Orygen, Parkville, Victoria, Australia.
The University of Melbourne, Melbourne, Victoria, Australia.
J Prim Care Community Health. 2020 Jan-Dec;11:2150132720921686. doi: 10.1177/2150132720921686.
Men with depression are known to have significant challenges with health service engagement. The current study sought to better understand attitudinal and structural mental health care barriers among those men identified as symptomatic for symptoms of major depression. Cross-sectional study with data provided by Canadian men via a nationally representative online survey. Outcomes examined depression, suicide risk, and barriers to mental health services. A total of 117 men (mean age = 42.36 years) reporting symptoms of major depression consistent with moderate severity as identified by the Patient Health Questionnaire-Depression Module (PHQ-9). In all, 51.3% of the sample reported previously receiving counselling or psychotherapy for mental health concerns. The majority (63.2%) reported past 2-week suicide or self-harm ideation; however, only a small proportion (8.5%) were currently engaged with professional mental health support. Logistic regression indicated that men's attitudinal barriers to mental health help-seeking had a greater predictive effect than structural barriers (33% vs 0% of items, respectively). In particular, lower likelihood of help-seeking was associated with men's reluctance to disclose mood-related symptoms to their physician/family doctor (adjusted odds ratio [AOR] = 0.37), a tendency for self-reliance and solving one's own problems (AOR = 0.34), and uncertainly about the process of psychotherapy (AOR = 0.29). Gender-transformative approaches to primary health care may be key to improving men's rates of disclosure and increasing detection for depression and suicide risk.
患有抑郁症的男性在寻求医疗服务方面面临着重大挑战。本研究旨在更好地了解那些被认为有重度抑郁症症状的男性的态度和结构性心理健康障碍。 这是一项横断面研究，数据来自通过全国代表性在线调查向加拿大男性提供的信息。研究结果检查了抑郁、自杀风险和精神卫生服务障碍。 共有 117 名男性（平均年龄=42.36 岁）报告有与患者健康问卷-抑郁模块（PHQ-9）一致的中度严重程度的主要抑郁症状。 总样本中有 51.3%的人因心理健康问题接受过心理咨询或心理治疗。大多数（63.2%）报告过去两周有自杀或自残的想法；然而，只有一小部分（8.5%）目前正在接受专业心理健康支持。逻辑回归表明，男性对心理健康求助的态度障碍比结构性障碍有更大的预测效果（分别为 33%和 0%的项目）。特别是，不愿意向医生/家庭医生透露与情绪有关的症状（调整后的优势比[OR] = 0.37）、自力更生和自己解决问题的倾向（OR = 0.34），以及对心理治疗过程的不确定性（OR = 0.29）与寻求帮助的可能性降低有关。 对初级保健进行性别转换的方法可能是提高男性披露率和增加抑郁和自杀风险检测的关键。
