Clinical psychologist Dr Jonathan Pointer and CEO of James' Place Ellen O'Donoghue spoke to Mental Health Today about men’s mental health, and more expansively about how we can all support each other and our own mental wellbeing this winter.

Conversations about suicidal thoughts are increasingly less taboo, and a masculine baritone pitch has become progressively more audible in these conversations. The reason given why more men take their lives than women, and remains a top cause of death for young men, is that it reflects an inability to participate in earlier discussions about mental health.

This year has been particularly difficult, and fittingly the challenge to maintain our mental wellbeing this winter can be best described by its 2020 duplexity – the compounding of the winter blues with feelings of social isolation, and the resurfacing of past traumas with the seemingly redoubled difficulty in addressing them.

Although the old phrase don't suffer in silence is equally as fitting in alleviating these perceived challenges. Therefore, many organisations and psychologists have asked us all to continue to break taboos, stimulate conversations, and especially for men to open up about our mental health even if it must happen socially distanced.

Why is suicide a problem for men?

Dr Jonathan Pointer, a clinical psychologist at TherapySanctuary.com, explained that while extreme mental health challenges are of course not exclusive to men, there is a difference in the expression of that pain: "Women are more likely to attempt suicide than men, and yet, currently in the UK, men account for over three-quarters of suicides, and in the US the ratio is even higher… This can, in part, be explained by how men tend to use more violent suicide methods than women."

Dr Pointer identified that the reason why men are more likely to express their anger and pain in this overwhelming way, is that masculinity is still tied to increasingly outdated beliefs on what constitutes legitimate masculine behaviour:

"Toxic beliefs about masculinity, such as 'men don't cry' and 'men are supposed to be emotionally independent,' means that men are more likely to experience a sense of shame when considering opening up about their mental health challenges and that rather than discussing their underlying experiences, such as anxiety, OCD, and/ or depression… they are more likely to use unhelpful coping strategies, such as drinking alcohol, to manage their emotions."

But, saying that, Dr Pointer mentioned that treating all men as a loose-fitting homogenous group misses an essential point. And it is only by breaking down men into smaller demographics that we can more clearly examine the diverse environmental and contextual factors that propel different outcomes, and then think about their possible solutions:

"Although white male Caucasians report higher suicidal ideation (thoughts of suicide) than other ethnic groups, it is the young men of Black African and Black Caribbean heritage who have the highest suicide rates. Along with mental health stigma, other contextual/environmental factors that detrimentally impact upon young men of Black African and Black Caribbean heritage mental health include systemic racism and discrimination, and economic, social, and criminal justice system inequalities."

While toxic beliefs about masculinity are evidently persistent, as men make up the vast majority of suicides, this is beginning to change with every successive generation, because of the refreshing of the historically stale discussion on male mental health. As Dr Pointer commented: "My own experience, as a psychologist, suggests that with each new generation comes a lessening of shame related to experiencing mental health problems, and an increased willingness to discuss emotions and related psychological issues. Therefore, even though I still tend to have more female clients than male, the ratio between the genders is beginning to balance out."

How can we support each other? And ourselves?

Gender partially aside, this year's festive season has been, and will increasingly be, different than previous years as more people will spend Christmas and New Year's alone or away from support networks. But social distancing doesn't have to mean isolation, now or ever. Ellen O'Donoghue, the CEO of James' Place an organisation that supports men in crisis, explained that if we are concerned about someone that we care about the best course of action is to reach out and listen:

"If you are concerned that someone you care about is feeling hopeless, the best thing to do is ask direct questions and listen to their answers… This is a big conversation, and you need to stop what you're doing and listen. Be prepared for the response, which may be emotional or upsetting. Have resources to hand such as Hub of Hope ready on your phone or phone numbers for helplines and their GP. Say what you're going to do to help them and stick to it."

"Keep in touch with your loved ones – while it is advised to avoid physical, social contact during the COVID-19 crisis, and to stick to the guidelines in your area, keeping in touch with people you love is very important… Have a chat about something other than the virus. Share ideas of what you are doing to keep busy at home. If you are worried about the person's mental health, do have a straightforward conversation about it and be ready to hear what they have to say."

Additionally, we can also still practice self-care. Ellen shared her advice on how we can support ourselves during any potential isolation and attempt to undo or avoid any negative thought patterns: "This year's holiday time will be very different to what we are used to. Try to remember some positive statements about the current situation for example: 'This is far from an ideal way to spend Christmas, but I'm doing everything I can to keep myself and the people I love safe.' 'The best thing I can do to help is to stay at home and contact my friends and family via texts or calls.'"

"Treat yourself – try to do things that make you feel better about yourself or help you relax. Take this time at home to do things you haven't had time for, such as reading books or watching films."

Ellen stressed that suicidal thoughts and depression are feelings that may flicker in and out, throughout our lives – but even if the person experiencing these emotions may feel that they are very much alone, they are not: "Many people will experience suicidal thoughts in their lifetime. For most of us, these thoughts will be fleeting, easily dismissed and often in response to a difficult situation or stressful event… If you are not able to dismiss the thoughts of suicide, if they are increasing in frequency and severity, if suicide is feeling like a solution to your problems – then please reach out and ask for help."