Non-communicable Diseases

Masculinity and mental health; Women have chamas, what do men have?

“There are things people say in the barbershop they won’t even say in their own living room, because it’s just one of those zones where nobody’s going to judge you too much about your dumb opinion,”

These words by Ice cube, an American rapper, actor, and filmmaker describe the safe spaces that barbershops are.

The appreciation that as they get a haircut, they are free to have a non-judgmental discussion with their peers is a model that has been adopted in parts of the United States of America to encourage men to openly speak about mental health issues affecting them.

In fact, the barbershop has been described as a free environment where men talk about their passions, sports, women, business, and even their manhood.

In Australia, this innovative approach to mental health known as men’s sheds was created where men feel included and safe to talk about anything. The aim of men’s sheds is to improve the health and wellbeing of their members.

The activities in these men’s sheds include a variety of activities from manual crafts to gardening to beekeeping. Some may undertake community projects such as making toys for local childcare groups. They also provide an opportunity for the men to learn new skills such as first aid.

                                                  Photo by Chris Knight on unsplash

The sheds are set aside for for all men from a local community who wish to join. They may particularly help men:

  • from disadvantaged areas or groups
  • who wish to learn a new skill
  • who want to spend some time in male company

Besides knowing everything that goes on in town, the barber has also been lauded for being that keen and listening ear where men pour out their hearts.

The American Psychological Association  observes that masculinity can actually be a burden on mental health. “If men are less willing to ask for help, they will continue to experience the symptoms contributing to depression,” one of the addiction counsellors observes.

A large number of studies provide strong evidence that gender based differences contribute significantly to the higher prevalence of depression and anxiety disorders in girls and women when compared to boys and men.

Photo by Nathan Mcdine on Unsplash

However, looking more closely at mental illnesses generally, there is no stark difference between mental illness in men and women.

It is all about the social constructs.

Prof. Lukoye Atwoli who is the Dean of the Aga Khan University Medical College observes that the prevalence of depression and anxiety is much higher in women, while substance use disorders and antisocial behaviours are higher in men.

Prof Lukoye Atwoli, Dean, Aga Khan University Medical College

“Suicide, which is the tail-end of most mental illnesses presents with a slight gender difference,” notes Prof Atwoli who is the Chair of Mathari Hospital.

“Women attempt suicide about three or four more times than men. However, looking at the rate of completed suicides, more men kill themselves by suicide about three times more than women. This is because men use more violent methods like jumping from heights, using a rope whereas women will use some ways like slitting their wrists, Prof Atwoli added.

Photo by Juli-kosolapova on Unsplash

Why do men bottle up their feelings?

Prof Atwoli notes that the gateway to the treatment and management of mental health, is speaking about how you feel. However, most men follow the unbending societal script that they need to stay macho.

“Mental illness in men is seen as a sign of weakness hence the tendency to keep to themselves to avoid ridicule,” said Prof Atwoli. Whereas women provide sympathy and support to each other, emotional sharing by men is  likely to be ridiculed and dismissed, he added.

“In our cultural setting, men are discouraged from speaking about psychological distress,” said Prof Atwoli adding that an expression of mental illness is akin to a sign of weakness. The society ‘allows’ women to talk about phases in life when they feel anxious, sad or troubled however men are expected to be ‘manly’

                                                         Photo by Zack Durant on UnSplash

“The language of distress in our setting has acquired gendered tones that discourage men from talking about mental illness, “Prof Atwoli observed.

These thoughts are corroborated by Dr Sarah Mackenzie and colleagues in a 2018 paper published in the American Journal of Men’s Health that observed that maintaining the façade that men do not talk or confide about their personal issues, or emotions, is problematic and could act as a barrier for those men who choose to actively seek emotional support from their networks.

“It could also leave some men socially isolated, with few avenues for social support during difficult life events, such as a relationship breakdown, which in turn could be detrimental to men’s mental health and well-being,” read an excerpt of the paper.

“Women have chamas. What do the men have? “

Dr Atwoli concludes that an effective health system is a non-judgemental mental health system that encourages people to speak up.

“We need to have safe spaces for men, women, young people and even children to openly talk about how they feel,” Prof Atwoli said.




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