While the COVID-19 pandemic has heightened mental and physical health concerns for everyone, the ongoing need to help some men overcome resistance or fears about seeking health care has become even more pronounced.
However, a form of health-care access that is rising to the fore during this unprecedented time may offer a solution.
In conversation with the Georgia Straight by phone, UBC’s Men’s Health Research program founder and nursing professor John Oliffe explained that due to pandemic restrictions, many men who have traditionally worked in the public sphere and are “outward facing” may experience unrecognized challenges in shifting to working from home.
“A lot of guys are probably trapped, in some ways, in the domestic sphere, and so some of those things in the public domain that they used to operate in are gone,” he said, “so that changes identity and that changes roles for guys.”
Issues such as employment fears or job loss, sharing the home environment with partners or children while working, and increased complexities of “hunting and gathering” with limited finances can add to tensions and conflicts, he said.
These factors could also exacerbate mental-health issues.
In simple terms, Oliffe summarized depression as “regret about the past” and anxiety as “worry about the future”, and he said the pandemic is a “perfect storm” that combines the two, creating time to reflect upon the past during great uncertainty about what will happen next. He added that being male as a risk factor for vulnerability to the coronavirus can also increase anxiety.
Oliffe said the risk for male suicide increases during times of economic hardship and that this pandemic could have mid- to long-term implications for male health. According to Statistics Canada, men are three times more likely to commit suicide than women.
A recurring problem in male health, Oliffe explained, is that many men may remain oblivious to their own issues or feel they can self-manage them—until it’s too late.
“The thing that tends to get guys in [to seek help] is pain, and often pain is late in a lot of disease processes,” he said. He explained that because many men “tend not to look for help because they feel like things are going along well”, they don’t have a lot of familiarity or connection to health-care systems when something does emerge.
Codes of masculinity can also be antithetical to self-care.
“There’s a long string of literature about men and invincibility and that notion that you’ve got a robust body and you’ll work your way through the challenges—you know, ‘No pain, no gain,’ that kind of ethos,” Oliffe said. “Many guys tend to go hard in terms of testing their limits, and there’s a kind of competitiveness that underpins a lot of the things that guys do, even in terms of risk-taking with their health.”
Accordingly, the erroneous association of weakness with asking for assistance can lead some men to avoid or even fear health care. Oliffe added that the stigma of mental-health issues can be a “double whammy”.
Several studies have found that men are more likely than women to view depression as a character weakness; a 2015 UBC study revealed that more men than women (57 percent versus 39 percent) would feel embarrassed about seeking help for depression.
Oliffe believes that the confidentiality afforded by virtual health care could help men feel more comfortable.
However, he remains concerned that time restrictions on online consultations will be the same as those on in-person ones, placing pressure on men to articulate quickly.
“There’s good evidence that suggests that guys might have a fairly challenging time articulating exactly what’s going on for them, especially in terms of mental health,” Oliffe said.
Nonetheless, Oliffe does believe that remote access can improve health-care options for residents in rural or outlying locations.
Overcoming both physical and mental barriers with a range of access options is a goal of the Vancouver-based queer-male-health organization Health Initiative for Men (HIM).
HIM associate director Aaron Purdie said that men who have sex with men (MSM) face many hurdles in seeking health care, as many “already deal with daily violence that is invisible to most people”, and many closeted males feel that “the idea of being out to your doctor is a scary idea.” Nonetheless, many need to discuss sexual-health issues in detail so they can be addressed accurately.
Although remote health care can offer privacy, Purdie pointed out that having only one kind of access is limiting; he emphasized that a diversity of health-care options, including in-person services, needs to remain available. For instance, many MSM prefer to have in-person appointments because they feel alone.
However, Purdie said he does believe that virtual connections, including to social groups, can be a “powerful option”, as they can help to reduce feelings of isolation and can also help men living in suburbs or remote places to receive services or programs that may not be available in their area.
“Any change that any organization can make to accessibility are good changes,” Purdie said.
For those concerned about visiting a doctor's office because of the pandemic, a telehealth provider can put them in contact with physicians and other health-care professionals.