Masculinity and Help-Seeking Among Men With Depression: A Qualitative Study

Abstract

Background: Many studies indicate that men are more reluctant to seek help for mental health problems than women. Traditional ideas of masculinity are often seen as a cause of this phenomenon. However, little is known about the diversity of experiences during the processes of help-seeking and service use among men with depression who have already utilized mental health services. This study aims to explore men's experiences and attitudes toward depression, help-seeking, and service use in order to develop gender-sensitive services.Methods: Narrative-biographical interviews were conducted with men treated for depression (n = 12). Interview topics included individual experience with depression, help-seeking behavior, and mental health service use. Transcripts were analyzed using qualitative content analysis.Results: Before seeking treatment, men's help-seeking behavior was negatively affected by internalized masculine norms. However, findings indicate a change of attitudes toward depression after mental health service use. Men with depression emphasized a salutogenic perspective toward mental health problems and critically reflected on masculine norms. The positive function of men-only groups were described as key for successful service use.Conclusions: Men with depression reported experiences toward help-seeking and service use on four different levels: (i) attitudes toward depression, (ii) perception of societal views on depression, (iii) experiences within the family context and (iv) experiences with mental health services. Interventions to reduce the stigma of being “unmanly” and to improve men's capacity to cope with being unable to work should be developed. Peer-led men-only groups may increase participants' self-esteem and assist in disclosing weaknesses. In the context of GPs' mediating role, training for health professionals concerning the impact of masculine norms on mental health is recommended.

Men’s Experiences of Mental Illness Stigma Across the Lifespan: A Scoping Review

“…Six studies reported how mental illness stigma and men's fear of transgressing masculine cultures normed by strength, independence, and invincibility, can play out in male-dominated environments such as places of paid work and professional sport (DeLenardo & Terrion, 2014;Hassouneh & Fornero, 2020;Mahalik & Dagirmanjian, 2019;Siegel & Sawyer, 2019;Staiger et al, 2020;Wood et al, 2017). Consistently reported by men in these studies was the fear of being perceived as weak, incapable of coping with distress, and failing to fulfill the masculine norms deemed mandatory for specific male dominated jobs and sports.…”

“…The stigma of EDs was seen as more stigmatizing and shameful for men given Eds are typically viewed as a feminine disorder. Staiger et al (2020), Germany To explore men's experiences and attitudes toward depression, helpseeking, and service use None Semi-structured interviews 12 men diagnosed or selfidentified as having depression (age 16-64) Men described feeling stigmatized and, in some cases, shunned by work colleagues for not being unable to cope with mental distress, and for failing to meet the norms relating to paid work. Men's depression-related incapacity to work and being labeled left them feeling further stigmatized.…”

“…They avoided disclosure and help-seeking in order to protect themselves from being stigmatized or labeled in ways that would hinder future professional relationships. For men in Staiger et al's (2020) study, their incapacity to work due to depression left them feeling stigmatized by colleagues who labeled them as "loser," "lazy" or "incapable." A workplace culture of "not being sick" was associated with masculine norms such as being strong, successful, and self-reliant.…”

“…These included peer support, increasing mental health literacy and reframing mental illness and help-seeking (Johnson et al, 2012DeLenardo & Terrion, 2014;Harding & Fox, 2015;Scholz et al, 2017;Ward & Besson, 2012). For some, connection with peers experiencing similar mental illness challenges was key to countering stigma by enabling disclosures in safe spaces where such issues and talk were normed (Ferlatte et al, 2019b;Harding & Fox, 2015;Staiger et al, 2020). Peers with similar illness experiences were perceived as more empathetic, trusted, and able to understand.…”

“…For example, on-line forums where mental illness experiences were openly shared, reinforced men's decision to seek counseling, enabling them to counter the associated stigma (Harding & Fox, 2015). For men with depression and a history of mental health service use, interactions with fellow services users provided valuable peer support and a destigmatizing "sheltered space" (Staiger et al, 2020). Men who participated in group counseling were not subjected to questions or made to feel weak and felt accepted by men with similar illness experiences.…”