Men, Let’s Talk About Mental Health

It’s said that men don’t like to talk about their problems. Dr T Ayodele Ajayi provides pointers on how to get men to open up about the issues affecting their mental well-being

The statistics regarding men’s mental health are a cause of concern. Three quarters (75%) of suicides in the UK occur in males (National Confidential Inquiry into Suicide and Safety in Mental Health). Globally, suicide is twice as common in males than females (WHO), yet only a third (36%) of referrals to Increased Access to Psychological Therapies (IAPT) in England are for men.

The conversation on how to support the men in our lives with their mental health could not be more timely. The challenge, however, remains that only one out of four men feel able to talk to friends or family about mental well-being. Men would rather talk about politics, sports and the economy, than emotions. Serious topics, like mental health, sexual problems, and money, remain hard topics to broach with even their closest of companions according to a recent survey. Could these facts partly explain disproportionate gender suicide? The most at-risk men are war veterans, low-income earners, BAME, gay, and the middle-aged. What is also concerning is that a good percentage of men also feel it’s a waste of a GP’s time to talk about anxiety or depression.

The Alpha Male

Why does the male gender struggle so much to talk about feelings and emotions? Could the societal traditional definition of masculinity and the expectation of stoicism, strength, dominance and control from the Alpha Male be contributory to this, and possibly detrimental to the species’ well-being? Some research suggests that a reliance on these traditional ideals – as what it means to be ‘a man’ – may negatively impact men’s mental health. Men who feel as though they are unable to speak openly about emotions may be less able to recognise symptoms of mental health problems in themselves, and less likely to reach out for support.

Broaching the Topic

From years of negotiating this difficult terrain, both in my professional and social life, there are certain principles that appear to work when it comes to getting men to talk about feelings and emotions.

Authenticity: Many worry that not being mental health experts disqualifies them from supporting or talking to one another about their mental distress. In reality, ‘just’ being a listening ear that offers compassion, empathy and thoughtfulness is what is required.

Attentiveness: Men are not as fluid with language when expressing mental distress. Be on the look-out for such phrases as “I’m feeling stressed” or “I’m not feeling my usual self”, as they may be the clue to ask again “Are you sure you’re OK?”  Visit for conversation prompts.

Privacy: Sometimes the opportunity to talk to a man about their mental state can come at an unguarded moment of disclosure. At other times, it may require some preparation on the part of the supporter to arrange a private place and time to talk. An invitation to lunch, coffee or even a jog or walk can be all it takes for the other to confide.

Parity: Approaching a friend as a peer rather than as a superior is more likely to get them talking. Phrases such as “Man up” or “Grow up” have been identified as conversation blockers. No man wants another advising them on how to run their lives! A collaborative approach to a safety plan is more effective. Don’t forget to agree further support and checking-in times and methods.

Reciprocity: 35% of men surveyed in 2019 disclosed that if they wanted to talk to a friend about their mental health, they would ask how their friend is doing in anticipation that their reciprocation will open a conversation. I have found that sharing some of my vulnerabilities can be a great way to put the other person at ease.

Celebration: One of the greatest boosters you can give another man at their moment of mental distress is to offer a genuine compliment on something that is going right in their lives. That may well be thanking them for granting you access to the recesses of their hearts.

Confidentiality: Men will only share their emotions, insecurities and feelings if they know they are safe with you. The caveat to confidentiality is that a disclosure may be mandatory if a suicidal or homicidal plan is disclosed. In such rare instances, it is best to let the other person know why it is in their best interests to share to get them immediate help.

Dr T Ayodele Ajayi MBChB FRCPsych is a consultant psychiatrist, founder and convenor of the Tripart Care Emotional Wellbeing Hub and a YouTube channel called Tripart Care.

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