The quiet crisis of older men in a world embracing mental health

The Mental Health Project is a Seattle Times initiative focused on covering mental and behavioral health issues. It is funded by the Ballmer Group, a national organization focused on economic mobility for children and families. Seattle City University offers additional support. The Seattle Times maintains editorial control over the work produced by this team.

Under the fluorescent lights of a community mental health clinic in King County, I opened the locked door to poke my head out into the lobby. Jack? A white-bearded man stood stiffly, gathered his backpack and Big Gulp, and met me to return to my office. As I held the door, I immediately smelled the familiar smell of Marlboro cigarettes mixed with machine grease, the same smell of holding the flashlight for my father on childhood weekends while he fixed some obscure valve or gasket.

Jack and I settled on our respective sides of the desk and over the next hour we got to know each other during his psychiatric evaluation. He shared his story of struggling with untreated depression and ADHD while working in warehouses, losing girlfriends and apartments, and in and out of prison. I shared my time spent working as a line cook and laborer, and as my parents’ helper in suburban Chicago, installing carpet, painting ceilings, and just about any odd job in between.

Our first meeting ended with a plan to begin regular counseling and a trial of medication for her depression and ADHD symptoms. For the next two years, we met every few months. He updated me on his life, how the meds were working, and if the fish were biting in his favorite spots. What I came to understand was that in addition to being a smart fisherman, Jack was also a rare bird in this world of community mental health, an older man looking for help.

Estimates from the Centers for Disease Control and Prevention consistently show that older adults (age 50+) and men receive mental health services far less often than their younger adult and female counterparts. The reasons behind this are clear: for older generations, talking about mental health and illness was deeply stigmatized, compared to younger generations who see it as an essential part of overall health. For older ones menthe stigma only deepens when we consider that traditional restrictive masculinity considers even the smallest act of seeking help to be feminine (read: weak), rather than a fundamental part of their humanity.

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The ripple effects of this underlying resistance to help-seeking are felt everywhere. Older men have worse mental health outcomes than older women, and overall life expectancy is about six years shorter.

Older men are in what psychologist Niobe Way calls a connection crisis, with 15% of men in a 2021 national survey saying they have no friends, up 3% from 1990. This social isolation, in turn, it adds an emotional burden to couples and families.

When men feel they have no one to turn to, many will turn to substances, all too often to tragic ends. Men account for the vast majority of despair deaths, including 70% of opioid overdoses and 75% of alcohol-related deaths.

Most worryingly, men account for almost 80% of all suicides. Age itself is a risk factor, as men are more likely to die by suicide as they get older. Other suicide risk factors for men include being a veteran, being LGBTQ+, living in a rural area, owning a gun, working in a blue-collar job, and being Native American or non-Hispanic white. In 2020, white men alone accounted for 70% of all suicide deaths.

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For too many of us, though, statistics and studies are cold comfort when we’ve felt the impact firsthand. For me, it came early on a Friday morning in September 2020 when my father took his own life in a surprising way. When it came to my father, I was his son before I was anything else. As his son I assumed he could handle whatever happened to him as his response to any concern was I’m fine and always similar well In retrospect, the signs of her quiet depression and distress were there, but even a doctoral-trained mental health professional like me missed them.

Upon learning this, you may begin to feel like all hope is lost for older men, but there are many organizations that are already doing the work to help men of all ages. Nationally, the best known may be Movember, while locally the Seattle Seahawks have been at the forefront of promoting mental health awareness through their Mental Health Matters campaign. Some community mental health clinics offer support groups such as Dudes and Donuts, a weekly men’s group at the Valley Cities Midway Clinic.

In countless small ways, we each reinforce the stigma against getting support when we assume older men are okay because we’ve never been proven otherwise. This quiet stoicism sows the seeds of loneliness when friends and family eventually stop offering support to the man who never accepts it.

Research shows that the key to overcoming this bond lies in meeting men where they are, rather than trying to rewrite their entire gender playbook at once. Asking about feelings may not be a start, but asking about sleep, motivation, and hobbies can be an indirect way to get a picture of possible depression or anxiety. Going to the doctor or therapist can be reframed as a sign of strength and a solution to a problem rather than ignoring it.

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Both personally and professionally, I’ve seen both sides of this bind for older men: those who struggle alone and can’t escape, and those who use their pride to find not only support, but meaningful connection.

Once Jack got better and his treatment was stable, I asked my first question again: What brought him to the clinic in the first place? With smiling eyes, he replied that I’m old enough to know what I don’t know, and I got tired of thinking that I could do it all by myself. Never one for too many of those emotional things, he jumped in to ask me if I wanted to see photos of his latest salmon catch, and of course I said yes.

Noah Weatherton, DNP-PMHNP, ARNP, is a psychiatric nurse practitioner at the Kent, Midway and Federal Way clinics in the Valley Cities. Noah serves on the board of a national non-profit organization, Partnership for Male Youth. She earned a Bachelor of Science in Nursing from the University of Wisconsin-Madison and a Doctor of Nursing Practice degree from the University of Washington. Noah is passionate about serving and supporting men of all ages, their families and their communities. Previously, he worked on the Doorway Project at the UW Homelessness Research Initiative, focusing on serving homeless youth and young adults in Seattle.

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