Barriers at Every Turn: How Systemic and Social Factors Block Men from Mental Health Care

Taking the important step of seeking care for mental health isn’t always an easy decision. Uncertainty about the need for care, social stigmas associated with mental health, and other perceptions can block people from seeking the care they need.

For men, there are often extra challenges. Long-held societal and personal beliefs about the need for men to “tough it out” can get in the way of getting help for a mental health issue.

On top of these obstacles, men sometimes find that the system seems to be working against them. They might feel misunderstood by healthcare professionals, or they may express themselves through such behaviors as irritability or substance use, leading to misdiagnosis, studies show.

“Societal stigma and cultural expectations discourage men from expressing vulnerability or seeking help, as doing so can be perceived as a sign of weakness,” said Yusen Zhai, Ph.D., director of the University of Alabama at Birmingham’s Community Counseling Clinic, in an interview published by UAB. “Additionally, traditional diagnostic criteria for depression may not fully capture the unique ways it presents in men, contributing to misdiagnosis or overlooking the condition altogether.”

Mental health conditions are taking a toll on men, according to research conducted in recent years.

Nearly one in 10 men experience depression or anxiety, and less than half of these seek treatment, according to the Anxiety and Depression Association of America. Even more troubling, suicide rates increased 26% among men from 1999 to 2017, with men about four times as likely to die by suicide as women, according to the U.S. Centers for Disease Control and Prevention.

Personal and Practical Barriers

Underscoring how men tend to view mental health concerns, a study published in 2020 showed that:

• 80% of men believed that many people feel sad or down
• 80% didn’t know what to search for in a counselor or therapist
• 73% said they needed to solve their own problems

The findings, in the International Journal of Social Psychiatry, also indicated that a majority of men (65%) actually wanted treatment. Of the 35% who said they didn’t want treatment, one of the leading reasons was that they felt unsure that counseling would be effective.

These barriers to care suggest that the delivery of mental health services should be modified to “better respond to dominant masculine ideals while also improving men’s ease of access into a transparent treatment process,” the study said.

While men might harbor personal doubts about getting help, societal norms – often reinforced by friends and family – can increase the pressure on men to avoid seeking the services of a mental health professional.

Rob Whitley, author of the book Men’s Issues and Men’s Mental Health, published in 2021, called the high degree of stigma in workplaces and families a leading factor in preventing men from seeking care.

And Nafees Alam, Ph.D., in an article in Psychology Today, wrote: “Traditional masculinity norms – such as the emphasis on stoicism, self-reliance, and emotional control – play a significant role in how men experience and respond to mental health challenges.”

Practical considerations such as the cost of care, difficulty finding the right mental health provider, and a lack of male-centered services for mental health can contribute to the reluctance to seek care.

Systemic Barriers

Researchers say that one of the most significant obstacles to men getting the care that they need can be found in the way mental health conditions are diagnosed and treated.

For example, Whitley concluded that the “formal mental care system can be unwelcoming and unengaging for men and typically suffers from male gender blindness, with few formal services devoted specifically to men’s mental health,” according to an abstract of the book.

Other mental health experts have cited similar concerns, such as a belief among men seeking care that providers have underestimated their needs or have failed to take a sincere interest in their mental health challenges.

An article written by researchers at the University of British Columbia in Canada, published in the journal Social Science & Medicine, said ineffectual help from mental health providers could be a contributing factor in the suicide deaths of men across the United States and Canada. The researchers cited a 2016 Canadian study that found more than 60% of men who died by suicide had received mental health treatment in the year before their death.

Since men are more likely than women to express mental health distress through such behaviors as anger, alcohol or drug use, risk-taking, and irritability, mental health professionals might miss symptoms of depression or anxiety when diagnosing a male patient.

“There is some evidence that, in contrast to depressed women, depressed men tend to report alternative symptoms that are not listed as standard diagnostic criteria,” according to a 2016 study published in the International Journal of Social Psychiatry. “This may possibly lead to an under- or misdiagnosis of depression in men.”

Possible Solutions

These and other barriers to men seeking care have led more clinicians to call for better training for mental health providers and the development of new methods of engaging men in mental health discussions.

Among the suggestions:

• Training clinicians to recognize male-specific symptoms of mental health conditions
• Developing outreach programs designed to break down barriers and encourage men to seek care
• Creating ways to normalize mental health conversations in settings where men get together

“The impetus is on those of us in the medical and mental health fields to ensure we’re empathetic to the struggles that men face in a changing world,” wrote three Georgetown University researchers in a 2024 article published by the Association of American Medical Colleges. “It is time we consider men’s mental health in its full context, and shift the focus to the ways our health care systems and providers are equipped to deliver services to improve men’s mental health.”

For more information about this topic and other topics, please visit:

https://genesight.com/blog/patient/the-relational-approach-to-talking-to-men-about-their-mental-health/

https://genesight.com/blog/patient/depression-diagnosis-treatment-and-beyond/