Male Mental Health: The Significance of 'Masculinity'

There is a framework showing how men cope with mental health concerns (particularly depression) in ways that escalate - the 'big build'. It is suggested that men initially begin with 'acting in' behaviours, such as 'avoidance' (e.g. overwork), 'numbing it' (through drug or alcohol use) and 'escaping it' (through increased risk-taking behaviours like gambling or having extra-marital affairs).
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HuffPost UK is running a month-long focus around masculinity in the 21st Century, and the pressures men face around identity. To address some of the issues at hand, Building Modern Men presents a snapshot of life for men, from bringing up young boys to the importance of mentors, the challenges between speaking out and 'manning up' as well as a look at male violence, body image, LGBT identity, lad culture, sports, male friendship and mental illness.

There have been positive advances in men's health over the last 20 years. Life expectancy continues to improve for both men and women, but at a greater rate for men, and the gap in life expectancy between men and women is now reduced to approximately four years. However, important issues remain in relation to men's health. The majority of improvements for men have been made through advances in heart disease and cancer diagnosis and treatment, which means there has been far less improvement for men under 65 years old. Important inequalities also remain between groups of men, with those in lower socio-economic groups having mortality rates almost three-and-a-half times greater than men in the highest group.

But perhaps the biggest concern lies with male mental health, as reflected in the continued high rate of suicide. Whilst suicide rates amongst women have reduced significantly since the 1980s, they are only slightly reduced for men, and the rate has been rising again since 2007 - amongst men aged 45-60 years the rate is the highest it has been since 1981. Currently 78% of suicides in the UK are male, with approximately 13 men in the UK taking their life every day. Research evidence shows that unemployment and redundancy has a particularly strong impact on men's mental wellbeing, and recent evidence suggests a greater impact of economic recession and financial austerity on male suicide than female in several European countries.

So why might this be? What is happening within the UK (and indeed in other Western nations) that seems to make suicide seem like the only option for so many men?

Some have identified how 'masculinity' (what it is to be a man in society) has an impact on men's lives, including their mental wellbeing. But what exactly is masculinity? Traditionally, masculinity has been defined around key ideals and expectations - not being or doing anything 'feminine', being successful (e.g. in work, at sport), being independent, strong and rational, but also taking calculated risks in order to achieve success. These traditional ideas continue to influence how many men think and behave. For example, because men are not supposed to display vulnerability or seek help for psychological problems, they may suppress emotional issues and actually make their problems worse in the longer term. Compared to women, men in general do not have relationships in which emotional support is sought or provided, especially with male peers, for fear of being perceived to be gay or girly. This may be especially true in tough, deprived neigbourhoods where masculinity may be very narrowly defined along traditional lines.

There is a framework showing how this process of socialisation leads men to cope with mental health concerns (particularly depression) in ways that escalate - the 'big build'. It is suggested that men initially begin with 'acting in' behaviours, such as 'avoidance' (e.g. overwork), 'numbing it' (through drug or alcohol use) and 'escaping it' (through increased risk-taking behaviours like gambling or having extra-marital affairs). If such strategies do not relieve the feelings of depression, they can lead to 'acting out' behaviours, which include more of the 'escaping it' behaviours outlined above, which may escalate further to 'hating me, hurting you' (acts of violence, aggression and crime) and 'stepping over the line' (deliberate self-harm and suicide). Again, men's responses to psychological problems will be influenced by the context they live in - some men will have greater access to resources for support.

Given the influence of traditional masculinity, how can we encourage more men to recognise emotional issues early and seek support from friends, family and health professionals? Ironically, we can draw upon some traditional masculinity norms here, for example framing help-seeking as a tough, rational and independent choice - a difficult but pragmatic step which then allows other male roles to be protected (being an involved father, successful at work etc.).

It is also worth noting that some aspects of masculinity are being challenged in society, with increasing numbers of men being more comfortable with engaging in activities often regarded as feminine, ranging from cooking and childcare to investment in appearance - perhaps men will gradually become comfortable with expressing their emotions as well. Also, it is possible to design mental health services which are more 'male-friendly', for example, located in community settings, involving physical activity as well as opportunities for informal support, employing peers as mentors instead of (or as well as) health professionals, and using non-medical language that men may be more comfortable with, for example referring to being 'stressed', 'miserable' or 'pissed off' rather than 'depressed'.

Another potentially valuable avenue for men to explore here is the online world, where men can gain advice and support anonymously, for example from relevant discussion forums, blogs and health sites.

It is clear then that 'masculinity' plays a significant and often damaging role in male mental health. However, masculinity is multifaceted and norms are slowly shifting such that more men may be encouraged to admit when they are feeling down or anxious and seek help. The provision of dedicated 'male-friendly' support in community and online settings may also facilitate greater engagement by men so that future generations will be less likely to struggle alone or opt for drastic strategies like suicide.

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