Men’s Behavioral Health: Unique Issues & Barriers to Care

Older man sitting and thinking.

By Steven Schwartz, PhD
Head of Research

It is well known in most clinical circles that men have a unique relationship to issues of emotional and behavioral health. In general, men underutilize behavioral health services. In Men’s Health Awareness Month, we would like to recognize the men in our lives who suffer with emotional or physical illness by highlighting some of the clinically critical issues and barriers that men face to receiving timely, relevant, and effective care.

In 2018, the Canadian Journal of Psychiatry dedicated a special issue to mental health, barriers to care, and the needs of men that remain largely unaddressed. They found men faced the following stumbling blocks to accessing necessary behavioral healthcare.

Coping Skills

Coping and related skills can either be healthy and adaptive, or unhealthy and maladaptive. As a result of persistent societal norms and a host of other reasons, men tend towards the use of negative coping skills by ways of emotional distancing. This often includes isolation, use of substances, high risk behaviors (i.e., thrill seeking), and expressions of anger and aggression.

Under-diagnosed Depression

Epidemiological data have long supported that unipolar depression is almost twice as prevalent in women than men. Several factors likely contribute to this, but a particularly relevant one is that men are more likely to express depression in ways not typically associated with the disorder (i.e., risk taking and anger). This display of less likely symptoms may potentially lead to under-diagnosis.

Substance Use
While a host of prescription and recreational drugs play their roles in complicating behavioral health issues, alcohol use is far and away the leader when it comes to men’s choice of coping mechanism for psychological distress. Studies indicate that men are 2–3 times more likely than women to have problems with alcohol. Alcohol also contributes to increases in risk taking and other barriers.

The CDC confirms that for the last 20 years, death by suicide has been 4–7 times higher for men across diverse countries and cultures.

If healthcare intends to move toward greater personalization of care, it requires all who develop and provide behavioral and other health services to understand, appreciate and address individual differences that are relevant to the access to and delivery of care.  How men perceive, manifest, and cope with psychological distress profoundly influences if and how they access care. In psychotherapy, we hear the common aphorism “meet the client where they are.” Given these and other patterns, it is critical to organize and design programs and measures that better align with the unique aspects of personalizing behavioral health services for men.


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