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(p. 102) Acceptance of Mental Illness Among Men: Masculinities and Mental Health 

(p. 102) Acceptance of Mental Illness Among Men: Masculinities and Mental Health
Chapter:
(p. 102) Acceptance of Mental Illness Among Men: Masculinities and Mental Health
Author(s):

Lauren Mizock

and Zlatka Russinova

DOI:
10.1093/med:psych/9780190204273.003.0007
Page of

date: 23 January 2018

Gender can have a profound impact on the process of accepting mental illness not only for women, as we discussed in Chapter 6, but also for men. Gender roles and expectations can shape the expression, detection, and treatment of serious mental illness (Mowbray, 2003). Here, we refer to gender as distinct from biological sex, but rather a social construction of a set of dominant norms, beliefs, attitudes, and stereotypes associated with one’s gender (Brooks, 2001; Courtenay, 2000).

In particular, men’s health behaviors may impact the process of accepting mental illness. Men with serious mental health problems have poorer health behaviors than their female counterparts. Many of these behaviors among men are associated with mental distress, including higher incidences of homicide, addiction, incarceration, and morbidity (Miller & Bell, 1996). Some men with chronic mental and physical illnesses, however, may hide their symptoms instead of asking for help for fear of being seen as weak (Courtenay, 2000). As a result, men may cope with symptoms through acting out or through self-destructive behaviors, posing barriers to the acceptance and management of mental illnesses.

In a seminal article on health behavior among, men, Courtenay (2000) addressed the chronic health disparity between men and women in the United States. Men have higher death rates than women, dying an average of five years earlier (Gorman & Read, 2007). Courtenay posited that traditional masculinity contributes to differences in positive health behaviors, accounting for these stark differences. For example, women are socialized to engage in more health-promoting behaviors and health care appointments, even beyond reproductive health visits. In contrast, men are more likely to smoke, drink and drive, refrain from safety belt use, and avoid health screenings (Courtenay, 2000). In fact, men top women in over 30 behaviors that increase the risk of disease, injury, and death. Courtenay spoke to the problem of a lack of inquiry into these health disparities: “Left unquestioned, men’s shorter life span is often presumed to be (p. 103) natural and inevitable” (p. 1387). Instead of accepting and responding to such problems, men may expect worse health and suppress symptoms of distress.

Courtenay (2000) attributed much of the gender disparity in mental and physical health to adherence to values of traditional masculinity, or hegemonic masculinity, the “socially dominant gender construction that subordinates femininities as well as other forms of masculinity…  . embodied in heterosexual, highly educated, European American men of upper-class economic status” (p. 1388). Hegemonic masculinity leads to hypermasculine constructions of men as stronger and less vulnerable than women. Consequently, many men with traditional gender values dismiss mental and physical health needs and express “toughness” and fearlessness in the face of danger.

Pressure to conform to hegemonic masculinity likely contributes to elevated suicidality rates among men (Emslie, Ridge, Ziebland, & Hunt, 2006). Men with serious mental health problems have described suicide as a means of regaining a sense of control from depression (Heifner, 1997). Gender pressures can delay recovery and help-seeking in attempts to assert masculine values of independence and strength through endurance of distress (Emslie et al., 2006). Rigid gender roles can contribute to a lack of disclosure of a mental health problem and an avoidance of treatment (Brooks, 2001), further interfering with acceptance of mental illness.

On the other hand, Miller and Bell (1996) posited that for some men, “the poverty of their/our emotional lives may be well compensated for by the material advantages that maleness can confer” (p. 319). By conforming to traditional notions of masculinity, men may sacrifice mental health but benefit from male privilege and unearned social advantages afforded to those with dominant power positions in society (McIntosh, 1989). A lack of acceptance of mental illness may be associated with this unconscious maintenance of power in promoting notions of men as immune to distress.

Acceptance of mental illness can be uniquely impacted by the lack of help-seeking behaviors by traditional men with serious mental illness. Traditionally masculine values of emotional rigidity and independence are threatened by help-seeking behavior (Addis & Mahalik, 2003). Sensitivity, compassion, and emotional injury are associated with femininity, leading to additional avoidance of mental health services (Bem, 1974). This poses a double jeopardy, with gender role conflict interfering with service access and leading to worsening of symptoms (Good & Wood, 1995).

O’Brien, Hunt, and Hart (2005) conducted a qualitative study on help-seeking and traditional masculinity. Many of the men attributed their avoidance of care for mental health problems to breadwinner stress and an associated fear of work impairment. The men also feared questions as to the authenticity of their mental health problem. These men viewed help-seeking as permissible mostly in cases of serious illness or obvious injury. Help was allowed when framed as a way to preserve or restore traditional masculinity, such as to maintain physical-labor jobs or sexual function. Some responded to mental health stigma by minimizing or renaming the depression as stress or grief, terms that were seen as less (p. 104) threatening to masculinity and more acceptable reasons for distress. Although renaming psychiatric diagnoses can often be helpful, doing so in a way that disregards one’s pain may further interfere with men’s acceptance of a mental health problem.

Another barrier to mental health care among these participants was a lack of internal awareness and ability to detect mental health problems (O’Brien et al., 2005). Heterosexual men often seek the assistance of female partners in health matters (Norcross, Ramirez, & Palinkas, 1996; Seymour-Smith, Wetherall, & Phoenix, 2002). Women may serve as medical mediators, helping to identify and interpret symptoms and encourage men to seek intervention. In fact, some men view help from friends and family as more acceptable, leading them to feel self-reliant by avoiding professional assistance (Berger, Addis, Green Mackowiak, & Goldberg, 2013). This lack of awareness of symptoms and evasion of treatment may further hinder the acceptance of serious mental illness among these men.

A number of studies on men’s mental health have focused on gender differences in depression, highlighting the impact of traditional masculinity on the process of acceptance of mental illness. The common statistic of women having twice the rate of depression as men (Nolen-Hoeksema, 2014), may be a result of overlooking what Kilmartin (2005) referred to as a “masculine” form of depression. As discussed earlier, men have four times the rate of suicidality, twice the rate of substance abuse problems, and commit the majority of violent crimes as compared with female counterparts. Kilmartin attributed these different rates to a lack of diagnosis and treatment of mental health problems among men, given that men are socialized to express more externalizing responses to psychological distress by acting out with angry outbursts, drug use, sexual risk-taking, gambling, and aggression. Other maladaptive coping with psychiatric distress among men may include infidelity, isolation, avoidance, and denial, further escalating these symptoms (Chuick et al., 2009).

Kilmartin (2005) argued that standard depression criteria fail to capture more of the externalizing symptoms of depression that traditional men have been socialized to express. The more traditionally “feminine” experiences of depression in the diagnostic criteria include fatigue, consciously depressed mood, loss of energy, and reduced interest in activities. Kilmartin reasoned that many men respond to depression through overinvolvement in work or sports, counter to the impaired functioning criteria that is a standard component of a depression diagnosis.

In addition, traditional men may be defended against the underlying emotional and cognitive experience of depression and less attuned to the internal experience of depression (Kilmartin, 2005). Kilmartin explained that men may be socialized to avoid introspection and awareness of internal distress, given that emotional awareness is associated with femininity. As a result, men may emotionally numb depression with substance abuse. Courtenay (2000) also theorized that men’s substance abuse may reflect private attempts to distract from or ameliorate depression in order to save face and avoid the vulnerability associated with help-seeking, thereby perpetuating denial and avoidance.

(p. 105) Other authors have agreed that the traditionally male symptoms of depression are different than what is accepted in the literature on depression. Researchers conducted a large inpatient study and found irritability and antisocial behavior were more common presentations of depression among men than among women (Moller-Leimkuhler, Bottlender, Straub, & Rutz, 2004). Additional research has found men are more likely to somaticize distress, while women tend to verbalize it (Danielsson & Johansson, 2005). Masculine values of independence and toughness may even lead men to perceive depression as a failure (Warren, 1983). In fact, men with higher identification with hegemonic masculinity perceive higher levels of mental health stigma (Magovcevic & Addis, 2005).

Based on this literature, we can presume that traditional masculinity may interfere with the acceptance of mental illness and with engagement in health-promoting behaviors. Self-management and help-seeking associated with a mental health problem are important facilitators to acceptance and may be stifled by these traditional gender norms. Men’s barriers to acceptance of a mental illness may include maladaptive externalizing behaviors, such as substance abuse, violence, and suicidality. There has been relatively little research to date, however, on the topic of acceptance of a serious mental illness among men.

The following two case narratives were selected to address the gap in the literature on acceptance of mental illness among men. We wished to highlight the role of traditionally masculine culture in impacting the process of acceptance of mental illness. These case narratives include a presentation of the person’s illness narrative, definitions of acceptance of mental illness, and identified barriers and facilitators to this process.

Case Narratives

Case 1—Tim

Tim is a white American man in his twenties who grew up in a low-income neighborhood in the Northeast. He was first diagnosed with attention deficit-hyperactivity disorder (ADHD) at the age of three years. He has been diagnosed with many other conditions since, including bipolar disorder, post-traumatic stress disorder (PTSD), and antisocial personality disorder. In response to his psychiatric symptoms, he frequently engaged in self-mutilation and severe alcohol abuse, captured with his words: “I got more scars than I can count.” He had recently consumed a nearly fatal amount of alcohol and was found unconscious and bleeding on the floor of his apartment. “I was just feeling like crap, so I picked up the bottle and started drinking. It was over 40, 50 beer cans, I think.” Since this incident, he had tried to cut down but continued to feel the need to drink, which he attributed to the compounded symptoms of his bipolar disorder and PTSD. “Somehow they’re linked. When one goes off, the other one goes off with it.”

(p. 106) Tim estimated a history of over one hundred psychiatric hospitalizations, which he found to be severely limiting to his freedom. “Being locked up and not able to leave for two weeks, yeah, it’s a pain in the ass. Might as well just throw me in jail.” As a result of these experiences, he found himself to be, “Extremely bitter and angry all the time… . Haven’t acted on it yet, but I tend to act like I’m going to get violent.” Tim described changes in his sense of self by acting out in response to his mental health problems instead of directing his pain inward. He believed this approach allowed him to change his self-image from “a worthless piece of crap” to what he referred to as, with humor, “the world’s biggest pain the ass.” He contrasted these two identities: “One was miserable; the other one’s having fun.” Acting “the clown” in treatment settings helped him make connections with his peers through humor. Being the rebel in these settings also allowed him to take a stand against a system in which he often felt abused.

When asked what acceptance meant to him, he replied, “I don’t think it’s going to happen anytime soon …” He attributed his negative attitude toward people and his drinking as signs that he had not accepted his mental health problems yet. He had little idea as to what might facilitate his acceptance process, but he did identify the primary barrier to be his chronic alcohol abuse. He also believed his negative history with providers interfered with his acceptance. “My psychiatrist wasn’t very great either. He almost freaking killed me with medication. And now I’m allergic to two medications because of him.” Tim had made threats to his most recent psychiatrist after he diagnosed him with antisocial personality disorder. As a result of these experiences as well as a general reluctance to pursue care, Tim felt quite negatively toward psychotherapy and tried to avoid it.

Tim’s case illustrated previous research findings that men with bipolar disorder and other serious mental illnesses have a higher rate of drinking problems. In fact, alcoholism is a contributing factor to symptom severity and nonadherence to treatment among men with bipolar disorder (Frye et al., 2003). Substance abuse served as a way to numb Tim’s distress. Misbehaving allowed him to reclaim power and control. It was notable that Tim had enough insight to recognize that his substance abuse and self-harm were antithetical to acceptance, an important first step in facilitating this process.

Tim had negative views toward help-seeking, which have been found in particular among younger men with mental health problems (O’Brien et al., 2005; Yousaf, Popat, & Hunter, 2014). This phenomenon may be due to the fact that younger men are simply at an earlier stage in developing a sense of masculinity. Tim’s self-destructive behaviors reflected his suppression of symptoms and attempts to manage them on his own through avoidance of services, which led to recurrent hospitalizations and near-death experiences. For Tim, antagonizing providers signified his resistance of mistreatment, while being passive meant giving up.

In spite of his negative experiences, Tim was able to participate in group treatment settings where he became the comedian, garnering attention from peers. It is not uncommon for traditional men to use humor as a coping strategy in order to mask their underlying pain and minimize distress and vulnerability (O’Brien (p. 107) et al., 2005). In many ways, Tim’s humor may have served him well, allowing him to save face while making connections with peers and contesting a treatment system in which he often felt targeted. Although his acceptance process was in the early stages, continued engagement in a number of these supports and adaptive behaviors adds hope to Tim’s future.

Case 2—Alonso

“Alonso” is a first generation African immigrant in his thirties. Alonso was diagnosed in his adolescent years with schizoaffective disorder, bipolar type. His diagnosis had changed to various disorders in attempt to characterize his episodic periods of psychosis and mood swings. Although he found these changes in diagnosis frustrating, he had coped with them by reading about the different diagnoses. “Just learning my ups and downs, how I’m manic or grandiose, how I get paranoid and stuff like that. Now I know why I have it, or why I take my medication. I take my medication every day. If I don’t take a medication, I’m in a mental institution.”

When asked what acceptance meant to him, Alonso indicated, “It wasn’t that hard to accept it, because what I was doing … was wrong. What I was going through was wrong. So, I needed to accept it, period. Because I knew what was going on. Why I did this, why I did that. [I knew] there was a problem … Now I’ve got to accept it and go on with my life.” For Alonso, acceptance came from self-evaluation of his behaviors during episodes of manic psychosis, and this process was vital to his recovery.

A key barrier to his acceptance process was being questioned as to the legitimacy of his mental illness. “A lot of people, my older brother has never until now, has never accepted it. He used to say, ‘Okay, you don’t have anything. You know, you’re just crazy, basically.’ And … he’s finally learning that I do have a mental illness. It’s not something I’m lying about. I was going to the hospitals. I was taking medications. He was like—he never accepted it. He told me, ‘Okay, you’re lying. You’re crazy. You’re this, you’re that. You’re hiding behind your illness. You’re lying.’ I’m not lying, I’m just telling the truth.”

Dominant cultural views and stigma toward mental illness held by members of his culture of origin also posed barriers to his acceptance process. “Only thing about [people from my culture], they don’t accept people who have mental illnesses. Like, a lot of cultures understand it, but they … don’t want to understand it … They just don’t want to accept somebody like that. I don’t think I ever understood why. My family does, but I don’t. A lot of people don’t understand that. Because I think instead of understanding, [they] think, ‘He’s crazy.’ ” It is important to note that although cultural stigma presented a particular barrier to acceptance for Alonso, cultural supports, connection to his religion, and a sense of community were, on the other hand, important facilitators in his acceptance process. He stated, “Like, those who are religious have, and in the culture, accept mental illness … Praying to God and things like that helps deal (p. 108) with your mental illness.” Culture, religion, and prayer had helped Alonso get to a positive place in accepting and managing his mental illness at the time of our interview. He spoke emphatically on this topic: “I love my culture. Those are things that I could talk about, and talking about religion is something else I could just easily talk about. So those are things that come hand in hand to myself.” Religion and culture were integral to his sense of self, and thus, to his acceptance process.

Other barriers to acceptance for Alonso included a lack of awareness and understanding of his behaviors in the past. He identified prior confrontations and aggression as signs of his previous lack of acceptance. These behaviors led to hospitalizations, which he also saw as facilitating his acceptance process by creating an opportunity for treatment and education about his mental health problems. Also interfering with acceptance were times when he was not aware of his mental health problem. He explained, “If I believe I don’t have an issue, then I won’t take my medicine … I think if I don’t accept it, then I won’t do what I need to do for my health.”

Alonso’s story demonstrates the intersection of gender, ethnicity, and religion, as explored in Chapter 6 in the discussion of women with serious mental illnesses, and in our discussion of spiritual and religious facilitators to acceptance of mental illness in Chapter 4. Ethnicity, religion, and gender uniquely intersected to impact his experience of accepting a serious mental illness. Alonso’s acceptance process also was affected by questions regarding the validity of his bipolar disorder. This barrier corresponded with previous findings among men with mental health problems, specifically those who fear being questioned as to the legitimacy of their mental health problems, given the pressures to maintain work and the silencing around men’s mental health (O’Brien et al., 2005). Like Tim, Alonso’s mental health symptoms could present in confrontational behaviors, somewhat typical of externalizing responses to distress found among traditional men. Ultimately, Alsonso’s acceptance process was fomented by cultural pride and connection, religion, prayer, education, recognition of the need for medication, and engagement in mental health services.

Understanding Acceptance of Mental Illness Among Men

As seen in these case narratives, hegemonic masculinity impacts the acceptance process for men with serious mental illness. These gender norms may include avoidance of help-seeking, substance abuse, and engagement in other risky, maladaptive behaviors. Men may particularly fear questions as to the validity of their mental illness due to pressures to work and fulfill traditional breadwinner roles, thus inhibiting acceptance. Like women, men are affected by intersectional stigma, with multiple marginalized identities combining to uniquely impact the acceptance process. Men may attempt to manage their symptoms on their own to (p. 109) avoid being perceived as weak or to avoid being mistreated in the mental health system. Bouts of aggression may reflect a gendered style of externalizing distress and a reaction to conflict intended to regain a sense of power, autonomy, and control. A summary of the barriers and facilitators in the process of acceptance among men with serious mental illness appears in Table 7.1.

Table 7.1. Barriers and Facilitators in the Process of Acceptance Among Men with Serious Mental Illness

Barriers

Facilitators

Limiting narratives of masculinity

Empowering narratives of masculinity

Provider mistreatment

Gender sensitive providers

Avoidance of help-seeking

Treatment engagement

Lack of awareness

Introspection and self-education

Emotional suppression and dismissal

Emotional expression

Intersectional stigma

Stigma awareness

Personal and family denial

Family psychoeducation

Substance abuse

Addiction recovery

Denial of mental health problem by others

Social support

Destructive health behaviors

Positive health behaviors

It is important to note that the men described in the present case narratives made up a small and unique sample. These men were recruited from a psychosocial rehabilitation center and agreed to participate in interviews on their mental health experiences. Thus, they may have been more likely to engage in help-seeking and in public discussion of their mental health experiences. Moreover, by participating in this type of setting and in an interview at all, these men actively contested the restrictions of traditional masculinity. Men who avoid talking about or seeking help for a mental health problem may continue to suffer in silence, and we must continue to find ways to capture their voices and involve them in care.

Applications to Clinical Work

Based on these findings, a number of clinical recommendations can be made to facilitate the acceptance process for men. It is important to conduct therapy in a gender sensitive manner in order to facilitate the acceptance process. Clinicians can screen men with mental illness for problems with help-seeking, substance abuse, acting out behaviors, and self-stigma in order to learn of any common barriers to acceptance. In addition to asking a male client to define acceptance, a clinician can inquire as to what being a man means to him. Clinicians can examine the messages these clients have received about mental health problems among men, and discuss how these messages impact acceptance. Men with (p. 110) mental illness can be encouraged to construct a positive sense of masculinity that promotes their acceptance.

There are a number of treatment considerations suggested in the literature that can also be helpful to engaging and sustaining men in treatment and to promoting acceptance. For one, it is important to note that although men may face barriers to acceptance and treatment engagement, research has found that psychotherapy is effective for men (McCusker & Galupo, 2011). Although one study found men might be less likely than their female counterparts to schedule therapy appointments, they have equal rates of continuing with therapy once enrolled (Vessey & Howard, 1993). In fact, many men may feel such relief at communicating suppressed distress at the onset of therapy that they sometimes drop out early, requiring therapists to take preventative efforts to sustain care (Kilmartin, 2005).

Kilmartin (2005) makes additional suggestions for culturally sensitive therapy for men who take on values of hegemonic masculinity. For one, instead of viewing men as inept at emotional expression, men can be encouraged to view such expression as a skill that can be developed. Therapists can work with men with traditional gender values to build an emotional vocabulary for identifying, articulating, and responding to the vulnerable feelings that underlie anger. Men can be supported in expanding traditionally restricted notions of masculinity to include attitudes and behaviors that are adaptive for one’s mental health. Therapists can engage men in treatment by constructing narratives of help-seeking as congruent with traditional masculine values, such as a demonstration of independence, leadership, and assertiveness in order to become courageous role models in self-care. Traditional gender narratives can be used to reframe the powerlessness one might experience as a result of a mental health problem—such as a courageous struggle that strengthens one’s sense of masculinity (Emslie et al., 2006). Therapists can work with male clients to examine the pressures of these narratives and re-author stories that promote empowerment in the face of vulnerability. Supporting emotional intelligence and a positive sense of masculinity can enhance men’s self-efficacy and facilitate the process of acceptance of mental illness among men (Kilmartin, 2005).

We should mention that in spite of media stereotypes, the threat of violence from people with serious mental illness is generally overestimated by the general public, and people with mental illness are actually more likely to be victims of violence themselves (Stuart, 2003). Stuart purported that substance abuse with or without a co-occurring serious mental illness is a key predictor of violence, suggesting a mediator in the incidence of violence among men with dual diagnoses. Understandably, there may be strong reactions from providers regarding the violence and aggression of men with mental health problems (Brooks, 2001). It is also important to remember that men with severe psychosis, personality disorders, substance abuse, and histories of violence are likely to be survivors of sexual and physical abuse themselves (Bryer, Nelson, Miller, & Krol, 1987; Miller & Bell, 1996). Many men face criminal detention without the adequate (p. 111) mental health treatment required to further target, treat, and reduce the source of abuse (Brooks, 2001). There is a need for additional antiviolence interventions that are sensitive to issues of masculinity, as well as mental health partnerships in criminal justice, social services, healthcare, and work settings (Brooks, 2001; Miller & Bell, 1996).

Empathy does not preclude accountability. Providers can recognize the underlying pain of acting out behaviors and demonstrate understanding, while also holding men responsible for making change (Brooks, 2001). This dialectic of empathy and accountability can help promote the acceptance process and facilitate mental wellness among men with serious mental illness.

Conclusion

Gender socialization impacts the process of acceptance for men, posing barriers to the acceptance and help-seeking that are essential to responding to the symptoms of serious mental illness. Men can be supported in their acceptance process to enhance their ability to detect and manage the symptoms and experiences associated with a mental illness. Clinicians must examine and affirm empowering narratives of masculinity as part of advancing acceptance and self-care.

Clinical Strategies

  • Ask male-identified clients what being a man means to them. Ask them to explore the messages surrounding masculinity they have received. Work on understanding privileges and challenges associated with male identity in the client’s culture(s) from an intersectional perspective, paying attention to overlapping aspects of his identity, including race/ethnicity, class, ability, sexual orientation, age, and other aspects of his background. Discuss the impact these factors have had on his mental and physical health as well as self-care.

  • Ask male clients to define what acceptance of mental illness means to them. Discuss how their ideas about manhood have either bolstered or interfered with their acceptance process. Identify ways of overcoming barriers and enhancing facilitators. Encourage them to implement these strategies.

  • Work with male clients to identify empowering narratives of masculinity that promote positive health behaviors.

  • Screen for a history of substance abuse, violence, and other harmful behaviors. Explore the impact of these behaviors on mental health and on the acceptance process. Identify and put in place needed supports.

  • Encourage connections to positive role models, activities, and male support groups that may benefit the male client’s recovery and acceptance process. (p. 112)

  • Explore male clients’ processes of introspection, self-education, symptom identification, communication, and treatment engagement. Support skill development in these areas.

  • Discuss the degree to which the male client’s mental health problems have been suppressed, questioned, or denied internally or externally by his family, peers, providers, culture, and community. Identify the impact of these experiences on the acceptance process. Validate the legitimacy of the client’s mental health problems.

Discussion Questions

  1. 1. What have been some of the messages you have received from peers, family, the media, or others about what it means to be a man? What are some ideas about masculinity that are limiting to men’s mental health? What are some ideas about masculinity that are adaptive for men’s mental health?

  2. 2. Discuss any ways in which men you might know have served as positive role models in promoting positive mental and physical health behaviors? What stories in the media or elsewhere have represented the dangers of rigid gender norms for men and their health? How might these various examples reflect barriers and facilitators to the acceptance process for men with serious mental illnesses?

  3. 3. Consider a man with a serious mental health problem that you have encountered in your personal or professional life. How have traditional gender norms and hegemonic masculinity impacted his mental and/or physical health? What recommendations would you make to promote acceptance of a mental health problem for him in a way that is affirming to his gender identity and sense of self?

Activities

  1. 1. Clinical recommendations exchange. Make a copy of the case narratives in this chapter and distribute them to a group. Create a list of clinical recommendations for working with these men from a gender sensitive framework. Trade recommendations with another group member and make comments on these lists.

  2. 2. Masculinity in the media. Gather newspapers, magazines, and other media resources and explore representations of hegemonic masculinity in the media. How are negative health behaviors (p. 113) associated with masculinity? One example might be the commonplace cigarette advertisement featuring “macho” cowboys. How do these representations affect males in the broader culture? How might these representations impact men with serious mental health problems?

  3. 3. Men’s mental health group. Develop a curriculum outline for a potential men’s mental health group. First, identify several of your goals for the group. Then identify the main topics you would want to address in the group. What potential activities might you include to attain these objectives? Explain how you would facilitate the process of acceptance of mental illness for these men, with attention to traditional masculinity. Compare and contrast these curriculum plans and combine into one group for future piloting. Identify the ways in which you might design a men’s group differently or similarly from a women’s group.

(p. 114)

Men’s Acceptance of Mental Health Worksheet