Reframing masculinity: Connecting men to mental health supports that work
This article was originally published on the Canadian Institutes of Health Research website.
It has been called a silent epidemic.
Men who are suffering from depression get diagnosed at half the rate of women, yet they are three to four times more likely to die by suicide. Globally, men account for 69% of all suicides – and in Canada, they account for about 80% – and many are without the support and treatment they need.
"Depression and anxiety are wrapped up in a lot of stigma, which can deter men from opening up about the challenges they're facing and asking for help," said Dr. John Oliffe, the founder and lead researcher of the Men's Health Research Program at the University of British Columbia.
Dr. Oliffe is working to change that. By collaborating with international researchers, clinicians, and community groups, Dr. Oliffe and his team are exploring how masculinities influence men's health so they can develop practical, web-based tools and resources to help men get the mental health care they need.
Understanding the relationship between gender and health
The first step, according to Dr. Oliffe, is to better understand the factors that prevent men from engaging in health care and mental health support in the first place. One element that comes up regularly in his research is the fact that masculine norms (the socially constructed ideals and expectations around "being a man") can shape men's health decisions.
"Men often like to be – or feel that they need to be – self-reliant," he explained. "But that can really be a double-edged sword." On the one hand, Dr. Oliffe said this self-reliance can make men more resilient and encourage them to proactively deal with health challenges, like looking for information online or developing self-management strategies.
On the other hand, however, the drive to be self-reliant can become isolating and risky for some men. Their self-management strategies may become unhealthy, and they may begin to deny their emotions and turn to alcohol and other drugs to cope with difficult feelings. Others may not be willing to accept their need for professional help until they are in crisis.
"While there are inextricable links between gender and health, there is also more than one way of 'being a man,'" Dr. Oliffe stressed. "'Masculinities' is not a singular term, it's plural – and men will express their masculinity in diverse ways. It's crucial to keep that in mind when studying the impacts of masculinities on men's health to make sure we're not overlooking their unique needs, experiences, and challenges."
The relationship between gender and health also has implications for health services, as it can affect the ways in which some issues get spotted and addressed. For example, many of the cardinal signs of depression in men include anger, irritability, risk-taking behaviours, and substance use, but these symptoms don't appear on generic screening tests used in clinics and hospitals to evaluate and diagnose depression.
"Men will rarely come out and say that they are depressed," Dr. Oliffe explained. "Instead, they will say things like, 'I'm really stressed out' or 'I'm irritable and frustrated all the time.' We need to get better at the clinical level at recognizing when these feelings indicate something more serious."
Moving from theory to practice
To address all of this complexity, a significant portion of the work done by Dr. Oliffe and the UBC Men's Health Research Program focuses on providing practical, science-backed mental health resources for men, their families, and clinicians.
And there is clearly an appetite for these types of accessible tools. For example, web traffic for HeadsUpGuys, a special resource designed to help men dealing with depression, typically sees 65,000 visitors each month. Created and led by Dr. John Ogrodniczuk, a co-investigator with the UBC Men's Health Research Program and one of Dr. Oliffe's collaborators, HeadsUpGuys serves as an excellent example of the type of knowledge mobilization that is making a real difference. The research helps to shape resources – and even community-based initiatives – to ensure they are designed to meet men's needs, whether that need is for professional help, healthier self-management strategies, or social support.
The next phase of Dr. Oliffe's research will add another dimension to the team's resource offerings, focused on helping men build better relationships.
"We've seen that when it comes to relationship break-ups, men who divorce are eight times more likely to suicide than women," he explained, citing financial hardship, severe emotional stress, and isolation from friends, family, and other third-party social supports.
"Relationship break-ups were a blind spot in men's health research, to be frank, so now we're working directly with guys who are going through these experiences to understand what would help them handle their emotional stress and anxiety in a positive, healthy way."
This collaborative, participatory approach is an integral component of Dr. Oliffe's research. By working directly with men and their families, Dr. Oliffe and his team are helping empower them to feel confident speaking up about their mental health challenges, confiding in others, and getting help.
"Our work is just one piece of a larger goal to help men get the health support they need," Dr. Oliffe said. "But we know that when men have strong social support networks and a healthy outlook on life, everyone benefits – and that's ultimately the outcome we want to achieve."
