MENtal Health

Nov 28, 2023

Sixty men die by suicide every hour around the globe and in the U.S. alone, men die by suicide at a rate 4x higher than women. Approximately 6 million American males are affected by depression each year and men are 2-3x more likely to misuse drugs than women. An article in the Epidemiologic Review describes the “tragic intersection” of low rates of diagnosed depression and high rates of suicide and substance abuse among men in the U.S., noting that men account for 75% of all suicide victims. 

Reviewing a sample of 4,790 male patients, with an average age of 37 and average length of stay in treatment at 6 weeks, who have taken mental health assessments on the ERPHealth GRO platform, we can better understand severity of depression and anxiety in this group as well as the extent to which improvement in symptoms can be realized with behavioral health treatment. The group completed the PHQ and GAD over 11,000 times with 33% of the group reporting at least moderate symptoms of depression (18% moderately severe or severe) and anxiety (16% severe). 


33% report moderate-severe depression or anxiety


MENtal Health Stigma – Suffering in Silence
Although both men and women are affected by mental health challenges, it more often gets overlooked in males.  While the prevalence of mental illness in men tends to be slightly lower than in women, men’s mental health often goes untreated because they are much less likely to seek treatment. Some of the common reasons men’s depression is underdiagnosed include:

  • Difficulty recognizing mental and physical symptoms – sadness is not the only symptom of depression!
  • Ignoring or minimizing signs and symptoms and assuming one will just get over it
  • Reluctance to talk about problems – speaking with friends or, gasp, a mental health provider is unlikely. 

Stigma can be complex and originate from various sources, including social stigma, self-stigma, professional stigma, and cultural stigma. According to an article in the American Journal of Men’s Health, social stigma, which is most the common stigma discussed, refers to negative attitudes toward a person experiencing mental health issues rooted in misperception that symptoms of mental illness are caused by weak character. Self-stigma is the internalization of that stigma that results in shame about symptoms. Professional stigma assumes that health professionals can transfer to and reinforce stigma of their patients and cultural stigma takes into account the various ways one’s culture interprets mental illness. Based on another study in the American Journal of Men’s Health, which focused on the influence of masculine norms and occupational factors on mental health, masculine norms are social rules and expected behavior associated with men and manhood within a given culture.

“American men are subjected to a culture where the standards of masculinity are literally killing them” – Benita Chatmon, PhD, MSN, RN, CNE;  Am J Mens Health, August 2020


MEN & Substance Abuse
Substance use disorders are 3x more common among men than women and research has shown that substance use disorders often have co-occurring mental health challenges, often describing drug and alcohol abuse as maladaptive attempts at coping or self-medication. There is a strong and positive correlation between substance use and suicide, which might explain why men die by suicide at much higher rates than women. 

A Call to Action
Considering historical socialization of men to be the bread winner for the family; the emotionally and financially stable foundation, and to define his self-worth by the amount of money he makes, the constant pressure is unsurprising, especially in the age of social media when social comparison is consistent and at one’s fingertips. While these stereotypes have evolved over time, the messages that men have received from generations past continue to shape the way they see themselves and the pressures they experience. 

ERPHealth CEO, Eric Gremminger, ICADC urges us to think beyond mental health and to consider mental WELLNESS.  “Mental wellness affects how we think, feel, act, make decisions, and relate to others. It’s more than just the absence of a mental illness – it’s essential to your overall health and quality of life.”  He further speaks to men’s hesitation to seek treatment by emphasizing that “self-care isn’t selfish…that prioritizing self-care will allow you to make a greater contribution to your family, friends, and community.”  Recalling the almost 5k men who took behavioral health assessments on the ERPHealth platform, with treatment, there was a 4-point improvement in PHQ (26%) and GAD (32%) scores, indicating an overall decrease in symptoms, sometimes into the mild range. This provides reinforcement for the value of engaging in behavioral health care. 

The purpose of the Movember movement, that encourages men to grow mustaches to raise awareness about men’s health, is to take on critical issues including mental health, suicide, prostate and testicular cancer.  The hope is to challenge stigma, spark conversations, and promote early detection and intervention.

Federal Resources

Health hotlines

  • 988 Suicide & Crisis Lifeline : The Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week, across the United States. Call or text 988 to connect with a trained crisis counselor. Support is also available via live chat . Para ayuda en español, llame al 988.
  • Disaster Distress Hotline : This helpline from the Substance Abuse and Mental Health Services Administration provides immediate crisis counseling for people experiencing emotional distress related to any natural or human-caused disaster. The helpline is free, multilingual, confidential, and available 24 hours a day, 7 days a week. Call or text 1-800-985-5990.
  • Veterans Crisis Line : This helpline is a free, confidential resource for veterans of all ages and circumstances. Call 988 then press 1; text 838255; or chat online  to connect with 24/7 support.
  • NIH Health Info Lines 
About The Author

Cori McMahon, Psy.D., NCCE, Chief Clinical Officer at ERPHealth

Dr. Cori McMahon is a digital health clinical leader and clinical health psychologist with over 20 years’ experience across academic, clinical, and behavioral health tech industries. She was most recently a key member of the senior team taking a SaaS-based behavioral health organization to acquisition at 12x its valuation. Dr. McMahon is the former Director of the Division of Behavioral Medicine at Cooper University Hospital and maintains part-time work in integrated primary care as a Ryan White-funded psychologist serving persons living with HIV. She has presented 40+ peer-reviewed projects nationally and chaired multiple panel discussions as SME on measurement-based care, integrated behavioral health, and patient-reported outcomes in digital health.

Dr. McMahon is an Associate Professor of Clinical Medicine at Cooper Medical School of Rowan University and serves as lead for the Trauma-Informed Care project in the Department of Infectious Disease in collaboration with the state of NJ.