We all know that men put off going to the doctor as long as possible, even when they’re experiencing life-threatening symptoms. Sadly, this seems to be especially true when it comes to men’s mental health. Although the situation has improved over the years, many men still don’t get seen by a doctor even when actually facing death.
One of the stereotypical attitudes that contributes to this long-standing behaviour is the mindset that admitting to mental health problems and seeking help is a sign of weakness. The survey of men’s use of counselling and health services carried out by Kantar Emor this year reveals that men aged 50-74 are the most stubborn when it comes to these issues, but men of all ages find it difficult to ask for help.
According to Keete Janter, member of the management board of MTÜ VAITER, counsellor and importer of the Caring Dads programme, the stigma related to mental health issues are particularly strong among men themselves. Expectations and norms about masculinity and femininity also play a role and can influence how we approach mental health problems and seeking help. “The fear of being misunderstood or judged can be a big barrier to seeking help,” says Janter.
Kelly Fisher, expert of the Norwegian organisation Reform, which focuses on issues of men’s mental health gives an example of a survey carried out in Sweden, which looked at areas where men don’t realise that they need help. “What did they find? They found that even when a man feels that he needs help, it’s less likely that he will seek this help,” says Fisher. “It’s also very likely that he’s not happy with the help he received,” says Fisher.
He also concedes that the assumption historically placed on boys and men – they do not seek help – has done them a disservice. The key to changing this mindset is in the hands of all of us and future generations. “We need to think about how we raise our children or teach them the values and importance of seeking help,” says Fisher.
Sad statistics show that men commit more suicides
One thing that stands out particularly vividly in men’s mental health issues is suicide statistics. According to Statistics Estonia, the number of suicides is decreasing year on year, but the Kantar Emor survey mentioned above shows that accidents, poisoning and trauma, which also include suicides, rank third among the main causes of death of men. Suicides account for 9.2% of men’s deaths and 3.6% of women’s deaths. Therefore, it can be said that men are almost three times more likely to commit suicide than women.
According to Janter, the reason for this sad statistic is that men are generally more prone to risky behaviour. This in turn can increase the risk of mental health problems and unfortunately means that suicidal thoughts and suicide attempts are more likely to occur among men.
Fisher also admits that although women are more likely to suffer from depression than men, men are more likely to commit suicide. “In both Norway and the US, where I come from, the statistics show that the number of suicides among men is four times higher than among women,” says Fisher. “It’s a very striking difference.”
According to Janter, there can be a number of factors behind men’s suicide, including social, economic and individual. “Men are in a higher risk group for suicide because they’re more likely to choose methods that are physically more effective and therefore more likely to result in death. Also, previously mentioned factors such as stigma and barriers to seeking help can increase the risk of suicide.”
Kelly Fisher, expert of the Norwegian organisation Reform, believes that the environment in which we grow up is also important in breaking stigmas and alleviating mental health problems. Photo: private collection
Reform focuses mainly on getting men involved in equality work and equality work involving men. The organisation oversees men’s support services, documents and disseminates knowledge about the life situation of men and boys – they are an important party in Norway’s equality policy. The Fund’s goal is to raise awareness of the challenges and needs of men and boys, and to promote active fatherhood, violence prevention, better physical and mental health and more equal standards of masculinity.
Stereotypes disappear slowly
Fortunately, the stereotypes mentioned at the beginning of the story have slowly but surely started to crumble. More and more men dare to admit when there’s a problem and to seek help and solutions.
“In some cases, men may feel that the health system is not sensitive enough to their mental health problems, or that mental health help is more targeted at women,” says Janter. “Not understanding the need to take care of one’s own mental health is also a big issue – even then, seeking help can take a back seat.”
As surveys and efforts are constantly being carried out in the field of mental health to better understand these issues, Janter says this will help to create more effective support systems that are accessible and acceptable to all, regardless of gender.
Janter also briefly highlights the main findings of Kantar Emor’s survey of men’s use of counselling and health services: “It was found that Estonian men prefer to remain silent about mental health problems. Seeking help and talking about one’s feelings is largely dependent on beliefs about masculinity. Most men (61%) are upset when they have to ask for help, and 68% don’t like talking about their feelings. Older men (aged 50-74) in particular found it difficult to ask for help, regardless of age. Only six per cent of them also sought specialist help, for example, to quit smoking or alcohol, suggesting a belief that men should be able to manage on their own.”
One other thing he points out is that when faced with a physical health concern, most men (86%) act constructively, for example by buying appropriate medication from a pharmacy. However, this percentage is lower in the case of mental health problems – only 62%. 63% of men behave in a destructive way when they have a mental health problem, for example by diverting their thoughts or using alcohol and other addictive substances. “This shows that dealing with mental health problems is more difficult,” says Janter.
No to pills, but a shot of something stronger or a couple of beers would be fine
Janter acknowledges that alcohol and drugs are important factors in the complex nature of men’s mental health problems. It’s therefore important that the impact of alcohol and substance abuse is taken into account when addressing mental health problems.
In order to start looking for help somewhere, he first directs the reader to alkoinfo.ee, where the link between alcohol and mental health concerns is well summarised. Alcohol is a legal drug in its essence, but its widespread visibility and easy availability in modern societies has unfortunately made it a routine part of everyday life. This is why, Janter says, the associated damage to human health and society as a whole is often overlooked.
“How and in what context a person consumes alcohol affects their social relationships, productivity at work and self-satisfaction,” says Janter. “Alcohol has a direct impact on mental and physical health and, depending on the quantity and frequency of consumption, it affects both quality of life and life expectancy.”
Alcohol also affects the brain’s reward and motivation system. According to Janter, alcohol causes excitement because it releases dopamine in the brain, which has an activating effect. In addition, it creates feelings of pleasure and enjoyment, but also makes thinking dumber and slower, the ability to control emotions is impaired and bad feelings are amplified, as the serotonin system becomes damaged. “That’s why alcohol is said to be a depressant, because it increases stress, depression and anxiety,” concedes Janter. “This is the case even if you’re not yet addicted.”
However, effort is needed in order for pleasure-inducing substances to be released naturally in the brain. “For example, learning something exciting, spending time in good company or exercising can make you feel good. Alcohol, on the other hand, makes it possible to experience these pleasurable sensations without any effort, which is why people want to experience it again and again.”
Young people struggling with eating disorders
While eating disorders are usually regarded as a problem that mostly prevails in girls and young women, Fisher says that it is increasingly spreading among boys and young men as well. It mainly manifests itself in excessive exercising and strange eating habits.
“In order to reach young men and boys struggling with the problem, a Norwegian charity focused on young people with eating disorders produced a TikTok series consisting of 15-16 videos,” says Fisher. “It stars a young man suffering from an eating disorder.” He adds that the goal of finding even more young men with eating disorders was achieved. The number of young men and boys contacting the help organisation has doubled since the videos hit social media.
According to Fisher, the campaign was also a success because it was finally able to show how big the gaps are in people’s understanding of their own mental health. “Many of the young people who sought help hadn’t even realised they had an eating disorder. They only understood it after seeing the videos.”
According to Fisher, this also shows how mental health problems can manifest differently in men and women.
According to Geete Janter, men are generally more prone to risky behaviour. Photo: private collection
Helping men to ask for help and get mental health services
According to Fisher, their practice has shown that in order to reach men, the service needs to be targeted specifically at them. “If we refer them to a service that has, for example, gender-neutral or female imagery in the ad, or if they think the text is somehow targeted at women, they’ll automatically think that the service is not for them,” explains Fisher.
That’s why Reform launched the Men’s Helpline in Norway. Their staff are trained to deal with even the most critical situations. Every year, thousands of callers get help from the Men’s Helpline and are referred to the right mental health services.
Janter also admits that, in general, there’s a need to offer different approaches through different channels. But we should start by changing attitudes – seeking help to deal with your mental health problems is not something to be ashamed of or a sign of weakness, it’s a normal thing to do.
“Just as it’s normal to seek help from the medical system for physical ailments, it’s also normal to seek help for mental health problems,” says Janter. “It’s important to enable open and non-judgemental communication, both in society at large and at an individual level, to encourage men to talk about their mental health issues and seek help.”
Just as there are organisations that focus only on men in Norway, they exist in Estonia as well. A good example is MTÜ VAITER, which offers the parenting support programme for fathers Caring Dads, which focuses on reducing violent behaviour when in the role of a father. "We’re also waiting to hear whether we’ll be able to import a support programme for divorced men from Finland with the support of the project," Janter hopes.
The Caring Dads groups meet both physically on site and virtually online, so that as many men as possible from all over Estonia can participate. “There are men who are not ready or not able to come to the contact meetings, but group-based support is suitable for them,” explains Janter.
In Estonia, men’s mental health is also supported by the activities of Peaasjad MTÜ. Also, the free counselling services of the Social Insurance Board are aimed at both women and men. “In recent times, self-initiated men’s friendship movements have also emerged and they focus on men’s physical and mental health and well-being, and promote healthy approaches in a broader perspective,” Janter acknowledges.
However, she says that there could be more community-based approaches to talking about men’s mental health issues and offering help. “For example, it would be important to offer a range of online options – both individual and group counselling.”
Speaking about men’s mental health, Fisher points out that in Norway the issue has been taken up at national level. Namely, a group of 15 government-appointed experts, including scientists, mental health experts and other men’s health experts, are working on a white paper on men’s and boys’ wellbeing, which also gives attention to the main challenges men and boys are facing in Norway today. It gives recommendations to the government on what needs to be done to improve the situation.
Help is at hand!
In Estonia, more and more opportunities have been created, both at NGO and national level, to offer help to men, be it counselling, support groups, programmes, therapies or any other help the medical system can offer.
There are also opportunities to seek help for specific issues, such as serious mood or behavioural disorders and suicidal thoughts, from a psychiatrist, for reducing and addressing the causes of violent behaviour from counsellors, psychologists or therapists, as well as from different support groups and training programmes.
The four major hospitals in Estonia have sexual violence crisis centres, where men can also go for support and counselling – help is guaranteed to them.
Male victims of domestic violence are also assisted by municipalities that provide a shelter service, available to all children and adults, regardless of gender, who have been victims of physical, psychological, sexual or economic violence, who need complex services or who are unable to stay safely in their own homes.
How can you maintain and improve your own mental health?
• Try to find an enjoyable and engaging hobby or learn something exciting.
• Socialise with family and friends, play with children and pets. Take long walks in nature together, get some fresh air and exercise in moderation.
• Get enough sleep and eat healthy.
• Start using a ‘toolbox’ that contains the necessary self-care techniques and tools, such as writing a diary, self-reflection and meditation, breathing exercises, yoga exercises, etc.
• Seek professional help if necessary. Join a support group or training programme, find a suitable counsellor or form of therapy, such as creative therapy.