Need2Know - Men, Mental Health and Non-Communicable Diseases
Men's mental health and non-communicable diseases (NCDs) represent interconnected public health challenges, with men experiencing disproportionate burdens in both areas worldwide. Non-communicable diseases (NCDs), including heart disease, diabetes, and respiratory conditions, are the leading causes of death globally, and men face higher rates of premature mortality than women. According to the latest WHO Global Health Estimates, men are 60% more likely than women to die from NCDs before age 70. Mental health conditions such as depression, anxiety, and substance use disorders further compound this burden, contributing significantly to disability and early death in men.
These issues are deeply interconnected: men with NCDs are at greater risk of psychological distress, yet mental health problems, when untreated, worsen physical health outcomes and increase mortality risk. Because men are less likely to disclose emotional distress and clinicians often overlook atypical presentations, common mental health conditions in men are routinely under-diagnosed, creating the false impression that they are less prevalent. Burden also varies sharply across male sub-groups, with disproportionately higher rates observed among gay and bisexual men, Black men living in majority-white societies, men on low incomes, and others facing intersecting disadvantages.
Critically, the most recent Global Burden of Disease analysis estimates that men account for 72% of suicides worldwide, with an age-standardised rate of 13.9 per 100,000 compared with 5.0 per 100,000 in women. Suicide is a significant cause of death for men under 50, with more than half of all suicides occurring before this age. Among young people aged 15–29, suicide ranks as the fourth leading cause of death globally. However, men are significantly less likely than women to seek mental health support, often due to stigma, gender norms, and healthcare barriers.
The economic impact is substantial, with the co-morbidity of mental health conditions and NCDs estimated to cost global economies $16.1 trillion between 2011 and 2030. While women also bear a large burden of mental ill-health and disability, men experience a distinct pattern of premature NCD-related mortality and under-treated mental ill-health. Given men's higher mortality rates, lower healthcare engagement, and the growing burden of NCD and mental health comorbidity, a gender-responsive approach to men's mental health within NCD prevention and care is essential. Without targeted action, existing health disparities will persist, leading to avoidable deaths and increased strain on health systems.
Here is what you “need to know” from the current evidence base.
(This brief has been led by Prof Paul Galdas, Professor of Men’s Health, University of York, in partnership with Global Action on Men’s Health)
The evidence at-a-glance
Which approaches work with men?
Gender-responsive interventions: Effective health and care services and programmes recognise that men’s engagement is shaped by gender norms. Aligning service design with men’s identities – emphasising action, problem-solving, and peer learning – can enhance engagement and adherence. Men often prefer structured, goal-oriented support for mental health and NCDs over emotionally focused approaches, benefiting most from interventions with clear purpose, practical strategies, and peer interaction [14]. Co-designing programmes with men, and tailoring interventions to show how improving mental and physical health can support success in valued life domains (such as maintaining work performance, intimate relationships, and family roles) can further enhance engagement, accessibility, and impact.
Integrated care models: Collaborative care approaches that integrate mental health screening and treatment within primary care and NCD management show significant improvements in both mental health symptoms and NCD outcomes for men.
Digital interventions designed for men: Digital mental health tools specifically designed with male preferences in mind (action-oriented, solution-focused, less emotional framing) can lead to higher engagement rates. These platforms can offer anonymity and flexibility, helping men overcome privacy or stigma concerns.
Workplace-based programmes: Interventions are most effective when delivered in settings where men naturally engage. Workplace-based programs in male-dominated industries have shown particular promise by addressing specific occupational stressors and providing accessible, structured physical and mental health support. Embedding interventions in familiar environments reduces barriers to engagement and fosters early intervention. Similar gains are seen when programmes are delivered through sports clubs and community sport initiatives (e.g., Movember’s Ahead of the Game [21]), which can help normalise conversations about mental health.
Which approaches are not effective with men?
Generic interventions and campaigns: Interventions that are not designed with the explicit goal of engaging and optimally serving men may be less effective than those that are responsive or sensitive to their needs, preferences, and norms. Interventions that lack a clear, practical purpose, do not provide meaningful, individualised strategies, or are perceived as ‘too emotional’ or ‘touchy-feely,’ particularly when these conflict with dominant masculine norms, tend to disengage men.
Siloed healthcare services: Separate mental health and NCD care pathways create additional barriers for men already reluctant to engage with traditional healthcare systems.
Stigmatising language and framing: Approaches that use clinical or pathologising language – such as describing common emotional struggles as mental illness or disorder – tend to alienate men, particularly those who adhere to traditional masculine norms. Research on men's lived experiences shows that men prefer non-stigmatizing language over traditional mental health terminology.
Key Evidence Summary
1. The Mental Health and NCD Burden in Men
Epidemiological studies within and across countries have established strong associations between NCDs and common mental disorders. These conditions share multiple risk factors and interact bidirectionally, influencing disease progression and exacerbating health, social, and economic burdens.
Men with severe mental illness have a mortality rate more than twice that of the general population, with life expectancy reduced by a median of 10 years and, in some cases, by over 20 years. The majority of deaths are due to preventable non-communicable diseases such as cardiovascular disease and diabetes, exacerbated by modifiable risk factors and disparities in healthcare access.
Suicide is a leading cause of death, with over 700,000 deaths annually, and men are over 3 times more likely than women to die by suicide in high-income countries.
The global economic cost of NCDs was $2.5 trillion in 2010, projected to reach $6 trillion by 2030, with most costs due to lost productivity. The cost of NCDs affecting working-age men is likely to be particularly significant given men’s lower healthcare engagement and higher rates of untreated conditions.
Economic modelling suggests that investment in prevention, screening, and early intervention for NCDs and mental health can generate substantial returns, positioning health spending as an economic investment rather than a cost.
2. The Bidirectional Relationship Between Mental Health and NCDs
The connection between mental health and NCDs in men operates in both directions and is mutually reinforcing:
Severe NCDs, such as cardiovascular disease, diabetes, and cancer, are closely linked to common mental health disorders like depression and anxiety. Chronic pain, functional impairment, lifestyle changes, and the psychological burden of an illness diagnosis can exacerbate mental health issues, particularly in men, who may be less likely to seek support and more prone to underdiagnosis.
Men with diabetes and heart disease are at increased risk of developing depression, with research showing a particularly strong bidirectional link between mental health and these chronic conditions. Depression is associated with an 80% higher risk of cardiovascular morbidity and mortality.
Common behavioural risk factors for NCDs – including tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol – occur in greater frequency among men with mental health disorders.
The physiological effects of depression and chronic stress, including dysregulated inflammation and elevated cortisol levels, create biological vulnerabilities to NCDs. These physiological changes, coupled with behavioural risk factors, establish multiple pathways through which mental health conditions increase NCD risk in men.
Treatment of depression in men with NCDs has been shown to improve medication adherence and reduce hospitalization rates, as depression significantly increases the risk of noncompliance with medical treatment. Addressing depression in these patients can enhance health outcomes and lower overall healthcare burden.
Men's coping behaviours, often influenced by masculine norms, may include increased alcohol consumption or substance misuse when under stress, which heightens the risk of liver disease, hypertension, and other NCDs.
3. Barriers to Care for Men
Men face specific challenges in accessing integrated mental health and NCD care:
Men are less likely than women to access mental health services due to stigma, cultural expectations of self-reliance, and socialized reluctance to acknowledge emotional distress.
Limited use of primary care, clinicians’ low confidence in recognising male-pattern presentations, and diagnostic criteria that under-capture externalising or somatic symptoms, can delay identification and referral. Organised screening for paternal perinatal depression, routine in Denmark but rare elsewhere, shows how male-specific case-finding can be implemented.
The fragmentation of mental health and NCD care leads to missed opportunities for early intervention and holistic treatment. This siloed approach disproportionately affects men, who are less likely to engage with multiple healthcare providers, further limiting access to integrated support.
High job demands, economic insecurity, and workplace stress contribute significantly to mental distress, with evidence linking burnout, low job control, and effort-reward imbalance to common mental health disorders. These stressors are also associated with increased risk of NCDs such as cardiovascular disease and diabetes. Despite this, many workplaces lack adequate mental health support, leaving employees – particularly men, who may be less likely to seek help – without necessary interventions.
The COVID-19 pandemic has exacerbated mental health disparities, particularly for vulnerable groups, with men facing heightened risks due to economic insecurity, job loss, and reduced access to mental health support. Addressing these challenges requires integrated interventions that consider how traditional masculine norms may discourage help-seeking, further compounding mental distress and long-term health risks.
4. Social and Environmental Determinants
Multiple external factors influence both men's mental health and NCD risk:
Commercial Determinants: Men are disproportionately affected by alcohol, tobacco, ultra-processed food, and gambling industries, all of which contribute to poor mental health outcomes and increased risk of NCDs. Marketing of these products often specifically targets men by leveraging masculine stereotypesthat can promote unattainable muscular ideals which contribute to muscle-dysmorphic concerns linked to depression, anxiety and disordered eating in men.
Climate change: Worsens NCDs and mental health conditions through air pollution, heat stress, and food insecurity, with men in high-risk jobs like agriculture and construction facing greater exposure. Economic instability and extreme weather events further heighten anxiety and depression, amplifying health risks.
Socioeconomic factors: including financial insecurity and precarious work account for up to 60% of health status variation, increasing men's mental health and NCD risks. Limited healthcare access and masculine norms further entrench these disparities. Addressing these determinants through economic security policies and cross-sectoral strategies is essential for improving men’s health.
What do men with lived experience want?
Research incorporating the voices of men with lived experience of mental health conditions and NCDs highlights several key priorities:
Non-stigmatizing language and approaches: Men tend to express a preference for terms like "stress management" or "physical wellbeing" over "mental health" or "emotional support" during initial engagement.
Practical, solution-focused support: Men consistently report a preference for action-oriented approaches that provide concrete tools and strategies rather than approaches primarily focused on emotional expression. Emotional support can be made more acceptable to some men when framed through humour, shared activities, or indirect conversations.
Peer support options: Models that incorporate peer support from other men with similar experiences show higher engagement and satisfaction rates.
Workplace integration: Many men are more likely to engage with health services if they are co-designed and integrated into workplace settings.
Implications for Policy and Practice
Global health authorities recognise that mental health must be integrated into NCD prevention and care. The World Health Organization (WHO) and the Lancet Commission on Global Mental Health have identified the integration of mental health services into primary care and NCD programs as a priority.
Integration of Mental Health and NCD Care
Embed routine mental health screening in NCD clinics and adopt collaborative care models where mental health professionals work alongside or as part of NCD care teams via shared electronic records, routine case-conferencing and rapid e-referral pathways. Evidence demonstrates that integrated approaches improve both mental health outcomes and NCD management by enhancing treatment adherence and overall patient well-being.
Develop collaborative care models that enhance adherence, engagement, and outcomes for patients with coexisting mental health conditions and NCDs. Strategies such as proactive case management, brief interventions, and integrated care within primary healthcare settings have been shown to be effective in improving both mental and physical health outcomes.
Gender-Responsive Interventions
Develop and implement mental health programmes in male-dominated industries (e.g., construction, manufacturing, emergency services) to address burnout, stress, and substance use, which have shown improvements in mental health outcomes.
Co-design care models and health programmes in partnership with men that can help foster progressive changes in the ways masculinity is interpreted and expressed as a means to achieve health for all.
Digital Solutions
Leverage digital mental health tools specifically designed for men, ensuring they incorporate principles of engagement that resonate with male users, such as goal-setting, tracking progress, and practical strategies.
Addressing Social, Commercial and Environmental Determinants
Strengthen public health regulations on marketing alcohol, tobacco, processed food, and gambling while leveraging industry shifts (e.g. non-alcoholic beverages, athleisurewear) to promote healthier behaviours.
Develop policies that address the socioeconomic determinants of men's health, including employment security, housing stability, and educational opportunities.
Implement workplace policies that address occupational stress and provide mental health support in high-risk industries.
Conclusion
The interplay between men’s mental health and NCDs presents a critical yet often overlooked public health challenge. While progress has been made in recognising the links between these conditions, the evidence highlights persistent gaps in prevention, care, and engagement. Without addressing these gaps, men will continue to experience a disproportionate burden of both mental and physical health conditions, with significant implications for individuals, families, and health systems.
The current evidence suggests a need for a more integrated and gender-responsive approach that acknowledges the specific ways in which men engage with healthcare, considers the broader structural and social determinants of health, and moves beyond reactive care towards proactive, preventive strategies. Strengthening care integration, co-designing interventions that align with men’s preferences, and leveraging workplace and digital solutions all offer promising avenues for improving outcomes. These efforts must be complemented by policies that address the wider commercial, economic, and environmental factors influencing men’s health. By adopting a more holistic and coordinated approach, health systems and policymakers can better support men’s mental and physical health, ultimately reducing the broader global burden of NCDs and mental ill health.
