By Mukarram Hamid

Men’s mental health needs to be spoke about more.

Mental health has grown more accepted and acknowledged throughout society, mainly for women. Conversely, men do not receive the same amount of acceptance from society when they face struggles with their mental health.

According to the National Library of Medicine (NLM): "Men are less likely than women to seek help from friends and medical professionals for mental health issues."

The main reason men don't communicate about their mental health struggles is because of the stigma they face from society; Stigma causes men to hide their struggles to maintain the idea of being "manly" and "strong".

Stigma is "when someone negatively views you because you have a distinguishing characteristic or personal trait that's thought to be or is a disadvantage."

Stigma does have numerous effects on men, such as: making them reluctant to reveal that they are struggling to medical professionals or loved ones; they will develop a fear of being misunderstood or being judged by their friends and loved ones; men would also experience overwhelming feelings of shame, isolation, or disconnection; they might also face bullying, verbal or physical assault and harassment; men will establish a lack of hope or belief in positive outcomes which would result in a significant delay in recovery.

Many different types of stigmas affect men throughout society, such as:

•Social stigma – the misunderstanding that someone who shows signs of having a mental illness is weak and, as a result, is discriminated against; they would also be avoided and rejected.

• Self-stigma- the internalisation of social stigma when the person experiencing mental illness feels ashamed for having the illness.

•Professional stigma- when health professionals reinforce the stigma that individuals face.

•Cultural stigma- affects how individuals with mental illness deal with it as a culture is "someone's beliefs, values, and norms within a given radical or ethical group" (NLM).

Societal gender roles can determine that when men express their vulnerability or seek advice for their mental health issues, they are no longer 'real men'.

Eddie Buggy, a councillor and well-being coordinator at the City of Glasgow College, said: "Self-stigma comes from us not reaching out and not being connected when we're stuck in our head and stuck in our mind.

"We've got an expectation to be a certain way, which goes unchallenged.

"The best way to kind of combating that is to connect to ourselves and to connect to other people."

The culture has a big impact on mental health.

Also, the culture a man lives in will directly affect how they handle their mental health.

For example, some cultures will make men believe they are to be strong and have no weaknesses or struggles, making men think that they must keep their mental health struggles a secret and not communicate their problems with anyone.

Buggy said: "Cultural stigma exists because of all the things that live in the public domain and again the expectations around people: how people should be, how people should act."

Another reason men do not speak out about their struggles is toxic masculinity.

Toxic masculinity is a by-product of social stigma; it enforces the demonstration of masculinities by restricting behaviours based on gender roles that amplify existing power structures that favour the dominance of men; it leads to difficulties in men expressing emotion.

For example, boys are acculturated to play rough and are often allowed to break the rules. Following their masculine norms may lead to various issues, such as discouragement and seeking help.

Buggy said: "My take on it is where masculinity becomes the be-all and end-all.

"I think it becomes toxic when it becomes the most important thing for people to feel that kind of masculine image.

"It doesn't allow the kind of scope for the whole person to be present."

Toxic masculinity will always affect men and how they feel surrounding their mental health, but we can fight against it and, hopefully, one day break it.

The phrase toxic masculinity was made popular in the late 2010s.

However, Buggy said:” It’s interesting that the word fight even comes up, but I think that's perhaps what toxic masculinity does.

"It's a threat response, and that then initiates another threat response almost to think we need to fight it.

"I think for me, it is about trying to understand why it's happening, what is going on, some people will feel benefits from it, so understand what they get from it, work alongside it and try and do it in a gentler, caring and understanding way."

He also believes that the idea of fighting has arisen a lot in conversations surrounding toxic masculinity, but to overcome it, we must first understand it and see where people who show toxic masculinity traits are coming from. If we understand it, we can help people realise why what they are saying is wrong and help them move on from it.

A study by Frontiersin, the sixth largest research publisher and open science platform, found that internalised masculine norms and self-stigma negatively affected men's help-seeking behaviour. However, findings indicate a change in attitudes towards depression after mental health service use.

Men with depression emphasised a perspective that focuses support health and well-being towards mental health problems and critically reflected on masculine norms.

There are numerous ways for men to deal with the internalised masculine norms they instil in themselves.

Buggy said: "The best thing is to try and connect to other people, to check out what those norms are, where you get them from, what keeps it as a norm.

"It's difficult when they're stuck in their head and mind, but it's about taking that risk."

There are various ways that individuals and society can tackle and hopefully break the stigma surrounding mental health in men.

Some ways that individuals can deal with stigma are:

•Speak out against stigma- consider expressing your opinion at events or on the internet. It can help instil courage in others facing similar challenges and educate the public about mental illness.

•Get treatment – Don't let the fear of being labelled with a mental illness prevent you from seeking help. Treatment can provide relief by identifying what's wrong and reducing symptoms that interfere with your life.

•Don't let stigma create self-doubt and shame- Stigma doesn't just come from others. You may mistakenly believe that your condition is a sign of personal weakness or that you should be able to control it without help.

•Don't isolate yourself- If you have a mental illness, you may be reluctant to tell anyone about it, but your family, friends and community members can offer you support if they know. Reach out to people you trust for the compassion, support and understanding you need.

•Don't equate yourself with your illness. You aren't your illness, so instead of saying, "I'm bipolar" say "I have bipolar disorder."

•Join a support group- Some local and national groups offer local programmes and internet resources that help reduce stigma by educating people with a mental illness, their families, and the public.

Fraser Devine, Founder of MenMatterScotland- a men's mental health charity, shared his ideas on how to beat and overcome stigma.

Devine said that the best way people can help fight against stigma is by "screaming from the rooftops" that it's okay for men to have illnesses and to speak out about them.

He also believes that changing how we ask simple questions, such as, how are you, will help break the stigma.

Devine said: "We at MenMatterScotland say, ‘how are you mate?’ And then we say, ‘no, how are you?’ And that can break the barrier."

The founder of MenMatterScotland continued by saying that he thinks men are uncomfortable speaking out about their mental illness because of their "pride, ego, fear of judgement" and believes that men are afraid of getting judged by others and their loved ones for having these feelings.

There are hopes that the stigma surrounding men in society will break and that "men will realise that they can open up and talk without feeling weak."

Devine and Buggy agree that talking is a big part of breaking down the stigma and allowing men to be more comfortable within society.

Buggy said: "Talking is a big part of it, staying true to who we are and being curious that talking from the point of view of being curious and listening to where someone's coming from and trying to create a space where we can share where we are coming from as well."

Devine admits that out of all the facilities that his charity offers, the one that helps the most is "talking therapy".

Another way to overcome the stigma is by developing policies for providing mandatory cultural competency training to physicians in medical school, developing and implementing public stigma reduction campaigns, diversifying the pool of mental health providers in urban and rural areas, and increasing diverse role models of positive masculinity.

Furthermore, Interventions should be developed to reduce the stigma of being "unmanly" and improve men's capacity to cope with being unable to work. Training for health professionals concerning the impact of masculine norms on mental health would help break and tackle societal stigma.

If you have a loved one struggling with mental health, there are several ways to support them.

supporting someone doesn’t always need to be a big thing: just listening helps.

One of these ways is by communicating openly and honestly – By discussing your issues. It creates an environment where it's acceptable for the men in your life to discuss their mental health; it will help them feel more comfortable sharing their difficulties. Showing a man that he is not alone is essential in breaking the stigma.

Buggy said: "The thing that you need to be careful of is that, so if I've experienced something and you've experienced something similar, I don't just give you advice based on what worked for me because that can leave you feeling more alone."

You could also be vigilant- Men often silently show signs of mental health difficulties. Be sure to make them feel comfortable and understand that by sharing their feelings, your perception of them will not change, nor will they be judged.

By actively encouraging men to share difficulties they might be experiencing, you will be normalising discussion and helping break the stigma.

Additionally, you can politely challenge negative behaviour- The reinforcement of harmful societal norms upholds stigma; society develops stigmas, but individuals sustain them.

If you overhear negative remarks, politely point out the harmful effects of their words. Some men will hear comments like this and reinforce those beliefs that they shouldn't share their issues.

We reinforce the stigmas that cause real-world harm by allowing judgement to remain.

Devine said: "I would advise any man or any young kid that's struggling to reach out and speak to anybody and realise that they are not weak, that it takes strength and courage."

The stigma surrounding mental health in men still exists throughout society, but there are many ways in which we can tackle this, such as communicating with those experiencing struggles, fighting societal norms that support stigma, and showing men that it is okay to have issues and to discuss them.

The redefinition of manhood is needed; there must be a transformation in changing the culture where males are more comfortable expressing themselves.

Why Men Don't Talk