The Gendered Barriers to Men’s Mental Health Peer Support: A Photovoice Study

Ready to Offer Help, Reluctant to Seek Help

The first paradox comprised self-contradictory statements wherein the intricate dynamics and high endorsement of giving peer support sharply contrasted participants’ reluctance for seeking the help of peers themselves. Max, a 20-year-old man, suggested this was normative, suggesting men are “way more open to help someone else than to get help for [themselves].” Aligning to masculine ideals for providing and protecting, many men spoke to their readiness and ability to help peers. Lucas, a 37-year-old man, elaborated:

When someone opens up to me, I’m actually quite comfortable with it. I don’t mind talking to someone and hearing what they’re going through and offering a bit of reflection or just an ear to listen.

Contrasting this ease, Lucas shared his discomfort and feelings of “vulnerability” and “embarrassment” when asking for help, positioning this paradox as learnt and deeply engrained: “from the generations of being brought up thinking that you just have to deal with it yourself, pull yourself up by your own bootstraps.” Here, despite the gendered reasonings for help-giving and the self-referential reticence for being helped, their co-existence and double standard was logically unacceptable. This paradox was, however, commonplace and often explained away as men’s alignments to masculine norms for providing (i.e., protector) but not needing help (i.e., self-reliance) from peers themselves.

These contradictory positions were somewhat reconciled with men responding to self-pressures to uphold masculine norms in denying their need for help, thus bypassing the marginalizing risks for transgressing manly self-reliance scripts. Liam, a 28-year-old man, explained these norms as socially constructed and persuasive:

We’re used to this image of, oh, guys are sort of rocks, right? And, you know, they’re supposed to be the rocks that people lean on. Once they crack, it can be like, you’re not really fulfilling your gender role, in a way. Like, you are not really being a man, I guess.

The duality of being strong and self-assured for others prevailed as the time-honored masculine script to which Liam and many participants narrated themselves as complicit. The net effect was men’s self-management of life transitions through concealments of mental health challenges that accompanied their shifts. Jayce, a 53-year-old man, critiqued the senselessness of this, highlighting the futility of buying into these unachievable and inauthentic masculine norms:

In things like sports, jobs, relationships, we’ve got an expectation to perform, to be the best … and at the end of the day, we may not be happy with that, and we might find ourselves sitting back and thinking, “How do I step away from all that, when I’ve created this perfection—or tried to create it—and it’s a façade, it’s a mask.”

Normed masculine competitiveness, combined with carefully curated public images of success over social media, isolated many men in their struggles, concealing their challenges and rendering moot the reaching out to peers for help. Being seen as less than or weak within masculine hierarchies drove these defenses in ways that were often positioned as requisite to giving peer help. That is, men’s displays of self-reliance served as assurance and evidence that they were legitimate candidates to support other men. Jayce later qualified that giving into peer help was reserved for and indicative of crisis and being rock bottom when self-resiliencies were replete:

I don’t want to end up sleeping on other people’s couches and sleeping in their guest rooms to try and get back on my feet … Do I want to call a friend? No, I should be going to the gym instead.

Here, Jayce questioned whether to ask for support, weighing his need for help against the fear of appearing vulnerable or powerless in the face of his challenges. Ultimately electing self-management through exercise, Jayce took the well-worn masculine path for independently and physically working through his mental health challenges.

Relatedly, not wanting to burden peers diminished the potential for men calling in a favor for help from male friends. Again, needing help was synonymous with debility, and these relational discomforts were often linked to the nature and limits of specific friendships. Jack, a 23-year-old man, explained, “unless it’s one of your very close friends … you may be nervous yourself, ‘am I overextending my boundary as a friend, is this too far.’” Emphasizing these uncertainties in contemplating who he could reach out to, Jack suggested trust and deep connection determined the feasibility for asking another man for help. Interestingly, Jack did not employ these criteria in suggesting he would provide peer support to anyone who needed it.

These relational paradoxes were also lifted into broader social norms and discourses, where some temporal shifts were espoused as slowly growing to offer easements for exchange and mutuality in men’s help-giving and taking. Kevin, a 22-year-old man, submitted Photograph 1 titled Fragmented and commented on emerging changes in societal attitudes toward men’s help-seeking:

I titled it, fragmented. Just because there’s so many branches coming off. I really thought, the broken branches near the bottom represented current societal attitudes towards men’s peer support. It dug into the ground, broken. And a few branches that are still growing up are a changing of attitudes, in terms of, progression.

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Photograph 1.

Fragmented.

Speaking to the pull of traditional masculinity, Kevin metaphorically pointed to the deep-rooted structures characterizing sturdy oak men as saying and needing less. Also claimed were some visibilities of men’s contemporary masculine offshoots for openly and authentically speaking with one another. Symbolically, traditional masculinity was depicted as an anchor and undertow, albeit amid some northbound reaches visibly pulling against those limits. There is evidence of a struggle here with the trunks and branches twisted directionally—a tension reflected in Kevin’s uncertainty for the new masculinities he craved.

Permitted to Open Up, Unequipped to Disclose

These structure and agency tussles were perhaps even more evident in the second paradox, which contrasted the growing public awareness of and de-stigmatizing work for promoting mental health by authentically speaking up about those challenges with men’s reticence to self-disclose specificities about what they were feeling. Ryan, a 25-year-old man, elaborated on the lag and discord between what could be discursively said and relationally done:

Even if we’re in an era where most, but not all folks our age are open to, and even actively saying that, we should be talking about our feelings, that still doesn’t represent all of society, including parents, siblings, co-workers, there’s still remnants and feeling that you shouldn’t be soft.

Here, expressing what was felt was troubled relationally with the paradox of being socially affirmed to speak up, but without the resources for doing that. Ryan and many men spoke to their silences as relationally policed outside male peers amid the public discourse for them to be more emotionally expressive. Building on this point, James, a 31-year-old man, spoke about using alcohol to break with the non-disclosure rules for mental health when talking with other men:

So, I think even though it’s [mental health] been much more destigmatized … at the same time, it’s just not comfortable, I guess. I’m much more open with alcohol. I probably should’ve started drinking before this interview.

Countering his wry quip, James went on to concede that “drink[ing] to have a chat when your mind is less clear is counterintuitive.” Noting the entrapped self-stigma for disclosing his own mental health challenges, and the shortfalls for using alcohol to ease that, James took some solace in those efforts. The silences arrested, James’ uncertainties were indeed momentarily remedied only to be amplified later in the aftermath of his alcohol use and its empty promise of agential liberation. This offers some context to men’s widespread use of substances to self-medicate, wherein it can facilitate mental health help-seeking with peers—even though the risks and redactions thereafter are heavily set.

For some men, the reluctance to open up to peers about mental health challenges underscored their lack of mental health literacy. Louis, a 20-year-old man, explained:

Mental health probably popped up more prominently in the last three, four years. When I was in high school, it was not something guys talked about. So, if you brought it up, nobody knew what would happen … we didn’t understand how big of a problem that was.

The generalizing of mental health and the lack of specificities for how to recognize or support the challenges limited Louis’s efforts for disclosing his own struggles. Spencer, a 32-year-old man, submitted Photograph 2 titled Sunset shared with friends as we reflected, which spoke to the disconnects between men knowing mental health was important but lacking the ability for securing that with their male friends:

I think a lot of the time it’s going to be just trying to process everything in your own head, knowing that you’re not really going to be that great communicating it, getting it, because you don’t really fully understand it yourself … managing the awkwardness of that conversation from the very beginning of having to try and overcome that, it just becomes a bit overwhelming to even begin to have that conversation.

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Photograph 2.

Sunset shared with friends as we reflected.

Contrasting the tranquil and idyllic Vancouver sunset, Spencer spoke to being in the company of men but without the cadence to start the conversation he needed. The awkwardness for incoherently stumbling through a struggle narrative that he himself did not fully understand left Spencer silent. The sunset came and went, as did the moment to deeply connect and share what he was really feeling. Interestingly, Spencer claimed that he did not expect anything different, but in the interview, it was clear that he needed and wanted more than the ascetics of and superficial banter around their shared sunset.

In summary, the dual paradoxes fuelling men’s silence reveal a complex interplay of tensions and alignments to prevailing restrictive traditional masculine norms with the net effect of men struggling to reach out to male peers amid their willingness to help others. While many men also bought into contemporary changes for seeking peer support, their concealments and inactions for reaching out and opening up revealed a lack of knowing how to connect and the strong potential for being isolated in and by their mental health challenges while in the company of other men.

Implicit Help-Seeking and Conditional Care

Men’s efforts to seek support were often communicated implicitly, leading to unmet needs and relational disconnects. Even well-intentioned peers frequently missed or minimized these subtle cues, reinforcing norms of stoicism and emotional self-reliance. Joshua, a 51-year-old man, discussed a text conversation he had with a close friend where he disclosed his recent intimate partner relationship breakup:

This friend of mine is a very kind-hearted man. He’s a very gentle soul, and he takes care of the other female friends. I have to own my part, I did not explicitly say, “I’d like to talk to you about it.” I felt awkward asking for this. So I sent him this long message hoping that he would offer, “hey, do you want to meet, or do you want to talk about it or even call me?” And I was surprised by the answer he gave me which is, “Sorry to hear that. Too bad when things don’t end up well, big hug my friend.” And that was it. He never called to check on me, he never wondered after a few days, “Are you doing okay?” This is a two-and a half year relationship that just ended. And I was really surprised and part of me said like “maybe you should ask for more,” then part of me says well, “he should know.”

Joshua’s disappointment for failing to connect was evident, especially having carefully selected a friend he believed to be compassionate and caring. Joshua’s friend’s gendered approach to supporting friends was also made apparent wherein it seemed he was more attuned to supporting female friends but missed the implicit (perhaps subtler, less normed masculine) calls from male friends. While Joshua’s friend was sympathetic to the situation, the shortfall of support left Joshua pondering his own text, and lack of directness in not explicitly asking for help. Likely at play was the norming of men’s emotion resiliencies, intimate partner relationship breakups, and the need to privately work through the many life transitions when partnerships end. Clearly disappointed, Joshua nonetheless fell in line with what he was being implicitly asked to do—move on from the pain by self-managing (rather than talking about) it. Like Joshua, many participants, while knowing they needed help, found themselves shutdown, wishfully waiting for permissions that never materialized and help that never came. The support men did receive was often pragmatic and operational, wherein peers would provide outcome-oriented assistance within well-defined parameters. Such approaches to peer support were reliant on and guided by traditional masculine relations between men, the sum and parts of which were experienced by men as restrictive and limiting. Jayce, introduced earlier, described the support he received from his friends after separating from his partner:

I went through a rough period, a breakup—and the solution with a bunch of my friends was … “We’re going to get Jayce and we’re going out to the bar. We’re going to get him back on the saddle. We’re going to introduce him to the next girl, and all of his problems are going to be solved.”

While Jayce’s friends were well-intentioned, their strategy focused on distracting and downplaying his emotional pain with alcohol and conquest, synonymous with masculine ideals. Jayce described this type of support as a “quick fix,” suggesting the counterproductive effects of not providing the space or safety to process all that happened in the relationship and the breakup: “Suddenly, those issues that you’re dealing with get pushed down and hid. It’s kind of you’re just ignoring it.” Like Jayce, many participants questioned the therapeutic value of this type of support and problematized it as driven by traditional masculine norms, which prize action over emotion—doing rather than thinking.

Other life transitions also featured wherein the support from other men was also focused on feeling less and downplaying the circumstances underpinning participants wanting help. Noah, a 40-year-old man, submitted Photograph 3 titled Only cuz you asked me 5 weeks in advance, describing his dismay for the lack of emotional support he received from his friend, as he navigated a potentially life-changing health scare:

I went to the first treatment alone, but I asked a friend of mine to drive me there because they’re gonna dilate my eyes … And I said, “hey, thank you, man, I really appreciate that you drove me to the hospital today.” And he’s like, “no, don’t worry I can always be here for you, as long as you ask me in advance.” It was a very peculiar moment for me, because sometimes you don’t know you’re gonna need somebody. How can you ask in advance, right?

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Photograph 3.

Only cuz you asked 5 weeks in advance.

Noah began by qualifying his need for help as justifiable given his risk for going blind, and the anxiety he had about the impact of that possibility on his life and partner. As Noah sought a moment to share his fears, his friend’s response closed off that possibility by offering only conditional, practical help—limited to situations where advance notice was given. Sharing the image of his friend’s hands upon the wheel referencing his straight-ahead gaze on the road, Noah was taken aback and silenced. Compounding fears about the impending treatment[s] and uncertain future were left unsaid, with rational and practical assurances that his friend would help out by driving him to the hospital if he could. In fairness, the friend may have been downplaying his help to reduce the potential for Noah feeling indebted. However, a heaviness ensued in their shoulder-to-shoulder silence for the commute home, leading Noah to whimsically remark, “I wanted somebody that made me feel safe, with compassion, without making me feel like less strong or less worthy.”

The examples above highlighted the relational, co-constructed nature of men’s peer support experiences wherein the unvoiced implicit asks for emotional support are missed or intentionally avoided in ways that could potentially heighten the mental health challenges of some participants. Jayce, introduced earlier, similarly noted an implicit temporal expectation of progress lightening mental health challenges, and thus paving the way for problem-free, fun-orientated get-togethers:

There’s an expectation that everything always moves forward. “Come on, it’s been a couple of weeks or whatever. You’re not passed that? I thought we talked about this already. You’re still not through it yet? Come on, man.”

Evident were mismatched expectations that men’s mental health challenges were time-bound and likely situational in their progress toward a resolution.

Over-Disclosing as a Trustfall Fail

Men often perceived an unspoken threshold in emotional disclosure, whereby sharing too much risked overwhelming the listener, resulting in silence, discomfort, or shame. Throughout men’s narratives, there was an ever-present risk to men who “overdid it” by belaboring their problems or sharing too much emotion about their struggles. Lucas, a 37-year-old man, submitted Photograph 4 titled The feels, describing his ruminations and doubt after sensing he had over-disclosed to a friend:

So, I took it [the photograph] thinking about after you have those conversations, how do you feel? It’s kind of embarrassed. It’s like, you want to hide for a second. Again, it’s that vulnerability thing. It’s, you’re vulnerable in the moment, and if the moment’s passed, you’re like, “Oh, was that too much? Did I say too much? What are they going to think? What are they going to say next time?” and you just want to hide for a second.

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Photograph 4.

The feels.

Hiding from himself, as well as veiling from the potential judgments of others, Lucas physically and emotionally recoiled from being “exposed.” The safety or affirmations in those disclosure moments with peers were gone, and Lucas’s fear of judgment and self-doubt took hold, exacerbating his worry about burdening others as well as concerns for damaging his masculine identity by over-disclosing his challenges. Here, Lucas’s vulnerabilities were for what was said, and the depth of the feelings shared, rather than any concerns about explicitly asking for or receiving help. In essence, the concerns are about breaking the masculine code and following through on a departure from what men do and reasonably can disclose and talk about with each other.

The effects of men’s mismatched attempts to solicit support and potential over-disclosures recursively flowed to and from trustfall issues and being negatively seen. Louis, introduced earlier, bluntly stated,

I don’t want people looking at me different. When I do tell people how I feel, like the times I have, they leave, so I don’t want people to leave.

Evident here was the confidentiality and off-the-record nature of men’s disclosures, and the muting effects that breaking that trust can have. Differentiated here also were the public nature of men’s social connectedness where lightness for doing rather than feeling contrasted the more private deep introspections and disclosures. Louis’ account indicated he had some transgressions wherein he misread opportunities about when and how to authentically show up among peers to talk about mental health challenges.

In summary, relational masculine norms driving misaligned support revealed the fragilities for men seeking and perhaps interpreting the support of other men. Seeking help was often implicit, with concerns about asking for too much and/or over-disclosing when those opportunities arrived. The support men did receive needed to be understood and accepted contextually within masculine milieus.