Is Care for Boys Nonexistent in the Mental Health System?

The mental health crisis among youth persists post-pandemic. Recent reports suggest fewer males seek help, possibly due to unique symptoms and societal norms.
struggling teen boy with head on his folded hands

We have acknowledged often that our youth are in a mental health crisis that is unprecedented since the impact of the pandemic. The effects are lingering and there are many children and teenagers who have been impacted. 

NBC News has recently reported an interesting trend that seems to be replicating across our country. It appears that we are seeing fewer males than females currently receiving help in the mental health system. Depression may look very different in boys than in girls and may be categorized differently or not seen at all.

A recent study published in the journal Pediatrics found that while antidepressant prescriptions have risen dramatically for teenage girls and women in their 20s, the rate of such prescriptions for young men “declined abruptly during March 2020 and did not recover.”

Dr. Kao-Ping Chua, a pediatrician at the Susan B. Meister Child Health Evaluation and Research Center at the University of Michigan, led the study. He said that his finding that boys weren’t accessing antidepressant medications once the pandemic hit has been “perplexing.”

The more likely explanation in Chua’s experience as a pediatrician, was that boys stopped engaging with the health care system overall during the pandemic, leading to an under-detection and, consequently, an undertreatment of mental health problems in young men.

“There was something happening to make male adolescents not come in for mental health,” Chua said. “They didn’t go to their doctors.They skipped physicals.”

What we know is that boys tend to be more physical and less emotional when they are depressed. One parent described it as a “sad anger.” It can come out in aggressive behavior, playing intense and/or violent video games or general irritability. These behaviors are not typically categorized as depression or anxiety. Often they are treated as oppositional-defiance which is handled by disciplinary measures at school or at home.

Since boys typically do not express emotions directly it will be important for parents and professionals if encountering aggressive emotions to be a bit more patient and empathetic.  They need a calming, listening posture even though they may have some sad anger.

Also it may be important to realize that as they want to play sports with friends, engage in healthy physical activities and even do some gaming, that social interaction can be a regulating part of their ability to cope. It may be helpful for their mental health to have those connections as they process their angst about their lives. We should be aware and alert to changes in behavior as a potential warning sign that they may be in their own existential or psychological experience that is a sign of significant anxiety or depression. In so doing we may be able to help them seek out the help they need in their time of personal duress.

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