Why is it so hard for men to say “I’m not okay”?
Three in four suicides registered in England in 2024 were men, and middle aged men still have the highest suicide rate of any group. Behind those numbers are men who were often struggling long before anyone knew.
We’ve talked about this a lot on our podcast, Tickety Boo, including with BBC radio presenter Phil Upton. This article brings together what we’ve learned, and what you can do if you’re worried about a man in your life or at work.
The rules boys learn early
“Big boys don’t cry.” “Man up.” “Get on with it.”
Messages like these can seem harmless at the time. But they quietly shape a lifetime of carrying everything alone. Toughness gets taught. Emotional language often doesn’t. So feelings get pushed down until they come out sideways, or until they become too heavy to carry.
Add the pressure to be the provider, the protector and the strong one, and it’s easy to see why so many men reach crisis point before they ever ask for help.
Struggling doesn’t always look like sadness
Poor mental health doesn’t always walk through the door looking sad. In men especially, it can look like:
- Anger, or a shorter fuse than usual
- Taking risks they wouldn’t normally take
- Drinking more
- Not sleeping
- Turning up late, or going unusually quiet
- Taking the mick out of everything
- Making mistakes they wouldn’t normally make
- Somebody who has always been reliable suddenly becoming unreliable
None of those on their own means somebody has a mental health problem. But they’re changes, and changes are worth noticing.
Men will talk. It’s how we ask that matters.
People sometimes assume that because a group is mostly men, nobody wants to talk. I don’t buy that. I’ve had some incredibly open conversations in rooms full of men. But you have to earn your way into them.
Walk in talking about “creating a safe space to explore emotional wellbeing” and you’ve lost half the room before you’ve finished the sentence. Ask “Who here has noticed a mate who’s gone a bit quiet?” and hands go up. Now we’re talking about something they recognise.
The barrier isn’t always that men won’t talk. Sometimes we’ve created a way of talking about mental health that doesn’t sound anything like them.
Sometimes humour is the doorway. Sometimes the person who takes the mick for the first twenty minutes asks the most serious question of the day.
How to start the conversation
You don’t need the perfect words. Keep it simple and sound like yourself:
“Mate, you’re not quite yourself today. Everything alright?”
- Ask twice. If he says “I’m fine” straight away, don’t always leave it there. “Are you sure? You just don’t seem quite yourself.”
- Listen more than you talk. You don’t have to fix it. Letting him say it out loud is often the first step.
- Know where to point him. His GP, a helpline, or support through work.
If you’d like more on this, our guides on how to start a conversation about mental health and what to do when someone says “I’m fine” go into more detail.
At work
Many men spend more waking hours with colleagues than with family, which means colleagues are often the first to notice a change. In mostly male workplaces like construction, engineering and energy, that matters even more. We’ve written about mental health first aid in construction, and how exhaustion builds in our guide to burnout warning signs.
Training people to notice and ask, in language that sounds like them, is one of the most useful things an employer can do.
If you need support now
Samaritans: call 116 123, free, any time.
Breathing Space (Scotland): call free on 0800 83 85 87.
Out of hours in Scotland, call NHS 24 on 111. If somebody is in immediate danger, call 999.
Questions people ask about men’s mental health
Why do men find it hard to talk about mental health?
Many men grow up with messages like “man up” and “big boys don’t cry”, and learn toughness rather than the language for feelings. Add the pressure to be the provider and the strong one, and talking about struggling can feel unsafe.
What are the signs a man is struggling with his mental health?
It doesn’t always look like sadness. Common signs include anger or irritability, drinking more, taking risks, poor sleep, going quiet, making unusual mistakes, or a reliable person becoming unreliable.
How do I start a conversation with a man about his mental health?
Keep it simple and sound like yourself, for example “You’re not quite yourself today. Everything alright?” If he says he’s fine, it’s okay to ask a second time, then listen rather than trying to fix it.
Where can men get mental health support in Scotland?
Samaritans on 116 123 and Breathing Space on 0800 83 85 87 are both free. A GP is a good first step, and NHS 24 on 111 is available out of hours. In an emergency, call 999.
You can hear more conversations like this on the Tickety Boo podcast.
This article is part of our practical guide to workplace mental health training for UK employers.
Help your team notice and ask
Talk to us about mental health first aid training that sounds like your workplace. You can also see all our First Aid for Mental Health training.