Men's Mental Health: Social Determinants and Implications for Services

被引:114
作者
Affleck, William [1 ]
Carmichael, Victoria [2 ]
Whitley, Rob [1 ,2 ]
机构
[1] McGill Univ, Dept Psychiat, Montreal, PQ, Canada
[2] Douglas Mental Hlth Univ Inst, 6875 LaSalle Blvd, Montreal, PQ H4H 1R3, Canada
来源
CANADIAN JOURNAL OF PSYCHIATRY-REVUE CANADIENNE DE PSYCHIATRIE | 2018年 / 63卷 / 09期
关键词
men; gender; sex; men's mental health; social determinants; mental health services; health service utilization; GENDER-DIFFERENCES; DESCRIPTIVE EPIDEMIOLOGY; POSTPARTUM DEPRESSION; UNITED-STATES; HELP-SEEKING; DISORDER; MASCULINITY; PREVALENCE; COMORBIDITY; SUICIDE;
D O I
10.1177/0706743718762388
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Numerous scholars have stated that there is a silent crisis in men's mental health. In this article, we aim to provide an overview of core issues in the field of men's mental health, including a discussion of key social determinants as well as implications for mental health services. Firstly, we review the basic epidemiology of mental disorders with a high incidence and prevalence in men, including suicide and substance use disorder. Secondly, we examine controversies around the low reported rates of depression in men, discussing possible measurement and reporting biases. Thirdly, we explore common risk factors and social determinants that may explain higher rates of certain mental health outcomes in men. This includes a discussion of 1) occupational and employment issues; 2) family issues and divorce; 3) adverse childhood experience; and 4) other life transitions, notably parenthood. Fourthly, we document and analyze low rates of mental health service utilization in men. This includes a consideration of the role of dominant notions of masculinity (such as stubbornness and self-reliance) in deterring service utilization. Fifthly, we note that some discourse on the role of masculinity contains much victim blaming, often adopting a reproachful deficit-based model. We argue that this can deflect attention away from social determinants as well as issues within the mental health system, such as claims that it is feminized and unresponsive to men's needs. We conclude by calling for a multipronged public health-inspired approach to improve men's mental health, involving concerted action at the individual, health services, and societal levels.
引用
收藏
页码:581 / 589
页数:9
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