Men will rather____________instead of going to therapy

There’s a meme that has been around for a few years now online where you insert some ridiculous thing men would rather do than go to therapy <https://www.dailydot.com/memes/men-will-meme-therapy/>

However, it’s rooted in a truth that men are less likely to seek support than women.  

The NHS talks about this in terms of societal expectations

“The deep-seated expectations set by society and traditional gender roles can impact men’s ability to talk about their health struggles, be that physical health or mental health. It’s common knowledge that stereotypes and societal norms can be harmful to women. However, we often overlook the fact that these expectations can also have devastating effects on men and their ability to be open and honest about what is really going on with themselves.”

<Men's health: Breaking the stigma of masculine identity and help-seeking - Gateshead Health>

They quote this this study <https://explore.bps.org.uk/content/bpstcp/17/2/30> which suggests that a coaching approach to support may align well to men’s priorities, which are expressed as

“Men are often taught to prioritise self-reliance, emotional control, avoiding dependence, and physical toughness as essential traits of being a man in Western society.”

The traits are not inherently problematic by any means, they carry positive psychological and social benefits, especially when balanced with self-awareness and adaptability. Resilience encourages us to develop coping strategies and problem-solving skills for managing life’s challenges. Emotional control helps maintain composure in stressful situations and reduces impulsive reactions, allowing for more thoughtful communication and decision-making.

But it’s all about a balance, this study and others <Berger: Men’s reactions to mental health labels,... - Google Scholar> Men and health help‐seeking behaviour: literature review - Galdas - 2005 - Journal of Advanced Nursing - Wiley Online Library finds that men who conform heavily to these traditional gender roles tend to have a more negative attitude towards seeking help. In short, men seek to avoid vulnerability and the stigmatising labels that associate problems with substance use as a moral weakness or a lack of self-control.

At Phoenix, our analysis shows a correlation between emotional intelligence and engagement in support. Recent analysis shows a correlation between agreeing with the phrase “real men don’t cry” and lower levels of treatment completion in residential settings. In fact, on average, treatment completion rates for men of all ages in residential treatment settings are lower than women of any age.

As a bloke, a father to a son and someone who lost a brother-in-law to end stage alcohol related liver disease in July. I’ve been thinking about how to avoid too much of a focus on those traditional male learnt-attitudes of self-reliance, being in control and having to be strong, that lead to poor health seeking.   

This is important, post pandemic premature deaths from alcohol related liver disease have risen more than 30%. Men are twice as likely as women to die from drug related causes and 3 times as likely to die by suicide.

It’s a complex issue, but there are signs of positive actions that might start to encourage men to overcome the ‘real men don’t cry’ stigma.

Services are being adapted. There is CGL’s in Your Corner project which aims to improve the attractiveness of treatment to men aged 18-30  Change Grow Live Annual Report 2024, CGL state that “By conversing with young people in places and environments that are more productive for engagement, we’ve seen increased interaction and positive engagement”

And Oliffe et Al https://icpa.org/static/1eb1d340-53a3-4c80-a4d26b1a3802e965/Health-Promotion-J-Oliffe-Lessons-Learned.pdf offer eight lessons regarding the design, content, recruitment ,delivery, evaluation and scaling of community based health engagement projects for men. For example they emphasize the importance of “activity-based programs in familiar spaces which offer purpose and structure without pressuring participants to chat” (Oliffe, Rossnagel, Bottorff, et al., 2020). A number of studies have shown that activity based projects like Men’s Sheds are effective in improving men’s mental health and reducing social isolation https://journals.sagepub.com/doi/full/10.1177/15579883221084490

Changing the narrative around substance use is key, problems with substance use are not a moral or character weakness. Reframing  messages have been successful in the areas of  mental health with reduced stigma around common mental health issue, although not more severe mental illness Changes in mental illness stigma over 30 years – Improvement, persistence, or deterioration? | European Psychiatry | Cambridge Core  . Notably again looking at recent Phoenix Futures analysis, Phoenix’s rehab residents increasingly frame their motivation for seeking treatment in terms of mental health improvement (2013 45% to 88% in 2025). The reason for this are not fully understood, but perhaps in part the relative destigmatisation of mental health vs addiction makes mental health a more socially acceptable way of talking about why we might need support. So re-positioning substance use as a health issue is helpful, but men are also poor at seeking support for wider health issue.

Fundamentally perhaps we need to look to ourselves and how we can dismantle stigma and role model healthier attitudes for ourselves, our friends and family. Specifically, role modelling seeking support, reframing what strength is, and being ok with not being ok - teaching our kids it’s ok to cry and ask for help. We can also think carefully about the men who we give status to in the public world of media, politics and sports.   

For example, a number of studies highlight the Adrian Chiles effect, the TV presenter and general all round good bloke who has been open about his relationship with alcohol. A study that looked at the impact of celebrity influrnce on use of an alcohol reduction app <The impact of celebrity influence and national media coverage on users of an alcohol reduction app: a natural experiment> – found that

"In this study, the influence of Adrian Chiles – a male TV and radio presenter, aged 51 years at the time – resulted in an immediate increase in the proportion of males and the mean age of users, suggesting that people identifying with Adrian Chiles were more likely to download Drink Less”

It seems in his openness around his alcohol use Adrian Chiles challenged the stereotype of the 'alcoholic', he was successful, functional, and socially active. His approach of mindful drinking resonated with many men who felt alienated by the binary framing of addiction (either you're an alcoholic or you're not). His openness about anxiety, depression, and the emotional triggers behind drinking—like celebrating, commiserating, or simply boredom—made his story relatable to many men.

So there’s a lot to do, but perhaps us blokes can start by being more Chiles. Dismantling stigma, being open to being vulnerable and seeking help could save our lives.

Blog by James Armstrong, Director of Marketing & Innovation at Phoenix Futures.