In contrast to women, men may be less forthcoming with information concerning their mental health, which may affect their help-seeking behaviour. In general, men may be less likely than women to visit a health professional, have lengthy consultations with health professionals, or seek treatment before symptoms become advanced [1830–1834]. There are a number of barriers that may prevent men accessing mental health treatment, including [1810, 1835, 1836]:
- Feeling uncomfortable and/or finding it difficult to discuss problems and feelings.
- Not wanting to appear weak, feeling embarrassed, afraid, or ashamed of their distress.
- Feeling very aware of stigma associated with mental health difficulties and accessing services.
- Not recognising feelings of emotional distress.
- Having a preference to work things out for themselves.
- Not considering their mental health a high priority.
- Believing that no one can help them.
- Previous unsuccessful attempts at seeking help.
- Not being aware of available services, and/or not considering the services ‘male friendly’.
- Having a tendency to manage emotional issues through silence or avoidance.
- Preferring ‘acceptable’ male outlets such as alcohol abuse or aggression to release feelings.
Although men are less likely to seek help, they make up 64% of those entering AOD treatment settings [432]. Physical, sexual, and emotional abuse are highly prevalent among men accessing AOD treatment settings, and can be accompanied by feelings of shame, guilt, and powerlessness [389]. There are also strong associations between AOD use (alcohol in particular) and the perpetration of domestic and other forms of violence, which is often exacerbated by the ways in which men are socialised, such as to display aggression and emotional restraint, rather than the use of adaptive coping strategies [389]. Difficulties regulating emotions in particular are associated with increased AOD use among men [1837] and, where appropriate, emotion management strategies should be integrated into treatment [389]. Men are also at considerably higher risk than women of death by overdose [1838] or completed suicide [1839], typically by more lethal means than women [1840], highlighting the importance of risk assessment (see Chapter B4; [389, 1817, 1841]).