What are men suffering in silence from?

Writer: Stephen Stratton, MA Medical Anthropology, Marta Perez Fernandez, BA Economics and Development Studies

I am a nurse. I first trained as a psychiatric nurse 35 years ago, in a nursing school at a Victorian asylum (with all its connotations) in Essex. I’m still unsure why I chose this profession: I can only, after all these years, recognize that it was either 30 years of therapy or 30 years of nursing.

Over the years, I have witnessed a steady increase in positive attitudes towards mental health. When I trained, the Mental Health Act hadn’t been reviewed since the 50s. Unregulated control and restraint, the regimented routine of custodial care, the miles and miles of criss crossing corridors and redbrick walls, are no more. Yet, mental illness still has to struggle to get the recognition it deserves, despite high profile attention.

In 2012 I became a full time Carer for my son, who has suffered with mental illness for the past fifteen years. We’ve realized men’s mental illness gets even less recognition.

It’s not often appreciated that men disproportionately suffer more from psychosis. For example, early onset schizophrenia between the ages of 18 and 30 affects young men more than women. The issue doesn’t appear to be recognition of symptoms – rather the impulse to seek help. The gendered assumption of men as invulnerable and strong disempowers them: despite any invalidation based on assumptions, a societal perception of women as ‘vulnerable’ leads to better care and a less final diagnosis.

There is also the issue of dual diagnosis. Oftentimes schizophrenia is paired with alcohol or substance abuse, which arguably should be treated like a mental illness in itself. In this case, they can be seen as symptomatic relief of a more serious problem. However, there is a discrepancy in treatment here also: in my experience, a woman with alcohol or substance abuse problems is more likely to be victimized and perceived as vulnerable to the influence of some male figure. Men, however, are given agency when they abuse substances. This difference in perception obviously impacts the treatment and care, as well as perceptions from family members and wider society.

There are many charities and organisations that offer men-specific advice and support and some offer helplines, like CALM (Campaign Against Living Miserably) but here societal perceptions hit harder than ever. It’s not that I don’t know where to go to help- I just can’t bring myself to admit that I occasionally need that help. Throughout these mental illnesses we have often been left struggling for no other reason than being men. The tremendous feelings of guilt and being a failure, should I simply wish to talk to someone about how difficult some days, are not uncommon amongst men in stressful situations.  This invincibility is hardwired into our mind-sets from such an early age- the fact that suicide is the single biggest killer in men under 45 in the U.K and that 75% of all U.K suicides are male is no coincidence.

There are glaringly obvious disparities in other areas of health, for example screening for male cancers, such as testicular and prostate. Spending and research is overwhelmingly in favour of cancers affecting women. This inclination comes from the assumption men don’t need NHS help, that they can look after themselves.

There’s a wider point here.

Over the preceding years as a male nurse I occasionally experienced levels of unwanted female attention. It’s brushed off as “you know what she’s like, loves a bit of a flirt” and other complacencies. If men were empowered to consider these undesired advances as assault, we might be willing to concede our vulnerabilities.  What are men suffering in silence from?

35 years ago as an 18 year old student psychiatric nurse I was at a clinical ward review, the only man in the room. Part way through the review a social worker had suggested that some of the female patients may benefit from a ‘Women Only’ group. Eager to please, I suggested the very same for the men on the ward. Within minutes I was asked to leave the room. I should hope that, if that were to happen today, my request would be considered.