Help-seeking for depression as a stigmatized threat to masculinity.

Abstract

To better understand men's reluctance to seek help for mental health issues, we investigated the contributions of depression, stigma, and masculinity on help-seeking likelihood in a sample of depressed men. Two-hundred and fifty-eight men, who screened positive for depression on the PHQ-2, completed measures assessing self-stigma, self-reliance, emotional control, and general help-seeking likelihood via an online Qualtrics survey. Path analysis using MPlus tested one model of moderated mediation and two mediation models among the variables. Results supported a partial mediation model where (a) self-reliance, emotional control, and self-stigma directly related to lower likelihood of help-seeking, (b) self-reliance and emotional control predicted greater self-stigma, (c) depression predicted greater self-reliance and emotional control, (d) self-reliance and emotional control had indirect effects on help-seeking being partially mediated by self-stigma, and (e) depression had significant indirect effects on both help-seeking and stigma, being fully mediated by self-reliance and emotional control. We discuss the need to develop practices and interventions that address self-stigma's contribution to men's help-seeking through the complex relationships between depression and men's self-stigma as mediated by self-reliance and emotional control. Limitations to the study and future research directions are discussed. Public Significance StatementDepression is costly in both human suffering and the hundreds of billions of dollars it costs the U.S. annually. Although treatment for depression is effective, men are less likely to seek help. The goal of this study was to better understand the complex relationships among masculinity, self-stigma, and depression as they explain help-seeking intentions in men who screened positive for depression. Our findings suggest the importance of psychologists addressing men's gendered reactions to their depression and how those gendered reactions contribute to self-stigma and less likelihood to seek help.

Australian men's initial pathways into mental health services

“…The prevailing narrative in academic and dominant social discourse portrays men as reluctant to seek mental health care for fear of being seen as weak 22 . Commonly implicated in explaining this reticence are psychosocial barriers including the perception of mental health care as emasculating or feminine 2,23 . That 40% of respondents in the current study initiated their own help‐seeking counters this long standing narrative, adding empirical weight to contemporary research showing that men's uptake of professional services is increasing 1,24 .…”

“…22 Commonly implicated in explaining this reticence are psychosocial barriers including the perception of mental health care as emasculating or feminine. 2,23 That 40% of respondents in the current study initiated their own help-seeking counters this long standing narrative, adding empirical weight to contemporary research showing that men's uptake of professional services is increasing. 1,24 A myriad of factors could explain this increase, including greater allocation of government funding to mental health services, alongside targeted public health initiatives aiming to normalise men's help-seeking.…”

The prevalence of perceived stigma and self-blame and their associations with depression, emotional well-being and social well-being among advanced cancer patients: evidence from the APPROACH cross-sectional study in Vietnam

“…Equally alarming is the extremely low utilization rate of mental health services among this study population and the relatively low interest in using mental health services. Studies have reported that individuals experiencing a mental condition such as depression are not likely to seek help due to stigmatization and fear for discrimination [ 43 – 45 ]. Due to the lack of resources or lack of help-seeking behaviour, these individuals might not receive the necessary intervention to address their depression [ 46 ].…”

Mapping Men’s Mental Health Help-Seeking After an Intimate Partner Relationship Break-Up

“…Though such mental health challenges can prompt men’s help-seeking, there is much debate about the role of masculinity in men’s use of professional mental health care services (Seidler et al, 2018). In gendered contexts, masculine norms and ideals—most prominently self-reliance—have featured as a pivot that can constrain (Addis & Mahalik, 2003; Mahalik & Di Bianca, 2021; Pirkis et al, 2017) or enable (Struszczyk et al, 2019) men’s engagement with professional mental health care. Herein, the predominance of professional mental health care services as what legitimately counts as the help has also limited depictions of, and insights to men’s mental health help-seeking (Fletcher & St George, 2010; Harding & Fox, 2015).…”

“…Self-reliance and suicidal thoughts have also been coupled to explain why men are unlikely to talk through problems or seek help from friends and family when feeling down or vulnerable (Pirkis et al, 2017). When depression threatens men, Mahalik and Di Bianca (2021) further suggest self-reliance is levered by men to re-establish their manhood. Qualitative work has consistently challenged these deficit depictions of self-reliance, contextualizing how a plurality of masculinities can be embodied to work for men’s mental health help-seeking (Emslie et al, 2006; Ferlatte et al, 2019; Oliffe et al, 2021; Player et al, 2015).…”