Key Statistics about Men and Mental Distress

Key Statistics about Men and Mental Distress

In the past much of the awareness and research regarding mental health issues has focused predominantly on women, whilst men with mental health concerns have had to face an element of negativity from society. Though in more recent years the stigma of mental health has been dramatically reduced for both men and women, many men still feel that it would be a weakness to acknowledge a mental health issue and either mask their problem or fail to recognise the symptoms.
This fact-sheet brings together a variety of information, facts and figures from various health resources, which we hope will further your understanding of the mental health issues thousands of men are struggling to cope with everyday.

Prevalence of key mental health problems among men

Depression
According to a study conducted by the Office for National Statistics (ONS), back in 2000 mixed anxiety and depression affected an estimated 7 per cent of men, with depression affecting a further 2 per cent¹. Though this study and various others have documented a higher prevalence of depression among women, others have suggested that depression is equally common in both sexes, but women are diagnosed and treated twice as often².
There are many factors which contribute to the lower diagnosis rate of depression within men, the first of which is failure to recognise the symptoms. Naturally we tend to associate feeling low and emotional for prolonged periods of time with symptoms of depression, but for many men these aren't actually the primary symptoms. Many men who are suffering may be instead experiencing an entirely different set of symptoms such as fatigue, headaches, irritability and feelings of isolation.
Others will recognise that something is wrong but will choose to suppress or mask their symptoms for fear of the stigma attached to mental illness, or because they are not used to being open about the way they feel.
Schizophrenia
Though roughly the same number of men and women are diagnosed with schizophrenia, various studies have revealed that men are more likely to be diagnosed at a younger age. Additionally the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) has suggested that men are less likely to make a full recovery.
Substance misuse
According to figures taken from the ONS, men are three times more likely than women to be alcohol dependent, which amounts to a five to one male to female ratio[3].
In addition to this, studies have also shown that the amount of men drinking large quantities seems to be gradually increasing, with the number of men exceeding the limit rising between 1999 and 2004 when an estimated two out of every five men were drinking more than the recommended quantity.
Men are also more likely than women to seek and use illegal drugs as well as standing a higher chance of developing an addiction or dependency. Between 1993 and 2004 there were 12,687 male drug misuse related deaths, compared to 3,401 deaths among females³.
NHS statistics have also shown that double the amount of men seek access to treatment and services for drug related issues than women do and 62 per cent of violent crime offenders were found to have been drinking at the time of the crime.
Personality disorders
Men stand a higher chance of being diagnosed with an antisocial, paranoid, schizoid or schizotypal personality disorders than women, all of which are more often than not diagnosed in early life.
Personality disorder such as the ones mentioned above are also extremely common in both sentenced prisoners and those on remand, affecting around 49 per cent and 63 per cent respectively⁴.
Attention deficit hyperactivity disorder
ADHD in young children is far more prevalent in boys than it is girls and though many may go onto outgrow the disorder, others will be affected well into their adulthood⁵. Unfortunately, research has indicated that adult ADHD services are unable to cope with the heavy demand, suggesting it is an area of mens health which is somewhat neglected⁶.
Post -traumatic stress disorder (PTSD)
The term post-traumatic stress disorder describes a mental health condition which usually develops after an individual has experienced a severe trauma.
An estimated 1 in 10 may develop PTSD at some stage and one large survey of the general population in England found that 3 in 100 adults screened positive for the condition⁷.
Though it is unknown what percentage of sufferers are male, PTSD has been found to be more common among certain groups which are male dominant, for example 1 in 5 firefighters and 2 in 3 prisoners of war are affected⁷.

Hospital Admissions under the Mental Health Act

Despite the fact that a higher proportion of women than men are likely to be diagnosed with a mental illness, men are more likely to be admitted to a mental inpatient ward and also stand a higher chance of being admitted formally ('sectioned') under the Mental Health Act⁸.
According to figures from the Department of Health, the number of men formally admitted to NHS hospitals throughout England and Wales under Part II of the Mental health Act has risen from 8,673 per year in 1990 to 13,400 in 2003-2004⁹.

Suicide

Though the National Mental Health Development Unit have found suicide rates in Britain to be the lowest they have ever been (2009), according to the World Health Organisation suicide is still the third largest contributor to premature mortality after heart disease and cancer with an estimated 4000 incidents per year¹⁰.
Prevalence of suicide among males
Though the suicide rate for women in England and Wales halved between 1971 and 1998, the same period saw the rates for men almost double. After reaching an all time high at 21.1 per 100,000 in both 1992 and 1998, the number of male suicides did begin to decline gradually and in 2005 a 30 per cent reduction was recorded, which many attributed in part to the Government's National Suicide Prevention Strategy¹¹. However, men still remain far more vulnerable to death by suicide than women, accounting for 75 per cent of all suicides in the UK. In 2008 the Office for National Statistics recorded 17.7 suicides per 100,000 in men compared to 5.4 per 100,000 in women¹¹.
In the UK the suicide rates for men are higher than for women across all age groups. According to the Office for National Statistics, back in the early 1990s the highest suicide rates in the UK were among men over the age of 75¹¹. Rates in this age group have since declined from 25.1 per 100,000 in 1991 to 14.0 per 100,000 in 2008 meaning the age group now has the lowest suicide rate across the three male age bands.
In contrast, suicide rates among men in the 15-44 age bracket peaked in 1998 at 24.0 per 100,000 then steadily declined until 2008¹¹. However, since then the rate has increased once again from 17.6 per 100,000 in 2007 to 18.6 per 100,000 in 2008.
There has been various suggestions as to why the suicide rate is higher among men, many of which have touched on their reluctance to discuss problems or express their feelings, resulting in a reduced likelihood of them consulting a GP or seeking help. It is also thought that various social factors such as education, employment and family relationships could have an affect, more details of which can be found in Social Influences and Mental Health.

Social and Economic Factors

The term social and economic factors basically refers to elements of an individuals life and surrounding environment that may influence their mental health. For instance, in the past there has been strong male stereotyping which has cast the man in the role as primary breadwinner. It is a combination of traditional expectations such as these and a variety of additional external factors that has resulted in many men being raised not to talk about or express their feelings, as confessing an emotional issue may previously have been considered a weakness.
In addition to this, men have also been affected more severely than women by the reduction of traditional manufacturing jobs, they are not doing as well in school and further education as girls and the breakdown of traditional gender roles has left many men feeling uncertain of what is expected of them.
Employment
Post World War II the UK began to see huge changes in employment patterns, with mining, steel manufacturing, ship-building and other heavy industries which have traditionally employed men gradually closing down, whilst many of the newly created jobs in the service sector were often considered to be 'women's work'.
There is a growing body of research which suggests that unemployment has a significant impact on mental health, with various studies finding that being out of work increases the risk of developing a depressive illness¹². One study in particular conducted by the Royal College of Psychiatrists found that unemployment may be associated with a doubling of the suicide rate.
As previously discussed, casting the male as the 'breadwinner' of the household could mean that an inability to fulfill this role may result in low self-esteem and in times such as an economic downturn a lack of job security could also be a risk factor.
According to an ONS report looking into the mental health and cognitive function of older people (aged between 60 and 74), the prevalence of common mental disorders increased steadily with decreasing household income¹³. In addition, individuals whose only source of regular income was some form of state benefit were also far more likely than those not receiving benefits to have mental health problems.
Family
The social and economic changes which have come into play during the past few decades have resulted in adjustments to the traditional family infrastructure¹⁴. Nowadays families are generally much smaller and it is not uncommon for extended family members to be located in various different areas of the country. The 21st century has also seen an increase in divorce rates, co-habitation and single person households which could be an indicator of why suicide rates in men are much higher than in women.
Of all men, those who are divorced are most likely to commit suicide, which could perhaps be related to the fact that depression is more common and severe in this group¹⁴. During and after a divorce a man may find that as well as the breakdown and loss of their key relationship, they lose touch with their children, they have to move house/area and they struggle with their finances. Aside from the stress of a break-up, all of these situations are stressful events in their own right and may trigger the onset of depression.
In a study conducted by the ONS it was found that individuals aged between 60 and 74 who were divorced and separated had the highest prevalence of mental disorders, affecting around 19 per cent of women and 17 per cent of men¹³. In contrast, being single was associated with a low prevalence in both sexes and interestingly being married was associated with a low prevalence of mental disorders in men (7 per cent) but a higher prevalence (12 per cent) among women.
Though the developments and changes to the 'traditional' family structure may have unsettled certain aspects of family life, there has also been a number of hugely positive developments, notably an increased willingness within men to discuss family issues and seek help. In addition to this, changes are now being made to certain areas in which men have previously been neglected.
Many organisations that help single parent families are now working hard to ensure their services reach fathers as well as mothers¹⁵. Furthermore, fathers disputing access rights to their children are now given more support and from April 2011 new mothers will be able to split their paternity leave with the father of their child.
Education
According to UK statistics, girls consistently outperform boys at all levels of education in the UK from Key Stage 1 right through until they reach university level. In 2005/06, 64 per cent of girls in their final year of compulsory education achieved five or more A* to C GCSE grades, compared with 54 per cent of boys¹⁶.
The trend of women achieving higher academic grades continues to the next level of education, where in 2005/06 women outperformed men in A levels in all subject groups with the exception of French, German and Spanish.
Furthermore, the percentage of individuals obtaining two or more GCE A levels (or equivalent)in general is strikingly higher among women than it is in men, with the number of young women gaining this result increasing from 20 per cent in 1990/91 to 44 per cent in 2003/04. In comparison, the number of young men gaining this result increased from 18 per cent in 1990/91 to 33 per cent in 2003/04.
Many studies have found that poor performance at school, particularly during compulsory education can lead to social exclusion and an increased likelihood of poorer health in later life. Education experts have suggested that the use of certain teaching and assessment methods are far more suited to the way in which girls work, thus contributing to the difference in academic success levels between the sexes. Further to this, doing well at school is often not seen as 'masculine' and can result in boys misbehaving so as not to conform to the 'boffin' stereotype.
The criminal justice system
As it stands, 94 per cent of the UK prison population is male, a huge number of whom are suffering from some form of mental health problem¹⁷. One large scale study of men serving prison sentences found that over one third had a significant mental health problem, almost one in ten had experienced psychosis and one in four had attempted suicide in prison¹⁸.
Furthermore, the suicide rate among male prisoners is six times higher than that of the general population¹⁹. In 2003, there were 94 suicides in prisons in England and Wales, 80 of which were males. 19 per cent of prison suicides were young men under the age of 21.
There were similar findings among prisoners on remand, 21 per cent of whom had received help or treatment before entering prison and 15 per cent of whom said they had received help or treatment since being in prison²⁰.
Prevalence of personality disorders in the UK prison system
Antisocial personality disorder usually begins with antisocial behaviour from an early age, which could explain why it is the disorder with the highest prevalence among UK prisoners²⁰. A report from the Office for National Statistics found that 63 per cent of male prisoners on remand, 49 per cent of male sentenced prisoners and 31 per cent of female prisoners were assessed as having antisocial personality disorder.
The second most prevalent was paranoid personality disorder, which was found in 29 per cent of male remand prisoners, 20 per cent of sentences males and 16 per cent of female prisoners.

Violence against men

In 2007/08 the British Crime survey found that the likelihood of becoming a victim of violent crime was far more likely for men, who stood double (13.4 per cent) the risk of women the same age (6.4 per cent)^{21, 22}.
The trend of risk decreasing with age occurred in both sexes with the percentage of 25 to 34 year olds who were victims of violent crime in the previous year falling to 5.7 per cent for men and 3.3 per cent for women. The proportions fell even further for those aged 75 and over to 0.3 per cent for men and 0.2 per cent for women.
The form of violence also seems to vary between sexes, with the number of domestic violence incidents experienced by women five times (85 per cent) greater than for men (15 per cent) in 2007/08.
In contrast to this, the British Crime Survey found that 78 per cent of victims of violence from strangers and 58 per cent of victims of violence from acquaintances were men. The trend of violence against men exceeding violence against women is true for the majority of categories apart from sexual abuse and domestic violence, though women still remain more than twice as likely to worry about violent crime than men.

Male rape and sexual abuse

Though statistics show that a higher percentage of women than men are victims of domestic violence, many experts believe that the estimates of domestic violence experienced by men are likely to understate the true scale of the problem, perhaps due to the fact that men are less likely to report their experiences^{23, 24}.
Many myths persist about male rape, for instance, that only gay men are raped, and that it only affects the weak. This can increase the trauma suffered by victims of male rape. Home Office statistics for 1997 show that 342 men were raped that year. This is almost certainly a huge under-estimate, as many male rape victims are extremely reluctant to report such attacks to the police.
Unfortunately the same goes for male rape and sexual abuse, which are both surrounded by stigma and myths which has resulted in many men suffering in silence. As it stands there are very few support services available to men who have experienced rape, as most crisis centres and services are female orientated. In addition to this, male rape has only been acknowledged as a criminal act since 1994.
Though the effects of childhood sexual abuse in later life are largely unexplored, certain studies have revealed that male survivors of childhood rape and sexual abuse are more likely than female survivors to be diagnosed with a psychotic illness. Both sexes reported equally negative experiences of the health services available to them which include little empathy and awareness from staff and a a deficiency in the support services available.
Boys and men who are victims of abuse often display symptoms of post-traumatic stress disorder, have issues with substance abuse, depression, self-blame, low self-esteem and could find they have difficulty developing relationships throughout their lives.
In addition to this, other long term problems which have been reported are related to the development of gender identity. Studies indicate that male survivors of child sexual abuse may attempt to ‘prove’ their masculinity by having multiple female sexual partners. They may sexually victimise others and/or engage in dangerous or violent behaviours. They may develop confusion over their gender and sexual identities, have a sense of being inadequate as a man and/or have a sense of lost power, control and confidence in their manhood. They may also fear that the sexual abuse has caused them, or will cause them, to become homosexual.

Physical Factors

Though we often associate mental health concerns solely with our emotions and whats going on in our minds there are various physical conditions which act as contributing factors towards mental illness.
There has been various research conducted which shows that men suffering from a long term illness stand an increased risk of developing a mental health concern and other studies have found that there is a higher prevalence of poor mental health in men who have either heart disease or high cholesterol^{25, 26}.
Other physical causes which seem to result in a higher prevalence of mental health concerns are that of circumcision and erectile dysfunction, the former of which can lead to the development of negative body image and post-traumatic stress disorder and the latter which can lead to relationship issues and depression^{27, 28}.

Mental Health of Minority and Specific Male Groups

Mental health disorders affect both men and women all over the world and belonging to a particular culture or a specific group means that each individual will face a different set of pressures and life experiences. All of these factors will have varying impacts on each individual and can result in certain groups of people being more prone to experiencing a problem at one time or another.
Below are a few statistics which outline some of the issues which certain specific male groups are facing today:

• Admission rates to psychiatric hospitals are three times higher among Irish men than among the general male population. In addition, Irish men have a significantly higher prevalence of depression, alcoholism, schizophrenia, anxiety and personality disorders than the general population ²⁹.
• According to The Count Me in Census (2008), in 2008 23 per cent of inpatients were from minority ethnic groups, compared with 20 per cent in 2005³⁰.
• The Chinese Mental Health Association have found that the misdiagnosis of mental health issues is extremely common among the Chinese community. It is thought the main reason for this to be partly due to the fact practitioners are not culturally aware of the community's explanations of mental health symptoms, and also because there is a lack of understanding of mental health issues in the community as individuals are reluctant to discuss their issues with their inner circle³¹.
• Recently much evidence has been found to suggest that continual media attention on Muslims in Britain has had adverse effects on the mental health of South Asian men³².

Young Men and Boys
Research and studies have found mental health concerns to be more prevalent in boys of all age ranges than that of girls. Though the reason for this is unknown many experts believe it could be related to a combination of various environmental and genetic factors.
In the 2009 Samaritans' report Young Men Speak Out, the attitudes of young males in the UK were explored and it was revealed that macho stereotyping meant that young men were reluctant to ask for help and were more likely to use violence and anti-social behaviour to express themselves rather then telling someone how they felt³³.
Additionally the report found that only 39 per cent of suicidal young men would consider phoning the Samaritans as well as finding and highlighting the following:

• 67 per cent of suicidal young men say they have nowhere to turn for emotional help
• Suicidal young men are four times more likely to smoke and ten times more likely to take an illegal drug to relieve stress
• More than one in three young men would 'smash something up' instead of talking about their feelings
• Less than one in five young men would ask their father for emotional support
• 78 per cent of depressed and suicidal young men have experienced bullying
• 69 per cent of suicidal young men have experienced violence from an adult
• 50 per cent of suicidal young men have been in trouble with the police compared to 17 per cent of the non-suicidal.

Older men
Figures show that older men have the highest rates of suicide in the UK which experts have linked to depression, physical pain, illness, living alone and feelings of hopelessness and guilt. The fact that mental health concerns in many older men go undiagnosed is largely due to the fact that there is a lack of support services and resources as a high proportion of medical resources cater to women (Well Women clinics), with far fewer male equivalents available.
Older men also experience some specific hormonal, physiological and chemical changes. This is sometimes referred to as the male menopause, and is also known as viropause or andropause. These changes begin generally between the ages of 40 and 55, though they can occur as early as 35 or as late as 65, and can affect all aspects of a man’s life, including their mental health.
Gay men
Homosexual men are likely to face various pressures throughout their lives as a result of their sexuality. Many will find it difficult to come to terms with their sexuality, others will feel isolated and may face negative attitudes and discrimination from society.
It is thought the poorer level of mental health among the lesbian, gay and bisexual population is strongly linked to homophobic stigma and discrimination, which they often face at school, from public service providers and also from family members and peers.