In a slight deviation from my four pillars series I have decided to write a short piece on mens mental health, in part because I have been in the process of writing a response to this very question for someone else and felt my musings could be of value to the wider audience.
Apparently in the UK, women are twice as likely to see a GP about their mental health than a man causing some to ask if the services we provide alienate men by being female centric.
I would start by saying that in my opinion, the biggest problem men face is not at the point of service but before that. Stigma is still the biggest issue standing between men and accessing mental health support in spite of significant efforts in recent times. Many men either don’t want the label that accompanies diagnosis, or they are unaware of their mental health in the first place.
Stigma has both social and practical consequences which challenge traditional views on masculinity and impact on areas of life like career. Anecdotally I am aware of men who fund therapy privately because of the negative impact a disclosed mental health condition would have on their career.
An example of where stigma may be contributing to misconceptions by men is the traditional portrayal of mental illness. The “head in the hands” picture accompanying so much of the discussion often does not fit the male experience. Many men may feel angry and frustrated as a result of mental illness but I rarely see this discussed or represented. It is highly plausible that many men simply do not understand that they are unwell and this is such a crucial part of the healing process. I am asked all the time by people how they can help a loved one who doesn’t want help or doesn’t know they have a problem. The simple answer is, you cant. You can love them and support them, talk to them, educate them but you cannot impose your will upon them. To heal from any condition there needs to be a degree of will and co-operation. I also wonder how prepared society is for managing this face of the problem. How do we reach out to angry people? It is difficult to show compassion and empathy to someone who is angry and as a result society tends more often to alienate them.
Male representations in media could help but we must tread cautiously. There is a tendency in my opinion to represent male mental illness through readily explainable conditions like PTSD, or through individuals who have experienced trauma or operate in high stress or highly psychologically challenging environments. It is incredibly important to support those in society that we expose to the most difficult situations but we must also remember that mental illness is not all trauma based. Many, in fact the majority, struggle like I do with common mental disorders through a combination of inherited, biological, psychological and lifestyle factors. Over emphasising trauma as a cause of mental illness risks creating a hierarchy that causes those suffering outside of this model to question wether they are truly ill or indeed have a right to be ill.
Challenges in Primary Care
Assuming that men, or anyone come to that, have managed to navigate the initial barrier of stigma, you must then overcome the practical considerations of accessing support. The problems with seeing a GP are well documented. You could pick up on any of the traditionally cited complaints, waiting times, being triaged, 10 minute appointments. All of these are seen as problematic in health provision (by doctors themselves) but it becomes additionally complex when your condition is sensitive and one of your primary considerations is maintaining discretion. Reflecting on some of my own experience I have often pondered the irony that at a time when I had exhausted my emotional reserves I needed to muster every shred of fortitude I could, just to navigate the system.
In many areas you are able to self refer into psychological services. Undoubtedly this helps but it is not always appropriate and is certainly not a substitute for face to face primary care.
My final observation, and one of my initial motivations for starting Talking FreEly, was the manner in which services are provided. In my local area I found them to be almost entirely provided during standard working hours, both public and third sector provisions. This automatically excludes anyone who is attempting to manage their illness discretely or in conjunction with holding down a job.
I am certain that, with regard to primary care, the current provision of services disadvantages anyone suffering with mental illness, regardless of gender. In the discussion about mens mental health however, the issue in my opinion is still one of getting men to the point that they identify with the need for help and feel confident in doing so.
We must be realistic about the challenges. I have campaigned for better tolerance and understanding of mental illness for over 10 years now. I didn’t sense any significant change in attitudes until the launch of Heads Together by Princes William and Harry. Whilst this and other campaigns have helped the discussion no end, attitudes do not change overnight. People dont open up about their mental health because we tell them to. They open up about their mental health when they feel it is safe to do so and that is why organisations like Talking FreEly exist, to create those environments and communities that will bring about the change.
Tony is a qualified acupuncturist with clinics across east Anglia. He is also the founder and a director of Talking FreEly, an organisation campaigning to break down the stigma of mental illness through honest and open conversations.
If you are interested in learning more about how Tony could help you to achieve your well being goals please get in touch or book an appointment at one of his clinics.
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