“Women seek help – men die”
(Angst & Ernst, 1990)
“… Men often have mental health needs that are distinct from those of women and which are particularly associated with the lived experience of being male”. (Untold Problems: published by the Men’s Health Forum, 2010)
These days, many organisations have wellbeing strategies and some of these can be very sophisticated but do they recognise the differences between men and women, when it comes to mental health or do they treat everyone in the same way? There has been a wealth of research into the mental health of women but still relatively little into the mental health of men and yet the research that has been carried out, to date, suggests that there are some real differences in the way that men experience mental ill-health. This suggests that organisations should take this into account when designing their wellbeing strategies, particularly those organisations that employ a lot of men.
Why Worry About Men’s Mental Health?
The research into mental health suggests that women are more prone to depression and anxiety than men e.g. the ‘Mental Health Foundation’ suggests that 1 in 4 women will experience depression at any time, compared with 1 in ten men and that women are twice as likely to experience anxiety as men. These statistics suggest that women are more at risk when it comes to mental health, however they are only one side of the coin and fail to emphasise the mental health risks for men. Statistics from the ‘Office for National Statistics Psychiatric Morbidity report, 2001’ indicate that:
- 76% of people who kill themselves are male.
- 67% of British people who consume alcohol at ‘hazardous’ levels and 80% of those dependent on alcohol are males
- Almost three-quarters of people dependent on cannabis and 69% of those dependent on other illegal drugs are male.
In addition, GP services are used 20% less by men than women. This fact is even worse than it looks because only a third of people consult their GP when they experience a mental health condition so, when it comes to men, we could be looking at a third minus 20%.
Men and mental health
The limited research that exists regarding the mental health of men paints a picture of men experiencing mental ill-health in a different way to women. This makes it less likely that it will be identified, recognised or addressed using the current ‘female model’ of mental health.
Men Have Lower Levels of Emotional Literacy and Fail to Acknowledge That They Have a Mental Health Problem
Women tend to have higher levels of emotional literacy then men i.e. they are more in touch with their feelings and therefore more able to recognise when they are experiencing poorer mental health and are therefore able to seek help for their problems (Addis & Mahalik, 2003). Sayers and Miller (2004) found that men often recognised distress only at crisis point, suggesting poor emotional and mental health literacy.
Lower levels of emotional literacy not only have an impact on the ability of a man to recognise when he is experiencing mental ill-health but also on his ability to communicate his distress. Rutz et al (1997) found that male depression was masked by irritability, anger, hostile-aggressive-abusive behaviour and alexithymia (defined as the inability to express or describe emotions with words).
Men present with different symptoms
When men experience anxiety and/or depression, they tend to exhibit different symptoms than the ones that we are taught to look for in women.
A Focus on Physical Symptoms
Men are more likely to focus on and describe the physical symptoms of depression (such as feeling tired or losing weight). Physical symptoms could include: backache, frequent headaches, sleep problems, digestive problems etc. that don’t respond to normal treatment.
Unlike women, instead of talking about low mood, men are more likely to describe feelings of anger or very irritability. This anger can manifest itself in different forms from being sensitive to criticism, through to a short temper, or even violence. Some men can become abusive, controlling and even verbally or physically abusive to wives, children, or other family members/friends.
Men who are experiencing depression may start exhibiting risky behaviour. They may engage in dangerous sports, drive their car at dangerously high speeds, gamble, have extramarital affairs etc.
Men tend to engage in alcohol and substance abuse more than women and this may be an attempt to mask the symptoms of mental ill-health.
Escapist behaviours are an attempt to escape from the reality of the symptoms of mental ill-health. Escapist behaviours that men with mental ill health engage in can include: playing sports all the time, sitting in front of the TV for countless hours, withdrawing from conversations that might arouse difficult emotions etc.
Men are less likely than women to seek help
“It is a paradox that men are three times more likely than women to take their own lives but only half likely to be diagnosed with depression......this may be explained by the fact that some men living with depression may never present themselves to a health professional who could diagnose them.” (Wilkins 2010)
‘Men's Mental Health Forum’ points identified that men are reluctant to go their GP A survey by Calm revealed that 69% of men said they preferred to deal with problems themselves, 56% didn’t want to burden others. Men tend to view depression and anxiety as something that women experience. Men compare themselves against a masculine ‘gold standard’ which prizes power, control and invincibility. When men believe they are not meeting this standard, they feel a sense of shame and defeat. The last thing that they are going to do is further compound that shame by asking for help.
Men are Less Likely Than Women to Receive a Diagnosis of Depression From Their GP
Men experience a bit of a double whammy, in that when they do finally seek medical help and visit their GP, they are much less likely than a woman to be given a diagnosis of depression or anxiety. GP’s are more likely to diagnose a man as having anger management issues, perhaps because they do recognise the differential symptoms that men present with and/or because men are unable to clearly articulate their feelings and symptoms.
How do you Ensure That Your Wellbeing Strategy Looks After Men?
Train your managers to recognise the differential symptoms of reduced mental health that men present with so that they can identify when male staff are experiencing mental ill-health. Train them to be mindful of men who are going through divorce/separation/bereavement as the research suggests that they do not to cope as well as women and this may increase their vulnerability to mental ill-health.
Raise awareness of the fact that men experience mental ill-health and that it is ok to talk about feelings. Educate your employees about the differential experiences of men and women with regard to mental health. Encourage employees to challenge traditional views about masculinity and discourage the cultural view that men have to be strong at all times. Promote role models of famous men who acknowledge that they have mental health issues as this helps make it more acceptable for men to talk about mental ill-health. You may wish to nominate one of your health and wellbeing team as a men’s mental health champion so that they can ensure that men’s mental health is taken into account of in any initiatives.
Remember that men may be very reluctant to talk to someone in the workplace about how they feel and may not want to talk to their GP for the same reasons. Try to give the option of talking to a male counsellor/colleague/mental health champion. Men with mental health conditions report that services offering help are often female-dominated and they like to have the choice of talking to someone of the same gender. Men have a low take up of traditional mental health services, which tend to offer talking therapies. Try to find male-led community groups that focus on mental health so that you can recommend them to men who are experiencing mental ill-health. You may be able to persuade the group leader to come in and talk to your organisation about the work that they do helping men with mental health issues.
Sharon De Mascia (email@example.com) Cognoscenti Business Psychologists.