1 Department of Psychiatry, Faculty of Medicine, University of British Columbia, British Columbia, Canada.
2 Black Dog Institute, University of New South Wales, Sydney, Australia.
Can J Psychiatry. 2018 Sep;63(9):590-596. doi: 10.1177/0706743718766052. Epub 2018 Apr 19.
This narrative review highlights key issues in men's mental health and identifies approaches to research, policy and practice that respond to men's styles of coping. Issues discussed are: 1) the high incidence of male suicide (80% of suicide deaths in Canada, with a peak in the mid-50 s age group) accompanied by low public awareness; 2) the perplexing nature of male depression, manifesting in forms that are poorly recognised by current diagnostic approaches and thus poorly treated; 3) the risky use of alcohol among men, again common and taking a huge toll on mental and physical health; 4) the characteristic ways in which men manage psychological suffering, the coping strengths to be recognised, and the gaps to be addressed; 5) the underutilization of mental health services by men, and the implication for clinical outcomes; and 6) male-specific approaches to service provision designed to improve men's accessing of care, with an emphasis on Canadian programs. The main conclusion is that a high proportion of men in Western society have acquired psychological coping strategies that are often dysfunctional. There is a need for men to learn more adaptive coping approaches long before they reach a crisis point. Recommendations are made to address men's mental health through: healthcare policy that facilitates access; research on tailoring interventions to men; population-level initiatives to improve the capacity of men to cope with psychological distress; and clinical practice that is sensitive to the expression of mental health problems in men and that responds in a relevant manner.
这篇叙述性评论强调了男性心理健康的关键问题，并确定了应对男性应对方式的研究、政策和实践方法。讨论的问题包括：1）男性自杀率高（加拿大 80%的自杀死亡，50 多岁年龄段达到高峰），公众对此认识不足；2）男性抑郁的复杂性，表现为当前诊断方法无法识别的形式，因此治疗效果不佳；3）男性饮酒风险高，这同样普遍，并对身心健康造成巨大影响；4）男性管理心理痛苦的典型方式，需要认识到应对优势，并解决差距；5）男性对心理健康服务的利用不足，对临床结果的影响；以及 6）旨在改善男性获得护理机会的针对男性的服务提供方法，重点是加拿大的项目。主要结论是，西方社会中相当一部分男性已经掌握了通常功能失调的心理应对策略。在他们达到危机点之前，男性需要学习更多适应性应对方法。建议通过以下方式解决男性心理健康问题：促进获得医疗保健政策；研究针对男性的干预措施；提高男性应对心理困扰能力的人群水平举措；以及对男性心理健康问题表现敏感并以相关方式做出回应的临床实践。
