Why Men are Poorer Users of Mental Health Services

By Letoo James, March 5, 2021

The link between gender and mental health has alarmed our society for some time now. Mental health experts agree that men suffer poorer mental health than their female counterparts. They record higher rates of suicide, homicide, violent behaviours, substance abuse, homelessness, unemployment, imprisonment, poorer lifestyle choices and lower life expectancy. Men are also more likely to find themselves in bad debt. My guess is as good as yours that out of the 14 million Kenyans now negatively listed on Credit Reference Bureaus, men constitute a higher percentage. The cost of poor mental health is not just in shillings, it runs deep and wide than it appears on the surface.

The negative impact of poor mental health in men is crystal clear. Our eyes are now open thanks to the media, statistics and the tragedies that have become too common.  How many students drop out of school because of deviant behaviour? How many of our children are orphaned or wives widowed because of suicide? How many homes have become dysfunctional because of alcoholism and substance misuse? How many times have we woken up in our neighbourhoods to find a whole family killed after what is often described as months of marital quarrels? The impact it has on our children, communities and the nation is enormous. We are losing many men who could have been productive participants in the lives of many children, families and communities. To state that men are in a crisis is an understatement. Men and mental health is an area we must reflect upon and get comfortable with the uncomfortable.

Various views from our elders, religious leaders, politicians, social scientists and mental health experts try to explain the gender differences in mental health. What is incontestable is that the factors associated with poor mental health in men are complex. Among the many reasons attributed to this problem, three stand out.

The first and most cited of all is the nature of men. The socially constructed masculine traits and roles place pressure on men to be independent, suppress emotions and avoid vulnerability. Enduring physical and psychological pain is a masculinity practice that boys are taught early on in life. Men are expected to be resilient given the power and status conferred to the male gender. The threshold of pain and suffering set for them is unrealistically high and they suffer greatly as a result.

Source: https://twitter.com/kenyapics/status/612583388977995777  

The second explanation follows the first and regards help-seeking. Help-seeking attitude and behaviour among men is poor. Men do not open up easily when they need to. They view opening up as a sign of weakness and so are put off by those who do. This discourages men from openly acknowledging their needs to others and instead try hard to display normalcy. Ego is also considered the biggest undoing for men in asking for help. By not opening up men are seen as victims of their own behaviours. Take the following two scenarios. A woman is seen in in tears in a matatu, initially everybody will seem to mind their business but soon other passengers will get concerned, inquire what the problem is, comfort her and offer to help. Now consider a visibly drunk man, talking alone in a matatu, chances are high he will occupy the entire row of seats alone and will be met with sneering faces from other passengers.

The third explanation is that mental health services does not provide male friendly services to men. It is argued that men are underserved in mental health services. Mental health providers have not aligned their services to fit men’s needs. Statistics show that fewer men make self-referrals for mental health services and when they do, they drop out sooner than women do. This could mean that the spaces where mental health services are provided is not safe for men to explore their problems.

Each of the explanation determines the kind of remedy that is prescribed. The first two explanations are not new and the solutions revolve around changing men. The argument is that masculinity stands in the way of men enjoying positive mental health. Masculinity is blamed for poor help seeking and help providing behaviours in men. The responsibility is squarely placed on the men’s shoulders and if they do not change, they are left to their own devices. This attitude of disengaging from supporting men has seen the society suffer. This approach does not seem to be helpful and offers no meaningful solutions. The third explanation is relatively new and progressive. It focuses on the service provision as a possible point of intervention. In many public health promotion programs like sanitation, blaming the targeted population has never been a smart strategy for behaviour change. Mental health service providers can take a cue from this and redesign their products to fit men’s needs. This explanation offers hope in the efforts to bring men closer and get them to utilize mental health services.

Mental health is a key determinant of general health and socioeconomic development for all. We as a society, aspire to provide quality and affordable mental health services to all. Our collective awareness, willingness and continuous effort should help reduce the gap between what we aspire on paper and the realities of everyday life for many men. In the next article we shall explore ways in which men can be engaged in mental health services and reduce the overall burden of ill mental health.

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