Historically,thespecialtyofurologyhasfocusedonsingle-systemdiseases.Inrecentyears,however,therehasbeenincreasingrecognition oftheinterconnectivitybetweenthevarioussystems,suchascardiovasculardisease,metabolicsyndrome,erectiledysfunctionandprostatecancer.Thisconstellationofdisease/syndromeanddysfunction mayplaceurologistsatthecentreofmen'soverallhealthconcerns. Asurologistsconsideringtakingonaleadershiproleinmen'shealth, theyshouldalsoconsidertheirpotentialinhelpingmensufferingfrom thesignificantburdenofamentalhealthdisorder.Urologistsmay haveauniqueopportunitytoidentifymentalhealthissuesintheir malepatients,influencehealthybehaviourchange,andsuccessfully refermen,whomightotherwisenotseekhelp,toappropriatemedical/ psychologicalcare.
Men's mental healthAn estimated 3.4 million Canadian men are currently living with mental illness. 1 This number is likely an underestimation given that a large proportion of men experiencing symptoms of mental illness do not seek the help of a professional. [2][3][4] This gap in care has grave outcomes as Canadian men are at least 3 times more likely to die by suicide than Canadian women 5 -a figure that increases to 7 times among elderly men.6 Specific to urologic diseases/disorders, such as urologic cancers, lower urinary tract symptoms and erectile dysfunction (ED), men experience elevated levels of anxiety and depression. 7,8 For example, the risk of suicide in men with prostate cancer is over 4 times that of a similarly aged man without prostate cancer. 9 Patients with lower urinary tract symptoms (LUTS) experience elevated levels of psychosocial distress, with depression rates of 6% to 21% and anxiety rates of 3% to 10%. 10 An estimated 10% of men with ED suffer from depression, and 2.5% to 37% suffer from anxiety.11 Given the relationship between mental health and overall health-related quality of life, it is clear that increasing numbers of men in general, and men with urologic disease, are suffering a significant burden and that most of this burden remains untreated by healthcare professionals. Barriers to accessing mental health services include stigma, differences in expression of emotional problems (compared to women), maladaptive coping, and lack of awareness of support services in the community.
StigmaResults suggest that the most prominent barrier to seeking and accessing mental health services is stigma.12,13 Seeking mental healthcare services remains a secretive and shameful activity for many individuals.14 The anticipation of social consequences and discrimination is often enough to force men into silence. While mental health stigma is not exclusively a male issue, men face a disproportionate amount of stigma, which is often perpetuated by masculine ideals of strength and self-reliance. A firm belief in stoicism and the need to control emotions may lead some men with anxiety and depression to perceive emotional distress as shameful, and hide their symptoms from others.
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Differences in expression of emotional problemsAnother factor that may complicate se...