Textbook of Men's Mental Health

Article excerpt

Textbook of Men's Mental Health edited by Jon E. Grant and Marc N. Potenza. Washington, DC: American Psychiatric Association Press, 2007,417 pp.

There are many ways a textbook of men's mental health might approach its subject matter. It might, for example, examine recent men's studies literature on the social construction of masculinity (Levant & Pollack, 1995) and its implications for men's emotional well-being. In doing so, attention would be given to how the male gender role restricts men's optimal potentials and sometimes produces behavior disordered enough to be labeled mental illness. A second approach might start with the recognized categories of mental illness and identify differing epidemiologies and symptom expressions between the sexes. The present volume takes the second tack since in the first paragraph of the Introduction uses the terms "mental health concerns" and "psychiatric issues" interchangeably, and although it strives to cover both approaches, it primarily succeeds in its efforts to explore "the clinical presentation and treatment of various psychiatric disorders in men" (p. xiii). As such, most of the material reads very much like an expansion of the DSM-IV-TR, with great of attention paid to the rates, clinical courses, and co-morbidities of specific psychiatric disorders.

It is a worthy ambition to provide greater attention to previously recognized male and female differences in psychiatric disorders. This is, however, an inherently limited approach to the broad subject of men's mental health, since it restricts attention to those men with diagnosed psychiatric pathology, so that what we have here is a textbook of "men's mental illness." In fairness, however, the editors have made efforts to incorporate life-span and sociocultural perspectives, thereby addressing matters relevant to non-clinical male populations. Some of the chapters are very well done, but some of them are not. Before discussing the merits of the various chapters, a few additional comments are needed on the textbook's adoption of a DSM-IV-TR conceptual framework.

First, a common challenge of this psychiatric diagnostic system is the need to deal with co-morbidity and the overlapping of diagnostic categories (for example, depression and anxiety disorders). The issue is important since much material presented is redundant (for example, anxiety disorders with depression; substance abuse with antisocial personality disorder; impulse control disorders with sexual disorders). A more fruitful approach would be one that integrates these symptom expressions with a broader coverage of men's developmental issues, coping styles and help-seeking patterns. second, any approach to mental health that begins by looking primarily at characteristics of men with psychiatric diagnoses cannot pay enough attention to the critical issues of men who "fly under the radar." That is, there are many more men whose lives are impaired by depression, anxiety, sexual problems, and substance abuse than those reflected in even the best epidemiological statistics.

The book's final chapter on stigma and barriers to mental health treatment for men is superb. The authors generate a broad theoretical model to account for men's underutilization of mental health services. The model incorporates general socio-psychological principles of stress and coping with more specific theories of masculinity ideology. It is unfortunate that, although many of the text's authors make reference to this chapter, few incorporate its perspectives into their own chapters. The book makes an effort to address men's life-span issues by including separate chapters on "childhood," "adolescence," and "older men." No rationale is provided for omission of the mid-life period.

The chapter on childhood includes interesting observations about problems resulting from boys' delayed language development, attachment issues, and "rough and tumble" play style. It does not pay much attention to the special qualities of "boy culture" (Rotundo, 1993) or the role of bullying and trauma in young men's lives (Lisak, 2005). …