From the deer head hanging on the wall in his virtual study to the fresh-caught trout he may produce from an icebox and clean with his pocket knife if you fail to click a link soon enough, Dr. Rich Mahogany is a guy’s guy.
Paunchy, with a rusty mustache and a comforting timbre to his voice, Dr. Mahogany is a fictional therapist, a focus-group creation who packs every good-ol’-boy stereotype into one website – making your all-knowing but profanity-prone uncle the spokesman for why a man needs to talk about his emotions.
“Here we won’t be complaining, whining and moping about,” he says, closing his chainsaw manual. “We’ll be getting off our keisters and form-tackling feelings like anger, stress and sadness.”
Dr. Mahogany is the comic face of Mantherapy.org, an online mental-health-awareness campaign produced in Colorado after two years of research and released this week. It is definitely an innovative alternative to more traditional campaigns featuring fierce-looking firemen and optimistic slogans. Instead, Dr. Mahogany demonstrates man-yoga in shiny blue athletic shorts from a cringe-worthy camera angle; at opportune moments, he points to the red phone in the corner that, with one click, produces a suicide-hotline number.
Humour and mental health is a tricky combination, but studies show that many men soon forget why the fireman was on the bus poster, if they noticed him at all. And men are far less likely than women to tackle problems by getting off their keisters and seeking a real doctor for help.
The cultural bias is that strong men keep it together and don’t lie on couches and spill their guts, unless they are HBO television characters. Meanwhile, experts are predicting that male joblessness and fragile work environments will increase depression and anxiety among men, and make them even less likely to tell their bosses if they’re in trouble. Middle-aged men already have the highest rates of suicide in the Western world, and there is evidence that those numbers are rising.
Dr. Mahogany represents an increasing awareness that there’s a gender element to mental health – and health in general – that has been overlooked when it comes to providing services, and ignored in research that has clumped the sexes together.
It’s not only that men and women tend to have different attitudes about mental health. Their symptoms are often not the same, and the forms of therapy that succeed with them, as well their responses to medication, may be different.
The shortage of male therapists hasn’t helped – all but a small fraction of graduates in psychology and social work are women. Even trivial design decisions, such as the pastel walls and women’s magazines that are the mainstay of many doctor’s offices, send a message, as one researcher put it, that “this is not a man’s space.”
But gender bias ripples throughout the entire health-care system, from cardiac care to cancer treatment, influencing how quickly patients get help and how seriously their symptoms are interpreted. Women having heart attacks have been sent home because their chest pain was interpreted as anxiety; men have died from suicide after their depression was misread as mere stress.
This week, President Barack Obama signed a law that requires the Food and Drug Administration to report gender differences in clinical trials – a move long advocated by women’s groups. A similar directive, requiring gender to be a consideration in studies, was issued by the Canadian Institutes of Health Research (CIHR) in December, 2010.
“We have a gender blindness when it comes to thinking about treatment and outcomes,” says Joy Johnson, the scientific director for the CIHR’s Institute of Gender and Health.
“How we began thinking about depression really came out of studying women. … Sometimes there are no differences, and that’s fine, but we are not paying attention. There are a lot of unanswered questions.”
Fifteen years ago, feeling overwhelmed and anxious at work, Robert, a Toronto-area lawyer, found himself in a therapist’s office. “It was the kind of therapy where you go in, and they sit there and wait for you to speak,” the 45-year-old recalls.