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- 25 - accessHealthNews.net December 2021 Volume 8 | Issue No. 52 "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." This article was originally published in June 2021. F or 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, Neb., poverty also played a role in Miller's mental health issues as money was tight and he didn't want to further burden his family by requesting extra money for 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, anyone's business was everyone's business and staying quiet was necessary to avoid being labeled a freak.

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