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PSY2014 Week 9 Lecture: Men's Mental Health

Introduction to Men's Mental Health in Australia

This lecture, presented by Nathan Ogilvie, underscores the critical importance of men's mental health, particularly within the Australian context. As a psychologist in this field and the unit coordinator, this topic holds personal significance due to its wide-ranging societal effects, impacting domestic violence, women's mental health, and children's mental health. The lecture respectfully acknowledges the traditional custodians of the Kulin Nations, recognizes indigenous resilience in suicide prevention, and acknowledges those with lived experiences of suicide and diverse genders often misrepresented in research. The focus on men's mental health is not intended to diminish the mental health needs of other groups but rather to address the unique challenges men face without justifying or explaining harmful gendered behaviors, such as the fact that approximately 95\% of domestic violence is perpetrated by males.

Key Facts and Figures on Men's Mental Health
General Mental Health Conditions

Across all age groups, females generally experience mental health conditions at a higher rate than males. However, the prevalence in males remains significantly high, and the total population average provides a crucial point of comparison, demonstrating the widespread nature of mental health challenges.

Substance Use Disorder

Substance use disorder exhibits a distinct pattern influenced by both gender and age. While rates are generally higher in teens and young adults, for males aged 35 and up, particularly between 35 and 44, the incidence is significantly elevated. This age range is specifically identified as a critical period for male mental health, especially concerning substance use disorders.

Male Suicide Rates

Suicide presents a profound gender disparity, with males far outweighing females across all age ranges in Australia. The presented data represents suicides per 100,000 people, not a percentage of the age group. Notably, no age range for women exceeds approximately 9 suicides per 100,000. In contrast, for males, every age range surpasses this figure. The lowest rate for males is observed in the 15-19 age range, which might be counterintuitive given common associations of suicide with adolescence; however, adult males consistently face higher rates. These rates climb significantly for adult males, peaking dramatically in older age. For instance, males aged 80 and over show rates exceeding 30 per 100,000 people, with the 85+ age group reaching approximately 36 per 100,000, marking it as a high-risk demographic. The 30s, 40s, and 50s also exhibit elevated rates, correlating closely with the peak in substance use disorders observed in related age groups. This data distinctly underscores the extent of the problem and the significant gender difference in suicide rates, necessitating a specific focus on men's mental health.

Factors Contributing to Male Suicide

Research identifies six key factors contributing to the observed gendered differences in suicide rates.

  1. More Lethal Means: Males tend to use more lethal methods in suicide attempts, which often indicates a stronger intent to die and an acquired capability to carry out the act. Gendered expectations may also influence a willingness to engage in highly lethal behaviors.

  2. Externalizing Depression: Unlike internalizing conditions such as sadness or withdrawal, males often externalize depression through behaviors like aggression, substance use, and risk-taking. This externalization can lead to interpersonal alienation, pushing away crucial support networks, which in turn reduces help-seeking behaviors and increases suicide capability. Furthermore, health professionals may misidentify these symptoms, as depression can be overshadowed by more immediate risks like violence or substance use, ultimately leading to unaddressed underlying mental health issues.

  3. Substance Use: High rates of substance use among men, particularly in their 40s and 50s, correlate directly with higher suicide rates. While substance use is not a direct cause of suicide, the increased distress, impulsiveness, and disinhibition experienced under the influence of substances can make suicide more likely.

  4. Social Connectedness: There are alarmingly high levels of social disconnection and isolation among men, especially young and middle-aged males. Social connection is recognized as a vital protective factor against suicide and other mental health issues; its absence significantly increases risk.

  5. Self-Reliance and Help-Seeking: Traditional masculine norms often promote strong self-reliance, leading to negative attitudes towards seeking help. Men may perceive seeking help as a burden to others or a sign of weakness, which consequently results in reduced help-seeking behaviors and a tendency to keep problems to themselves.

  6. Masculine Norms: These norms, which are prevalent in Australian society, often reinforce stoicism, independence, invulnerability, and an avoidance of negative emotions. While some aspects of stoicism, such as emotional regulation, can be healthy, rigid and inflexible adherence to these norms can be extremely unhealthy. This rigid adherence leads to reduced and delayed help-seeking, increased suicidal thoughts, attempts, and deaths, higher alcohol and substance use, and overall negative mental health outcomes, including depression and anxiety, due to untreated issues.

Suicide Prevention Strategies

Effective suicide prevention requires a multi-faceted approach that addresses various levels of intervention.

Promoting Well-being

This strategy involves fostering general well-being, encompassing both mental and physical health, through addressing social determinants and building resilience. For males, this specifically includes increasing help-seeking behaviors, strengthening social connections, and encouraging community engagement.

Universal Prevention

Universal prevention strategies are applied to the entire population. These include raising public awareness about mental health and suicide, restricting access to lethal means (for example, Australia's gun law reforms in the 1990s significantly reduced gun violence, contrasting with countries like the US without similar changes), and promoting responsible media reporting that encourages resilience and help-seeking.

Selective Prevention (for at-risk populations like males)

Selective prevention targets specific at-risk populations, such as males. This involves training and detection initiatives, equipping healthcare professionals, friends, and family (e.g., through initiatives like R U OK? Day) to recognize warning signs of depression or suicidal thoughts. It also includes ensuring that professionals can accurately diagnose and treat underlying mental health issues, especially when depression manifests as externalized symptoms.

Indicated Prevention

Indicated prevention targets individuals who are already experiencing symptoms. This includes providing direct therapeutic interventions and support, offering aftercare support post-attempt (e.g., hospital aftercare), and providing support for family members affected by suicide (postvention). Aftercare also involves ongoing support for individuals managing persistent symptoms.

Frameworks and Research

The overarching frameworks and ongoing research are crucial components supporting all these prevention strategies.