Strength in the Open: A Clinical Perspective on Men’s Mental Health and the Role of Grief
by Gregory Wm. Branch, M.D., MBA, CPE, FACP
May is Mental Health Awareness Month. It is an opportunity not only to raise awareness, but to advance understanding—and to correct long-standing gaps in how we approach men’s mental health.
From a clinical perspective, one truth is increasingly clear: men are not experiencing fewer mental health challenges. They are simply less likely to be diagnosed, less likely to seek care, and more likely to experience severe outcomes.
The Clinical Reality in 2026
Current data indicate that approximately one in five men experiences anxiety or depression each year, yet men remain significantly less engaged in treatment. More concerning, men die by suicide at rates several times higher than women.
This is not a failure of individual resilience. This reflects a failure in access, engagement, and cultural alignment in delivering care.
We are also seeing a shift in the clinical presentation of distress among men. Increasingly, men present not with stated depression, but with:
- Irritability and anger
- Sleep disruption and fatigue
- Chronic stress and burnout
- Substance use
- Somatic complaints such as headaches or pain
These are not peripheral symptoms. They are often primary indicators of underlying mental health conditions that have gone unaddressed.
The Role of Social Conditioning
One of the most persistent barriers remains what clinicians often refer to as “restrictive emotionality”—the learned tendency to suppress emotional expression due to cultural expectations.
The “toughness” narrative continues to shape behavior. Men are taught to internalize distress, avoid vulnerability, and delay help-seeking. Over time, this contributes to:
- Delayed diagnosis
- Increased severity at presentation
- Lower treatment adherence
Clinical evidence consistently shows that when men do engage in care earlier, outcomes improve significantly. The challenge is not willingness—it is timing and access.
Grief as a Foundational Driver
In clinical practice, grief is frequently under-identified in men.
Grief is not limited to bereavement. It includes cumulative loss:
- Loss of loved ones
- Loss of identity or role
- Loss tied to trauma, violence, or systemic inequity
- Repeated exposure to community-level loss
When unprocessed, grief becomes clinically relevant. It contributes to depressive symptoms, anxiety, substance use, and dysregulated emotional responses.
Importantly, men are less likely to label their experience as grief. Instead, grief is often expressed behaviorally—through withdrawal, overwork, irritability, or risk-taking.
From a public health perspective, unaddressed grief is not benign—it can evolve into complicated grief with real mental health consequences.
Dr. Gregory Wm. Branch serves as Vice President with Roberta’s House he is the former Director of Health and Human Services for Baltimore County.
Gregory W. Branch, M.D., MBA, CPE, FACP
Vice President
Roberta’s House
