May 3, 2021

Shifting the narrative – men and mental health

Shifting the narrative – men and mental health

Only around 30 per cent of people who use mental health services are men, yet men and women have similar rates of mental illness. Men also make up the majority of suicides and those dealing with substance abuse.

Why is it that men aren't seeking help?

Narratives in mental health

"Narrative therapy basically says that many of the problems that we all have are fundamentally 'storied' through our experiences as we grow up in family contexts, in the larger cultural contexts – where gender shaping happens," says George MacDonald, a counsellor with Manitoba Blue Cross's Employee Assistance Program, who specializes in narrative therapy.

In the context of men's mental health, this "storying" starts right from birth, says MacDonald.

"As you grow up, you'll hear people tell boys that they shouldn't cry, that if there's some difficulty, they should 'man up' to deal with it," he says.

It's these negative experiences and expectations that combine to shape men's lives and affect how they deal with their mental health.

"The problem of gender storying for men is a major problem insofar as it's never really talked about," he says. "It's different from women's stories, because women have been very clear about how problems have been storied into their lives."

Moving away from victim blaming

A 2018 report in the Canadian Journal of Psychiatry outlines a change in how researchers are viewing men's mental health. It reports that some practitioners are moving away from a "victim-blaming" approach that tends to attribute men's mental health problems to men being stubborn or bottling up their concerns.

"Men often feel blamed for why things are going wrong, and that makes them reluctant, sometimes, to present themselves in counselling," says MacDonald.

"You've heard people say, 'Well, if men wouldn't be so stubborn, if men wouldn't have to manifest always being in charge or showing strength, or avoiding emotion, and being aggressive in what they do,'" George says. "So, men do worry about being somehow identified as the problem, and what isn't identified as the problem is the gender storying that influences how men should be."

When MacDonald sees male clients in counselling, he takes extra care to not attribute their problems as their fault. Using the narrative approach, George works to help the person think of the problem as separate from themselves – as the adage goes, the problem, not the person, is the problem.

"So, if you can separate yourself from the problem and we can talk about the problem as if you're a prisoner of it, that helps," says MacDonald.

Men's mental health versus women's mental health

While both men and women experience a lot of the same problems, MacDonald finds men often discuss issues related to success more often.

"They'll have a job, they look after their family, they're moving up the ladder of success, but something is bothering them," says MacDonald. "And so, trying to find out what the problem is can sometimes be overlaid with a lot of discussion about success."

These problems help contribute to the significantly higher rates of drug abuse in men.

According to 2018 figures from Statistics Canada, men were 1.5 times more likely to report heavy drinking than women.

Improving mental health care for men

The Canadian Journal of Psychiatry's report also outlines alternate methods of mental health treatment aimed specifically at men, including "men's sheds," where men work side-by-side on tasks such as woodworking.

"I think it's a great development because it flies directly in the face of the gender-shaping idea of men acting as lone wolves in the world," says MacDonald. "It very much shows up as a community of concern for other men; a place where men can actually show emotional sensitivity to other men and be supported. Men can certainly use lots more of that."

Counselling support from Manitoba Blue Cross

If you're experiencing mental health concerns, reach out for help.

Manitoba Blue Cross members with Employee Assistance Program or Individual Assistance Program coverage can get counselling support. Begin the process here.

Unsure of your coverage? Confirm your eligibility in your mybluecross® account.

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