Underpinning a general pattern of higher suicide rates in men is the assumption that men do not ask for help or utilize the health-care system during times of psychological distress. There has been a failure to grapple with the dynamic of when, how and from whom men might ask for help during times of psychological distress, and what key barriers or enabling factors are likely to influence potential help-givers' capacity or willingness to offer help to men in psychological distress. The aim of this study was to investigate how masculine norms impact men's help-seeking as well as care givers' behaviors and willingness to support men in need of psychological help or perceived to be at risk of suicide. Focus groups ( n = 13) were used with "high-risk suicide" groups of men and community gatekeepers. The principles of grounded theory were used for data analysis. Three themes emerged: "negotiating ways to ask for, offer and accept help without compromising masculinity"; "making and sustaining contact with men in psychological distress"; and "navigating roles responsibilities and boundaries to support men in psychological distress." Approaches to suicide prevention need to take account of how masculine norms shape men's willingness to ask for and accept help during times of psychological distress as well as care givers willingness to offer help. The findings address a gap in the literature by looking beyond men's help-seeking as a passive, one dimensional construct, to a more dynamic triad of help-seeking/giving/taking behaviors that are embedded in the sociocultural context of men's lives.
Keywords: gatekeepers; gender; help-giving; help-seeking; men’s health; suicide prevention.