Clinical FeaturesMen’s HealthMental Health

Men’s Mental Health

Recent years have seen a welcome increase in public awareness about psychological wellbeing, mental health, and treatment of mental illness. There is growing recognition that a healthy lifestyle, good diet, and reasonable exercise pattern all help to maintain mental health and deal with life’s difficulties when they present themselves. The Covid-19 pandemic generated additional challenges for many people, but also served as a reminder of the value of social connection and mutual support in sustaining wellness.

Notwithstanding these positive developments, there is still room for improvement, especially in recognising the continued impact of common mental illnesses and issues relating to misuse of alcohol and other substances. This article provides an overview of these topics from the point of view of men’s mental health, which has become the subject of enhanced focus in recent years (Castle and Coghill, 2021).

Common mental illnesses in men

The World Health Organization (WHO) points out that one in every eight people in the world live with a mental disorder (WHO, 2022). Anxiety disorders and depression are the most common conditions. In 2019, 301 million people were living with an anxiety disorder around the world (including 58 million children and adolescents) and 280 million people were living with depression (including 23 million children and adolescents). These are enormous numbers, especially when many people do not have access to effective care in some parts of the world.

From the point of view of men’s mental health, it is noteworthy that while depression and nonfatal deliberate self-harm are more common in women than men, completed suicide is more common among men. In Ireland, the HSE National Office for Suicide Prevention (NOSP) Annual Report 2021 presents provisional data for 2021 (excluding late registered deaths) and shows that 302 males and 97 females died by suicide in 2021. Final data are available for 2019 and reveal a similar picture: 408 males and 116 females died by suicide in 2019. This gender ratio is broadly consistent over time.

Better treatment of depression must form part of broader efforts to address mental health problems, deliberate selfharm, and suicide, in both men and women. Anti-depressant medication and psychological therapies such as cognitive behaviour therapy (CBT) have both been proven effective for depression, once they are accessed in an appropriate, timely manner. Despite this, there is still a reluctance among many men to acknowledge symptoms and to come forward for treatment. Public education has a vital role to play in addressing these issues and increasing uptake of mental health services and psychological supports among men.

For everyone with depression, a careful consideration of the social environment and social reengagement is another useful step on the road to recovery. Self-help groups and organisations such as Aware ( are extremely valuable. For men, Men’s Sheds also offer psychological support and social outlets, and can be accessed through the Irish Men’s Sheds Association (

Alcohol and other substance misuse in men

Substance misuse, including alcohol, present problems for both women and men but are generally more common among men. The Healthy Ireland Survey 2021 found that “almost two out of every three (61%) men who drank alcohol in the last six months did so at least once a week, with 53% of women drinking this frequently”. The report also points out that “men remain more likely than women to binge drink on a typical drinking occasion (35% and 10%, respectively), and younger people remain more likely to do so than older people (31% of those aged under 25, compared with 13% of those aged 65 and older)”.

This problem is not confined to alcohol: men are also more likely than women to enter specialised treatment for cannabis, cocaine, heroin, and amphetamine misuse. Therefore, while alcohol and substance misuse present problems for both men and women, it is probable that they make a particular contribution to the higher rate of suicide among men.

Treatment for alcohol misuse or dependence is provided through local addiction services which can be accessed following referral by a GP, psychiatrist, or other health professional, as well as through self-referral in certain circumstances. Abstinence is the usual and most sensible goal of treatment. The precise supports offered depend on the stage of the person’s addiction, their general life circumstances, any previous experiences of treatment, and their readiness for change on this occasion.

Overall, while men face specific challenges in relation to mental health, especially substance misuse and suicide, treatments and solutions are available. Services need to improve in many respects, but wider public education would be a good first step towards utilising the services we have and improving mental health outcomes for men.

Brendan Kelly is Professor of Psychiatry at Trinity College Dublin and author of “In Search of Madness: A Psychiatrist’s Travels Through the History of Mental Illness” (Gill Books, 2022).

Written by Professor Brendan Kelly

Read the full magazine: HPN November

Catch up on our previous features: Clinical Features

Leave a Reply

Your email address will not be published. Required fields are marked *

Please Confirm

This website is only for the eyes of medical professionals. Are you a medical professional?