Why Do Men Have Low Rates of Formal Mental Health Service Utilization? An Analysis of Social and Systemic Barriers to Care and Discussion of Promising Male-Friendly Practices

Less than 50% of people with a mental illness use formal mental health services, with service-utilization rates significantly lower in men compared with women, even when controlling for the presence of mental disorder. This underutilization has typically been attributed to harmful masculine norms that lead to a dysfunctional silence and stubbornness among men with mental health issues. However, this monocausal explanation ignores several pertinent factors related to men’s underutilization of mental health services. First, there is a high degree of external stigma in workplaces, the family, and elsewhere that can deter men from using formal mental health services. Second, evidence suggests that the formal mental care system can be unwelcoming and unengaging for men and typically suffers from male gender blindness, with few formal services devoted specifically to men’s mental health. Third, research indicates that there are various modalities of healing, with men often preferring more informal action-based approaches, but these are not readily available in the formal mental healthcare system, which typically proceeds on a “one-size-fits-all” approach. All this has contributed to the growing popularity of informal action-based interventions such as men’s sheds, which are a promising and innovative practice that incorporates many essential elements of a male-friendly approach.