In contrast to women, it is important to be aware that men may be less forthcoming with information concerning mental health, which may affect their help-seeking behaviour. There are a number of barriers that may prevent men accessing mental health treatment, including [1116]:

  • Feeling uncomfortable and/or finding it difficult to discuss problems and feelings.
  • Not wanting to appear weak, feeling embarrassed 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.
  • 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.

Physical, sexual, and emotional abuse are highly prevalent among men accessing AOD treatment settings, and, as with female clients, treatment should be trauma-informed, bearing in mind feelings of shame, guilt, and powerlessness that can be the result of abuse [276]. Men are also at considerably higher risk of completed suicide than women, and are more likely to choose lethal means for suicide attempts, which highlights the need for risk assessments (see Chapter B3) [276]. There are also strong associations between AOD use (alcohol in particular) and violence, and it is important for treatment to address AOD-related violence, including family and domestic violence. Where appropriate, anger management strategies should be integrated into treatment [276].