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The gender gap in mental health service use

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This study examines why men engage less in mental health service use, by studying how gender is performed in interactions, following the doing gender perspective. We hypothesize that seeking help for mental illness may constitute a gendered role conflict among men since help seeking is associated with femininity. Therefore, we expect that men will recommend reliance on self-care options to other men, and in cases in which professional treatment is recommended, they will prefer medication to psychotherapy. We also expect that men will report greater stigmatizing attitudes.


The survey Stigma in a Global Context-Belgian Mental Health Study (2009) conducted interviews of a representative sample of the Belgian general population (N = 743). The vignette technique, depicting depressive and schizophrenic symptoms, was used. Multiple linear and logistic models were estimated in SPSS.


In male vignettes, self-care is more likely to be recommended, both by male and female respondents. Men are less likely to acknowledge the helpfulness of psychotherapy and women rate psychotherapy as less helpful when judging a man compared to a woman. Men rate tranquilizers as more helpful for other males than that women do for other females. Furthermore, male respondents seem to ascribe more shame and blame to the situation.


The gender gap in mental health service use is due not only to men and their negative attitudes toward help seeking, but also to structured social norms that are reconstructed in interactions. Women also contribute to the maintenance of masculinity norms.

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We wish to thank Bernice Pescosolido for the opportunity to collaborate on this project and the Brocher Foundation to provide a stimulating environment to work on this paper. This project was supported by a grant from the Research Foundation (FWO) Flanders, and from the Special Research Fund of Ghent University (BOF).

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Correspondence to E. Pattyn.



The depression vignette was as follows: Jan/Marie/Ahmed/Fatima is a Belgian/Turkish man/woman. For the last several weeks NAME has been feeling really down. She/he wakes up in the morning with a sad mood and heavy feeling that sticks with her/him during the rest of the day. She/he is not enjoying things the way she/he normally would. In fact, nothing seems to give him/her pleasure. Even when good things happen, they do not seem to make NAME happy. The smallest tasks are difficult to accomplish. She/he finds it hard to concentrate on anything. She/he feels out of energy and cannot do the things she/he usually does. And even though NAME feels tired, when night comes she/he cannot go to sleep. NAME feels worthless, very discouraged and guilty. NAME’s family has noticed that she/he has lost appetite and weight. She/he has pulled away from the family and just does not feel like talking.

The psychosis vignette was as follows: Jan/Marie/Ahmed/Fatima is a Belgian/Turkish man/woman. Up until a year ago, life was pretty okay for NAME. But then, things started to change. He/she thought that people around him/her were making disapproving comments, and talking behind his/her back. NAME was convinced that people were spying on him/her and that they could hear what she/he was thinking. NAME last his/her drive to participate in his/her usual work and family activities and retreated to his/her home, eventually spending most of his/her time on his/her own. NAME became so preoccupied with what she/he was thinking that she/he skipped meals and stopped bathing regularly. At night, when everyone else was sleeping, she/he was walking back and forth at home. NAME was hearing voices even though no one else was around. These voices told him/her what to do and what to think. She/he has been living this way for 6 months.

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Pattyn, E., Verhaeghe, M. & Bracke, P. The gender gap in mental health service use. Soc Psychiatry Psychiatr Epidemiol 50, 1089–1095 (2015).

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