Authors: Dr Vanessa Cooper and Dr Alicia Hughes
Depression: Helping men to get help
Rates of diagnosed depression and the findings of surveys suggest that women are at least twice as likely to suffer from depression than men.1,2 In contrast, rates of suicide and substance abuse disorder are consistently much higher in men.3 It may therefore be that the true prevalence of depression in men is masked by the underreporting of depressive symptoms, gender differences in the presentation of depression and lower rates of diagnosis of depression by clinicians.4
How does depression differ in men
In many cultures, boys are socialized not to express feelings such as sadness and fear, so men may be more likely to respond to mental pain by externalizing symptoms such as substance misuse, risk-taking and poor impulse control or experience emotions through physical (somatic) symptoms such as headaches.5,6 These symptoms and behaviours may be seen as “depressive equivalents,” meaning that they mask underlying sadness, loneliness and alienation.3 Studies have found that men who conform to the traditional masculinity norms (for instance, independence, physical toughness, minimal emotional expression) are more likely to have a more externalising, somatic pattern of depression than with less traditional gender norms.6
Are men less likely to seek professional help for depression?
Men may be less likely than women to seek help when they experience difficulties with their mental health.8 In a recent study of 530 men with moderate to severe depression, only 8.5% were currently engaged with professional mental health support.9 Tailored approaches to screening, promotion of help-seeking and treatment of depression in men may therefore be needed.5
How can we support men to seek help for depression?
In order to understand some of the barriers to receiving mental health support faced by men, we conducted a rapid review of the literature (Figure 1). We categorised these barriers in terms of the COM-B model.
Most of the barriers we identified could be addressed by targeted interventions. We’ve included examples of intervention components to address each group of barriers.
|Barriers||Potential interventional components|
Additional resources and programs to support men’s mental health
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- National Institute of Mental Health. Major depression. Retrieved June 2021, from https://www.nimh.nih.gov/ health/statistics/major-depression.shtml
- Affleck, W., Carmichael, V., Whitley, R. Men’s Mental Health: Social Determinants and Implications for Services. Canadian Journal of Psychiatry / La Revue Canadienne de Psychiatrie 2018, Vol. 63(9) 581-589
- Mahalik, J.R., Dagirmanjian, F.R. Working-Class Men’s Constructions of Help-Seeking When Feeling Depressed or Sad. American Journal of Men’s Health. 2019, 1-13.
- Oliffe, J., Rossnagel, E., Seidler, Z.E., Kealy, D., Ogrodniczuk, J.S., Rice, S.M. Men’s depression and suicide. Curr Psychiatry Rep. 2019; Spe 14; 21 (10):103
- Magovcevic M, Addis ME. The masculine depression scale: Development and psychometric evaluation. Psychology of Men and Masculinity. 2008;9:117–132.
- Burns J. & Birrell E. Enhancing early engagement with mental health services by young people. Psychology Research and Behavior Management 2014:7 303–312
- Sagar-Ourighli, I., Godfrey, E., Bridge, L. Improving Mental Health Service Utilization Among Men: A Systematic Review and Synthesis of Behavior Change Techniques Within Interventions Targeting Help-Seeking. American Journal of Men’s Health (2019): 1–18.
- Rice, S.M., Oliffe, J.L., Kealy, D., Seidler, Z.E., Ogrodniczuk, J.S. Men’s help-seeking for depression: attitudinal and structural barriers in symptomatic men. J. Prim Care Community Health, 2020,11:2150132720921686
- Fogarty, A. S., Proudfoot, J., Whittle, E. L., Player, M. J., Christensen, H., Hadzi-Pavlovic, D., & Wilhelm, K. (2015). Men’s use of positive strategies for preventing and managing depression: A qualitative investigation. Journal of Affective Disorders, 188, 179–187.
- Lynch, L., Long, M. Young men, help seeking and mental health services: exploring barriers and solutions. American Journal of Men’s Health, 2018, Vol 12 (1); 138-149
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- Vogel, D. L., Wade, N. G., Wester, S. R., Larson, L., & Hackler, A. H. (2007). Seeking help from a mental health professional: The influence of one’s social network. Journal of Clinical Psychology, 63, 233-245.
- Cleary, A. (2012). Suicidal action, emotional expression, and the performance of masculinities. Social Science & Medicine, 74, 498-505
- Clement, S., Schauman, O., Graham, T., Maggioni, F., EvansLacko, S., Bezborodovs, N., . . . Thornicroft, G. (2015). What is the impact of mental-health related stigma on help seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45, 11-27.
- Booth, M. L., Bernard, D., Quine, S., Kang, M. S., Usherwood, T., Alperstein, G., & Bennett, D. L. (2004). Access to health care among Australian adolescents: Young people’s perspectives and their sociodemographic distribution. Journal of Adolescent Health, 34, 97-103