Getting Our Men Help
Recently, we got a call from Elaine*, who was concerned about her boyfriend Titus; Titus had quit his job three months ago. Elaine complained that he refused to look for work, although they had several mounting bills. Titus had also started drinking heavily; on one occasion; he even hit Elaine, behaviour that she would have never expected or imagined from the man she loved.
On many occasions, people like Elaine have contacted us, often distressed and concerned about the men in their life. In addition, these friends, partners, or relatives often express concerns about the man they love, getting angry, withdrawing, or acting out.
While men and women usually have similar prevalence rates for mental illness, it is apparent that gender socialisation experiences, the roles men and women play, and power differences have significant implications for the presentation of mental health distress. Furthermore, these factors also affect help-seeking behaviour when they experience mental pain.
While women often internalise mental distress, men’s presentation when experiencing things like depression is different. Men may often externalise their mental pain; for example, Titus, who later learned that he was living with depression, registered that something was different because he was always angry and acting out. For many men, acting out may include drinking, using drugs, or risky sexual behaviour. Men experiencing psychological distress might also engage in violence. Violence might manifest in intimate relationships and with other family members and peers. Men in most societies are also at greater risk for suicide.
Of course, when Elaine called concerned about Titus, like many other people who call our practice, worried about the man in their lives, she had difficulty getting him to acknowledge that he had a problem or needed help. Gender socialisation, mainly what men, like Titus, learned about being a “real man”, remains one of the most potent barriers to accessing mental health services.
As Titus recalls, the concept of a “real man” taught him several things, including hiding and containing his emotions because talking about emotional or psychological distress is considered a weakness. Titus also learned that asking for and seeking help is a sign of softness. Because he was socialised not to seek help, he would need to “tough it out”. Being a “real man” can quickly become toxic to men because it isolates them from social support and often exacerbates symptoms because it discourages them from seeking assistance.
The mental health research indicates because of gender socialisation, many men do not access mental health treatment, or when they do, it is later, and symptoms are more severe. So when Elaine called, her urgency was apparent, “How can I get my boyfriend to see you?” Several strategies might be helpful to get men to access mental health services. One approach is to get men to start conversations with people they might already trust, including talking to a trusted friend or family member. Hence, they are beginning to access helping by utilising and accessing a natural helping system. For example, Elaine encouraged Titus to speak to an older cousin who for many years was his mentor; they had a frank conversation about Titus’s feelings. Because Titus trusted him, he was more ready to get help when his cousin suggested it.
Another approach is getting men to educate themselves about mental health. Again, there is a plethora of available resources online. Titus found his online research particularly empowering because it helped him realise that he was not the only man experiencing mental health distress. Knowing he was not alone and other men were living with depressive symptoms and were securing mental health services was essential in him eventually calling and beginning therapy.
Titus also accessed education and support by attending a men’s health forum in one of the polyclinics in Barbados. Peer support is a valuable resource for many men. For example, male peers helped Titus normalise his own experience; speaking about their experience also helped Titus begin destigmatising his mental health concerns.
As therapists, we are acutely aware of the significance of the language we use with clients. Over the years, we have learned to adapt our languaging when we engage men as clients. For example, Titus and Jomo mainly focused on “goals” and “solutions” to the problems he was experiencing. However, we also discussed the importance of getting “mentally strong” to “fight” the challenges he was facing in his life and begin to do the vital work of supporting the people who were essential to him. Using language that is informed by the nuances of gender is a powerful way of showing understanding and joining up with men who might be struggling with mental health concerns.
Gender socialisation experiences, the roles men and women play, and power differences significantly affect how men show and experience mental health distress. Nevertheless, several strategies might be helpful to get men the assistance they need. The helping methods include encouraging men to have conversations with people they might already trust, educating themselves about mental health, and accessing peer support. Persons engaging men also need to be aware of the nuance of language as they engage men struggling with mental health concerns.
*Persons’ names in this blog post have been changed to protect their identity.