44% of men do not complete therapy (Constantino et al., 2021). “Consider Amir, a 34-year-old engineer, who after months of restless nights decided to arrange his first therapy appointment. He went twice, spoke very little and gradually ceased going”. While men are becoming more open to mental health services, it is very difficult to retain men in the counselling room, research has shown. This can worsen mental health symptoms and make the man less likely to return.
This article will discuss the increase in dropouts from mental health services among males. We will explore how society has indoctrinated men to suppress their emotions, some of the challenges they may face, and why standard talk therapy might not work for them. Knowing these reasons can help us learn how to make mental health care more suitable for men.
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The Pressure of Traditional Masculinity
From an early age, boys are indoctrinated by society that they should be tough, independent and never complain about emotional distress. This attitude has been called “traditional masculinity ideology”, and it basically means that a “real man” does not ask for help, does not seek support from others, and never ever shows weakness when encountering difficulties. For example, a man who has lost his job might go to great lengths not to show how he’s feeling about it so as not to look weak. If men bring these beliefs with them as adults, there’s a massive obstacle to mental health treatment.
Counsellors understand that clients need to feel safe enough to acknowledge they need help, they must seek help, and they must talk about their feelings. This is often seen as going against “how men should behave” by many men (Seidler et al., 2021). Just sitting in the waiting room, there can be a sense of great shame. Even if a man has gone for a few sessions of his therapy, he should not be deterred from going back to treatment because he doesn’t want to feel like a man anymore (Seidler et al., 2021).
Additionally, men are taught to suppress their emotions and may also find it difficult to identify or label emotions. Based on psychology, failure to identify one’s emotions is known as alexithymia. The perception that men who express their feelings are weak must be challenged. Men can benefit from therapy just as much as women can. It takes considerable courage for a man to seek help. Seeing a therapist is a thing for men to do; it really is. Men can benefit from therapy. It is a beneficial thing for men to talk about their feelings with a therapist.
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The Disconnect in the Therapy Room
A prevalent factor for men’s withdrawal from counselling is a perceived lack of connection with their counsellor. The latest study, which polled men, identified the primary reason for their disengagement in treatment as a lack of connection with their therapist (Seidler et al., 2021). Several therapy rooms have been designed for Depth Emotional Speaking (DES). However, that’s not the only mode of communication for men.
When a man goes to a clinic, he is looking for tools and action-based solutions. They wish to resolve the problem. If a male client is continually asked, “How does that feel for you?” he will feel like he is not making progress. In one study, men were asked why they stopped therapy, and a number of them indicated that the therapy model was not appropriate to them and that the therapist was judging them and they felt they were not being understood (Springer & Bedi, 2021). If they feel they have to go to therapy and it is difficult, they go away silently.
Different therapists should use different approaches that are appropriate to the person. Some men may not wish to talk about their history or experience, for instance, but wish to learn how to cope so that they can achieve some goals. Some individuals may prefer engaging in dialogue during an activity or participating in a casual chat before addressing profound trauma. Establishing confidence requires time. A man experiencing a mental health crisis will most likely not abide a failure to provide him with a supportive, solution-focused setting by a mental health worker (Jones et al., 2024). The needs of patients for mental health care should be communicated in their language. As long as the system remains unchanged and doesn’t get used to working with men, there will be a significant number of dropouts.
Read More: Masculinity and Emotional Suppression
Practical and Cultural Barriers to Care
Along with beliefs and therapy methodologies, practical issues of everyday life also contribute to men’s disengagement from continued mental health therapy. Many people don’t care for it due to the expense. Counselling sessions can be very expensive when taken on a weekly basis. The additional cost puts financial strain on men, forcing them to leave treatment when their symptoms have eased a little and never make it to the end (Springer & Bedi, 2021).
The time and work commitments are also significant. A lot of men have to work for a long period of time, work shifts or have demanding work. It’s really hard to find the time to make appointments during typical working hours. A man may worry about losing his job or facing judgment from colleagues if he seeks therapy. The lack of job opportunities can also be responsible for dropouts. Unemployed men tend to have higher levels of stress and financial insecurity, which increases the risk of them not finishing their treatment as compared to financially secure men with stable employment (Firth et al., 2021).
Furthermore, cultural factors influence men’s attitudes toward therapy. Lack of knowledge and judgment regarding mental health issues is prevalent in many societies. Getting out of a health facility can be really tough. The Organización Mundial de la Salud 2022 says that people do not seek help because of the stigma that comes with mental health issues.
In 2022, they reported that millions of people do not get the treatment because of this. For boys, it is especially hard because they do not want their family and friends to think they are wild or broken. Mental health problems are common. Fear of judgment discourages many individuals from seeking help. The World Health Organisation also notes that this stigma is a problem. It prevents people from talking about their struggles and seeking help.
This is a burden of fear. The Centres for Disease Control and Prevention (2023) tell us that men have shockingly high rates of suicide (Garnett & Curtin, 2024). We must overcome these obstacles to save lives. Practical steps aimed at making counselling accessible (such as making sessions more flexible by scheduling them during weekends or evenings as well as lowering costs) might make male participation in the process easier.
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Conclusion
A male’s resistance to seeking psychological help is a multi-faceted problem, based on social norms, varied psychological treatments, and practical aspects. The male society encourages the notion that men should “toughen up”, which makes notions like intimacy and psychotherapy distasteful. In a therapy session, patients crave attention from the therapist and expect practical responses regarding their problems; consequently, they quit prematurely.
Moreover, the expenses associated with treatment and the established treatment regimen contribute to dissatisfaction, resulting in many individuals discontinuing treatment without achieving a cure. We cannot disregard this trend. The mental health system must address men’s communication requirements through a pragmatic, courteous, and adaptable approach.
We need to change the way we think about men showing their feelings. A lot of people think that it is not manly for men to talk about their emotions. This is not true. Men can really benefit from talking to a therapist like women can. So, when a man is having a hard time, it is good to tell him to go see a therapist. We should also let the man know that going to therapy is a very brave thing for him to do. This is because therapy is not always easy. It can really help men deal with their problems. Men can learn a lot from therapy. It can make them stronger, not weaker.
Reference +
- Constantino, M. J., Boswell, J. F., Coyne, A. E., Swales, T. P., & Kraus, D. R. (2021). Effect of Matching Therapists to Patients vs Assignment as Usual on Adult Psychotherapy Outcomes: A Randomised Clinical Trial. JAMA Psychiatry, 78(9), 960–969. https://doi.org/10.1001/JAMAPSYCHIATRY.2021.1221
- Firth, N., Barkham, M., Delgadillo, J., Allery, K., Woodward, J., & O’Cathain, A. (2021). Socioeconomic Deprivation and Dropout from Contemporary Psychological Intervention for Common Mental Disorders: A Systematic Review. Administration and Policy in Mental Health, 49(3), 490. https://doi.org/10.1007/S10488-021-01178-8
- Garnett, M. F., & Curtin, S. C. (2024). Suicide Mortality in the United States, 2002-2022. NCHS Data Brief, (509). https://doi.org/10.15620/CDC/160504
- Jones, F., Timulak, L., Keogh, D., Chigwedere, C., Wilson, C., & Ward, F. (2024). Client predictors of dropouts and outcomes in psychotherapy for generalised anxiety disorder: an exploratory study. Person-Centered & Experiential Psychotherapies, 23(3), 344–361. https://doi.org/10.1080/14779757.2024.2335383
- Organización Mundial de la Salud. (2022). World Mental Health Report. Organización Mundial de la Salud, 32–39. https://www.who.int/publications/i/item/9789240049338
- Seidler, Z. E., Wilson, M. J., Kealy, D., Oliffe, J. L., Ogrodniczuk, J. S., & Rice, S. M. (2021). Men’s Dropout From Mental Health Services: Results From a Survey of Australian Men Across the Life Span. American Journal of Men’s Health, 15(3). https://doi.org/10.1177/15579883211014776
- Springer, K. L., & Bedi, R. P. (2021). Why Do Men Drop Out of Counseling/Psychotherapy? An Enhanced Critical Incident Technique Analysis of Male Clients’ Experiences. Psychology of Men and Masculinity, 22(4), 776–786. https://doi.org/10.1037/MEN0000350
