Men’s Mental Health

Men’s mental health is a topic that is grossly overlooked by contemporary society. There are a multitude of reasons why men are less likely than women to speak about or seek help for mental health issues, with the societal expectations of men being a major one. The effect of societal expectations for women to look and act a certain way have been discussed more openly, whereas the effect of these same expectations on men have not been highlighted. The issue of male suicide has been termed as a ‘silent epidemic’, as men are 3 to 7.5 times more likely than women to die by suicide. Men are also at a higher risk of using maladaptive coping strategies for poor mental health, which is why men are 2 to 3 times more likely than women to have serious alcohol misuse issues (Bilsker et al, 2018). This writeup will explore men’s mental health in Pakistan, the role of gender roles and masculinity in mental health, the high suicide and depression rates and help-seeking behavior, as well as ways to improve the state of and response to poor mental health among men.     There is a dearth of mental health facilities in Pakistan, with only around 500 psychiatrists for a population of 220 million. This results in people with mental illnesses not getting the treatment they need and oftentimes aggravating existing conditions. Only 10% of people who suffer from mental health issues get help for their conditions, and research conducted by the WHO has stated that around 14000 people die by suicide in Pakistan every year with the number of suicide attempts that have been unsuccessful being in the millions (Ali, 2021). There are more men than women who die by suicide, with the ratio being 6.1:1. The high prevalence of male mental health issues in a patriarchal society like Pakistan can be attributed to the increased stress of upholding traditional masculine roles. The pressure to be the sole breadwinner of the family causes an immense amount of stress among men and the idea of women contributing to the family income can be perceived as emasculating (Fatima, 2018). There is a lower willingness to seek help for psychological or physical health issues among Pakistani men as they tend to have lower egalitarian gender beliefs and consider their personal masculinity of great importance. They also have been seen to believe that non-traditional behaviors have negative implications in regards to men’s masculinity (Visser et al, 2020). Due to the lack of help being sought to address any mental health concerns, the symptoms of poor mental health then tend to manifest in the form of external anti-social, impulsive, and even risk-taking behaviors (Fatima, 2018). Therefore, to fully comprehend the extent of the issue surrounding men’s mental health it is crucial to consider how masculinity and traditional gender norms affect mental health and help-seeking behavior.      As mentioned above, traditional male gender norms have been seen to be harmful for men’s mental health, as they entail dominant characteristics such as conferring power and status to men which make them difficult to shift. Masculine norms include social rules and expected behavior of men in society (Chatmon, 2020). Gender norms tend to mold mental health and help-seeking behaviors in boys and young men when they are being learnt during childhood and adolescence. Boys are taught to be strong, competitive, and unfazed by adversity. They are discouraged from showing any vulnerabilities (sadness, anxiety, or fear) and are encouraged to exhibit anger, hostility, and emotional control. These values reinforce shame in boys at experiencing any vulnerable emotions and thus impedes on their ability to seek mental health help (Rice et al, 2021). The restriction in certain behaviors (such as crying when sad and showing fear) leading to difficulty in emotion regulation due to rigid masculine norms is known as toxic masculinity. Toxic masculinity can have pernicious effects, such as substance misuse issues, problems with interpersonal violence and interpersonal intimacy, as well as discouraging help-seeking behaviors (Chatmon, 2020). Masculinity has also been seen to decrease the need for social connectedness and building emotional and supportive relationships for men between women and other men as well, which can also contribute to poor mental health (Mckenzie et al, 2018).      Most of the social discourse on men’s mental health has focused on masculinity which tends to victim-blame men for poor mental health by attributing the cause to men’s attitudes and behavior. This disregards positive male traits and alienates them. Health services that have adopted this victim-blaming approach fuel the stigma surrounding their patients (Whitley, 2018). Public stigma is the general perception of a mentally unwell person being socially undesirable which can lead to stigmatized people internalizing prejudices faced and developing a self-stigma (Latalova et al, 2014). Therefore, instead of promoting diverse and healthy masculinities, male-centered treatment approaches should concentrate on counteracting unhealthy stereotypes (Seidler et al, 2018). Other social determinants that contribute to mental health issues among men include occupational and employment issues, family issues (such as divorce), adverse experiences during childhood, as well as certain life transitions (such as that to parenthood). While dominant notions of masculinity (for example, qualities like stubbornness and self-reliance) can hinder any help-seeking behavior, it is imperative to consider the claims from men that mental health services tend to be “feminized” and unresponsive to men’s issues. This is why developing a multipronged approach to ameliorate the state of men’s mental health at the individual, health-service, as well as societal levels is crucial to effectively tackle this issue (Affleck et al, 2018).     The approach to deal with the issue of male mental health could also involve combating the issues relating to male depression, suicide, and help-seeking behavior. The risk of suicide among men can rise due to the interplay of masculinities with health inequities. Research has indicated that there are three common determinants of death by suicide among men. The first reason is the feeling of entrapment to conceal any reasons for or attempts at dying by suicide. Another reason found was to be the presence of an illness that could not have been helped due to the lack of peer and professional help before the suicide. The final reason discovered was the mental health services proving to be ineffectual at preventing the suicide (Oliffe et al, 2020). Depression in men, on the other hand, has been characterized by male-type or externalizing depression, which includes symptoms such as anger, risk-taking behavior, and emotion suppression. These characteristics have also been linked to the existence of suicide ideation and a high risk of suicide (Rice et al, 2021). While depression and suicide are both high among men and are considered to be a “silent epidemic”, the reasons for the lack of help-seeking behavior have seemed to be the fear of other’s reactions, personal challenges, fear of psychiatric medication, cultural and environmental factors, worry of homophobic reactions, as well as traditional masculine ideals (Lynch et al, 2018).      While this essay has shed light on the myriad reasons for poor mental health and help-seeking behavior among men, there are various methods that could be efficacious in addressing these societal failures. Research has shown that toxic masculinity and traditional masculine norms have deleterious effects on men’s mental health and help-seeking behavior. A study conducted on gender norms and mental health has found that developing and honing emotional intelligence can result in encouraging respect for diversity in gender identities, emotional expression, and also gender roles (Rice et al, 2021). A few ways to help mitigate the detriment caused by masculine norms and improve help-seeking behavior in men could be tailoring mental health advertising, the amalgamation of mental health and the formal education curriculum, along with making mental health care more accessible (Lynch et al, 2018). To address the public and self-stigmas around mental health problems, a successful approach may be to target changing help-seeking attitudes rather than the stigmatized attitudes directly (Latalova et al, 2014). Men suffering from any psychological distress in contemporary society tend to adopt maladaptive and dysfunctional strategies (such as frequent violent outbursts or substance misuse) as a coping mechanism. Therefore, it is essential to develop population-level programs to teach men healthy ways to manage psychological distress. Clinical practice should also work towards incorporating sensitivity to men’s expressions of mental health issues and handling that in an appropriate manner (Bilsker et al, 2018).     In conclusion, toxic masculinity and traditional male gender norms have been seen to contribute to mental health issues and even hinder help-seeking behavior. Traditional masculinity dictates that exhibiting any vulnerable emotions (such as sadness, fear, or pain) does not align with the traditional role of men and thus, makes them weak. Toxic masculinity also tends to encourage anger and aggressive behavior, thus pushing men to adopt dysfunctional coping mechanisms, such as issues with substance misuse. That being said, it is essential to avoid taking a victim-blaming stance when discussing men’s mental health as the issue is a lot larger than individual attitudes and beliefs. The victim-blaming approach tends to solidify existing public and self-stigmas in regards to problems with mental health. Some approaches to mitigate the treatment gap for men include taking into account societal and cultural factors, along with individual factors, to develop a multi-pronged approach to address the issue. 

Father hood:

• Emotion regulation are important across the lifespan for psycological and interpersonal functioning. Research on children’s emotion regulation skill development often looks at parent socialization of emotion.

 

References:

Affleck, W., Carmichael, V., and Whitley, R., 2018. Men’s Mental Health: Social Determinants and Implications for Services. The Canadian Journal of Psychiatry, 63(9), pp. 581-589.

Ali, B., 2021. Mental Health of Men in Pakistan. Pakistan Today, available at: https://www.pakistantoday.com.pk/2021/12/15/mental-health-of-men-in-pakistan/.

Bilsker, D., Fogarty, A.S., and Wakefield, M.A., 2018. Critical Issues in Men’s Mental Health. The Canadian Journal of Psychiatry, 63(9), pp. 590-596.

Chatmon, B.N., 2020. Males and Mental Health Stigma. American Journal of Men’s Health, doi: 10.1177/1557988320949322.

Fatima, N., 2018. Society: Why Mental Health Problems Are Killing Men. Dawn, available online at: https://www.dawn.com/news/1424880.

Latalova, K., Kamaradova, D., and Prasko, J., 2014. Perspectives on perceived stigma and self-stigma in adult male patients with depression. Neuropsychiatric Disease Treatment, 10, pp. 1399-1405.

Lynch, L., Long, M., and Moorhead, A., 2018. Young Men, Help-Seeking, and Mental Health Services: Exploring Barriers and Solutions. American Journal of Men’s Health, pp. 138-149.

Mckenzie, S.K., Collings, S., Jenkin, G., and River, J., 2018. Masculinity, social connectedness, and mental health: Men’s diverse patterns of practice. American Journal of Men’s Mental Health, 12(5), pp. 1247-1261.

Oliffe, J.L. et al, 2020. Help-seeking prior to male suicide: Bereaved men perspectives. Social Science & Medicine, 261, 113173.

Rice, S. et al, 2021. Gender norms and the mental health of boys and young men. The Lancet Public Health, 6(8), pp. e541-e542.

Rice, S.M. et al, 2021. Male-type depression symptoms in young men with a history of childhood sexual abuse and current hazardous alcohol use. Psychiatry Research, 304, 114110.

Seidler, Z.E. et al, 2018. Men’s Mental Health Services: The Case for a Masculinities Model, The Journal of Men’s Studies, 26(1), pp. 92-104.

Visser, R.O., Mushtaq, M., and Naz, F., 2020. Masculinity beliefs and willingness to seek help among young men in the United Kingdom and Pakistan. Psychology, Health & Medicine.

Whitley, R., 2018. Men’s Mental Health: Beyond Victim-Blaming. The Canadian Journal of Psychiatry, 63(9), pp. 577-580.