Men are largely absent from mental health policy globally, says new report
Men are largely absent from the mental health policy produced by many of the leading organisations in global health, say the authors of a new report released by the Global Action on Men’s Health (GAMH) this week
While policies may refer in passing to some of the issues concerning men, this rarely leads to any analysis of the policy changes required to make a difference to men’s outcomes, they state.
The study - Absent-Minded: The Treatment of Men in Global Mental Health Policy – examines the way men are considered in 25 global and regional mental health policy-related documents.
Researchers Dr Natalie Leon and Professor Chris Colvin set out to understand the gaps in addressing the unmet needs of men, considering:
- Globally the rate of suicide in men is more than twice as high as in women, in some geographic settings up to four times the death rate of women
- Men consume nearly 4 x more pure alcohol per capita than women
- Many men attach stigma to mental health issues and don't seek help
- Men often externalise their distress through behaviour that is anti-social, aggressive or violent
- Boys and adolescent males are particularly vulnerable, with higher rates of conduct disorder compared to girls, and with mental and social impairments that track into adulthood
- Common mental health problems are under-diagnosed and under-treated in men
- Black men in white countries face a double barrier- race and gender - when in need of mental care
“Specific policy initiatives in mental health are needed to get a better understanding of gendered disease patterns for men and to identify evidence-informed strategies to address male health needs,” they report.
“Achieving this will require sustained and effective advocacy for considering the mental health of men in policy.”
In their extensive study of global health policy documents and global health interventions, half of the selected reports provided some form of disaggregated data on mental health, “but, for the most part, these were cursory references that were limited in scope, and depth.”
“In most reports, gender was acknowledged as a determinant alongside other socio-demographic determinants of mental health, but with no gender analysis to explain mental health risks and vulnerabilities of boys and men.
“Gender disparity was discussed in relation to the disproportionately negative effects of gender on mental health of women. Cursory references were made to the mental health needs of men in these reports.”
The report acknowledges those countries that have brought greater focus to men’s health, and even developed national policies that focus on improve male health, namely: Australia, Brazil , Iran, Ireland, and more recently, Mongolia, the Philippines, South Africa, and Malaysia. The World Health Organisation’s European Region has also published a men’s health strategy covering its 53 member states.
“These male health-focused policies are a major step forward, and this momentum should be extended to key areas where men face a specific inequitable burden of disease, such as suicide in the context of poor mental health.”
The report concludes with reflections on the kinds of strategies that policy advocates might pursue in increasing attention to and engagement around the issue of men and mental health.
Using John Kingdom’s Three Streams Model of policy windows of opportunity and agenda setting, the Problem Stream outlines the current understanding among stakeholders of the nature, scale and impacts of the problem at hand.
The Policy Stream is comprised of the policy solutions—real or potential—that are on the table for debate and decision-making by those stakeholders.
And the Politics Stream is the set of external events, institutions and conditions in the political environment that can either close down or open up opportunity for policy change.
Leon and Colvin say the World Health Organisation (WHO) and its regional offices, together with partners such as UNICEF are key organisations to engage with to advocate for increased focus on the gender disparities, and more specifically, to advocate for gendered approaches that address male equity in mental health. Other organisations of interest include the World Federation for Mental Health and the International Association for Suicide Prevention.
They quote from a 2020 WHO report for addressing how sociocultural considerations of masculinities relate to men’s mental health seeking, which suggested the following policy considerations:
- promote collaboration and partnerships between the health sector and community organizations working with diverse groups of men across projects (eg. cultivating responsible and involved fatherhood, violence prevention, addressing substance abuse), including engaging schools, parent and community stakeholders,
- educate health- and social-care professionals about how gender influences how men present with mental health problems (and the need for gender-responsive approaches to treatment).
- develop male-friendly initiatives tailored to the values, customs and priorities of those groups of men most in need,
- promote strengths-based approaches to men’s mental health that build on positive aspects of traditional masculinity and normalize mental health issues,
- engage with health-focused multi-media programmes to promote men’s awareness and engagement with peer and expert support platforms (including online platforms with relevant information and resources).
DOWNLOAD ABSENT-MINDED: The Treatment of Men in Global Mental Health Policy