‘I’d lost myself’: As men struggle with mental health, Steven knows how hard it is to ask for help

When someone asks Steven Smith about the tattoo on his arm, he invites them to touch it while he tells what he is determined “does not become a shame story but an opportunity for human connection”.

The outline of a mountain range symbolises what he has learnt from walking through mental health challenges where “we can find ourselves in a mist so deep you can’t see your hand in front of your face”.

Steven Smith spent five years healing his own mental health, and now helps other men who feel overwhelmed by a sense of disconnection.Credit: Chris Hopkins

After a week when men’s mental health came into renewed focus, Smith said the hardest times he encountered were a “wilderness, a place of desolation”. He is not ashamed to say he felt overwhelmingly convinced that ending his life would be “the most loving thing to do”.

“Even the headspace of that time wasn’t my normal headspace,” says Smith, a project manager and now avid men’s mental health volunteer and mentor.

“I felt like I’d lost myself, I wasn’t ‘me’ any more, I couldn’t think ‘me’, let alone find the words to share with others.”

Once through the valley of anxiety or “foggy-cloudy” experience, “even a week down the track you think, ‘Oh why didn’t I think about the three people I could have spoken to?’

Smith’s tattoo of a mountain range reminds him of what he went through as he healed his mental health.Credit: Chris Hopkins

“That experience can be really disorienting and hard to explain. To try to describe a mist where you still have your hand, you still have your feet, you just can’t see them right now ... At the time, you don’t know what you need.”

Though Smith has a good mate who is a therapist, he couldn’t find the words to share his suffering. “I’m like, ‘Why can’t I have this kind of conversation with the people around me, with a psychologist?’ I would be frustrated with myself,” he says.

It took him five years “to understand more deeply what was happening and to know how to find pathways” to health, and now Smith finds value in supporting other men through the free service Mentoring Men.

How well men’s mental health is catered for in Australia is in the spotlight as the community comes to terms with the sudden deaths of former AFL players Adam and Troy Selwood.

Joel (left), Adam and Scott Selwood farewell their brother, Troy, at GMHBA stadium in February.Credit: AFL Photos

Troy Selwood, a former Brisbane Lions player, died by suicide, aged 40, in February. His twin brother, West Coast premiership player Adam, died aged 41 on May 17.

Advocates including former Australian of the Year Professor Patrick McGorry have renewed calls for a mental health round in the AFL, but as men continue make up the vast majority of Australian suicide deaths, other experts want more attention on providing gender-attuned mental healthcare.

Australian Bureau of Statistics data shows that in 2023 (the latest available data), of the country’s 3214 deaths by suicide, 2419 – or three-quarters – were men. Men aged 55-59 accounted for the largest proportion of five-year groupings for deaths by suicide.

A small study released on Thursday by Mentoring Men found nearly half (47 per cent) of 2000 men surveyed in Victoria, NSW and the ACT said they were experiencing stress and anxiety now, 40 per cent were struggling with emotional regulation and 36 per cent “face difficulties maintaining relationships”.

The survey found 95 per cent of respondents acknowledged some form of support would benefit them, and they would be open to it, but two in five (42 per cent) admitted to “pushing through on their own”.

Professor Simon Rice, global director of the Movember Men’s Health Institute, says stereotypes that men are “bad at seeking help” should be challenged, as research suggests it could be that therapy styles are failing men who do try to seek help, and men’s depression presents differently from women’s.

More men are seeking mental health care, Rice and other experts say, but suicide rates are not coming down despite significant investment and years of high-profile campaigns.

“What we see is a healthcare system that’s not that responsive to men’s needs,” says Rice, also the co-founder of the Elite Athlete Mental Health Research Program at the University of Melbourne.

Adam Selwood’s death came three months after that of his twin brother Troy.Credit: 9News Perth

Talking therapy assumes patients can be vulnerable with therapists, but even when men are treated by other men, they often can’t connect with the therapist because of ingrained assumptions about emotional talk, and don’t stick it out.

“There are significant socio-cultural things that unfold: sure, a man can be good at engaging a guy, but helping them be fully open … is a different equation”, Rice says.

Research with 421 therapists by Dr Zac Seidler, the director of research at Movember and an associate professor with Orygen, which provides mental health support for young people, found talk therapy requires emotional communication, “which can conflict with traditional masculine norms”, and make it difficult to form alliances with therapists.

“Men routinely drop out of psychotherapy, with the most common reason being a lack of connection with their therapist,” the research found. Their experience can lead to mistrust of psychological services, reluctance to go back “and/or total avoidance of formal help”.

Last month, federal Health Minister Mark Butler announced $11.3 million in funding to deliver Movember’s men’s mental healthcare training program, based on the organisation’s research, to 60,000 mental health workers, doctors and nurses.

Butler’s statement notes “as many as two in every three men are foregoing health support due to gender stereotypes – and around half believe avoiding health check-ups is normal”.

“Australian men are three times more likely to take their own life than women, and are significantly less likely to seek mental health support,” the statement says.

Rice says a large study soon to be released by Movember will show two of the biggest risk factors affecting men’s mental health are emotion regulation, and rejection or relationship difficulties, which he describes as “a broad societal challenge”.

Dr Zac Seidler’s research found talk therapy requires emotional communication, “which can conflict with traditional masculine norms”.

“We’ve got to support men with how they manage rejection, and how do they better manage emotion regulation, and how do we better support men in their relationships full stop,” he says.

“You would think we would be far more advanced in these areas than we are, but in how to engage with and shift men’s behaviour, we’ve got a lot to learn.”

Psychiatrist Steve Moylan, the chair of Lifeline, says the fact far fewer men than women feel able to reach out for help is shown in the service’s call volumes. Of 4000 calls a day, just over one-third are from men, despite the fact they are so over-represented in suicide figures.

But calls to Lifeline’s gender-specific MensLine Australia exceed capacity of 190 calls a day, which shows men are willing to seek support when they get over the barrier of stigma around men discussing distress.

Current facts about suicide in Australia, provided by Black Dog Institute

• In 2020-2022, one in six Australians aged 16–85 years had experienced suicidal thoughts or behaviours in their life
• 60,000 Australians a year make an attempt to end their lives
• About 75 per cent of them are men, 25 per cent are women
• Suicide is the leading cause of death for Australians aged between 15 and 44
• Australians are more likely to take their own lives than die in motor vehicle accidents
• In 2022, more than 3200 Australians died by suicide
• Understanding the scope of suicide helps work towards prevention

Moylan says decades of work to reduce the male suicide rate have made progress, but for every person who enters the mental health support system, more than one person is becoming unwell.

Data shows midlife stressors drive happiness levels down, generally, when people are in their 40s and 50s, Moylan says. But alcohol and drug use, relationship issues and “a sense of disconnection” adds to men’s distress.

A combination of “feeling a burden for many possible reasons, and a sense of disconnectedness” are key risk factors for men. “When those two factors overlap, that can be where suicide can become a contemplated option for someone,” he says.

It is vital, Moylan says, that people close to a man who they suspect may be struggling don’t fear “making a mistake” and go ahead and say something.

‘People who had a high level of self-reported masculinity were less likely to seek help when they had clinically relevant depression.’

Dr Sean Martin, head of an Australian study on male health

About 18 per cent of men and boys participating in the Australian Institute of Family Studies’ Ten To Men: Australian Longitudinal Study on Male Health project said they had had a significant depressive episode in the previous 12 months, in one of the first snapshots of the research.

The study began in 2013 and is following the wellbeing of 24,000 men. Its lead, Dr Sean Martin, says the study will strive to measure how men’s depression may present differently, on average, from women’s, so it can be better treated.

“The challenge for us is understanding a bit more about male-type depression and suicidality; we’ve been trying to understand the critical transition points in men’s lives and when they’re at risk of these,” Martin says.

“Men are sensitive to issues like employment and engagement in the workforce, then they come out of that they’re in a vulnerable period, [and also after] coming out of long-term relationships, and significant periods of living alone.”

Social connection is vital for men’s mental health, and those who lose it can be more vulnerable to depression, Martin says, but when they’re experiencing depression they are also more likely to withdraw socially. Loneliness is a strong factor driving male suicide.

Martin agrees with Simon Rice that ideas about what it means to be masculine continue to prevent Australian men seeking support.

A flagship study showed “people who had a high level of self-reported masculinity were less likely to seek help when they had clinically relevant depression”, Martin says.

One sign for hope is that help-seeking rates among men have increased by 32 per cent in the past 15 years, says Beyond Blue clinical psychologist Luke Martin. But that only one in three men experiencing a mental health concern will reach out means turning around suicide statistics remains “a generational project”.

As current economic conditions increase stress, Luke Martin says the community and health sectors must strive to connect men with earlier support. “We have a very crisis-driven system,” he says.

“[Men] don’t reach out until they’re at breaking point; we need to start much earlier and get support around those key situational drivers of distress.”

Given men may be more likely open up to those close to them than to specialists, he says efforts to boost the mental health literacy in the community must continue, to improve recognition of signs of distress.

Though cost of mental health care is also a barrier to treatment for many, Luke Martin says men may not be aware that free services such as Beyond Blue can and do offer high recovery rates: “More than seven in 10 people who engage in mental health coaching services recover: but we think there needs to be a lot more early intervention for men,” he says.

Steven Smith says he couldn’t talk to his good mate, a pyschologist, when his mental health was so challenged.Credit: Chris Hopkins

Filipe Gama e Silva, the chief executive of Mentoring Men, says the idea that men won’t or don’t discuss their need for support is wrong and dangerous.

“We’re constantly told men don’t talk, men don’t seek help, and whilst this has served its purpose to raise awareness, that narrative is no longer a fair reflection of men today,” he says.

“It perpetuates the idea a bloke who has relationship issues or is struggling at work, might have addiction issues or is feeling lonely is not open to talk: men do talk … they talk to family and friends. We need to work out how to encourage them to reach out sooner.”

Lived experience has taught Steven Smith of the potency of “fellas showing up for other fellas”, which has prompted him to give a large amount of time as a mentor.

“Realising the power of a safe place, and safe conversations is something I’ve come to really appreciate and value,” he says.

“[At first] it feels difficult and awkward, but it becomes a place of discovery, when you verbalise and externalise, it’s actually a place of strength.”

If you or someone you know needs support contact Lifeline on 13 11 14 or Beyond Blue on 1300 22 4636. In the event of an emergency dial triple zero (000). Support is also available from MensLine on 1300 78 99 78.

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