By Jean Stratton

It’s an age-old adage that men don’t always like to ask directions when driving. Not always true, of course, but just often enough to have become something of a stereotype.

Increasingly, however, the question is do the guys take proper care of their health? Do they hesitate to make doctors’ appointments, hoping whatever symptom they have will just go away? Are they reluctant to admit concerns over feelings of anxiety or depression — perhaps out of worry that it indicates waning masculinity or self-reliance? Do they attempt to ignore a persistent ache or pain, cough, etc. thinking it’s not a big deal?

Many health care systems, medical groups, and organizations are working today to shine a light on men’s health issues, both mental and physical, and remove any stigmas about asking for help.

Such serious problems as the severe opiate addiction crisis across the country, concerns over prostate and testicular cancer, the increasing number of suicides among middle-aged and older men, and ongoing, seemingly relentless, gun violence (possibly related to mental problems), are all a growing focus of healthcare professionals and organizations.

Health Crisis

“The state of men’s health is in crisis. Men experience worse longer-term health than women and die on average six years earlier. Prostate cancer rates will double in the next 15 years. Testicular cancer rates have already doubled in the last 50 years. Three-quarters of suicides are men. Poor mental health leads to almost half a million men taking their own life every year worldwide. In the U.S. nearly 50,000 individuals die from suicide each year, and the number has increased 24 percent over the past 15 years. Seventy-seven percent involve men, and seven out of 10 are white middle-aged individuals.

“Our fathers, partners, brothers, sons, and friends are facing this health crisis, and it’s not being talked about. We can’t afford to stay silent.”

This startling information is from the U.S. Movember Foundation and the Center for Disease Control. Known for its moustache-growing movement in the month of November, the Movember Foundation is a multi-national charity that aims to raise awareness of and money to promote men’s health.

Founded in Australia in 2003, it has become a significant force in focusing on men’s health issues. As of 2017, the Movember Foundation has raised more than $580 million as a charitable institution and has funded more than 800 programs and 1,200 men’s health projects. It is active in 21 countries.

Its annual Movember moustache event, during November, when men are encouraged to grow a mustache, has become a favorite activity for many men and a unique opportunity for fund-raising.

From just 30 moustaches in 2003 to five million most recently, the Foundation has grown into a global force, supported by corporations, organizations, celebrities, athletes, and individuals in many countries.

Around the World

By encouraging men to get involved, it aims to increase early cancer detection, diagnosis, and effective treatment, and ultimately reduce the numbers of preventable deaths. In addition to annual check-ups, the Movember Foundation urges men to be aware of family history regarding cancer, and to adopt healthy lifestyles.

As it reports in its mission statement: “We are the only charity tackling men’s health on a global scale, year-round. We know what works for men. We are transforming the way research into men’s health is done and the way health services reach and support men. We don’t take government funding so we can challenge the status quo and invest quicker in what works. We are also bringing leading experts together from around the world to collaborate on solutions that will fundamentally change the way men are treated and supported.

“Our goals are big, but the impact of doing nothing is bigger. We need to act. We believe that by 2030, we will reduce the number of men dying prematurely by 25 percent. What does the future look like? Half as many men dying from prostate and testicular cancer. Half as many men suffering serious side effects as a result of their treatment. A quarter fewer men dying from suicide.

“We are committed to funding groundbreaking programs all over the world, engaging with men where they are, to understand what works best, to help make change happen sooner.”

The Princeton area is fortunate to have a number of institutions and organizations exploring ways to help men become more aware of health issues and take appropriate action.

For example, the Princeton Family Institute, founded in 1982, focuses on psychotherapy with couples, families, and individuals. Its group of experienced clinicians offers a collaborative and culturally-sensitive approach to help patients within a healing atmosphere.

Guiding Perspectives

Dr. Norbert A. Wetzel, co-founder and director of the Institute, explains its goals and mission. “At Princeton Family Institute, we look at men who come to us for therapy with a ‘kaleidoscope of perspectives,’ whether they come as individuals, as members of a couple, or as part of a family. These guiding perspectives are men’s economic situation and their social status (including their position in the social hierarchy). We talk about their race, ethnicity, and cultural background; we are curious about their gender identity and their sexual orientation and identity.

“We explore their extended family legacies and traditions; we hear about their religious faith and practice, and examine their health history, including addictions and hereditary diseases. As we learn from the conversations with men about different facets of their identities, we listen carefully to what these aspects mean to them.”

This therapeutic conversation is unique, continues Dr. Wetzel, and “constitutes an attempt to privilege the client and his expertise about himself and not our expertise as therapists. It is different from the question and answer examination by a medical expert who inquires about a patient’s symptoms and then prescribes medication. Defining someone as ‘having a mental illness’ that needs to be treated with medication is the result of a fairly recent ‘medicalization’ of human experiences that we conceptualize as having to do with all-too-human challenges, with traumata, personal suffering, painful losses, victimizing abuses, physical illness, failures, and so on.”

“The experiences men share with us are comprehensive and complex. They include mental, spiritual, psychological, physical, cultural, emotional, and behavioral aspects of who they are. While it may be important to include psychiatric and medication-focused aid to the treatment, at Princeton Family Institute, we see this support as part of the overall healing process. No topic in our therapeutic conversations is excluded. Suicidal thoughts, disabling depression, embarrassing behaviors, ‘crazy’ and confused thinking, or the life-destroying struggle with addiction can all enter into the broad realm of healing conversation.”

As has been stated above, suicide has increased in recent years. In fact, because of the stigma often attached to it, studies indicate it is often under-reported, and that the numbers are even higher.

Prevention is key, and doctors, other health professionals, and therapists are dedicated to working toward that end.

Essential Information

The Jed Foundation was established in 2000 in memory of a young man who took his own life. A nonprofit organization, its goal is to find ways to prevent suicide, offering help to those who are so troubled as to be considering such a drastic step. It provides essential information about emotional health issues, and offers guidance for those concerned about a friend or family member or about themselves. It also works to encourage openness about the subject and overcome the shame and secrecy that often prevents honest discussion of mental health issues.

The Jed Foundation reaches out to young people, in particular, but as its Chief Medical Officer, Victor Schwartz, MD, points out, its approaches can be equally helpful to adult men. For example, he notes, “Family and work stresses can cause anxiety and depression and in some rarer cases, suicidal thoughts or behavior. We know that an acute family or work crisis can sometimes result in suicidal thoughts and behaviors, but typically in the context of other mental health or substance-related concerns.”

Regarding younger people and students, he says, “If young people have anxiety or sadness or thinking problems that are disruptive to their functioning (trouble with sleeping, eating, self-care, concentrating, getting things done) or are very painful or are getting worse, then this would suggest there is possibly a problem that needs attention. Trust your gut; if you think there is a problem, there very likely is.”

Dr. Wetzel suggests important ways family and friends of a troubled individual can be aware of signs that the person is considering suicide, and what they can do to help prevent it. “The first thing is that simply being a good and supportive friend (‘being there’) is helpful and supportive, and can lead to someone feeling less isolated and hopeless. If a person is really having thoughts of despair and self-harm, then a friend or family member can assist this person to find help and support in their local care system (since sometimes, a very depressed person might not have the motivation to seek help for themselves), and if there is an acute danger, you might go with them to a local emergency room or call the local emergency services to get care.”

He also emphasizes the importance of positive connections to others, and that these can be protective for people who are struggling with problems.

“We also know that getting counseling and mental health care when there is a problem are both very important in lowering the risk for suicide. Along with this, we try to educate people about when to see their medical care professionals, and when to access care. We need to have a mental health system that can provide good care for typical problems and be able to respond to a crisis. We need to make it easier for people in distress to tell someone and for a concerned family member or friend to start a conversation when they are worried.”

Increasing Openness

Dr. Wetzel believes that currently there is increasing openness among people, especially younger people in general, including men, in talking about their mental health concerns.

The Jed Foundation has taken a significant step in advancing this awareness, particularly regarding suicide, as it has launched a blueprint for prevention.

Trinity Counseling Service (TCS) has provided help, guidance, and hope to many people during its nearly 50 years of operation in the community. It will mark its 50th anniversary in the spring of 2018. It offers counseling to people of all ages, including adolescents, adults, and senior citizens.

Forty percent of the clients are male, notes Trinity Executive Director Whitney B. Ross, EdM, PhD. “The number one diagnosis (which is consistent with the national average) at TCS is generalized anxiety disorder, and many of the men seen at TCS are here as a result of anxiety. We also see low-grade depression and issues resulting from life transitions (job change or job loss, marital issues, moves, the loss of a spouse).”

TCS has an experienced staff to help clients, and can direct them to other professionals if they need further help, explains Dr. Ross. “Currently, we have 14 clinicians working at TCS: licensed professional counselors, licensed social workers, and psychologists. We do not have psychiatrists on staff, but we have psychiatric nurse practitioners and psychiatrists in the community to whom we refer clients for consultations (psychiatric and/or medication) or to be followed for medication management when needed.”

The fact that many male clients are seeking help is an encouraging sign, she adds. “We are seeing more adult men coming in, aware they have something troubling them, and hoping to find ways to address it.”