Integrated Care for Gender Specific Risks: Depression, Alcohol and Suicide

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As models for integrated care are implemented, it is important to develop a systemic focus on population health risks for men. Embedded in cultural and social gender values are strong barriers to help-seeking behavior for depression. It is imperative that we understand the risks to these men in order to develop a clear vision of need and applicable models of care and interventions for depression and suicide. Careful assessment and screening are necessary, because the experience and expression of depression is different for men than they are for women. While the US Preventive task force lists measures and protocols to address anxiety screening, alcohol mis-use and suicide risk as well as guidance on pay-for-performance quality measures that are also part of the SBIRT model of care, providers must also consider ways to create a supportive environment that promotes collaborative care. Sensitive and timely assessment for those with an acute or chronic health condition is also needed to monitor co-occurring treatment and early intervention for emotional distress. With treatment engagement and retention essential to collaborative care and care coordination, minimizing the stigma that holds men back from speaking about their daily stresses, traumatic events, life challenges and fears, and risky behaviors is key. We must develop ways to reach out by exploring the risks that exist in specific populations and creating culturally congruent opportunities for sharing and support. These are some of the ways we can help our grandfathers, fathers,  brothers, uncles, sons, and friends who may need a shoulder to lean on.