Men are the least likely group to engage in mental health treatment (SAMHSA, 2014) in large part due to stigma. Men’s engagement is consistently low across severity levels (NIMH, 2019), see Table 1. While years of research, public education, and COVID have led to a decrease in mental health stigma, barriers still exist. Perceptions about counseling and societal norms are barriers for men in particular (Heath et al., 2017). BIPOC males are even less likely than white males to seek help (Blumberg et al., 2015). Societal norms discourage men from engaging in emotional discourse and instead encourage development through careers. However, career and mental health are interrelated (Olesen et al., 2013). Encountering challenges in a work setting can influence an individual’s overall health (Kramer & Chung, 2015), just as stress at home can influence work performance and employment status (Pacheco et al., 2014). Thus, Career Counselors are uniquely positioned to help men navigate mental health treatment.
Engagement in Mental Health Services
Spheres of Influence
Stigma also influences how men create treatment roadblocks for others (Vogel et al., 2009). Men negatively influence health decisions for family members, consciously and unconsciously, through snide comments about diagnoses, creating scheduling conflicts, refusing to pay for services, or developing roadblocks to change. Fear about how loved ones will be seen or that family members will grow apart can lead some men to undermine others.
Men wield influence over the mental health of others at work as well. Men often have decision making authority regarding mental health in the workplace, controlling insurance coverage, access to services or resources, or factoring an employee’s mental health into career advancement decisions. Unconscious biases can result in limited support for those experiencing mental health challenges and increase the likelihood of issues for employees whose struggles are ignored or denied.
Emphasize the Career-Mental Health Relationship
The majority of adult time is spent at work. Challenges such as over/under-employment, toxic work environments, and changes in work settings can have a negative impact on an individual’s health (Tang et al., 2020). Challenges include increased risk of suicide, stress, financial insecurity, as well as loss of identity, resources, and social connections. These factors highlight the importance of helping clients navigate the career-mental health relationship. As some counselors-in-training express greater interest in addressing mental health issues over career concerns, it is important for the counselor educator to showcase the career-mental health relationship throughout the training program. Here are three strategies counselor educators can share with counselors-in-training to learn more about addressing the needs of male clients.
Strategy #1: Build Common Language
Language is the most powerful tool used by mental health professionals. Shared language creates common ground and normalizes difficult experiences. Building emotional vocabulary is a common strategy to increase a client’s access to their emotional world. Similarly, providing language to help clients understand mental health services can encourage utilization of those services. In a qualitative focus group, a participant summarized the groups’ view of counseling:
“The word counseling is something we’ve heard in lots of different spaces. When you say you’re a counselor, it’s too fuzzy for me. I don’t understand what that means. What kind of counselor?”
Career Counselors have the advantage of a professional title that tells clients exactly where their work will begin – with career and professional development. Counseling’s professional identity has been challenged by multiple specialty areas with ambiguous titles (e.g. counselor, clinical counselor, behavioral counselor; Leahy et al., 2009). These ambiguous titles leave clients unsure of where to start. Career counseling is an effective place for men to start if unsure of what they need from a mental health practitioner.
Strategy #2: Teach the Connection
Career Counselors help clients identify areas for deep exploration. Career counseling can reveal depression, damaged self-efficacy, or decreased life satisfaction. Signs of distress can range from martyrdom (“I take care of my family – I don’t really need anything”) to self-centered impulsivity (“I work all the time; I deserve a drink when I want it”). Career and mental health issues may be expressed in a variety of ways in the sessions with a counselor:
“I want to explore career options, but I’m not sure my family would support that. I definitely don’t have the choice to not work so I guess I’ll just stick it out.”
“I spend a lot of time at the office. Not that I love my job, it’s just easier than being at home. At least I feel useful at work.”
Male clients may quickly attribute problems to stress at work – a socially acceptable explanation. Teaching the effects of mental health on job satisfaction, performance, employment status, relationship health, and general life satisfaction can raise client awareness of factors influencing wellbeing. Clients may avoid looking deeply at a psychological challenge for fear of uncovering a problem they do not know how to solve. Encourage clients to use self-reflection as a means to understand themselves more fully.
Tool #3: Dispel the Myths
Myths cloud men’s perceptions of mental health and are a significant contributor to stigma. In the qualitative focus group mentioned above, men shared misconceptions about practitioners’ training, expertise, and scopes of practice:
“A counselor has been through it from an academic perspective. They haven’t been through it in terms of life experiences.”
“If my employer told me they would pay for me to go to a coach, I would think they believed in me. If they told me they wanted me to go to a counselor, I would think they thought something was broken.”
Career Counselors are uniquely positioned to dispel myths by using mental health careers as an example in sessions. Teach clients that mental health practitioners are trained in human development, assessments, systems theory, abnormal psychology, diagnosis, cultural competence, and research. Teach clients that all licensed mental health professions are governed by a rigorous licensure process and a board that is in place to protect the public.
Fulfilling the Vital Role
Career Counselors work in the area most socially acceptable for men to enter the mental health dialogue. Men can benefit when Career Counselors build shared language, explain the career-mental health connection, and dispel mental health myths. Counselor educators who assist counselors-in-training in acknowledging and addressing this connection help ensure the vital role is not overlooked.
Blumberg, S. J., Clarke, T. C., & Blackwell, D. L. (2015). Racial and ethnic disparities in men's use of mental health treatments (pp. 1-8). U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.
Heath, P. J., Brenner, R. E., Vogel, D. L., Lannin, D. G., & Strass, H. A. (2017). Masculinity and barriers to seeking counseling: The buffering role of self-compassion. Journal of Counseling Psychology, 64(1), 94.
Kramer, A., & Chung, W. (2015). Work demands, family demands, and BMI in dual-earners families: A 16-year longitudinal study. Journal of Applied Psychology, 100(5), 1632.
Leahy, M. J., Rak, E., & Zanskas, S. A. (2009). A brief history of counseling and specialty areas of practice. In M.A. Stebnicki & I. Marini (Eds.), The professional counselor’s desk reference (pp. 3-13). Springer Publishing Company.
National Institute of Mental Health [NIMH]. (2019). Statistics of mental health. https://www.nimh.nih.gov/health/statistics/mental-illness.shtml
Olesen, S. C., Butterworth, P., Leach, L. S., Kelaher, M., & Pirkis, J. (2013). Mental health affects future employment as job loss affects mental health: findings from a longitudinal population study. BMC psychiatry, 13(1), 1-9.
Pacheco, G., Page, D., & Webber, D. J. (2014). Mental and physical health: re-assessing the relationship with employment propensity. Work, Employment & Society, 28(3), 407-429.
Substance Abuse and Mental Health Services Administration [SAMHSA]. (2014). National survey on drug use and health: Summary of methodological studies, 1971–2014. Substance Abuse and Mental Health Services Administration (US). https://www.ncbi.nlm.nih.gov/books/NBK519735/
Tang, M., Montgomery, M.L., Collins, B., & Jenkins, K. (2021). Integrating career and mental health counseling: Necessity and strategies. Journal of Employment Counseling, 58(1), 23-35.
Vogel, D. L., Wade, N. G., & Ascheman, P. L. (2009). Measuring perceptions of stigmatization by others for seeking psychological help: Reliability and validity of a new stigma scale with college students. Journal of Counseling Psychology, 56(2), 301.
Dr. Meredith Montgomery, LPCC-S, is a Supervising Professional Clinical Counselor, Counselor Educator, Researcher, and Counseling Advocate at the University of Dayton in Ohio. She is the Program Director of UD's Behavioral Health Workforce Education and Training Program (BHWET), an interprofessional education and practice program involving students in clinical mental health counseling, school counseling, school psychology, and clinical psychology. Dr. Montgomery's research focus is on the intersection of career and mental health and interprofessional workforce development. She also owns a private practice where she specializes in men’s mental health. She also serves on the Board of the Greater Dayton Brain Health Foundation. She can be reached at email@example.com