Overview

Men's mental health remains a significant public health concern and a priority issue for Australia. In 2020-21, 7.8% of Australian men were estimated to have depression or feelings of depression while slightly more (10.6%) had an anxiety-related condition.

While mental ill-health constitutes a substantial cost to the public health system (Doran & Kinchin, 2019), Australian men tend to have lower usage of health care in general compared to women, despite comparable health needs (Burgess et al., 2009; Mansfield, Addis, & Mahalik, 2003).

Understanding patterns of mental health care use among men in Australia is essential for addressing this gap, particularly in the context of ongoing mental health needs. This chapter addresses this issue in six different ways. First, using data collected across the first three waves (2013-21) of Ten to Men: The Australian Longitudinal Study on Male Health (TTM), it outlines Australian men's self-reported experience and trajectories of depressive symptoms, as measured by the Patient Health Questionnaire-9 (PHQ-9). Second, this chapter examines the different types of mental health services and mental health prescriptions accessed by Australian men through linked Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data. Third, patterns of health care usage over time, and typical monetary costs paid by men for health care, are presented. Fourth, differences in several priority population groups identified in the National Men's Health Strategy 2020-2030¹ are highlighted. Fifth, factors associated with the non-use of mental health care among men are presented. Finally, the chapter examines patterns of mental health service usage during COVID-19-related restrictions in 2020.

Key messages

• Around three in 10 Australian men accessed a mental health service at least partly funded by the Medicare Benefits Schedule (MBS) at some point between 2012 and 2021. Almost one in three were prescribed mental health medications at least partly funded by the Pharmaceutical Benefits Scheme (PBS) during the same period.

• The most commonly used MBS-funded mental health service was a mental-health-specific general practitioner (GP) consultation; antidepressants were the most commonly prescribed PBS-funded pharmaceutical for mental health. Use of both these forms of mental health care became more common over time among Australian men.

• The proportion of visits to services that involved no out-of-pocket expenses included 84% of visits to GPs for mental health reasons, 30% of visits to psychiatrists and 50% of visits to psychologists.

• Men's use of MBS- or PBS-funded mental health care differed by socio-economic factors; usage tended to be higher among men who were older, less educated, unemployed or who identified as Aboriginal and/or Torres Strait Islander. These usage differences were more pronounced in mental health prescriptions compared to mental health services.

• Conformity to traditional masculine norms was associated with reduced use of mental health care services among those in need (i.e. those with greater depressive symptoms).

• Rates of mental health service use between March 2020-February 2021, during the COVID-19 pandemic, were similar to pre-COVID levels (January 2018-February 2020); however, 18% of services during COVID-19 were delivered through expanded telehealth measures.