Monday, January 10, 2011

Man Up! Suicide Prevention and Men of Working Age Part I: Men at Risk

photo from Velvettangerine
  • Suicide is the second leading cause of death for men 25-34 
  • Males are four times more likely to die from suicide than females
  • The majority of people who die by suicide in Colorado are white (non-Hispanic) men of working age   

Source: WISQARS, Centers for Disease Control

Gender role socialization theories offer a perspective that helps explain these statistics. Cultural codes of achievement, aggression, competitiveness, and emotional isolation are consistent with the masculine stereotype; depressive symptoms are not.  Cultural ideals of rugged individualism lead to social fragmentation and fewer coping alternatives.  In fact, when we look at gender roles a double jeopardy emerges.  That is, those men who are in the most need of psychological help are the least likely to use them.
            According to Mansfield, Addis and Mahalik (2003), when men consider seeking help, they often go through a series of internal questioning:
1)      Is my problem normal?  The degree to which men believe other men experience the same problem affects their decision to seek help.  A prime example of this psychological process is erectile dysfunction.  Before Senator Bob Doles’ public disclosure, many men thought they were the only ones suffering from this highly common and highly treatable problem.  After the public campaign, many more men sought help.
2)      Is my problem central to who I am?  If the mental health symptoms reflect an important quality about the person (for example the hypomania in bipolar disorder that impacts creativity or productivity), then the person will be less likely to seek help.
3)      Will others approve of my help-seeking?  If others, especially other men, are supportive, then the person will be more likely to go.  Help-seeking is particularly likely if the group is important to the person and unanimous in their support.
4)      What will I lose if I ask for help?  For many the biggest obstacle for asking for help is fears losing control: losing work privileges or status, being “locked up,” or losing one’s friends or family.
5)      Will I be able to reciprocate?  Usually, the mental health services offered do not allow opportunities for reciprocity.  Because of ethical standards, the mental health practitioner is often not allowed to share personal information or receive favors, thus maintaining a position of power over the client.  For some men, receiving help is acceptable only if they can return the favor later on; in the relationship with a mental health provider, this is often not possible.  One exception is Alcoholics Anonymous (AA).  According to their mission, “Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism.” According to the AA fact file, men make up 65 percent of membership in AA, indicating that this model of reciprocity is appealing to men. By contrast, among persons with any recent mental health disorder, a higher percentage of women (16%-26%) made mental health visits than men (9%-15%).
Thus, as we begin to this of how to reach men at risk, we need consider alternative ways to reach those who might be the least likely to seek help. This requires a paradigm shift on our part. Stay tuned to the second part of this series to learn more.
What are your thoughts on men and help-seeking?

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