Confronting the ‘Wall of masculinity’ in mental health

Why men are less likely to speak up about mental health in the U.S.

Photo by Todd Quackenbush via Unsplash Photo by Todd Quackenbush via Unsplash

By Jessica Perry and Brandon Latham/Matters of the Mind

While the majority of mental health diagnoses are for women, according to the National Institute of Mental Health, the American Foundation for Suicide Prevention indicates that almost 78 percent of deaths by suicide in 2013 were completed by men.

What accounts for this discrepancy?

Some experts trace it back to a reluctance among men to seek help for mental illness. Keeping quiet is common for many men in a culture that values pride. This is known as a cultural gender bias.

“Turning to someone else for help runs counter to the masculine ideal of the protector,” said Joseph Vandello, a professor of psychology at the University of South Florida. In addition to protection, the other masculine ideal he noted was procreation.

A large part of this reluctance is related to self-stigma, according to David Vogel, a professor in the Iowa State University department of psychology and clinical counselor. The term “self-stigma” is derived from the idea that masculine pride is internalized.

Men are tough on themselves, according to Vogel. “It comes to statements like, ‘I’m weak,’ or ‘I’m a failure,’ or ‘There’s something wrong with me,’ ‘I wasn’t able to handle an issue on my own or within my family,’” Vogel suggests. Vogel also says that masculinity “might heighten those statements,” especially as related to conditions like depression. Men may feel as though they are  “not supposed to be depressed, and if they are sad they should be able to handle it,” Vogel says.

He also says that men are more likely to seek out mental health help when other markers of their manhood are directly threatened.

“When it starts to impact your ability to take care of your family, hold down a job, then men are more likely to do something about it,” Vogel says. “That’s when it plays in that we’re supposed to be the caretakers, [and] have success in careers [among other] things.”

Manhood and Millennials

These issues are increasingly relevant for millennials, as many transition from being in school  to  working and starting families.

More women are taking on breadwinner roles, which Vogel says should ease pressure on men. Conversely, he says, social norms have expanded more for women than for men.

According to Vandello, manhood has historically been based on rituals and traditions. Today’s young men face a unique challenge as  there are fewer rites of passage than in the past. In generations past, military conscription has meant hundreds of thousands of young men have gone to war. That is not the case now.

However, recent research from the American Psychological Association suggests that men are still emotionally affected by both economic and social problems, both of which are still closely related to male suicide.

Perception, power and control

Photo by Brandon Latham

American University student Patrick Noel works with Men of Strength, a group that focuses on preventing domestic and sexual violence on college campuses. // Photo by Brandon Latham

Masculinity and manhood are perceived states; even if this is only self-perception, men seek to prove their manhood in ways that Vandello describes as “public and verifiable.”

One of the aforementioned ways is sexual performance. Vandello cites losing one’s virginity and producing children as examples of verifiable and socially-acceptable proofs of manhood.

Self-perception of manhood is tied to sexuality through an individual’s sense of control, according to Patrick Noel, an American University student who works with Men of Strength. The group focuses on preventing domestic and sexual violence on college campuses.

Sexuality “intersects with masculinity because men are taught throughout their lives to be in control of all aspects of their lives, from their emotions to their finances to their family lives,” he says. “A perceived failure of any of these things is seen as a failure of their masculinity.”

This is why men are reluctant to seek support from their communities, Noel says, because it would mean surrendering “power and control.” Even when there are spaces, such as the home, where communication is welcome, Noel says men are not talking about their health and mental health issues.

He provided an example of two fraternity members who were both battling similar mental health issues, but never would know because neither felt that they could speak up to their friends.

“It’s a constant reassertion of this wall of masculinity, as if we have something to prove to the entire group,” Noel says. “Really, I feel like if more men talked to each other, we’d realize we all have a lot of similar problems.”

‘More lethal means’: Gender differences in suicide

‘The solution is not to win the tug-of-war, but to drop the rope and then use the energy you used to spend fighting yourself to focus on … what is really important to you in life.’


And part of what drives differences in suicide is that men and women use different means to commit or attempt suicide. Research shows men are more likely to use firearms, while women use less deadly means — or means where they can be resuscitated. This is known as the “gender paradox” of suicide.

“The research shows that women attempt suicide more often than men, but that men are more likely to complete suicide, likely due to use of more lethal means,” Vogel wrote in an email.

It is possible that this paradox is reinforced by American accessibility, as suggested in a Scientific American blog by Jesse Bering: studies show that women are prescribed significantly more antipsychotic medications, and men have better access to weapons.

Other cultures worldwide do not demonstrate the same gender paradox, according to the World Health Organization.

Means aside, why do men go through with suicide more often than women in the U.S.? An American Psychological Association study suggests that suicide itself has masculine connotations. The conclusion, according to the study, is that men may perceive surviving a suicide attempt as failure. And in this culture, failure takes away what makes men masculine.

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