Facilitators and Barriers to the Utilization of Psychotherapeutic and Psychiatric Services among Men with Depression – A Qualitative Interview Study

Psychother Psychosom Med Psychol. 2026 Apr 23. doi: 10.1055/a-2842-9225. Online ahead of print.

ABSTRACT

OBJECTIVE: Men with depression are underrepresented in psychiatric and psychotherapeutic care, despite their increased risk of suicide. Studies point to the influence of traditional masculinity norms, stigma-related attitudes, and gender-specific coping patterns on help-seeking behavior. However, it remains unclear how affected men themselves interpret barriers to and facilitating conditions for the use of professional help. The aim was therefore to explore these perspectives using a qualitative approach and to derive practice-relevant implications.

METHODS: In a qualitative study, ten men aged 22 to 64 years were interviewed about their experiences with mental illness and professional help. Data were analyzed using content-structuring qualitative content analysis according to Kuckartz and Rädiker. In addition, two subscales of the Male Role Norms Scale (MRNS; status and toughness norms) were administered to assess normative beliefs about traditional masculine roles and to contextualize the qualitative findings.

RESULTS: Key barriers were shame, internalized stigma, a pronounced need for autonomy, and fears of losing control or facing professional disadvantages. Help-seeking often occurred only after the onset of acute crises. Facilitating factors comprised social support, positive experiences within the healthcare system, and low-threshold services. Women in close relationships played a crucial role in motivating help-seeking. MRNS scores were mostly below average, indicating a comparatively low adherence to traditional masculine norms.

DISCUSSION: The findings confirm known associations between masculinity norms, autonomy-related expectations, and delayed help-seeking, and further differentiate them by providing insights into subjective interpretive patterns and biographical contexts. They highlight the importance of social support and low-threshold access to services. Overall, the findings support gender-sensitive mental health care that both reduces barriers and makes targeted use of existing resources.

CONCLUSION: A better understanding of men’s non-utilization of psychiatric and psychotherapeutic services may provide insights for the further development of mental health care provision. Central strategies include low-threshold contact options, the involvement of social networks, and the reflection of traditional masculinity norms in prevention and treatment.

PMID:42025189 | DOI:10.1055/a-2842-9225