With the pressures of the COVID-19 crisis on mental well-being, Cayman Health shines the spotlight on the issues being faced by men.
Two experts on men’s mental health are psychiatrist Dr. Marc Lockhart, chairman of the Cayman Islands Mental Health Commission, and Dr. Stenette Davis, psychiatrist at the Health Services Authority.
Here, they talk about the risks, symptoms and treatment of this often overlooked issue.
What are some of the pressures that men in the Cayman Islands and across the wider region are facing?
The socialisation of boys and men to ‘be strong’, with the expectation that being strong means suppressing emotions, feelings and asking for help, has contributed significantly to the manifestation, onset, and complexity of men’s mental health challenges.
In societies where a hyper-masculinised approach to maleness is held as a norm, mental health challenges can be more insidious, with complex presentations.
What are the symptoms that family members/friends should look out for?
Challenges with financial stability, especially during an economic downturn, like the COVID-19 pandemic, along with cultural expectations of the male being the ‘breadwinner’ and ‘head of household’, complicates how men cope with self-doubt, appraise self-esteem and seek comfort and guidance.
Symptoms consistent with reduced ability to perform tasks needed to cope with the normal stresses of life should be a cue that something is amiss. This includes a change in mood, with men experiencing not
just periods of sadness and depression, but irritability, anger and short-tempered episodes.
Reduced enjoyment in activities, disturbances with sleep, appetite, including decreases or increases with both, changes with thinking, unusual beliefs, preoccupations or activities with any increased use of alcohol or other substances, are some of the symptoms that family and friends should look
At what point should men themselves seek help?
A man should seek help when he finds difficulty coping with the normal stressors of daily life and that he is not living up to his full potential. A discussion with a primary care physician is a good starting point if any of the aforementioned symptoms are noticed by the person or a loved one. Taking the discussion seriously and persisting with recommended interventions is extremely important, as earlier intervention can forestall a more complicated onset of illness.
How important is the new mental health facility in East End going to be for men’s mental health (along with other mental health patients, in general)?
While the facilities at the HSA provide a wide range of services, an area of continued need is for those with serious and chronic illness requiring longer term treatment.
Efforts are underway by the Cayman Islands Government to complete the construction of a therapeutic community facility in East End by the end of 2021. This facility will play a vital role in the continuum of care and provide a missing component that is required for reducing the burden of disease.
This facility will be instrumental in providing the compassionate, evidenced-based rehabilitative, occupational and social skills rebuilding vital for those with serious and persistent disorders. This includes a large segment
of men with chronic and serious disorders.
What is the greatest piece of advice you give to anyone facing mental health challenges?
The best advice that I would give, based on more than 20 years of practice, is to seek guidance or help early. Do not feed denial, if you or a family member is having changes in mood or behaviours that are affecting functioning, social interaction, work or
school pursuits, then talk with a professional.
This can include your family doctor, school counsellor, therapist, psychiatrist, or a spiritual or religious advisor.
Care and consultation provide confidentiality without stigma. Interventions to re-stabilise mental health challenges come in many different forms: talk therapy, occupational therapy, intensive psychotherapy, medication assistance, cognitive assessments and other emerging and novel treatments.
There are risk factors for mental illness that are ubiquitous and sets up Caribbean men for mental illness, just like other nationalities.
A growing trend in Caribbean men is an education deficit and, as such, a growing number of men are unemployed or have low- income jobs. Financial distress is an invariable stressor.
Loneliness is an under-reported problem as Caribbean men are not traditionally taught to talk about their feelings. This means men socialise to displace their feelings but do not address it; this creates a disconnect of being alone in a crowd.
Stigma is also an overwhelming force where men feel that their manhood is challenged if they were to admit to having symptoms of mental illness.
Outside of mental health personnel, other medical practitioners are less likely to screen males for mental illness. Women are also more likely to be supported if they become mentally ill. Males are disproportionally homeless if they develop serious mental illness like schizophrenia. All of the above creates barriers for men to access treatment until their symptoms become overt or seriously impact their lives.
What kind of stigma is attached to mental health issues in Caribbean culture, how difficult is it to overcome and what is being done to do so?
A large portion of Caribbean folks still attribute mental health issues to spiritual cause or witchcraft. There is still a belief that mental illness is a result of mental inferiority or weakness. There is also unreasonable fear of being harmed, or wondering if the person will ‘flip out’.
Oftentimes, employers do not want mentally ill persons in the workplace, automatically assuming they are not fit for work.
Are you seeing that the COVID pandemic is adding challenges to men’s mental health?
COVID has increased the amount of clients being seen for anxiety, depression and, of concern, suicidal thoughts. There has also been an uptick in persons starting to use drugs excessively, or persons who were recovering addicts relapsing.
Can you give some self-help tips and practices for men if they are feeling under pressure, to help ease mental health strain?
• Firstly, admit there is a problem.
• Learn to identify the emotion you are feeling and the thought going with emotion.
• Next step: ask is this true or just the way I feel?
• What is a more useful thought that helps me move forward?
• Exercise 30 to 45 mins at least three times per week, especially with friends.
• Practise deep breathing.