We are constantly told that men are in crisis. We see the suicide statistics, the substance abuse rates, and the silent suffering. The standard cultural response to this is a simple, three-word command: "Go get therapy."
It sounds like the right advice. But for millions of men who summon the courage to walk into a therapist's office, the result is often disappointment, alienation and frequently early dropout before they see any results.
This isn't because men are "bad" at therapy. It’s because the current model of therapy is, in many ways, fundamentally broken for them. As I train to enter this profession, I see the flaws firsthand. We aren't just dealing with a lack of demand from men; we are dealing with a failure of supply. Specifically, a supply of care that is competent, accessible, and designed for the male brain.
Let’s dissect why the system is failing and look at a few simple improvements to fix it:
1. The "Gender Competence" Void
The most glaring failure is a lack of training. We train therapists to be culturally competent regarding race, sexuality, and religion, but we almost entirely ignore gender—specifically, the culture of masculinity. As a side note, I just wrapped up a module on Cultural Competence as part of my masters in Clinical Mental Health Counseling and while it went into great detail on how to approach counseling almost every ethnic group, the elderly and women specifically, you can guess what was missing. That’s right, nothing at all, not even the briefest of mentions on how to counsel men.
Dr. Zac Seidler, a leading researcher in men’s mental health, argues that the majority of clinicians lack "gender competence" when working with men (Seidler et al., 2022). They haven't been taught how masculine socialization impacts a man's ability to express emotion, ask for help, or process trauma.
When a man walks into a session and expresses his depression through irritability, anger, substance use or a focus on physical symptoms, an untrained therapist might view him as "resistant" or "difficult." They might try to force him into a mold of emotional vulnerability he isn't ready for, rather than meeting him where he is. The result? The man feels misunderstood and leaves, likely never to return. This isn't the client failing; it's the clinician failing to speak the client's language.
2. The "Feminization" of the Therapeutic Model
The demographics of the mental health profession have shifted dramatically. The field is now predominantly female, and while there are countless brilliant female therapists (including those that specialize in working with men), the culture of therapy has increasingly skewed toward communication styles that women often favor; open-ended, purely emotive, and introspective "talk therapy."
Research indicates that many men prefer a different approach. Men often thrive in therapeutic environments that are action-oriented, structured, and solution-focused (Seidler et al., 2018). We are "doers." We want a plan. We want to know the mechanics of why we feel this way and the specific tactical steps to fix it.
When therapy becomes an aimless "talkfest" without a clear roadmap, men can feel like they are spinning their wheels. The lack of "doing" in the room, skills training, concrete goal setting, and behavioral challenges, can make the process feel abstract and ineffective for a mind wired for problem-solving.
3. The Workforce Bottleneck
Even if a man finds a therapist who "gets it," he often has to wait months to see them. The barrier to entry for becoming a licensed therapist is incredibly high, years of graduate school, thousands of hours of unpaid or low-paid supervision, and rigorous licensing exams. For men especially, who are frequently in the role of being the financial provider, taking such a huge hit in earnings for 5 years or more while they qualify is simply not a viable option.
This long pipeline creates a massive supply shortage. There simply aren't enough licensed clinicians to meet the demand, and the shortage is most acute among those specialized in male psychology. This scarcity drives up prices and increases wait times, turning mental healthcare into a luxury good rather than a basic utility. We are trying to fight a forest fire with a garden hose.
4. Filling the Gap: A Triage Model for Men’s Health
We cannot wait a decade to train enough therapists to fix this (and without large-scale, institutional change this isn’t going to happen anyway), so we need to rethink the model of care entirely. We need to stop viewing a licensed therapist as the only solution and start seeing them as the specialist at the top of a pyramid.
To fix the system for men, we need to legitimize other layers of support:
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Men’s Coaching & Lifestyle Intervention: Many men suffering from anxiety or depression don't need deep trauma work immediately; they need to fix their biological baseline. Sleep, nutrition, exercise, and routine are potent antidepressants. Coaches who can help men correct these lifestyle issues can resolve a huge portion of distress without a clinical diagnosis, or a need for therapy or psychiatry.
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Peer Support Groups: Isolation is a primary killer of men. Peer support groups provide the "tribe" and connection that men desperately lack. Research shows that peer support is a resilience-building practice that can be incredibly effective for men (Robinson et al., 2015). It normalizes the struggle and offers a space for "shoulder-to-shoulder" connection that feels safer than face-to-face therapy.
The Path Forward
Acknowledging these flaws isn't about bashing the profession; it's about trying to improve it, and at the same time being creative with other types of support that can enhance the work of therapists.
We need a revolution in training that actually teaches therapists how to work with male clients (Seidler et al., 2022) to the same degree that it teaches them to work with minority ethnic groups. We need clinicians who can speak the language of masculinity and critically, we need to embrace a broader ecosystem of help. One where coaches and peer groups handle the foundational work of lifestyle and connection, allowing highly trained therapists to focus their limited time on the deep clinical work they are best suited for.
So that’s what we’re setting out to do here at Fellowman, elevating the work of great therapists who specialize in working with men in need, while plugging the gaps with easy to access coaching and groups.
References
Robinson, M., Raine, G., Robertson, S., & Rugkåsa, J. (2015). Peer support as a resilience building practice with men. Journal of Public Mental Health, 14(4), 196-209. https://doi.org/10.1108/JPMH-04-2015-0013
Seidler, Z. E., Rice, S. M., River, J., Oliffe, J. L., & Dhillon, H. M. (2018). Men’s mental health services: The case for a masculinities model. Journal of Men's Studies, 26(1), 92-104. https://doi.org/10.1177/1060826517729573
Seidler, Z. E., Wilson, M. J., Toogood, N. W., Oliffe, J. L., Kealy, D., Ogrodniczuk, J. S., Owen, J., Mackinnon, A., Le, L. K.-D., Mihalopoulos, C., Pirkis, J., & Rice, S. (2022). Protocol for a randomized controlled trial of the Men in Mind training for mental health practitioners to enhance their clinical competencies for working with male clients. BMC Psychology, 10(1), 174. https://doi.org/10.1186/s40359-022-00883-3