Masculinity Norms and Mental Health and Suicide Prevention Help-Seeking Intentions

Background and Purpose: The CDC reports 75% of people who died of suicide in 2024 were men. Men are less likely to seek mental health support than women. Prior studies indicate that masculinity norms may play a role in men’s help-seeking intentions. Man Therapy (www.ManTherapy.org) (MT) was created to engage men in conversations about their mental health and suicide prevention, while providing free online tools and referrals. MT is research-based in response to what men said they wanted from an online intervention. This included talking about hope and recovery with men who looked like them and including humor to break through stigma. MT was created to break through barriers reinforced by some traditional masculinity norms that can increase stigma. This study is the first to explore how masculinity norms relate to men’s mental health help-seeking intentions.

Methods: Participants completed two online surveys (baseline during initial visit to MT and one-month follow-up) if they were male, reported moderate to severe depression or suicidal ideation, lived in Michigan or Ohio, and were 25 years or older. 214 completed survey one; 128 completed survey two. The majority of participants were not in mental health treatment at the time of the study. The survey asked about depression, help-seeking intention (formal and informal), stigma, barriers toward help-seeking, and 3 masculinity norm subscales from the Conformity to Masculinity Norms inventory (CMNI; Playboy, Self-reliance, and Emotional Control). Data were analyzed using bivariate and linear regression methods to assess relationships among masculinity and help-seeking.

Results: Pearson correlations showed there was a significant negative relationship between Emotional Control, and formal and informal help-seeking intention. After viewing MT, the correlation remained significant. Emotional Control was positively correlated with stigma and barriers towards using mental health services. This remained significant after viewing MT. The Self-Reliance subscale was significantly and negatively correlated with both formal and informal help-seeking. Self-reliance was positively correlated with stigma and help-seeking barriers. Results showed a significant increase in the formal help-seeking scores (p=0.02), and a significant decrease in depression scores (p<0.01). Linear regression prior to MT showed that for every unit increase on Emotional Control, scores for informal help seeking decreased by 0.45 (p<.01, 95% CI[-0.67, -0.22]). Formal help-seeking, scores decreased by 0.23 (p=0.03, 95% CI [-0.43, -0.03]). The Self-Reliance scores for seeking help from an informal source decreased by 0.28 (p=0.08, 95% CI [-0.59, 0.03]), and for formal help-seeking, scores decreased by 0.35 (p=0.01, 95% CI [-0.62, -0.07]).

Conclusions and Implications:

Traditional masculinity norms, particularly Emotional Control and Self-Reliance, were associated with lower formal and informal help-seeking intentions and greater stigma and barriers to care. Following exposure to MT, the relationship between Self-Reliance and help-seeking appeared attenuated, while formal help-seeking increased and depression symptoms decreased. Findings highlight an important role for social work in developing and implementing gender-responsive, stigma-reducing suicide prevention interventions that address masculinity norms. Social workers in clinical and community settings may be well positioned to engage men not currently connected to care and to increase access to help-seeking and suicide prevention supports.