Dimensions of Masculine Norms, Depression, and Mental Health Service Utilization: Results From a Prospective Cohort Study Among Emerging Adult Men in the United States

The purpose of this study was to examine the role of multidimensional masculine norms ("status," "toughness," "anti-femininity") on depression and mental health service utilization among emerging adult men in the Northeast United States. This study examines substance use and hostility as secondary outcomes and depression status as an effect moderator on the relationship between masculine norms and mental health service utilization. This study used data from a prospective cohort study that followed 18- to 25-year-old heterosexual men over 6 months. At baseline and 6 months, approximately 29% and 25% of the sample met the criteria for depression. The results of multivariate linear and logistic regression models found that greater endorsement of masculine status was associated with less depressive symptoms at baseline and 6 months, masculine toughness was associated with more substance use at baseline, and masculine anti-femininity was associated with greater hostility at baseline and 6 months. The multivariate Poisson model found that greater endorsement of status was associated with greater mental health service utilization in the prior year, especially for men not meeting the criteria for depression. In contrast, greater endorsement of anti-femininity and toughness norms was associated with less mental health service utilization; for men endorsing toughness norms, this effect was greater for those who were depressed. This study sheds light on the harmful and protective effects of masculine norms on depression, related mental health outcomes, and mental health service utilization, with implications for gender-tailored approaches to engage and retain young men in mental health services.