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PAGE 08 June Issue 2021 By Staff Writer Elena Cleaves "I literally would have rather died than have someone know I was seeking mental health treatment. Mental health treatment was for psychos and legitimately crazy people – not 'normal' kids and young adults like me." For 44-year-old Brian Miller and many other white men in the rural Midwest, mental health stigmas and strict gender roles discourage attempts to seek help and contribute to high suicide rates. Nationally, males have a suicide rate 3.7 times higher than females and in Missouri, white suicide rates doubled that of other races. According to Missouri Department of Mental Health (DMH), adult men are most at risk for suicide, with 380 adult men between the ages of 35-60 years old dying of suicide each year. While small-town stigmas and machismo stereotypes contribute to shame driving men away from asking for help, the armed forces also play a unique role. Veteran suicide rates are 1.5 times greater than non-veteran suicides and many former members point to the lack of support when returning to civilian life. Men feeling ashamed, isolated, and unsupported are more likely to turn to substances to cope and are at-risk for suicidal thoughts, ideations, and attempts. While the number of mental health providers in Missouri increased throughout 2020, resources are irrelevant if men don't feel comfortable utilizing them. Each June, Men's Health Month highlights the unique health challenges men face and the changes necessary to improving men's physical and mental health. Men's Health Month underscores the need to not only help men now, but to better support boys raised in the future, which must include normalizing conversations around mental health. While rural attitudes surrounding mental health and treatment may vary, many men agree on one resource they wish they had sooner: another man to talk to who could understand. Masculinity, Mental Health, and Men's Confidence As an adolescent in Omaha, Nebraska, poverty also played a role as money was tight and Miller didn't want to further burden his family by requesting extra money for mental health care. When he did raise concerns about his anxiety, he was told he "didn't have the balls to handle the situation." This expectation of constant hypermasculinity is unfortunately the norm for many men, especially in rural areas with gendered family dynamics, and can push men away from seeking help in the future. In his small town growing up, any business was everyone's business and staying quiet was necessary to avoid being labeled a freak. Patrick Williams, a 34-year-old Kansas City, Missouri resident, was singled out for his differences as an adolescent while growing up in a rural town. "No matter how much I'd been through, I internalized the need to ignore how I felt if it wasn't in line with stereotypical male behavior," he said. "There were a lot of stigmas around the ideas of treating mental health, or that seeking help made you weak or less than someone else." His 'different' behaviors as a youth have since been diagnosed as Combined ADHD (ADHD-c) for which he currently receives treatment, but also wishes he had the knowledge and tools sooner, rather than believe there was something wrong with him. Both Miller and Williams turned to alcohol as an escape from their struggles and suicidal thoughts throughout the years, a common reality for many men. Mike Campbell, a 30-year-old service and brewing industry worker in central Texas, found that easy access to alcohol allowed him to use it to cope with negative thoughts. In a pro- drinking industry, he's been told he's a fun drunk among other compliments but has not been told as many positive things when sober. "Sometimes I feel like people like me better when I'm drunk," he said. "It sets off alarms in my head when I think like this, because I have a goal of one day quitting drinking." All three of these men were diagnosed later in adulthood with various mental health disorders and challenges which were worsened by compounded feelings of shame, low self-worth, and substance use over the years. These factors can cloud a person's mental judgement and overwhelm them with feelings that they are better off gone. When substances are present, the risk of overdose increases and the situation can quickly become fatal. One avenue to improving men's mental health is recognizing the comorbidities between substance use and mental illness/suicidal thoughts, as well as addressing the pressures to fit a certain mold of masculinity. Criticizing men for not being manly enough, showing improper emotions that need to be hidden, or implying that they are more likeable when exhibiting unhealthy behaviors chips away at one's sense of self and their relation to their emotions. By teaching, raising, and encouraging men to freely explore their identities and emotions, we can encourage confidence and comfort in being vulnerable – both of which men have far too long been denied on a mass scale. From Soldier to Civilian For men returning home from the armed forces, a lack of transitional support can lead to isolation and difficulty re-establishing stability and a sense of belonging. "The first few years trying to come back into a civilian life were extremely hard for me," said Richard Green, a 36- year-old southwest Iowan who served in the U.S. Navy in the early 2000s. "Going from the only structure and lifestyle I knew as an adult (© Halfpoint - stock.adobe.com) *Names have been changed

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