The focus of this year’s Men’s Health Week is mental health in a COVID world.

The campaign asks ‘what next for men’s mental health?’ and highlights that as society opens up, we need to open up too.

We know that men’s mental health is a concern. The suicide rate is the most striking reminder of this.

The Office for National Statistics said last year that men accounted for about three-quarters of suicide deaths registered in 2019.

But we also know from data – including our own Public Perception survey – that fewer men have counselling than women.

Our survey carried out with YouGov earlier this year found that 27% of men said they’d had counselling, compared to 38% of women.

So we asked some of our members what their experience was of why fewer men come to therapy if they are struggling with their mental health – and also what they would say to allay any concerns or to reassure them.

Stigma

“I feel that men are put off seeking counselling due to the stigma around men's mental health and how men 'should' deal with their emotions,” says our member Siri Lewis, a Shropshire-based counsellor.

“Men are often viewed as the 'man of the house' they feel they would be the strong one in terms of their relationships or family dynamic. Men are also told from a young age 'boys don't cry'”, she adds.

Our member Noah Sisson-Curbishley expands on this. “Men keep their heads down and get on with things even at their worst, hiding visible emotion or not displaying sensitivity for fear of ridicule and fear of weakness.  Ultimately this is about being rejected from those around them and the society in which they develop - they aren’t a real man if they show emotion,” he says.

Reinforced stereotypes

He draws on examples from popular culture – such as in superhero films or from Love Island – that reinforce male stereotypes.

Andy Garland, a Cardiff-based psychotherapist also cites male norms and stereotypes as sometimes being a barrier.

“I see men continually doing their best to live up to masculine norms.  These norms are seemingly what society has dictated to them, us, me.  Is that really true though, and is society asking us to be superhuman?”

But he also adds a note of hope.

“We’re beginning to acknowledge and understand that roles aren’t defined by gender.  It’s okay for a boy to cry, and we don’t have to ‘man-up’ when life gets tough.”

Emotions

Paul Mollitt, a north London therapist, agrees that men tend to open up less than women.

 “Men tend to be less in touch with their emotions than women, preferring to ‘tough it out’ in the hope that things will improve. While women generally open up more readily than men, shame and fear of being seen as weak may prevent men from seeking help. Being vulnerable tends to be more difficult for men culturally and seeking help is admitting your vulnerability. Men may see strength and vulnerability as opposites, women and those more in touch with their emotions see them as related.”

Noah adds: “In my therapy space, men (and this is by no means a generalisation some other people want this as well) want to understand reasons and how to cope with mental health challenges to get back to ’normal’ initially and over time they begin to connect to what is happening to them emotionally.  

“Women are more happy to talk about their feelings (although there are some people who are very happy to emotionally explore) and are more open to expressing themselves emotionally.”

Andy summarises: “All of these worries and fears become barriers to men seeking psychological help.  We need, as a society to continue to talk about mental health, especially breaking down the stigma and shame, so men find it easier to present for therapy.”

We know, of course, that each person is unique and that not all men – or women - will respond the same.

But if these members are noticing the same trends that might stop men going to therapy, what would they say in response to these to help more men seek the support of a therapist if they’re struggling with their mental health?

A revelation

Paul says: “The most compelling thing I can say is that most of the men I work with wish they had sought help sooner as it is often a revelation for them to be able to speak so openly and vulnerably with someone they trust. The hardest part is making first contact and finding the right therapist – after that, you are building a relationship and men often look forward to the hour a week they can be totally free in expressing themselves, without judgement.

“Men often come to therapy during a crisis, but many stay longer for the positive overall impact on their lives.”

Never judge

Siri adds: “Men shouldn't feel ashamed if they are down and need someone to talk to.

“As therapists we are not here to judge and we would never judge men for seeking therapy.”

Noah’s response is the same to both men and women who put off attending therapy. He uses the analogy of a broken leg.

“Imagine you had a fractured leg somehow and you didn’t go to hospital to get it sorted, what would happen?  You couldn’t walk around on it, your leg will likely be swollen, probably going a funny colour, really painful - it will prevent you from going to work, getting out of bed, socialising, washing or dressing…what would people be saying to you?  Would they be telling you to suck it up, get on with it, would they be telling you your pathetic, reject you…if they did would you want those people in your life?  So having a mental health condition is like having a broken leg but no one can see it - you literally struggle to do the same things someone with a broken leg would do, but you're hiding it; your metaphorically forcing yourself through life with similar (if not worse) emotional pain than having a broken leg.”

Things are changing

There’s a positive note to end the piece with, as our members acknowledge things are heading in the right direction.

Siri adds: “I think the way we look at mental health is slowly changing and hopefully more men will open up about how they're feeling.”

Andy says he’s seen an increase in the number of men coming to therapy during his 20-years in practice, but says men still only make up 30% of his clients.

He adds: “Things are changing for the good, and with high-profile campaigns over the last few years we are on the right path, though there’s still work to do.”