April 17, 2024

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

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

Jack and I settled into our respective sides of the desk, and over the next hour 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 being in and out of jail. I shared about my own time spent working as a line cook and farmhand, and as my dad’s assistant throughout suburban Chicago, installing carpets, painting ceilings, and nearly any odd job in between.

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

Estimates from the Centers for Disease Control and Prevention consistently show that older adults (age 50-plus) and males both receive mental health services significantly less often than their younger adult and female counterparts. The reasons driving this are clear: For older generations, discussing mental health and illness was deeply stigmatized, compared to younger generations who see it as an essential part of overall health. For older men, the stigma only deepens when we consider the ways that traditional “restrictive masculinity” regards even the smallest act of help-seeking to be “feminine” (read: weak), instead of a fundamental part of one’s humanity.

The Seattle Times Mental Health Project features contributed essays from members of our community as part of our Mental Health Perspectives guest column. We invite individuals with personal stories related to mental health to share their experiences that reflect broader issues and concerns in the field. If you would like to inquire about submitting a column, please email [email protected].

The ripple effects of this underlying resistance to seeking help are felt far and wide. 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 “crisis of connection,” with 15% of men in a 2021 national survey stating they have zero friends, up from 3% in 1990. This social isolation, in turn, adds emotional burden on partners and family.

When men feel there is no one to turn to, many will cope with substances, too often to tragic ends. Men account for the vast majority of “deaths of despair,” including 70% of opioid overdoses and 75% of alcohol-related deaths.

Most soberingly, men make up nearly 80% of all suicides. Age itself is a risk factor, with men being at higher risk to die by suicide as they get older. Other suicide risk factors for men include being a veteran, being LGBTQ+, living rurally, owning a gun, working a blue-collar job, and being Native American or non-Hispanic white. In 2020, white males alone accounted for 70% of all suicide deaths.

Read more Mental Health Perspectives guest columns

For too many of us, though, statistics and studies are cold comfort when we have felt the impact firsthand. For me, it came early on a Friday morning in September 2020, when my dad shockingly took his own life. When it came to my dad, I was his son before I was anything else. As his son, I assumed that he could handle whatever happened to him, since his response to any concern was “I’m fine” and he always seemed fine. In hindsight, the signs of his quiet depression and distress were there, but even a doctoral trained mental health professional like myself missed them.

In learning this, it may begin to feel that all hope is lost for older men, but there are many organizations already doing the work to help men of all ages. Nationally, the most well-known may be Movember, while locally the Seattle Seahawks have been out front on promoting mental health awareness through their Mental Health Matters campaign. Some community mental health clinics offer support groups like Dudes and Donuts, a weekly drop-in men’s group at Valley Cities’ Midway clinic.

In countless small ways, we each reinforce stigma against getting support when we assume older men are “fine” because they’ve never shown us otherwise. That quiet stoicism sows the seeds for loneliness when friends and family eventually stop offering support to the man who never accepts it.

Research shows that the key to overcoming this bind lies in meeting men where they are at, instead of trying to rewrite their whole gender playbook all at once. Maybe asking about feelings is a non-starter, 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 as solving a problem instead of ignoring it.

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Get in touch with us at [email protected].

Both personally and professionally, I have seen both sides of this bind for older men: those who struggle alone and are unable to escape, and those who push through their pride to find not just support, but meaningful connection.

Once Jack had improved and his treatment was stable, I asked my first question all over again: What brought him to the clinic in the first place? Through smiling eyes, he answered “I’m old enough to know what I don’t know, and I just got tired of thinking I could do it all on my own.” Never one for too much of that emotional stuff, he jumped to asking if I wanted to see photos of his latest salmon catch, and I of course said yes.

Noah Weatherton, DNP-PMHNP, ARNP, is a psychiatric nurse practitioner at the Kent, Midway, and Federal Way clinics at Valley Cities. Noah serves as a board member for a national nonprofit, Partnership for Male Youth. He earned a Bachelor of Science Degree in Nursing from University of Wisconsin-Madison and a Doctor of Nursing Practice degree from University of Washington. Noah is passionate about serving and supporting men of all ages, their families, and their communities. He previously 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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