What affects it and how to improve support

Surveys from around the world find that males everywhere are reluctant to talk about their mental health and are more likely to die by suicide than females. Here’s why this may be happening — and how some healthcare professionals and researchers are trying to address it.

Across the globe, among many races, ethnicities, and income brackets, males often avoid getting help for their psychological issues.

According to the World Health Organization (WHO), males die by suicide at twice the rate of females. And high income countries have the highest suicide rates among males.

In the United States, males make up nearly 80% of all deaths by suicide, report the Centers for Disease Control and Prevention (CDC). Males die by suicide four times more often than females do.

Mental health professionals diagnose depression more often in women than in men, according to the nonprofit Mental Health America (MHA). At the same time, the organization adds, more than 6 million American men experience symptoms of depression annually — and most go undiagnosed.

Situational stressors also play a major role in suicide deaths among males, many of whom do not have a documented mental health history, according to a 2021 analysis from the CDC.

These stressors can include anything from relationship troubles to arguments, but all indicate a need for “support during stressful transitions,” explains a press release from UCLA, the professional home of one of the report’s co-authors.

Men are less likely than women to receive formal mental health support of any kind.

Recent research explains why this could be happening and suggests ways to remedy the situation.

On a daily basis, many males find themselves grappling with prescriptive, antiquated ideas about gender — and this struggle can contribute to their mental health issues.

It also explains why so many males have a difficult time admitting that they need help and pursuing it.

“Sex differences in mental health typically emerge across late childhood and adolescence,” wrote Simon Rice, an Australian mental health expert, in The Lancet Public Health in 2021. “This time is also when gender norms become entrenched, persisting into later life, whereby they continue to shape mental health and help-seeking.”

In 2022, the American Journal of Public Healthpublished a review of studies dealing with the societal stigma surrounding mental illness. It found that men who internalized that stigma were less likely to get help for their psychological issues and more likely to face challenges and “a heightened risk for severe mental illness.”

Research shows that people who are treated for depression or suicidal thoughts (whether through therapy or medication) are far less likely to think about or attempt suicide.

Sometimes, difficulty with money or other practical issues is linked to suicidal ideation. In times of personal hardship, getting material or emotional support from others has also been shown to reduce these thoughts.

Men of color and those with diverse racial and ethnic backgrounds face additional challenges when it comes to looking after their mental health.

The National Alliance on Mental Health notes that just 1 in 3 Black adults with mental illness receives treatment, despite the fact that they are more likely to experience emotional distress than white adults. Generational racial trauma and violence against people of color, as played out in the news media, intensify this distress.

Members of the Black community may also have difficulty trusting healthcare professionals.

According to MHA, “Historical dehumanization, oppression, and violence against Black and African American people has evolved into present-day racism — structural, institutional, and individual — and cultivates a uniquely mistrustful and less affluent community experience.”

Suicide rates have gradually risen among Black and Hispanic adults in recent years, while steadily dropping among white adults, notes the CDC.

American Indian and Alaskan Native individuals have the highest suicide rate of any demographic group. In surveys, members of these groups are 60% more likely than white individuals to say that “everything is an effort, all the time.” Trauma and lack of resources are contributing factors.

Octavio Martinez, Jr., MD, the executive director of the Hogg Foundation for Mental Health, says men of color are more likely to face poverty and violence, higher rates of incarceration, and fewer employment opportunities.

The effect of such disparities on their mental health is “a double whammy,” he emphasizes.

All of these issues, taken together, act as a further barrier to people of color seeking care for their mental health when they need it.

The same mental health issues can manifest differently in males and females. This is thought to be a possible “side effect” of their divergent views on mental health.

Males with depression may exhibit higher levels of anger, aggression, and irritability, or showcase their distress in other “culturally acceptable” ways. Females with depression may display signs of low mood instead.

Symptoms of depression in males can be physiological, such as a racing heart, digestive issues, or headaches. Males may be “more likely to see their doctor about physical symptoms than emotional symptoms,” says the National Institute of Mental Health.

The organization notes that men who experience depression may self-medicate with alcohol and other substances. However, this can exacerbate their issues and put them at risk of other health conditions.

So what can mental health professionals and policymakers do to ensure that men feel confident and comfortable seeking support, and receive appropriate care?

The first step in addressing mental health issues, researchers say, is expanding general awareness and education around the topic itself.

In a 2016 Canadian Family Physician essay, researchers suggested breaking down the stigma by launching national campaigns that make seeking help a sign of strength and a necessary part of caring for one’s overall health.

Community-based programs can help counter risk factors for mental health problems, particularly among elderly men, who may feel isolated and are more likely to attempt and die by suicide than younger men.

However, no intervention is complete until it accounts for groups that face systematic marginalization, such as men of color and those of diverse ethnic and racial backgrounds.

Specialists suggest that Black males in the U.S. may be more likely to seek support in informal settings, such as places of worship or barbershops — and they benefit from coming together and talking as a group.

Dr. Martinez promotes interventions that encourage men and boys of color and those with diverse backgrounds to connect on a personal level.

“Stigma fades when men and boys see resilience and mental health self-care modeled by their fathers, brothers, teachers, faith leaders, and friends,” he says.

Males are much more likely than females to die by suicide. This disparity may be due, in part, to the greater reluctance among males to seek mental health treatment and internalized expectations around “masculine behavior.”

Males who experience suicidal thoughts should know that help is available. Therapy, medication, community interventions, and real-world assistance can lessen suicidal ideation and help address depression.

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