Men Are Showing Up. Is the System Ready to Meet Them?

A conversation with Dr. Jeff St. John about new Canadian research, why the first response matters, and how communities can make support easier for men to find and use.

A new report from the Movember Institute of Men's Health, developed with Mental Health Research Canada and the Centre for Addiction and Mental Health, challenges one of the most persistent stories about men's mental health: that men simply refuse help.

Men are showing up. They search privately, test a concern with a friend, raise a physical symptom with a doctor, contact a service or wait until the situation becomes acute. Too often, what they find is difficult to enter, poorly matched to how distress is showing up, or disconnected from a credible next step.

A System Falling Short asks governments and health systems to do five things better: Research, Reach, Respond, Retain and design around the Relational conditions of men's lives. We spoke with Dr. Jeff St. John of Men & about what the findings mean for men, the people around them and the communities and systems trying to respond.

Q: When you first read the report, what stood out to you?

The scale of the unmet need is significant, but what stayed with me was where the report places responsibility.

We often hear that men are difficult to reach or unwilling to seek help. This research offers a more complete picture. Men are reaching in different ways. They may begin with a private search, a conversation with someone they trust, a physical concern raised with a doctor or an emergency department after things have become overwhelming.

The problem is not only whether a man asks for help. It is whether he can recognize a door, whether that door opens and what happens when he steps through it.

That changes the question. We still need to encourage men to act earlier. But we also need to ask: What are men finding when they try?

Q: The report says more than 85 per cent of Ontario males with an identified mental health problem accessed no publicly funded service within a year. What does that tell us?

It tells us that the publicly funded system is seeing only a small part of the need.

That finding has an important boundary. It is based on Ontario data and does not capture privately paid therapy or most prescription medications for people under 65. It should not be translated into a claim that 85 per cent of men received no help of any kind.

Even with that qualification, the gap is striking. Improving the experience inside a clinic is essential, but it will not reach the many men who never arrive there. We also need visible and trusted ways into support through primary care, workplaces, community organizations, sports, friends, family members and other places where men already have relationships.

Support has to become easier to find before the situation becomes a crisis.

Q: So, are we wrong when we describe men as reluctant to seek help?

Reluctance can be real, but it does not exist in a vacuum.

Men make decisions based on what they believe will happen if they speak. Will they be understood? Will there be a practical next step? Will they be treated with dignity? Will the response fit their circumstances? Will asking for help cost them control, credibility or safety?

If someone expects to be dismissed, judged or passed between disconnected services, holding back can feel rational. Encouraging men to reach out matters. Building pathways that justify their trust matters too.

Q: The first interaction or attempt at seeking help seems especially important. Why?

The report found that 67 per cent of Canadian men who were satisfied with their first healthcare encounter said they would seek help again. Among those who were dissatisfied, that fell to 26 per cent.

That is an association, not proof that one encounter determines everything that follows. But the difference is large enough that we should pay attention.

For many men, asking for help is not one big decision. It is a series of small tests. They share a little and watch what happens. If the response is rushed, dismissive or disconnected from a useful next step, they may decide the system is not for them.

Our early review of Men's Resource Line data suggests a related operating pattern. Calls that move beyond the opening few minutes often become longer and more substantive, shifting from a presenting symptom toward relationships, fatherhood, conflict or harm. We are working to verify and understand that pattern more carefully; it should not yet be treated as a formal finding.

What it has taught us in practice is simple. A good first response does not require solving the whole problem. It requires listening, taking the concern seriously and helping the person find one credible next step.

Q: What does a more responsive approach look like?

It begins by recognizing that distress does not always arrive in clinical language. It can look like anger, withdrawal, substance use, risk-taking, conflict, physical complaints or a sense that life is becoming unmanageable.

Recognizing those presentations does not mean excusing harmful behaviour. It means becoming curious enough to understand what is happening and skilled enough to respond without losing the safety of other people from view.

What is happening beneath the behaviour? What has changed? Who may be affected? What matters to this person? What kind of support is he ready for today? What requires a specialist or a firmer safety response?

This is where Men &'s dignity-grounded lens matters. Accountability and dignity belong together. We can take harmful behaviour seriously, protect safety and still engage a person as someone capable of reflection, responsibility and change.

Q: The report points to coaching, skill-building and problem-solving as useful alternatives or complements to one-to-one therapy for some young men. Why is that relevant?

People need different starting points.

Therapy may be the right next step for one person. Another may first be ready to learn how to regulate anxiety, handle conflict, set a boundary or repair a relationship. Practical learning can give someone language, confidence and a sense of movement.

Self-guided tools are not substitutes for professional care, crisis response or specialized services. They are another possible door. Men & is working to provide practical resources at different depths alongside human contact and service navigation, so a man can begin with a step he can take and move toward more support when he needs it.

Q: The report organizes its recommendations around Research, Reach, Respond, Retain and Relational. Where is Men &'s work aligned?

The alignment is not that Men & has already solved each part of the problem. It is that we have been working across the same set of system functions.

On Research, we are working to understand the pathway rather than count activity alone: what men encounter, which resources they use, when they make human contact and whether that contact leads to a service or another useful step. We can report parts of that journey, but we cannot yet track it as one continuous pathway. Closing that gap is part of the work.

On Reach, Men & has built several low-friction doors: public articles and tools, cards shared through police and community partners, a national Service Navigator and a route to talk or text with a real person. As of September 28, 2026, the Service Navigator contained 417 approved service-provider or programme listings across 12 provinces and territories. That is a measure of the inventory available to search, not evidence that 417 people were connected to care.

On Respond, we are building capacity around men as well as resources for men. That includes conversation tools and training intended to help informal supporters, practitioners, first responders and organizations recognize how a concern may present, respond with dignity and accountability, and make a more useful connection.

On Retain, our focus is on a stepped and human-supported pathway: private self-resourcing when that is where a man can begin, a person to talk to when he is ready, navigation toward appropriate services and a clearer handoff into structured or specialized support. We do not yet have the evidence to say that the full pathway reliably keeps men connected. The report strengthens the case for building and evaluating that continuity.

And Relational is central to how Men & understands the terrain. A man's mental and social health is shaped by relationships, belonging, work, income, culture, geography and the people around him. Friends, partners, family members and workmates are often the first to notice a change, and they frequently carry the consequences when effective help is not available.

Q: Where does Men & fit within the system described in the report?

Men & is not trying to become every service a man might need. We are working on the connections that make a fragmented system easier to enter and more capable of responding.

That work has four connected parts. We are building clearer access and change pathways for men with tools like the national Service Navigator. We are developing practical capacity for supporters and practitioners with theMen & Community model bringing together Champions, organizations and vetted Service Partners around that shared goal. We are helping organizations make better engagement part of roles, routines and practice rather than a one-time training event. And we are working with communities to identify what already exists, find the gaps, connect local doors and strengthen long-term stewardship.

These parts depend on one another. Awareness without a receiving pathway fails. A tool without a person or place able to use it rarely travels far. Training without organizational support fades. Community coordination without something concrete a man can enter becomes abstract.

The work is to connect the pieces.

Q: Men & is violence-prevention-first. How does that sit beside a report focused on mental health and substance use?

The two are aligned, but they are not identical.

Men &'s governing purpose is violence prevention. Its terrain is relational health: the places where mental health, isolation, relationships, fatherhood, abuse, control, conflict, safety and help-seeking can become entangled.

That does not mean distress causes violence, and it does not turn mental-health support into an excuse for harm. It means the systems around men need to be able to hold more than one reality at a time. A man may need support for his own pain and accountability for the pain he has caused. Other people's safety and agency must remain visible. Where harm exists, safety, repair and healing are connected but not interchangeable.

The report does not take up violence prevention directly. Men & extends the system question into that territory: how do we engage earlier, recognize risk, support responsibility and connect a man with the right help without minimizing the people affected by his behaviour?

Q: Why does Men & talk about relational and social health, rather than mental health alone?

Because no one experiences mental health in isolation.

A man's wellbeing is shaped by his relationships, sense of belonging, work, income, culture, geography and access to community. The report recognizes partners, children, friends and workmates as possible routes into support. That matters. These people are often the first to notice that something has changed.

Relational and social health draw attention to the conditions around a person: healthier relationships, trusted connections, practical skills, institutions that know how to respond and communities that can connect rather than simply refer. This complements clinical care. It does not replace it.

Q: What should people take away from this research?

For men, the message is that you do not need to have everything figured out before taking a step. You can start with a conversation, an article, a practical tool or a search for support.

For friends, partners and family members, the first job is often to listen, stay curious and help make the next step easier to find. Supporting a man does not mean carrying the problem alone or compromising anyone's safety. Get Involved

For practitioners, the first interaction matters. Feeling heard and leaving with a clear next step are associated with whether a man is willing to seek help again.

For community and system leaders, outreach cannot end with awareness. The work is to build connected pathways that reach men earlier, respond more effectively and stay present long enough to earn trust.

The report does not prove that Men &'s approach works. It does strengthen the case for the kind of connected system we are working to build—and it gives us a clearer standard against which that work should be tested.

Men are already showing up. Our responsibility is to build the people, pathways and systems ready to meet them.

Sources

Movember Institute of Men's Health. (2026). A system falling short: Men's experiences with mental health and substance use services in Canada.Movember Institute publications.

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