Key Words: men's help seeking, health care, strategies to increase men's help-seeking behavior
A greeting card pictures Moses walking in the desert, looking lost. The caption reads: "Why did Moses spend 40 years wandering in the desert? Because he wouldn't ask for directions." Popular images of men who refuse to ask for help for problems abound in U.S. culture. Sadly, research findings validate the popular idea that men do not seek help often enough. In this article, we review the evidence supporting the conventional wisdom that men infrequently seek help. We use case examples to illustrate three bodies of theory and research that are particularly relevant to understanding the problem and suggest strategies to increase men's help seeking.
THE CURRENT STATUS OF MEN'S HELP SEEKING
According to the U.S. Department of Health and Human Services (1998), men make fewer contacts with physicians across the lifespan than do women and are twice as likely as women to have gone two years or more since their last contact with a physician (DHHS, 1998). Men suffer higher mortality rates than women (DHHS, 1997; Stillion, 1995; Waldron, 1995) but seek help less often than women for a variety of problems in living including depression, cocaine use, alcohol use, and medical problems (McKay, Rutherford, Cacciola, & Kabaskalian, 1996; Padesky & Hammen, 1981; Thom, 1986; Weissman, & Klerman, 1977; Wills & DePaulo, 1991). In addition, men have suicide rates four to 12 times as high as women, suffer higher levels of substance abuse, and are more likely to suffer chronic conditions and fatal diseases than are women (DHHS, 1997; Kessler, Brown, & Boman, 1981; Robins & Regier, 1991).
Although these findings appear to be robust across age, nationality, and racial/ethnic background (DHHS, 1998; Husaini, Moore, & Cain, 1994; Neighbors & Howard, 1987), it is important to note that underprivileged men are at especially high risk. For example, according to the Department of Health and Human Services (1997), Black men are more likely than White men to die from HIV and diabetes, and they typically receive poorer health care than do White men (Staples, 1995). Similarly, men who do not have citizenship and/or do not speak English are especially disadvantaged regarding health care. Immigrant men may choose not to seek help for a medical problem at all rather than risk being deported. Thus, although men overall suffer higher mortality rates than do women, underprivileged men are especially vulnerable to disease because of their restricted access to resources and services.
Men's low rates of help seeking have only recently come to be considered problematic (Courtenay, 2000). In the past, men's rates of help seeking for problems in living were considered normative; if men sought help less than women, then women were thought to be overutilizing services, while men were using services just the right amount (Courtenay, 2000). Such interpretations of sex differences in help-seeking behavior served both to position women as weak and hypochondriacal and to construct men as the stronger sex. As Courtenay (2000) points out, these beliefs were maintained in spite of strong evidence that men need more help than they receive.
Despite consistent documentation that men seek help less often than do women, little of the research conducted to date is capable of explaining why this is so. Consequently, there is currently a dearth of interventions, empirically supported or otherwise, for facilitating men's help-seeking behavior. In an effort to develop a framework for understanding men's help seeking that is well grounded in existing theory and research, Addis and Mahalik (2003) integrated work from masculine gender socialization, social constructionist, and social psychological perspectives. For the remainder of the current paper, we consider some of the clinical implications of Addis and Mahalik's framework. …