Written by Dr Sara Tookey
November is Men’s Mental Health Awareness Month, also known as 'Movember'. While Movember often focuses on mustache-growing campaigns, its purpose is to raise awareness of men’s health issues, including mental health. Men face disproportionately high rates of mental health challenges and suicide compared to women, yet stigma prevents many men from seeking help. Providing compassionate, male-centered mental health resources and support is crucial.
The Problem: Statistics on Men's Mental Health
According to the Office for National Statistics (ONS, 1) in the UK, men account for around 75% of registered suicides, with an average of 84 men dying by suicide per week. Men aged 45-49 have the highest suicide rates, at 25.5 deaths per 100,000 in 2019 (1). A report from the World Health Organization estimated that men are 1.8 times more likely to take their own lives when compared to compared to women, a fact supported by a recent review of research into men's mental health.
Men also have higher rates of substance abuse disorders. Per the Substance Abuse and Mental Health Services Administration (SAMHSA), men are over twice as likely as women to be heavy drinkers and three times more likely to have a cannabis use disorder (2).
Despite these statistics, men are less likely to access mental health services. Only 36% of referrals to NHS talking therapies are for men (3). Outdated stigma prevents many men from seeking help.
Patriarchy Harms Men Too
While patriarchal structures privilege men over women in many ways, rigid masculine norms also have detrimental effects on men's mental health and wellbeing. Research over the past 20 years has shown that traditional masculinity – marked by stoicism, competitiveness, dominance and aggression – is largely harmful for men (4).
Cultural norms and gender stereotypes have been circulating for generations, and they can be toxic for men and their personal relationships (4). When it comes to processing emotions, there are different expectations for men and women. Women are often viewed as “sensitive,” and therefore society finds female expression of feelings, like sadness or fear more acceptable. But men, who are seen as strong and fearless ("masculine") are not encouraged to outwardly express their emotions.
Men have been socialised to be strong, fearless, to restrict emotional expression and vulnerability, and just "get on with it". However, restricting emotions and feelings can be detrimental to a man's mental health. Researchers have also found men who conform more to masculine norms see risky behaviors like heavy drinking as more normal and are more likely to engage in them (5), further endangering their physical and mental health.
This masculine avoidance of vulnerability extends to seeking psychological help. Men who embody traditional masculine ideals are more negative about mental health services than men with flexible gender attitudes (6) and as a result are less likely to seek help (7). Male socialisation that emphasises self-sufficiency leads many men to suffer privately rather than seeking crucial support.
For example, norms discouraging emotional expression teach boys to suppress feelings rather than develop healthy coping strategies. This makes men less likely to seek help for mental health issues out of shame and increases their risk of commiting suicide (8) by denying them access to crucial support structures. Beliefs that seeking help shows weakness (9) discourages men from seeking professional and social support, leading them to feel more isolated and alone in their struggles.
Patriarchy also defines masculine value largely by status, strength, and career success (9). When men fail to achieve these narrow goals, they may experience profound self-doubt and low self-worth, despite accomplishments in other areas like relationships or community. Rigid thinking defines some emotions, like empathy, as exclusively "feminine," preventing human connection and preventing them from accessing crucial social connection and support.
Dr Fredric Rabinowitz, former president of the American Psychological Society and steward of the 2005 guidelines for the Society for Psychological Study of Men and Masculinities emphasises how men are raised to be "self-sufficient and able to take care of themselves" and that "any sense that things aren't OK needs to be kept secret".
Rabinowitz says. “Men who keep things to themselves look outward and see that no one else is sharing any of the conflicts that they feel inside. That makes them feel isolated. They think they’re alone. They think they’re weak. They think they’re not OK. They don’t realize that other men are also harboring private thoughts and private emotions and private conflicts.”
Stephanie Pappas, writer of the American Psychological Association Journal, highlights the the "tragic ramifications of these private conflicts" when she writes:
"These private conflicts can have tragic ramifications. Though men report less depression than women, they complete suicide at far higher rates than women, and the numbers are moving in the wrong direction" (Stephanie Pappas, 2019, APA, Vol 50, No. 1).
Dismantling restrictive masculine norms liberates men to embrace their full humanity. Supporting boys to process and express their emotions in healthy ways (10), have diverse interests, and nurture intimate bonds without shame leads to improved mental health outcomes. Constructing masculinity as multifaceted and flexible rather than oppositional to femininity benefits men and society as a whole.
Compassion in Men's Mental Health
Compassion-focused therapy (CFT) is an integrative psychotherapy approach developed by psychologist Dr. Paul Gilbert that combines research and tools from psychology, neuroscience, and Buddhism. CFT focuses on cultivating compassion towards oneself and others as an emotional resource for managing difficulties like shame, self-criticism, trauma, and mental health issues. (I will delve more into CFT in future articles- so stay tuned)
The Founder of Compassion Focused Therapy, Dr Paul Gilbert says:
“If you want one recipe to make you unhappy, it would be to focus on the things you criticize or don’t like about yourself.” Paul A. Gilbert, The Compassionate Mind
CFT can be particularly helpful for men struggling with mental health difficulties due to its emphasis on self-compassion (11). Rigid masculine norms that discourage emotional expression and help-seeking and encourage perfectionism and career status often lead men to be very self-critical about themselves and their own mental health struggles. CFT teaches men to treat themselves with the same understanding they would show a friend, thereby reducing shame (12).
CFT uses evolutionary psychology and affect regulation systems theory to explain why self-criticism develops and how to strengthen inner compassion (13). Mindfulness, imagery, and behavior change exercises aim to activate the self-soothing system to balance excessive threat and drive system reactions. A compassionate therapist models and nurtures compassion skills development.
Research employing CFT in the male population has shown that self-compassion partially mediates the relationship between mental health shame and mental health problems (12) and improves wellbeing (11).
By focusing on self-care rather than self-blame, CFT can make therapy more accessible for men. It provides tools to manage unhelpful thought patterns while reducing shame and stigma as barriers to treatment. Integrating self-compassion into men's mental health services may improve mental health treatment outcomes and save lives.
What does CFT look like in the therapy session?
For many of my male clients, the first step in seeking help for their mental health is admitting that they need help and this can often be the most difficult step. This is because, admitting they need help contradicts the gender norms they grew up with, which highlighted traditional masculine ideals of strength, control, and self-reliance (often masquerading as "resilience").
Some of the most valuable work we can do in therapy is to support people to learn how to bring compassion inward toward themselves. Some us are taught as children, the importance of offering courtesy, kindness and generosity to others, but few are ever taught the importance of showing this same kindness to ourselves. Many are taught by their caregivers and by their social groups that self-compassion is an "indulgence", "selfish" or "soft" and "weak".
CFT uses mindfulness, relaxation, and imagery exercises to develop inner compassion. Men cultivate an "inner ally" to replace the "inner critic" that fuels shame and self-blame. By relating to themselves and others with more kindness and empathy, men can improve self-esteem, reduce anxiety, and boost motivation for positive change. Integrating self-compassion into therapy gives men an emotional toolkit to navigate life's challenges. The inner ally's supportive voice counters negative thoughts and creates an emotional safety net during difficult times. Compassion-focused approaches build on men's strengths while addressing destructive shame and self-criticism.
Conclusion & Summary
Challenging outdated masculine stereotypes and stigma against mental illness is key to improving men's mental health. Offering compassionate, male-centered care can encourage men to seek help early, preventing mental health crises and suicide. Supporting men's mental health requires understanding gender-specific barriers and providing tailored resources. With compassion and understanding, we can create a society where men feel comfortable prioritizing mental wellness.
Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance.
WANT TO LEARN MORE?
Below are recommended readings exploring the impact of Masculinity and Men's Mental Health.
The Boy With the Topknot by Sathnam Sanghera, and Toast by Nigel Slater
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References
1. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2019registrations#main-points
2. https://www.samhsa.gov/data/report/2019-nsduh-detailed-tables
3. https://www.menshealthforum.org.uk/key-data-mental-health
4. Pappas, S. (2019). APA issues first-ever guidelines for practice with men and boys. CE CORNER, APA, Vol 50, No. 1. https://www.apa.org/monitor/2019/01/ce-corner
6. Yousaf, O., Popat, A., & Hunter, M. S. (2015). An investigation of masculinity attitudes, gender, and attitudes toward psychological help-seeking. Psychology of Men & Masculinity, 16(2), 234–237. https://doi.org/10.1037/a0036241
11.J Smith , S Lad , S ; Hiskey , J A Barry , R Kingerlee , M Seager , L Sullivan (2019). Of compassion and men: using compassion focused therapy in working with men The Palgrave Handbook of Male Psychology and Mental Health, p. 483 - 507
12. Kotera, Y., Green, P., & Sheffield, D. (2019). Mental health shame of UK construction workers: Relationship with masculinity, work motivation, and self-compassion. Journal of Work and Organizational Psychology, 35(2), 135–143.
13. Chris Irons (2014). Royal College of Psychiatrists, publication. https://www.rcpsych.ac.uk/docs/default-source/members/sigs/spirituality-spsig/spirituality-special-interest-group-publications-chris-irons-compassion-evolutionary-understandings-and-cft.pdf
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