Saúde mental e masculinidades : experiências de sofrimento psíquico e autocuidado narradas por homens

Abstract

Introduction: Social construction of gender changes the way males express emotional distress and self-care. The cultural expectation that men should not show feelings leads them to seek out for health services in situations of unbearable emotional distress. Postponing mental healthcare can compromise people’s psychological and social functions. Healthcare policies and infrastructure, as well as healthcare providers’ capacity are also shaped by low demand and gender stereotypes. Consequently, the reception provided in healthcare services does not encompass the complex and diverse ways in which men express themselves, resulting in their discomfort, unmet needs and reinforcing their absence. Objective: To understand social constructions of masculinities within the context of mental distress and self-care from the perspectives of men. Methodology: This study is a qualitative research based on interviews guided by a thematic script with questions about mental distress and self-care strategies completed. The interviews were conducted with 13 male participants linked to the mental health service in the city of Santos, São Paulo, Brazil. The data analysis was conducted through immersion in the empirical material, followed by coding and categorization. The interpretation of the results was based on the analysis of the narratives, which were grouped into two main categories: (1) Mental distress experiences: origin and ways of expression (2) Self-care strategies. Results: Mental distress experiences were illustrated by stories of failure in social life, at work and in relationships, having its origin attributed to the abandonment of the female figure. The expression of distress was presented through traditional depressive symptoms, violence, substance abuse and suicide attempts. Work has proved to be a central organizer in men's lives. Among the self-care strategies presented, the most prominent experiences were about accessing and remaining in mental healthcare service linked to a combination of elements of distraction, pleasure and privacy, with emphasis on religion. Discussion: The various social constructions of masculinities revealed different experiences and forms of expression of psychological distress, with a particular emphasis on activities that involve the numbing of consciousness, such as the use of psychoactive substances. Other activities that involved distraction and pleasure, albeit individually, are considered self-care strategies for promoting self-awareness and autonomy. Religion and familial bonds restore lost community ties and prove to be a way of coping with and reinterpreting suffering through forgiveness. Returning to work, financial independence or fulfilling a professional dream proved to be an important self-care strategy, as it decreased the feeling of social failure. On the other hand, the loss of identity, coupled with the idealization of a masculinity model, resulted in suicidal attempts and thoughts. The origin of mental distress associated with the female figure is related to a social construct rooted in misogyny and neoliberalism. Other forms of abandonment, which evade conscious narratives, contribute to a condition of mental distress and vulnerability, including the abandonment of the paternal figure and the State. Conclusion: Experiences of mental distress and self-care are shaped by social constructions of gender and the neoliberal means of production. As a result, healthcare services need to provide space to reflect over the complexities and singularities of male expression.