7 Barriers Men Face When Seeking Mental Health Treatment
It’s a refrain I hear over and over again from men and women alike:
“He won’t go to therapy, no matter how many times I bring it up.”
“I’m just not into that sort of thing.”
“My issues aren’t so bad that I need professional help.”
Or my favorite:
“No offense, but talking about my problems isn’t going to do anything!”
It’s a taken-for-granted fact that men are much less likely than women to seek help for mental, emotional, and relationship issues. So taken-for-granted, in fact, that most of us would rather assume the problem is with men themselves rather than look critically at the roadblocks they face, both internally and externally, in getting the help they need.
After working with men for over a decade, I’ve identified a number of barriers to seeking mental health care. Here are my top 7. I hope that understanding these difficulties can shed some light on the challenges being faced by you or a man you care about and maybe even give you some direction in moving forward.
1) Help-seeking puts men in the “one-down” position.
The very things that create a man’s wounds also keep them deeply hidden. Most of our upbringings taught us to avoid vulnerability at all costs lest we be viewed as weak or dependent. There is stigma around any kind of help-seeking (I’ve met men who are shamed for having someone else change their oil), but there is a special kind of stigma around mental health help-seeking. It runs counter to everything we’ve been taught about what a man should be: strong, stoic, independent, invulnerable. I like to say that strength is not the absence of vulnerability, but rather the courage to accept and work with it. I wish the world had more of this kind of strong man.
2) Most mental health services are marketed towards women and children.
Women account for 70% of the consumers of self-help material. That’s 70% of a 13 billion-dollar industry! The adjacent mental health industry has certainly caught wind of this and realized that there is much money to be made in targeting women, who are often primed and motivated. Even the simple act of sitting in a room facing each other -- taken for granted as the standard in psychotherapy -- appeals more to women than men, who often prefer a side-by-side communication style. I have long viewed men as an underserved population in this regard. If we don’t market to men, we won’t reach them, and they will continue to fall through the cracks.
3) Men don’t want to be “analyzed.”
There’s a lingering view -- among therapists and laypeople alike -- that therapy is about analyzing someone, telling them why they are the way they are, and then doing something to “fix” them. I often hear from men that they don’t want someone “tinkering” with them, as if we therapists are going into their brains and crossing and uncrossing wires to see what works! This thinking is a holdover from a time when psychotherapy largely operated off the medical model of identifying and treating pathology. The therapist was the “expert,” and the client was largely a passive recipient that was either “compliant” or “non-compliant” with the “treatment.”
The medical lens is an important one, but it is not the only one. In more recent years, there’s been a shift towards emphasizing a client’s agency as well as their right to define their own reality. The therapist may be regarded as an expert in therapy, but the client is considered the expert on their own experience. Therapy becomes less of something that is “done to” the client, and more of a collaborative, co-creative dialog that moves the client closer to well-being as he defines it.
The field as a whole does a poor job when it comes to outreach towards men, and media portrayals of therapists as coldly detached and over-analytical don’t help. I think more men would go to therapy if they could see therapists as real people who are potential allies that care about them and can coach them towards a better life, instead of as power figures attempting to change them. There’s a sad irony to me that the institution of psychotherapy, which was largely created by men, is now alienating men due to its historical emphasis on power dynamics, intolerance of alternative perspectives, and sometimes harsh enforcement of its own rules. A bit like a snake biting its own tail.
4) Male depression is often covert.
If we look at raw statistics, women are diagnosed with depression at a rate that is twice as high as men. Part of this is certainly that more women are seeking help, but it’s also because male depression presents differently. When we start to factor in substance abuse, workaholism, anger management problems, and general irritability, the numbers even out. We need more ways of reaching men with covert depression and helping them recognize they are struggling.
5) Men aren’t always all that bothered by their own behavior.
Psychiatrist George Valliant once said there are two types of people: the guy who walks into a crowded elevator, gets claustrophobic and turns green; and the guy who walks into a crowded elevator, lights up a big cigar, and makes everyone else turn green. The first one might actually end up in therapy, while the second one is unlikely to seek help on his own...he’s not all that bothered! Yet, both of these men are equally unhealthy. One is just oblivious. Instead, it is the people around him that suffer.
Our masculine upbringings teach us a very specific set of skills to manage our pain. Men tend to use workaholism, substance abuse, risk-taking, gambling, food, exercise, television, the Internet, and sexual compulsivity to medicate ourselves. In so doing, we often inadvertently push our pain off onto those around us. Dad may be an irritable jerk when he gets home but that’s ok, he works hard...right? It’s time that men recognize that damaging the relationships around us does ultimately harm us.
6) Men think therapy is about feminizing.
I am very clear in my work that my goal is not to feminize men, but to help them move towards healthy, mature masculinity. It just so happens that mature masculinity often requires reclaiming parts of ourselves that were lost because they are “feminine!” I would love to frame therapy as a way of masculinizing men in a healthy way.
7) Men don’t know that it can be better.
The unfortunate experience of many men in this country is that they are so beaten down, broken, and isolated by masculine culture that they have completely disconnected from any hope that things can be better. Like the dogs in Martin Seligman’s famous Learned Helplessness experiment, men learn that “this is the way it is” and simply tolerate increasing amounts of loneliness and isolation. I’m on a mission to show men that we can live healthier, happier, more connected lives than that which was presupposed for us.
I’ve spent my entire career studying, caring for, and empowering men. A key piece of this is understanding what inhibits men from getting the care they so desperately need. If you or a man you care about is struggling, please reach out today and I will do my best to assist you in overcoming these obstacles.
Yours, unimpeded,
Hayden
