Editor’s Note: This blog was written in September 2021. It remains critical and timely, and as a result we are sharing it again now.
FLATTENING THE MENTAL HEALTH CURVE SHOULD BE OUR NEXT CHALLENGE
In a recent conversation with a colleague, we spoke about the professional and personal changes in our lives due to the COVID-19 pandemic. The way we practice, how unpredictable life has become, our inability to connect with people interpersonally, and the professional challenges that lie ahead of us. Uncertainty was the prevailing theme.
Something we both could agree on was that a mental health crisis already existed before the pandemic, and it may get even worse. In particular, an alarming number of men and boys face many difficulties which result in a worrying number of outcomes involving mental health. Most concerning is the high percentage of males globally who die by suicide.
To give some context, according to the World Health Organization, one person will die every 40 seconds, and men account for approximately 3-4 times the number of suicides compared to women. In Canada, males account for more than 75 percent of suicides. That’s an average of 50 men per week dying by suicide.
In the USA, male suicides have been on the rise since 2000, and while suicide is the 7th leading cause of death, it is the 2nd most common cause in males under the age of 45.
People thinking about suicide can show warning signs, and in men, this can be any sudden change in behavior. Some of the most common warning signs include:
Losing interest in activities they normally enjoy and get pleasure out of. Disconnecting from family and friends, not being as present or engaged as they normally would, and not responding as often to messages.
Some of the signs can be more noticeable, especially if you know the person and understand their patterns. You may perceive changes in their sleep habits, such as sleeping more or being restless and having trouble sleeping.
Other warning signs to be aware of are drinking excessively or taking drugs more than is normal for them. Men can show increases in anger, irritability, and risk-taking, but some of the most obvious signs are talking about wanting to die and already having a plan.
What puts someone at risk of dying by suicide is still not fully understood, and it might never be. However, we are slowly starting to learn more about certain factors that can place men at a higher risk. Firstly, finding support can be difficult. A lack of policy and investment to create services has left limited options, especially those with few barriers, for men reaching out for help. Nevertheless, many of the barriers to treatment exist due to misconceptions about mental health, and longstanding social expectations on men.
How masculine qualities are promoted in many cultures can often encourage men to suppress their emotions and keep silent about challenges in life. The expectations they attract and the way they shape us can dramatically affect our behavior and wellbeing. Many men reading this will likely have been told, or bear witness to hearing, “take it like a man” or “suck it up”. Toughness is expected and emotional vulnerability is seen as a negative mark on our manhood. For many, to carry the pressures of societal expectations, such as being self-reliant, strong, and in control of your life, can lead to a breaking point. Asking for help may be mis-interpreted as admitting that something is wrong. This can further delay the time between professional help and accessing treatment.
Many men also think they are a burden. More often than not, we can find it easier to help others but neglect our own needs. We worry about asking for help because of the perceived stigma and concern that by being diagnosed, you have to carry the shame of having a mental illness. The effects of stigma run deep. The only fact here, many misconceptions exist.
Not many people are aware, but loneliness is a factor that men endorse as one of the top stressors in life. They can count on friends when it comes to counsel for everyday practical problems, but not for their emotional needs. Loneliness and social isolation are different, but related. Loneliness is an emotional state. Social isolation is the lack of social contacts and having few people to interact with. regularly.
As an emotion, loneliness prompts us to seek out the safety of social groups. More often than not, we can adjust and cope to take the necessary steps to build connections. But when it lingers and doesn’t go away, it can create many problems. We are more likely to consume too much alcohol, make poor nutritional choices, and exercise less. This can all lead to a further decline of our mental health. In addition, these are all contributing factors to depression and suicide in men. The lack of an emotional network has a profound negative impact for men’s social connectedness and mental well-being, putting many younger men at heightened risk of suicide.
Since we already know that men are less likely than women to utilize mental health support, men can ultimately look toward women and find similar ways to create social connections that can also double as meeting their emotional needs. In an age where we can connect with more people at the touch of a button, people have never been as lonely. Having deeper human connections is one of the most important factors in protecting our well-being and promoting good mental health.
In healthcare, the key to preventing long-term and severe issues that require intensive treatment to resolve is upstreaming and getting to problems at the earliest point. Upstream exists in our communities and removes societal and structural barriers to improve health outcomes.
As friends, family, or colleagues we should all strive to become more alert to any noticeable change in behavior, that could be a warning sign that someone is not doing well. We can educate ourselves on how to ask the right questions at the right moment and maintain a conversation that might just save a loved one’s life.
When a community works together to promote mental health, it opens the door for men to gain the knowledge and support they need to look after themselves and the people around them. Men who are empowered to embrace how they feel are more likely to share their experiences before they become overwhelming, a model that can be shared and encouraged.
WHAT CAN MEN DO?
We usually push personal time to the bottom of the list. Hobbies, relationships, and creating free time are often neglected, especially when stress is at its worst.
We often hear about ‘self-care’, but self-care doesn’t have to be soft and fluffy – it’s about paying attention to your needs, be it physical, emotional, or mental.
Men tend to do their talking shoulder to shoulder, not face to face. We need to be more active in maintaining social connections by prioritizing friendships and good relationships. Men who are connected and able to maintain relationships are already more likely to have a safety net. They are therefore better placed to ask for help; this is important if a man is thinking about suicide.
If you’re experiencing thoughts of suicide, don’t push them to one side. If you don’t feel like you are in a safe space, it’s time to reach out – you’re not alone in this battle and help is out there.
Recovery is possible. Men who have tried to end their lives, or have suffered from mental illness and suicidal thoughts, successfully recover, and live a full and meaningful life.
Mental health should no longer be a taboo subject.
MÍCHEÁL O’ROURKE is a Registered Psychotherapist with the College of Registered Psychotherapists of Ontario (CRPO) and a member of the Ontario Association of Mental Health Professionals (OAMHP). He has held previous status as a Chartered Psychologist with the Psychological Society of Ireland and as a graduate member of the British Psychological Society.
Mícheál currently co-leads several projects across the Centre for Mental Health at University Health Network (UHN). This includes providing leadership and supervision within the Community Mental Health program and UHN’s 2021 Centre for Mental Health Accreditation process.
Mícheál provides supervision to qualifying members of the CRPO and to other colleges in the province of Ontario. In affiliation with the University of Toronto, he provides leadership to Psychiatric residents completing their internship within UHN’s mental health programs. In previous roles, he has also served as co-facilitator of St Michael’s Hospital Community Addiction program in Toronto.
Mícheál has worked in both public and private health sectors, as well as educational and employment settings. He has worked in multiple healthcare systems including the NHS in the UK and the HSE in Ireland. Although having worked in numerous settings, he has a particular interest and passion in working closely with men and helping them resolve mental health and substance use challenges.