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Treatment-seeking differences for mental health problems in male- and non-male-dominated occupations: evidence from the HILDA cohort

  • A. Milner (a1), A. J. Scovelle (a1) and T. King (a1)



There is a well-established gender divide among people who do and do not seek professional help from mental health professionals. Females are typically more likely to report, and seek help for, mental health problems. The current paper sought to examine the role of employment context on help-seeking for mental health issues. We hypothesised that men and women in male-dominated occupations would be less likely to seek help than those in non-male-dominated occupations.


Data from the Household, Income and Labour Dynamics in Australia survey were used. Help-seeking, measured in 2013, was defined as whether a person reported attending a mental health professional in the 12 months prior to the survey. The exposure, male- and non-male-dominated occupations (measured in 2012), was defined using census data based on self-reported occupation. Analyses were stratified by gender and controlled for relevant confounders (measured in 2012), including mental health and prior help-seeking. We conducted multivariate logistic and propensity score analyses to improve exchangeability of those exposed and unexposed.


For males, being in a male-dominated occupation was independently associated with reduced likelihood of help-seeking (OR 0.66, 95% CI 0.46–0.95) in the adjusted model, although this result fell just out of significance in the propensity score analysis. There was no independent effect of being in a male-/non-male-dominated occupation for help-seeking among women.


Results suggest that male-dominated occupations may negatively influence help-seeking among males. There is a need for more research to understand this relationship and for workplace-based prevention initiatives.


Corresponding author

Author for correspondence: Allison Milner, E-mail:


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ABS (2006) 2006 Census – Labour Force. Occupation 06 (ANZSCO) (OCC06P) – 2 Digit by Sex Male/Female (SEXP) Counting: Persons, Place of Usual Residence. Canberra: Australia Bureau of Statistic (Accessed 1 April 2017).
ABS (2017) Labour Force, Australia, Nov 2017. Cat. No. 6202.0. Canberra: ABS. Available at (Accessed 12 December 2017).
Addis, ME and Mahalik, JR (2003) Men, masculinity, and the contexts of help seeking. American Psychologist 58, 514.
Ahs, A, Burell, G and Westerling, R (2012) Care or not care – that is the question: predictors of healthcare utilisation in relation to employment status. International Journal of Behavioural Medicine 19, 2938.
AIHW (2016) Mental health services in Australia: Medicare-subsidised mental health-related services. Available at (Accessed 1 April 2017).
Alonso, J, Angermeyer, MC, Bernert, S, Bruffaerts, R, Brugha, TS, Bryson, H, de Girolamo, G, de Graaf, R, Demyttenaere, K, Gasquet, I, Haro, JM, Katz, SJ, Kessler, RC, Kovess, V, Lepine, JP, Ormel, J, Polidori, G, Russo, LJ, Vilagut, G, Alamansa, J, Arbabzadeh-Bouchez, S, Autonell, J, Bernal, M, Buist-Bouwman, MA, Codony, M, Domingo-Salvany, A, Ferrer, M, Joo, SS, Martinez-Alonso, M, Matschinger, H, Mazzi, F, Morgan, Z, Morosini, P, Palacin, C, Romera, B, Taub, N and Vollebergh, WAM (2004) Use of mental health services in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandivia 109, 4754.
ANZSCO (2009) Australian and New Zealand Standard Classification of Occupations, 1st Edn, Revision 1. Canberra: Australian Bureau of Statistics. Available at (Accessed 8 August 2012).
Austin, PC (2011) An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behavioral Research 46, 399424.
Baxter, J (2012) Fathers’ involvement in children's personal care activities. In Australian Institute of Family Studies (ed.) The Longitudinal Study of Australian Children Annual Statistical Report. Canberra: Australian Institute of Family Studies.Available at (Accessed 8 March 2018).
Becker, SO and Ichino, A (2002) Estimation of average treatment effects based on propensity scores. The Stata Journal 2, 358377.
Connell, R (2012) Gender, health and theory: conceptualizing the issue, in local and world perspective. Social Science & Medicine 74, 16751683.
Connell, RW and Messerschmidt, JW (2005) Hegemonic masculinity: rethinking the concept. Gender and Society 19, 829859.
Craig, L and Mullan, K (2010) Parenthood, gender and work family time in the United States, Australia, Italy, France, and Denmark. Journal of Marriage and Family 72, 13441361.
Galdas, PM, Cheater, F and Marshall, P (2005) Men and health help-seeking behaviour: literature review. Journal of Advanced Nursing 49, 616623.
Gullestrup, J, Lequertier, B and Martin, G (2011) MATES in construction: impact of a multimodal, community-based program for suicide prevention in the construction industry. International Journal of Environmental Research and Public Health 8, 41804196.
Hammarström, A, Johansson, K, Annandale, E, Ahlgren, C, Aléx, L, Christianson, M, Elwér, S, Eriksson, C, Fjellman-Wiklund, A, Gilenstam, K, Gustafsson, PE, Harryson, L, Lehti, A, Stenberg, G, Verdonk, P. (2014) Central gender theoretical concepts in health research: the state of the art. Journal of Epidemiology and Community Health 68, 185190.
Honkonen, T, Virtanen, M, Ahola, K, Kivimaki, M, Pirkola, S, Isometsa, E, Aromaa, A and Lonnqvist, J (2007) Employment status, mental disorders and service use in the working age population. Scandinavian Journal of Work Environment and Health 33, 2936.
Kovess-Masfety, V, Boyd, A, van de Velde, S, de Graaf, R, Vilagut, G, Haro, JM, Florescu, S, O'Neill, S, Weinberg, L, Alonso, J and EU-WMH investigators (2014) Are there gender differences in service use for mental disorders across countries in the European Union? Results from the EU-World Mental Health survey. Journal of Epidemiology and Community Health 68, 649656.
Leuven, E and Sianesi, B (2003) PSMATCH2: Stata Module to Perform Full Mahalanobis and Propensity Score Matching, Common Support Graphing, and Covariate Imbalance Testing. Boston College Department of Economics. doi: S432001.
Mansfield, AK, Addis, ME and Mahalik, JR (2003) ‘Why won't he got to the doctor?’: The psychology of men's help seeking. International Journal of Men's Health 2, 93109.
McDowll, L (2003) Masculine identities and low-paid work: young men in urban labour markets. International Journal of Urban and Regional Research 27, 828848.
McFarlane, AC, Hodson, SE, Van Hooff, M and Davies, C (2010) Mental Health in the Australian Defence Force: 2010 ADF Mental Health Prevalence and Wellbeing Study. Canberra: Department of Defence.
Milner, A, Spittal, MJ, Pirkis, J and LaMontagne, AD (2013) Suicide by occupation: systematic review and meta-analysis. British Journal of Psychiatry 203, 409416.
Milner, A, Smith, P and LaMontagne, AD (2015) Working hours and mental health in Australia: evidence from an Australian population-based cohort, 2001–2012. Occupational and Environmental Medicine 72, 573579.
Milner, A, Kavanagh, AM, King, T and Currier, D (2018a) The influence of male gender norms and occupational factors on mental health: evidence from the baseline of the Australian Longitudinal Study on Male Health. American Journal of Men's Health 72, 696705.
Milner, A, King, T, LaMontagne, AD, Bentley, R and Kavanagh, AM (2018b) Men's work, women's work, and mental health: a longitudinal investigation of the relationship between the gender composition of occupations and mental health. Social Science & Medicine 204, 1622.
Möller-Leimkühler, AM (2002) Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression. Journal of Affective Disorders 71, 19.
Petersen, ML, Porter, KE, Gruber, S, Wang, Y and van der Laan, MJ (2012) Diagnosing and responding to violations in the positivity assumption. Statistical Methods in Medical Research 21, 3154.
Preston, JA (1999) Occupational gender segregation trends and explanations. The Quarterly Review of Economics and Finance 39, 611624.
Seidler, ZE, Dawes, AJ, Rice, SM, Oliffe, JL and Dhillon, HM (2016) The role of masculinity in men's help-seeking for depression: a systematic review. Clinical Psychology Review 49, 106118.
Tynan, RJ, Considine, R, Rich, JL, Skehan, J, Wiggers, J, Lewin, TJ, James, C, Inder, K, Baker, AL, Kay-Lambkin, F, Perkins, D and Kelly, BJ (2016) Help-seeking for mental health problems by employees in the Australian Mining Industry. BMC Health Services Research 16, 498.
Wang, PS, Aguilar-Gaxiola, S, Alonso, J, Angermeyer, MC, Borges, G, Bromet, EJ, Bruffaerts, R, de Girolamo, G, de Graaf, R, Gureje, O, Haro, JM, Karam, EG, Kessler, RC, Kovess, V, Lane, MC, Lee, S, Levinson, D, Ono, Y, Petukhova, M, Posada-Villa, J, Seedat, S and Wells, JE (2007) Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. The Lancet 370, 841850.
Watson, N (2011) Methodology for the HILDA Top-Up Sample. Hilda Project Technical Paper Series No 1/11. Melbourne: Melbourne Institute.
Wenger, LM (2011) Beyond ballistics: expanding our conceptualization of men's health-related help seeking. American Journal of Men's Health 5, 488499.
Whiteford, HA, Ferrari, AJ, Degenhardt, L, Feiginm, V and Vos, T (2015) The global burden of mental, neurological and substance use disorders: an analysis from the Global Burden of Disease Study 2010. PLoS ONE 10, e0116820.
Wilkins, R (2013) Families, Incomes and Jobs, Volume 8: A Statistical Report on Waves 1 to 10 of the Household, Income and Labour Dynamics in Australia Survey. Melbourne: Melbourne Institute of Applied Economic and Social Research Faculty of Business and Economics.
Windfuhr, K and Kapur, N (2011) Suicide and mental illness: a clinical review of 15 years findings from the UK National Confidential Inquiry into Suicide. British Medical Bulletin 100, 101121.


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