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Why Men from Rural Communities Avoid Seeking Mental Health Counseling


Men, in general, are far less likely than women to seek professional help for mental health problems. But a new study, led by Joseph H. Hammer and David L. Vogel of the Department of Psychology at Iowa State University, suggests that men from rural communities are even more resistant than urban-dwelling men when it comes to getting psychological counseling. The study expands upon previous research by the team and explores the factors that create barriers to treatment. For example, in the study, Hammer and colleagues identified self-stigma as the primary reason that men from rural areas do not reach out for help.

Masculine norms of success, power, emotional control, and self-reliance are evident throughout Western cultures. In America, men are taught early on the significance of these norms. Asking for help and showing emotional vulnerability is perceived as a sign of weakness and often makes young boys the target of ridicule by family members or peers. To avoid this victimization, young boys and teens will resort to internalizing and will transfer external stigmas regarding counseling to themselves as self-stigmas.

For this most recent study, the researchers interviewed 4,748 men from both urban and rural communities. They discovered that the men from rural areas were twice as likely to conform to traditional masculine norms as their urban peers, which led to concerns about treatment. In particular, there are fewer clinicians in rural communities, so confidentiality was of major concern to the men. Also, the targeted treatment designed to address specific mental health problems could require travel to another town, resulting in time away from family or work, threatening self-reliance and role fulfillment.

Although income did not influence men’s motivation to seek help, education did. In all communities, men with the least amount of education resisted treatment because of self-stigma more than any other group. The researchers believe nonconventional treatments, such as adventure therapy or internet treatment programs, could provide resources that would appeal to men with strong masculine norms, particularly those in rural communities. Literature aimed at dispelling the stigma of treatment, available in doctors’ offices or through community clinics, could also help these men overcome their resistance. The researchers added, “Working to build greater trust in the therapeutic relationship may also reduce the perceived threat of seeking help to clients’ self-esteem and confidence.”

Hammer, J. H., Vogel, D. L., & Heimerdinger-Edwards, S. R. (2012, January 23). Men’s Help Seeking: Examination of Differences Across Community Size, Education, and Income. Psychology of Men & Masculinity. Advance online publication. doi: 10.1037/a0026813

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  • Austin January 28th, 2012 at 5:25 AM #1

    I think that men from rural areas are more hesitant to seek treatment because they are not as familiar with mental health care as people from the city. For urban dwellers maybe this is the morm, or you know someone in treatment. This is not the case in areas of the country that are more isolated. And add this to the fact that care like this is not as accessible and there you have it.

  • Paige M January 28th, 2012 at 7:46 AM #2

    It would be sad to think this but maybe these are men who have been made to feel ashamed of the fact that they have some mental health issues, like there is something taboo about that in their community, and this has made them even more hesitant than the typical male population to seek help. If someone has been made to feel ashamed then it is all the more unlikely that they are going to want to call even more attention to the issue. They think that they just have to keep their head held high and keep going, but when it comes to sustaining strong mental health, often this alone is not going to be enough.

  • grant January 29th, 2012 at 6:36 AM #3

    Added to all of this is the fact that this kind of care is not nearly as readily available in the rural areas as it is in larger cities. People in the country are not as accustomed to people seeking care for mental health issues as those of us are who live in cities. Sometimes it feels like everyone I know is in some form of therapy, and some just because it seems like the right thing to do, and not necessarily because they need it! Oh well, different strokes for different folks I guess, but it does not seem fair in many ways that the care is not consistent across the board.

  • Jay T January 30th, 2012 at 5:17 AM #4

    Most men from these areas think that they can do this alone. I know because I used to be one of those guys. Most of them would have to hit rock bottom more times than you can count before they thought that it was ok to ask for help

  • Jann January 30th, 2012 at 11:26 AM #5

    Interesting that men with less education avoid therapy more than the educated. I would have thought that the pride associated with education may have caused that group to neglect therapy just as much.

    It does make sense though. Thanks for the post.

  • BR January 30th, 2012 at 3:45 PM #6

    …and this is the same reason why the reception to mental health counseling is different in different parts of the world.its not enough to put out enough counselors but also very important to see that people’s awareness of counseling improves.

  • cannon January 30th, 2012 at 4:59 PM #7

    These are men who have a pull yourself up by your bootstraps kind of mentality and for them to ask to help is to be perceived as weak.

  • rupert January 31st, 2012 at 9:44 AM #8

    a history of misconceptions about mental health problems,the unwillingness to change and also inaccessibility would all play a part in why rural men are not adept to therapy.no amount of convincing will help until and unless they are interested.

  • Janet February 1st, 2012 at 3:44 AM #9

    I grew up in the country, and now work in a Community Managed Mental Health Service. no one seeks help unless they want, need, know that support is there, trusts the help source and sees a purpose to the help seeking. We can change the culture of stoic ness but that will take time and bold action. Speak up. challenge, ask questions and continue when you think/or know the door has closed, the eyes glaze over.. keep talking.

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