Dr. John Oliffe - The True (And Troubling) Face Of Men's Health
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All right, Dr. Alif, how are you doing today? Yeah, good. Thank you, Karin. Nice to have you.

have a chat. Yeah, we're going to dive in men's mental health. So, you know, interestingly enough, the team from November had reached out to me. I think we were talking about this before we just sort of hit record here, but they had reached out to me with this new piece of research, the men's health report for Canada. And there were some very interesting findings in there. And I thought it would be worthwhile to chat with you. So maybe just lay out the kind of the broad spectrum pieces of

of what your findings revealed and then maybe we'll go deeper into into each of them yeah there's a couple of empirical chapters within this report it's a it's a big report it's kind of glossy it's got pictures and high level stats so it's it doesn't read long but it is long you know in terms of pages but just to say a couple of the interesting things you know

This affirmation that men are dying prematurely, you know, so 44% of guys in Canada are dying before age 75 from preventable causes. And I think that's, you know, it might not be necessarily new, but I think empirically it really says something for this current time. We did some work around

So when a guy's not got great health, it often defaults to the people around him and the costs that are associated for those people. And we also did some research in terms of how guys do and don't connect with primary health care. And again, oftentimes we've belabored the idea blokes don't go in and seek help. And this kind of pushes back on that a little bit. It acknowledges that, but also acknowledges

They talked to some structural elements around that. I mean, you guys dug into some interesting pieces as well because you've, one of the things that I've talked about on my show, but also in podcasts that I've done is the impact of fatherless homes and how many men that are at

at some point, homeless or struggle with addiction, come from fatherless homes. But you dug into accidental and unintentional deaths as the third leading cause of male deaths, which was kind of surprising. And I think one of the things that stood out was, I think it was between January and June of 2024, 72% of accidental opioid deaths and 63% of accidental opioid-related poisoning hospitalizations involved men. That's a pretty high percentage

percentage. That's a really high percentage. Do you have a sense of what maybe culturally or within us as men drives us towards those types of addictive patterns and behaviors or anything that you want to just sort of comment on that? Yeah, sure. So we often talk about this notion of the three I's like injury, interiority, and isolation. And so

I think for a lot of guys, when they get an injury, and it might be something like a relationship breakup, their parents divorcing, or accumulation of issues, they tend to look interiorly. They look for the remedy, and the most often go-to for a little bit of respite within that is substances. So we talk about guys self-medicating a lot.

and then isolating in the problem and isolating in said remedy, which is around the self-medication. So it's not to at all, you know, suggest that this is intentional. I think for a lot of guys, it's impulsive because they get further away from what they're feeling and don't necessarily get to, you know, engage with the core elements of why they're feeling what they're feeling and working through some of those emotions. So I think it's one of the things. I think the other bit, you know...

So it would be remiss not to mention the social determinants of health. There's many guys who are poorer off in terms of education levels, income, that puts them in positions where they don't have choices. And so that can lend itself to this kind of underground underbelly of kind of substance use and some of the behaviors that go with it.

There's a few things there that are mighty interesting in terms of males and that help to explain perhaps a little bit that disproportionate number that you mentioned. Yeah, I think one of the big pieces was just premature mortality and how men generally die younger.

and are dying far too young. And I remember, I think it was somebody I had on the show was talking about young male syndrome, you know, this sort of period of time between 16 and I think it was 16 and something like 24, where a lot of male suicide happens, but also this hyper, hyper risk-taking happens. And there's much more injuries and accidental deaths that happen within this period. I mean, I think about my own life and that

That was definitely the age range where I was the most susceptible to all kinds of bullshit. I bought a 1,000cc V-twin sports bike at the age of 19 that my mom basically begged me not to buy and doing 320 kilometers an hour on the highway and stuff like that.

So I'm one of the fortunate ones that managed to escape driving a sports bike ridiculously fast through the streets of Alberta and come out largely unscathed. But what are some of the things that are outside of our own kind of stupidity and hyper aggressive risk taking, we might call it? What are some of the things that are leading to this premature mortality within men? I think you raised some really good points about young guys.

I think a lot of times we forget that you're still forming your identity up until 25, according to the psychology texts. So a lot of what you might be doing as a young man might be testing the boundaries or proving your masculinity in some ways, shape or form, and also

You know, back to the old days, we'd often talk about guys feeling invincible, you know, like the risk taking is part of their risk reliance almost. You know, I think there's, again, there's a, there's a lot of things that you can unpack within that, within that context. I think for a lot of guys are trying to prove themselves and,

And it's interesting, I think we've got a new generation of young men who perhaps crave the milestones that maybe their forefathers had in terms of, you know, house, partner, family, all of that sort of thing. And all of those have been pushed back by, you know, really by societal and structural pieces. So again, some of that risk-taking is maybe, you know, in Connell's words would be something around protest masculinity at some level as well. So it's just to say those...

those things are really, really interesting. And I think also we tend to forget that guys, you know, tend to have higher levels of exposure to occupational hazards. You know, we're still overrepresented in constructions and skills trade, even though things are evening up a little bit, you know, at least in an inclusive way to bring other folks into those areas. But, you know, some of those issues as well, because it's interesting that

substance use in the skilled trades and construction is quite high and that's male dominated. So again, there's reasons for that, you know, around exposures, like the direct exposures, but also the nature of that work and the difficulties around it and even the pay around that as well. So, you know, just to try and contextualize it a little bit. Yeah. I mean, I worked construction and gravel pit in Northern Alberta after high school and

I started in February when I was 18 years old. I started in February, late February, opening the Gravel Pit. I was working the night shift from 6:00 PM to 6:00 AM. It was a rude awakening, not just from the elements, but from the men that I was working with. Here I was, this young kid out of high school, didn't do very well academically and didn't really have a lot of prospects, wasn't going to university or college.

and show up to the job site outside of a place called Camrose. I think it was Camrose, but anyway. It's 6 p.m. to 6 a.m., and it's minus 45, minus 50 the first week that I was working. Here I am outside, and I just remember it just being brutal, but those couple of years working construction,

Gravel pit, sidewalks, working concrete, stuff like that. I got to see a lot of the men. It's tough. It's a hard life. And a lot of my friends were working on the oil rigs as a way for them to make really quick money, but it's a really hard thing.

physically exhausting, and sometimes mentally boring and repetitive experience. I think to your point, the marker has shifted, but the expectations have somewhat stayed the same. I think a lot of men still feel the pressure of the expectation to buy the house, have the car, be the provider. I think a lot of the data on

on dating, a lot of the research on dating shows that, you know, for the most part, I think the majority of women's expectations of what they're looking for from a man have shifted a little bit, but largely have stayed the same. And so I think, you know, to your point, it's become for a lot of men exponentially harder to just do what their previous generations had done.

Right. You know? Yeah. And it's the hangover, you know, like those roles, some of those traditional roles, you know, we interviewed guys across the world, 15 countries.

and they were 19 to 44 and they buy in they totally buy into the breadwinner provider protector roles and you know there's a strength in that there's a resilience in that too things that make you rich can make you poor though so the kind of pressure that goes or can go with putting yourself in those positions or

co-constructing those positions with a partner can be really tough on guys of a generation where there might not be, you know, the opportunities that their forefathers had nor the differentials in pay. Like a lot of households are equal income these days, you know. But we talk to guys and oftentimes they're still on control of the outgoings from the house even though it's equal pays coming in. So it's a real – it's complex sometimes.

And it's certainly something to work through about what kind of things you're taking on that are traditional versus these contemporary things. But also it's by negotiation as well. That's the other bit, you know, like it's co-constructed. It's not just, there's no magic formula out there. What do you mean by co-constructed? Just say a little bit more about that for the listener. Yeah, just in terms of, I think oftentimes we talk about,

you know masculinity is somehow being in a vacuum and guys decide and you know pick up the norms that they want and this and that i think relationships we've done a lot of work in men's intimate partner relationships and also peer relationships and we know that it's by negotiation so when i say co-constructed it's like well how you show up within that relationship is it's there's a co-construction around that and when it's discord there's there's there's distress

And when it's not, when you've got a decent even keel going and an agreement and things are working okay, that's a completely different story. But it is co-constructed. Like it's not just some guy dreaming it up that's walking into something and it just doesn't work that way or it doesn't work that way for long. Yeah. So there's external pressures, expectations, but also there's a kind of a negotiation around

the expectation of how that man should be showing up? Is that what you're talking about specifically? Or are you talking about finances, relational pieces, where he works? Yeah, it's both. So like a lot of times we'll talk to guys about, we did this study and it was about gender equity, right? So guys are really good at gender equality, the 50-50 stuff. And the trouble comes when they get into the hard counts, you know, because nothing's 50-50, nothing's equal.

right and so the gender equity piece about 25 of these hundred odd blokes understood it in a way where it's about fairness and justice and those things aren't they're not a cross-sectional moment they're longitudinal so that that's like everyday check-in like who's got the energy to do what by negotiation so you know it's it's super it's just interesting that

You know, we talk about gender equity and I think most guys would go, absolutely, fairness and justice, absolutely, I'm all in. But then there's the work of it.

it and we often default to oh well let's let's do gender equality like let's be equal and it's like no it's a bit more complex than that or let's default to the breadwinner provider role and that might be okay by agreement but there might be times when that doesn't work out you know and when that when there's a child born like yeah it might it might just need to shift right so then it's interesting because you've got these structures that are

that are saying, hey, be different in the world and the world is changing for good, I would argue, in a gendered space. But there's also this kind of this pullback to traditional ways and this uncertainty about am I losing something? Am I gaining something? Like is this, how is this playing?

So for a lot of guys, they work through that in their relationships. Yeah, I think when I listen to... Our YouTube channel has grown so much in the last couple of years and there's like 175,000 people that follow the channel now and tons of people tune into the podcast and on social media. And I really try and do my best to...

to tune in to all the commentary online, which at times is, it's like a little bit of, you got to brace yourself for it. You kind of got to get ready. But after a decade of this, it's like nothing much really phases me anymore on that front. My four-year-old can still get under my skin pretty well, but the social media kind of doesn't rattle me.

But it is interesting because I think for a lot of men and for women as well, it's like things have become quite complex relationally. And the sense is, you know, there's kind of this...

frustration of, well, how should things actually be? Because it is quite complicated. And for a lot of men, I think a lot of guys are like, I just want to know what should I do in the relationship? Give me the formula. And if you give me the formula, I'll execute on the formula and then everything will be okay. But it seems like it's kind of an ever moving target and the plane can never really land. And so I think there is this shift between

kind of a move back to those older, you know, like the trad wives and the trad, you know, husbands and that, that type of stuff. I think that movement has kind of been birthed out of that of, you know, just keep, keep things simple for better or for worse. And so it's interesting. Do you have any thoughts on that? Yeah, I, I, I hear for sure. You know, it's so interesting because a lot of times like a, that masculine norms are around, you know, routine and purpose. So,

So it lends itself to like the hard count, like the 50-50. It lends itself to tell me what I've got to do and I'll do it happily. Just it can't change. I need to stick with this plan and work through it. And I guess, you know, the flexibility around that is probably key. And then I know it sounds so basic, but guys over and over again, we talk to them about relationship breakups and their biggest thing was,

The biggest learning was about communication and I know that sounds so basic but it's like that was the learning. It was like I can't assume things, I need to be direct, I need to actually

Protect some time for us to sit down and work through what's going on, you know, in the relationship, not just what we're planning next weekend, but, you know, like what's actually happening, where are we headed, you know, in certain directions, where are we spending, where are we not, like what are our plans? Working through that and I just sort of, and what's working and what's not, you know, that honesty to get into that. Not always easy, but that was the major thing

thing from all of the guys that we spoke to in the breakup phase to just say, hey, I wish I'd been able to communicate a little bit better within that. So it was a key learning. So I know it sounds basic, but I think it's often a blind spot.

Yeah, you're speaking to the right audience. Communication. You mentioned, what was the term you used? Protest masculinity. Can you outline that for the listener? I didn't want to skip past that. Yeah, I've always been a fan of Raewyn Connell, who came up with this plurality of masculinities. And so Raewyn would talk about these different kind of groupings of masculinity, so the dominant ideals.

And then there was one particular caveat around this, which was called protest masculinity. So it was like guys who maybe didn't have the masculine capital that we idealize. So it might not be, it might be things around, you know, resources, career, those sorts of things. And for the guys who don't necessarily have it, they might protest that by taking risks, by proving themselves, you know, by pushing up against the structures that norm that.

So it's just a way of saying, you know, it's another way of saying, thinking about guys who might be subordinate or marginalized by those dominant masculine ideals. It's another way of just saying where their actions can actually be about contesting that whole piece and trying to prove themselves as philistines.

fitting into some part of those norms. So would this be affiliated with a political ideology or identity, or is it more pressing against the behaviors and the traits and the actions of modern masculinity or what's considered to be modern masculinity? Yeah, it could definitely be both. But the way we've used it in the context of mental health is definitely it's been more about these characteristics, these kind of states that men have.

Oftentimes we say they've got traits and the shortfall with that is traits are kind of immovable. They're kind of locked, but we think they're states and states are, they're by negotiation. They fluctuate depending on where you are and what you're doing. And in terms of health and mental health, oftentimes we know that what we construct around identity and

and that particular state of crisis or not would determine some of their behaviors. We don't think they're locked. So, yes, just to say that in the context of mental health, there are some elements of protest that are about, it's actually about buying into norms that are unhelpful for us. In the report, just to come back to this, especially on the piece of mortality, the report found that the two and five groups

men living in Canada will die prematurely before the age of 75 and that many of those deaths are preventable. I think I knew that men died prematurely. I've seen some of the data and I've read some of the research, but that was a much higher percentage than I expected. And I'm hoping that you can kind of flush some of that out because I've been on this big, I have a four-year-old and a 10-month-old. I've been on this big health kick lately of really getting

a serious look at what my health looks like in every way, shape, and form because it was something where

certainly in my 20s, I was that classic risk-taking, treating my body like garbage, eating whatever, drinking whatever. And it got better when I went to university just because of the career path that I was on and had to give up smoking cigarettes, which I got from construction and cut back on the drinking, which construction also didn't really help. But

But it wasn't something that I really looked at for a long time. And then obviously recently I did. So can you give some insight into what causes or what's contributing to so many men dying prematurely? Yeah, it's a complex question and I'll try to answer it relatively simply. Just to say the most often told story about men's health is that they...

live 4.5 years less than women. It's true. I just think it's unhelpful because when you actually get to the five causes, that's where the heart of the matter is at. So we sort of intimated, look, it's cardiovascular disease, it's cancers. And for those things, you can get screening early rather than wait for some kind of cardinal sign that you might be carrying something that's not working for you in terms of a pathology.

So, you know, those are a couple of things. They're the biggest killers. The unintentional injuries we've mentioned, suicide, a whole world of pain in that dire outcome, and we want to get upstream of that and also lower respiratory. So all of those things are earlier. So there's a couple of things that we need to think about. One is that there is an element of

you know, behaviors. Like it's about, are we seeking help? Are we actually, have we got some kind of interface with the healthcare system? Have we built a bit of a team around us that can help us with our health, especially around mental health? That's one of the things. Then it's like, well, what about services? Like, like how easy is it to get into services? We have fragmented pathways here a lot of times around mental health. If you don't have a job, you've got to have money to get access mental health care.

Like it, and none of that is necessarily easy. So we have to pay attention to what we say is the structural determinants of health within that context as well. And there's a generic component and we don't want to deny that, you know, you can only play the cards that you dealt, but we think behaviorally and also from the healthcare provider point of view and systems, we can do a better job, you know, in each one of those areas, we can just be on top of it. Yeah.

Yeah. I think one of the things just on the mental health side of things, and then we'll come back to physical health, which there were some really interesting findings on that side, but I've had a couple of folks on the show and they've talked about this study out in the UK that looked at men that had taken their lives.

and found that 90% of them had sought out some form of counseling or therapy. And then of those 90%, 80% of them had been deemed by the therapist or the counselor as low risk or no risk of suicide. And so I think that there's a gap in some of the field around being able to sometimes identify when men are really at that point because it can look very different. And I think one of the things I've continued to hear and see from people is

that when a man takes his life, it's almost always, not always, but it's very often completely a surprise. It's like there was no signs. I was completely shocked

None of us knew, you know, or we knew he was struggling a little bit, but he was seeing a therapist. It wasn't really that big of a deal, you know, didn't think it was that big of a deal. And all of a sudden he's gone. And so I think there's a gap in the mental health space and the therapeutic industry of being able to identify when a man is truly at that point of, you know, contemplation of something like that. I would love to get your insight and just sort of thoughts on that area. Yeah, there's so much in there, Conor, just to say, yeah.

Let me start with the three biggest risk factors for suicidality, you know, substance use, relationship breakdown, being single and depression. So right there, like that, when I talk about injury, interiority and isolation, like we want to get there before the isolation, because it's like, oftentimes, like what you say,

No clue, you know, no clue that someone's at risk and then they're gone and you're like, gee, what did I miss or what didn't I see or that there was no clue. It's so interesting in terms of with guys, suicidal thoughts are quite common. Plans are less common and attempts are less common again. So there's a kind of a pathway, like there's a kind of a, a tiered system on that. So sometimes if we could get guys to maybe.

get upstream, if we could get upstream with them and better identify depression for a start, know that when the 54% of marriages that end, it's actually a huge risk factor for guys, massive. And also substance use. Like we, if we were watching friends who are kind of like a little bit off kilter in terms of their amount of substance use and rather than explaining it away as what young men or men in general do,

I think we'd be in a better place of starting to work with that. As clinicians, you've got to ask about that. You have to ask about those things. And I've been like 20 years in the emergency room. I don't remember ever asking anyone about their relationships.

You know, like, and GPs, I don't think I've ever been asked as a patient about my relationship. So there's a blind spot. So I think we need to do a better job because you're right, 60% of men in Canada who suicide have been in professional healthcare in the 12 months prior to their death. So we're clearly, like, we're not engaging them to a point of retaining them to bring them back in. And I...

My caveat is I know we can't save everybody, but I think we can do a better job. If we've got 60% reaching out for help, in some way, shape, or form, we should be able to do a better job of retaining them. Yeah. Yeah, I agree a thousand percent. And I think, like I spoke last year, sorry, this year in March at, it's called the Psychology Networker in Washington, D.C., and it's like one of the biggest psychology conferences in North America. Yeah.

and talked, I led a workshop on how to work with men for therapists and psychologists. And one of the things that my colleague and I talked about was just this notion of how a lot of the times when therapists feel like the work with a man in session has kind of

been stunted or there's blocks or there's resistance or there's kind of this natural stagnation that starts to happen, there's a lot of looking at what's he doing? He's not opening up. He's not, the client, the patient is not opening up. And there's kind of this, I heard it framed the other day like this, which is, and I think it's a little extreme, but it's something along the lines of it's hard to see that men have problems when you view men as the problem.

And it really hit me because I think for a lot of men in our current culture, that's the internal consensus, right? You talked about interiority. It's like inside of a lot of men, there's this feeling of,

I'm just a problem to society, to women, to my wife, to my girlfriend, to my employer. And I think I'll just say one last piece. I want to hear your thoughts on all this. But I remember one of the guys that I work construction with, who is my mentor when I was working there with the company, went on to start his own company.

And later on, when I moved to New York, and this is a decade later, basically, my stepdad called me and told me that that man had taken his life, that he'd committed suicide. And he had a wife and three girls. And basically what had happened was he had started this company and got the company up and running and then had 40 or 50 employees.

And then the company started to struggle financially and it kind of put him into a tailspin and then things just got worse and worse. And he didn't tell people what was going on until basically the company was bankrupt. And then he kind of saw that as his only way out.

But I think it's those types of stories where if we have much more robust people and friendships and relationships in our lives where we can actually talk about some of those things, the likelihood of us going down that path is, I think, much lower. And he was seeing a therapist.

But I think, and again, it's not about the effectiveness or not of that therapist, because sometimes I do think that there's something within us as men that causes us to not want to fully open up and talk about the really dark, heavy shit that we're dealing with. Yeah, I agree. Concealment with interiority and isolation is massive. And if you think about

you know that sure you're in care and you have a therapist and that might be your once a month or week whatever release it's still confidential it's still on the side right so it might it might get you a little bit of i'm glad i could just talk about it but i know it's not going anywhere it can still be concealed it can still be isolating you know you've just got this confidant

not just i mean i think there's i think there's value in it and talk therapy a lot of guys like you know really you know enjoy it it's important to them but it's just to say it's not in and of itself the remedy this comes back to self-work and i think to your point about this notion of concealment and to the to the testimonial that you shared

It's so interesting. We've got all this work that's talking about, you know, men and vulnerabilities and isn't it great that guys talk about their vulnerabilities, but most of the media depictions of that are the Hollywood ending in which the guy has been vulnerable, but he's talking about his resilience because he's through it. He's on the other side of it.

And it's, you know, so it's like this, it's just that ending where you go, oh yeah, no, like it was really tough, but yeah, I got through it. And in the eye of the storm, we're not such good storytellers, you know, to get that narrative out in a way that would

I just think, affirm all of us in the struggles that are the everyday. Yeah. Yeah, I agree. I agree. I mean, we do on the podcast, I do live sessions with men. And it started off as just anonymous guests because there was such an influx of men that were reaching out for help. And there's just a lot of men. It's like, I can't afford to be in any of these programs. And so this was just an avenue to say,

I'll just sort of volunteer my time and work with men anonymously. And it's grown to something else where it's kind of part of the staple of the podcast. Because I also wanted to give people insight into, here's a man in the middle of his shit. Here's just what it looks like. Here's what it sounds like. Here's him dealing with, I'm stuck, or I'm going through the divorce, or I don't have access to my kids now, and I don't know how to deal with that. Or

I want to make this big transition in my career and it feels overwhelming and I'm terrified, right?

I think that's been very helpful for a lot of guys to kind of, oh yeah, I'm there. I'm in that same position because you're right. We often do hear about the arc to the other side, but not a lot of, I'm just in the middle of the crap. Right. Exactly. Because, you know, and that up to the other side, as you eloquently say, like, I mean, that's just reifying the norms about being resilient, self-reliant, you know, competitive, independent. Yeah. And for a lot of times,

For many of us, the day-to-day is tougher than that. And to acknowledge that, I think, is really, and to witness that and to hold that, I think, is incredibly important. No one's looking necessarily to get their problems solved.

But I think, you know, the concealment is a huge burden because it comes with shame and it comes with guilt all on its own, you know, let alone what's going on for you. So it's an interesting thing if you can get the conversation and we often say, you know, get the conversation with peers that are deeper, you know, not in terms of looking for remedy, but just in terms of those things that can just norm it and help to have someone who's got your back.

I think is really, really key for mental health. - Yeah, absolutely. Yeah, I mean, I do think that we need a direction to focus on sometimes and to march towards, but Jung said that confession is the first step in the therapeutic process, that this notion of revealing and pulling things out and actually letting other people know where you're at is the first step.

Why do you think that concealment is such a strong thing? Because in the research, in the report, I think you put that 65% of men waited more than six days with symptoms before visiting a doctor, which I've definitely been in that category. 27% of men waited for more than a month. 9% of men waited for more than two years. And I don't know what those symptoms were, but I think that's a very common thing that I've heard with

a lot of my male friends where they know something's off physically in their body or they know something's off mentally and there's just this hedging game of like, maybe it'll go away. Maybe I'll try this thing over here and it'll go away. Why is concealment and just sort of waiting such a huge part of this? I think for some guys and certainly in the context even now in terms of

mental health it's about you know the denial of weakness or in experiencing that problem and not being able to deal with it yourself as weakness so then I've got to reach out for help and then I'm indebted I think also for a lot of guys we don't have a relationship to the healthcare system you

We've had lives of work and families and growing up and feeling good and nothing would take us to the interface other than pain or fractures or dysfunction. So that's usually the ER that we'd be at, not our general practitioner. So that makes sense because it's a masculine space because we're overrepresented in every ER across Canada. So that's good.

Been there a couple of times. Yeah, the magazines in there where there are none, you know, so don't worry about that with the GP part and the funny wallpaper. Like, it's kind of like, well, you know, so there's these structural pieces again and there's also this reticence. And, you know, the number of guys that come to us and will say, oh, yeah, my partner, you know, said, oh, I should come in because...

You know, I'm getting up and peeing three times a night and like, ah, yeah, so that's what brought me in. It's like, it's almost excusatory, but it's also the affirmation that can come in. And that sounds old style, like real traditional, but we still hear that all the time. So there's this kind of this reticence, I think, you know, and you've got to have the right language too when you get into that healthcare provider space where you have to have the ability to say what's going on for you fairly quickly.

articulately a lot of times as clinicians we'll ask you closed-ended questions to get you into a spot on a clinical pathway so you were like stuck going yes no yeah nothing outside that so they're not easy interactions right so it's it's not excused to you but maybe it explains the reticence is like what we did find in that report as well is if a guy has a crap experience the first time second time going into health care

he's not coming back like he's generally like that's where your two-year people are like they're like nah nah I'm not doing that again because the experience wasn't good for me and I didn't feel heard or I felt like I was wasting their time you know I felt somehow indebted and foolish you know so those sorts of things are not heard and so

We've got some work to do, you know, in that regard, for sure. Yeah, I think what I liked about your report is it's not just sort of pinning the tail on the donkey of men and saying, you know, men just need to do better. You actually talk about building a healthcare system and workforce that delivers and sort of caters to men in some way. Maybe not caters to, but it's more specific to their challenges because

You talked about how men don't feel seen, heard or understood across the healthcare system. Can you talk a little bit more about that and maybe we can go into solutions after? Yeah, so one of the policy asks we make in the report is around health literacy. And health literacy used to be this, in academia, bit of a dreary silo. It was about like, can you remember the names of your tablets and to take them and what they're for? But we know that health literacy is more about how

you know, you interface with the system, how you understand the system, how you access it, what access you've got.

And just to say that within the Canadian context, we actually invented health promotion and health promotion is these community-based services, many of which are for men. If you think about men's sheds, if you think about the e-health space of Heads Up Guys. So these other, this diversification of services. So again, it's, which takes the emphasis off the traditional literacy you'd need to interface with the, with

with the hospital or you know the the family physician so again it's thinking about how we build those systems in a sustainable way that are outside the traditional hospital and acute care which is for problems not for health promotion how do we build that in a way that maintains and also brings guys in for where they're at because there's a lot of guys in the community that will show up at

at a men's shed or they will we get 50,000 people a month access heads up guys and it's it's about men's depressive symptoms I mean like it's pretty it's impressive right so it's this diversification we need to think about as well as helping our traditional health care providers just be a little bit more cued to what they're seeing and interpreting what they're seeing when they're working with guys.

Love that. Yeah, because I think one of the things I was reading through some of the data in the report, it was talking about how 42% of men report having experienced some sort of gender bias from their healthcare. 51% reported feeling that they were not actively listened to about their health concerns, which can, as you were saying, sort of reduce the likelihood that they're going to go back in. And then 67% of men are likely to seek help in the future, which

when needed, when they feel satisfied with the care that they receive. So clearly there's a correlation between, okay, I'm going in. And I do think that for some men there is, we've talked about some of that resistance

And so I do think it's important to kind of like, not nail it, but to get it, you know, to get that guy when he comes in and he's saying, listen, something's off. And to have that be taken seriously. And so how big of a focus is that for you with regards to the healthcare system and making sure that those men are really heard and understood when they go in? Yeah, it's certainly something and it relates to our second policy asks and it's

and it's about building those better healthcare systems. So there's a program from Movember, it's called Men in Mind and it's just, it's a really straightforward self-guided tour, eight modules about how to better interact with guys so as they'll come back. It's in the context of men's mental health but it's, you know, much to what the workshop you were talking about, probably similar kind of things about how you engage.

We know that if guys can establish expectations about what they're there for and going forward and the take-home work, that's really key. If they can establish a rapport and build some trust, and that might take a few sessions, but you've got to get them back in, you know, to build that and not rush them. Let them give them some room to sort of feel in it. So there's basic, basic principles about how to work with guys. And so, again, it's just trying to...

acknowledge that we can do a better job because if we're losing guys to follow up,

If they're one and done and gone because they were looking for the instant remedy and we haven't been clear about this is going to take some work, let's do the work of it, let's get through this, here's a plan, how does it sound, get some buy-in and get some trust that you're heading in the right direction. If we can do that, we can make a difference to their engagement and by extension their outcomes. What would you say to the average guy that's out there

who maybe has been resistant towards going to see the therapist because he's feeling depressed or going to have a talk in a program or joining a group or clearly feels like there's some health issue that he's dealing with, but he's kind of resistant towards going in. Because I think there's sort of two things I want to touch on. One is for that guy, because I think sometimes that guy

You know, it's like in AA, there's the saying, like, you can never make an addict go to rehab. You know, they have to make that choice. The first step of AA is admitting that you have a problem, right? And so it's almost like with men, like we almost have to get to that place of, yeah, something's off, something's not okay. But

I think for a lot of people that are in men's lives, they're kind of asking the question of how do I support my buddy, my brother, who I can see is struggling mentally or emotionally, or I can see he keeps bringing up this physical thing that he's dealing with, an injury, et cetera. How do I talk to him and support him? So I'd love to just piece those apart for the guy that's dealing with it and then for the people that are around that man. Sure. Yeah. So for the guys that are dealing with it, my advice is,

It is not a one-time ask. It's like you'll have to show up and ask for help and articulate what's going on for you more than once. And what's working for you this season will not be working for you next season. You have to switch it out. You have to build a team. It's like, you know, if your running game's not working, you better start passing, right? So it's working through that.

So is to take the pressure off the first time ask, the second time ask, understand the resilience is in accessing the help and building the right help for you. And that's tailored. The other thing I'd say to guys is don't wait for the crisis. We're so, we're so late in our actions that we arrive in

in a way that we're probably a little bit tilted and tainted in terms of what's being provided or what's on offer. And if you're under stress and you are in a crisis, it's very hard to take the help. You know, it's tougher. Your options are less. But if you go in when there's a niggler or there's just something not quite right or a little bit off or, wow, I actually want to prevent something, you know,

I want to just be better mentally, you know, for performance, for job, for any of those things, like just getting above, you know, the crisis, that would be perfect, right? Because then it can just be maintained and you can work through it. And then you've got all the tools you need when you do hit crisis. You know, there'll always be something, but at least you'll be equipped and it won't be in the eye of the storm you're trying to develop it.

And to your point, you know, when you're trying to help out guys in your life, you know, I default to Movember's ALEC acronym. You know, the A is for ask, open-ended questions. They're not easy to ask, but if you ask close-ended questions, you get yes, no answers from blokes. They're great at yes, no answers. And you're just locked in to have her to ask again. But just open-ended questions, expect them to speak and talk and disclose. You know, the L is for listen, and that's not always easy because a

guys go to would be to solve someone else's problems typically and we learn that in our own intimate partner relationships too that that's probably not going to be it's probably going to have to listen to a little bit of processing and work with that and the E is for elaborate where we sort of say well you know what's worked for you in the past what's been good for you historically to sort of switch them out of the problem into some sort of space around a remedy you know and also I'll drop in third person stuff sometimes and say I've

I've got a mate who does this and it seems to be working really well for him. I'm not providing advice, I'm just talking about someone else. I'm dropping it into a third person. And then that, the C in our, which is so important, is to check back in. And we do a really poor job of that. If a guy's disclosed stuff to you, you have to be back to him within 24, 48 hours. Even if it's a text, just a, hey, really appreciated, you know, the chat.

really keen to catch up next month. What are you doing on X, you know, X day and, and to sort of get it back in. And that norms the conversation, not as something that he's worried about having disclosed too much.

And that would, they sound really basic, but it's a, it's a great way to engage with guys. Guys do talk. I hear them all the time on the, on the bus, you know, I talk all the time. It's just the permission and it's just how we work with them. Yeah. Yeah. I love that. Love that. Yeah, it is. I think it's sometimes we overcomplicate it, you know, it's, it's, it is easier than we expect, you know, um,

I want to just shift gears a little bit before we have to wrap things up and talk a little bit about your take on some of the shifting landscape around masculinity. And if there's anything in the research that

that can indicate what's sort of happening. Because I think with men, one of the things that we've seen, I've had Richard Reeves on the podcast who wrote a great book called The Boys and Men. And I've talked quite a bit about this sort of decline in men that men are checking out from dating and relationships and the work environment and colleges. And there's kind of this little bit of an exodus that's happening. And men are really in decline in a lot of

And so I'd love to get your take on what's happening in terms of the shifting landscape within men and masculinity. Yeah, it's interesting. Just by way of background is to say when I started out doing men's health, always used the masculinities framework, you know, so always spoke to the masculinities in a theoretical kind of way about how we would work with men better.

And it's only been in the last, I reckon, five years that it's become more about a political kind of piece around masculinity that has direct implications for health. But the things I get asked to talk about these days, 10, 15 years ago, people were not contemplating

contacting me and asking me for my take on the world of masculinity. Right, right. So it's interesting. And I say it not as I'm not prepared to say stuff. I am. I'm happy to talk about it. But I think, you know, in terms of mental health, maybe some of the destigmatizing has got us into a place where we can have these conversations. And the masculinities piece is we used to never even use the word in interviews with people about health. And now the guys we speak to lead with it.

They talk about it like self-displacement. So just to say, I think it's great that we're having the conversation. So about masculinity and what's changing. I think the Me Too movement forever changed, you know, gender. I think for a lot of guys, there's been some challenges around what might be lost in that. And we often talk to fellas about the opportunity of that.

And I know it's like a, it's a very basic example, but I grew up watching male athletes, like professional athletes. There were no female professional athletes. And I often go, I so enjoy the soccer, the women's soccer, the basketball. I'm having a great time with that. I think it's so interesting. And it's like, we actually missed out. There's a generation of actually having missed out. So I'm very like, we're not losing here. There's some gains here.

And I'm not saying it's only about sport. I'm saying more broadly, if we want to do inclusivity and we want to accept diversity, which we do, and we want to talk about equity, those changes are massive for all of us. And there's gains. There's just gains to have. So the masculinities piece, I think there's a lot of guys out there that are really bought in, that actually have bought into that whole idea and are in that space, but still trying to work out their own identity within that because

because that shifted as well, you know, so from the things they grew up with, you know, or their exposure. So it's really complex terrain and it does have implications for mental health in men and sort of because their relationships, because of their substances, all of it. So

I don't know that I have the answer. I appreciate folks like Richard Reeves, Zach Seidler who trundle out all of this piece about what's happening with men. It's really, really key and it does have implications for health. I just, you know, again, I just want to acknowledge the diversity within the category of men, the plurality. And so when we situate something as crisis based on an N of 1500 or, you

you know, having a particular pocket of men that we're talking about. I just don't want to do a disservice to, you know, the diversity that is within the category of men. Some guys might not be quite, you might not be, you might be misrepresenting some guys within that, but I think it's interesting to try and think about the patterns, but you never want to lose sight of what's, what's diverse within the category of guys too and masculinity. Beauty.

Beauty, my friend. Well, thank you so much for joining me today. And thank you so much for the research that you and your team have been doing. I mean, there's some really, really important stuff in here. And so we're going to have a link to the research. But where can people find more about you and the work that you're doing? Yeah, we're menshealthresearch.ubc.ca.

We've been going for 20 some years now. You know, we do the social medias and we produce a lot of stuff that we share. We also curate a lot of things that we find interesting in the space of masculinities and men's health. And you can find us live too on the 22nd of July.

at UBC Robson launching this report in a conversation that includes, you know, five panelists all talking about different aspects of mentor promises to be a great night out there at UBC Robson. Awesome.

Awesome. Well, thank you so much for joining me and for everybody that's out there. We'll have the links in the show notes for you to check out. Don't forget to man it forward. Share this conversation with a guy or a person that you know will enjoy it. Might spark a great conversation. And as always, until next week, this is Conor Beaton signing off.

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