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How asking one question can help open discussion around men’s mental health

There is a stereotype that men don’t talk about their feelings or struggles. Whether a child is told to “walk it off” or that “boys don’t cry,” outdated social expectations like these can profoundly affect people as they grow up and well into adulthood. Public awareness campaigns like Movember help to put a spotlight on men’s mental health issues and remind us that sometimes the struggle is not only real — it’s silent.

“If you surveyed the average Canadian and asked them what they think the leading cause of death among young and middle-aged men is, I think they would be shocked to hear the answer,” says Dr. Matthew Chow, a Psychiatrist and the Chief Mental Health Officer at TELUS Health. 

“But the reality is that today, drug overdoses account for more deaths than homicides, suicides, motor vehicle incidents (MVIs), drowning, and fire-related deaths combined1.” - Dr. Matt Chow

What is more startling is that in his home province of British Columbia, drug overdoses are now the leading cause of death for males between the ages of 10 and 592. He explains that, in the past, drug overdose was the leading cause of accidental death among adult men aged 25-55. Today, it’s the leading cause of death, regardless of whether accidental or not, for anyone 10 years of age or older.

“As a father, I worry about my 10-year-old choking on a grape or getting in a bike accident. But the reality is that kids at that age are now more likely to overdose, and unfortunately, so are their dads,” he says.

4 common signs of men’s mental health issues loved ones can look out for

Seeing past the silence and sensing that someone is not doing well might feel overwhelming for loved ones who are unsure what to say or do.

“I want to debunk a myth about men’s mental health concerns — there is a fear that simply asking how they’re doing is going to make them worse or that you’re going to break them because they’re fragile,” says Dr. Chow. “Asking how someone is doing is actually a life-saving act. Asking and connecting in a human way, with genuine care and compassion, makes a difference.”

Dr. Chow explains that some common stressors or situations can negatively affect men’s mental health, so spotting these can be early indicators for loved ones to offer help. Experiences of grief and loss like losing a loved one, losing their job and experiencing major injury or illness can contribute to feeling a loss of self-identity or self-worth. There are also more minor stressors that people face on a daily basis that can contribute to feelings of helplessness or hopelessness, exacerbating depression, anxiety and other mental health issues.

4 common signs that someone in your life might need support: 

  • Changes in personality: If your ordinarily extroverted coworker becomes distant and withdrawn or perhaps you notice their work performance slipping
  • Changes in sleep: If your partner experiences sleep disturbances like starting to toss and turn at night, oversleeping or relying on substances
  • Changes in appetite: If you observe changes in your best friend’s appetite or weight compared to their norm
  • Increased substance use: If your sibling enjoys a beer a couple of times a week but begins drinking more frequently, heavily or to the point of exhibiting concerning behaviour

Tuning into changes in these core behaviours can help open the door to conversation. By taking the time and space to genuinely ask, “How are you doing?” you could be throwing a life preserver to someone who isn’t showing the full extent of their pain. 

Openness around men’s mental health has improved but still has a long way to go, especially among men themselves

Understanding the links between mental health, suicide, substance use and drug overdose can help friends, family and colleagues to spot when someone may be facing mental health issues to offer a helping hand.

Dr. Chow believes there is more social acceptance in disclosing or sharing other health issues compared to talking about mental health, particularly men’s mental health issues.

“If someone is going through cancer treatment, they may find people around them are more willing to disclose that they’ve had cancer, too. Those folks might even share intimate details about their experiences or perhaps share that they’ve supported a loved one with cancer,” he explains.

When it comes to talking about mental health, he finds that gender expectations can be the biggest barrier to seeking help. Of the estimated 4,000 suicides in Canada each year, three in four are men3. Dr. Chow observes that this silent suffering can stem from childhood where boys are not often taught about emotions or self-expression.

“From an early age, men are generally taught that they're supposed to be stoic, they're supposed to suck it up and not complain when they're having mental health, psychological or emotional problems,” explains Dr. Chow. 

Although there is growing public awareness about men’s mental health, masculine stereotypes are still deeply, generationally ingrained. Additionally, people in specific careers, spanning first responders all the way to the factory floor, may feel added pressure from their workplace culture to endure stoically.

How to reach out to someone who may be facing challenges 

First and foremost, Dr. Chow recommends that friends and family try to remember that reaching out or checking in on someone who may need support doesn’t come with an obligation to fix the situation.

“There can be a reluctance to reach out to someone who is struggling with their mental health because we might feel like we need to fix it,” he says. “If we can look past that self-imposed expectation of fixing, we can see that what people really need is your gift of giving time and attention, which helps reduce feelings of isolation.”

He advises to start by asking how they’re doing and taking the time to dig beyond “everything’s fine” or “I’m okay” answers. By probing further or mentioning that you’ve observed a change in their demeanour or behaviour, you can nudge open the door to deeper conversation. 

If it feels accessible to you, offering assistance or self-disclosure can also help to show that you care. “Personally, I've dealt with mental health issues in my life, and I've gone to therapy. And I choose to openly and willingly share this with people to let them know that ‘Hey, it's actually okay not to be okay,” shares Dr. Chow. 

Finding and sharing resources like free hotlines or employee assistance programs (EAPs) might not be used right away, but they might come in handy one day. 

Taking the time to establish a line of communication with your loved one so that they know they are not isolated — that you are there to listen and support them — can make all the difference in feeling seen and heard.

If you or someone you love is in crisis, please call your local support hotline or dial 9-1-1. If you could benefit from counselling support, you can book a confidential appointment through the TELUS Health MyCare app.4

1. BC Coroners Service Death Review Panel: A Review of Illicit Drug Toxicity Deaths, March 2022

2. Unregulated drug supply claims 184 British Columbians in June 2023

3. Mental Health and Suicide Prevention in Men - Evidence Brief, June 2022. 

4. Users must be 16 years or older to access counselling appointments. Counselling appointments require additional payment of $120 plus applicable taxes. Any payments for appointments must be paid using a valid credit card. An in-app receipt will be provided for you to claim for reimbursement if applicable.