this as an assumption.

    Psychiatric service use contradicts masculinity.

    “In contrast to the assumption that psychiatric service use contradicts masculinity (27)”
5 of 5

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Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • James is described as a father but has no children listed

    Minor

    James says he is a father, but his Table 2 entry has a dash in the children column. The table's total of seven participants with children also excludes him.

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Metadata

Authors
Staiger, T., Stiawa, M., Mueller-Stierlin, A. S., Kilian, R., Beschoner, P., Gündel, H., Becker, T., Frasch, K., Panzirsch, M., Schmauß, M., & Krumm, S.
Affiliations
  • Universität Ulm (DE)
  • University of Augsburg (DE)
Corresponding author
Staiger, Tobias
Venue
Frontiers in Psychiatry
Published
2020-11-24
Volume
11
Pages
599039-599039
ISSN
1664-0640 (ISSN-L)
OpenAlex
W3106546635
Cited by
146
References
30
Citations by year
2026: 37 · 2025: 29 · 2024: 25 · 2023: 26 · 2022: 23 · 2021: 5
FWCI
19.27
Type
journal article
Language
en
Open access
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • OPen Access Repositorium der Universität Ulm (OPARU) (Ulm University) (submittedVersion, cc-by)
  • OPUS (Augsburg University) (submittedVersion, cc-by)
  • Universität Ulm, Kommunikations- und Informationszentrum (kiz) (cc-by)
Funders
Deutsche Forschungsgemeinschaft
Topics
  • Social Sciences › Gender Studies › Gender Roles and Identity Studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
Keywords
masculinity, help-seeking, male depression, masculine norms, mental health service utilization, gender-sensitive services, salutogenic perspective, stigma, attitudes toward depression, family environment, general practitioners, peer-led intervention

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