Uncover strategies to engage men quickly and effectively and support them with healing options that meet their needs. This webinar offers insights into stigmatization, men’s perceptions of mental health care, and reasons why they may hesitate to seek the support they desire and need. It explains the 4 Questions Deep by 4 Questions Wide conversation method to maximize the impact of brief interactions. And, it provides tips for effective messaging for social media, advertisements, and literature that resonate with men. 


“A sad soul can be just as lethal as a germ,” Greg Mayo, Men’s Healing Strategist at Support After Abortion, opened with a quote from John Steinbeck and continued, “Many men struggle with a lot of different things that we’re going to talk about, and those lead to their seemingly averse attitude toward  mental health opportunities. So what are we missing?” 

Greg shared a few statistics and information from an article published this year by the Association of American Medical Colleges titled, Men and Mental Health: What are we Missing? According to the article, the suicide rate among men is four times higher than among women. Greg noted that any Google search related to men and mental health will yield results centered around depression and suicide rates.

He mentioned the article’s discussion on how society historically has blamed men for their own issues. It highlighted that modern culture often holds men responsible for their problems, such as feeling depressed or lonely, attributing these issues to personal failings rather than acknowledging external factors. Greg emphasized that this attitude discourages men from seeking help, perpetuating the harmful notion that if a man experiences difficulties, it’s solely his fault. 

Greg highlighted an important statement by the article’s author, Dr. Derek Griffith which states, “Men aren’t the problem. The way that we – society as a whole and health care providers specifically – treat them is.” Greg recalled how that played a role in his own life, saying, “I think back to my early years in therapy. I was encouraged to think and talk in a way that resonates with women, which didn’t work for me.” Greg said that men often feel that providers mislabel and underestimate their needs, appearing to not have a genuine interest in what their real problems are. 

“Confucius once said, Balance is a perfect state of still water. Let that be our model. It remains quiet within and is not disturbed on the surface,” Greg said. He explained that this quote serves as an important personal reminder for him – to be quiet within and not disturbed on the surface. However, he added, “Unfortunately, what a lot of men do is they figure out a way to maintain that still water on the surface, but underneath is a churning mess.”  Reflecting on the quote, Greg emphasized the challenge of achieving balance, noting that for many men, it’s elusive. He remarked that most men have become adept at projecting a facade of composure, masking their inner struggles. 

Greg cited a meta-analysis paper based on nine different studies conducted by The National Institute of Health which found that over 70% of suicide deaths in the U.S. are men. He explained how the disproportionally higher suicide risk for men can be attributed to men being less likely than women to seek help for mental health difficulties, as they hold more negative attitudes toward the use of mental health services and their unwillingness to seek mental health support. Greg validated the study’s findings sharing that in his experience working with men in recovery and healing, the level of despair and depression is substantial. 

He addressed the challenges related to men’s perception of mental health, highlighting their tendency to focus outward and seek solutions. He referenced an article by the Walker Center, titled Why are Men Less Likely to Get Mental Health Help? explaining that women typically focus inward, addressing their emotions and behaviors, while men are inclined to fix external issues. 

Greg also noted that men often act out instead of expressing their emotions directly, resorting to behaviors such as alcoholism, substance abuse, workaholism, and seeking multiple romantic partners. He observed that these behaviors serve to either mask emotional pain or provide a means of feeling something. Ultimately, Greg emphasized that these actions are attempts to address underlying issues without directly confronting them. 

He discussed the stigma surrounding men seeking mental health care, noting society’s expectation for men to be pillars of strength and support for others. He emphasized the importance of men taking care of their own mental health, highlighting the disconnect between societal expectations and men’s needs. Greg shared an experience from earlier in the day from a men’s group he is a part of, where another member discouraged others from discussing their feelings and problems, posting, Why do men come on here and talk about their feelings and problems? Urging them to “man up” instead. Greg pointed out the contradiction in a group designed for support and encouragement dismissing men’s struggles. Greg concluded that the stigma around men seeking mental health care is likely to persist, but optimistically shared that we can do something about it. 

Greg challenged the idea of “toxic masculinity” being the main deterrent to men seeking therapy. He highlighted the lack of substantial research supporting this claim, noting the prevalence of opinion pieces on the topic. Quoting from an article by The Centre for Male Psychology titled, You can’t Help Men by Attacking Masculinity, he emphasized that violence and sexism stem from past trauma rather than masculinity itself. 

Greg then discussed the changing dynamics in today’s society, where a significant percentage of boys are raised by single mothers and taught by female teachers, leading to a lack of male role models. Reflecting on his own journey, Greg underscored the importance of addressing trauma rather than attributing negative behaviors solely to masculinity. 

Greg critiqued the Duluth Model, which attributes domestic violence to patriarchy and toxic masculinity. Greg shared that a meta-analysis found a less than 50% success rate with it and models like it, highlighting its ineffectiveness in addressing underlying trauma and the negative impact on men’s sense of masculinity. 

“Men feel that their masculinity is attacked, they want help, but many believe that nobody cares.” Greg said. he continued, “Men want help, but many men believe that nobody cares.” 

With permission, Greg shared some quotes from men he has worked with to support this idea: 

  • “If a man is suffering, then women will see them as weak, as a weak partner, and avoid him.” 
  • “I’ll never get married if a woman finds out I have pain.”
  • “Help? Who would help? No one gives a (expletive) about what I’m going through. How do I know? Because I’m a man.” 
  • “As long as I’m providing, that’s all that matters. My junk is my own.” 
  • “Seems like every time I try to talk to someone, my feelings end up being my problem, then their response to my feelings ends up being my problem. It’s like, why do that to myself? I’ll just keep quiet.” 


“We can see by what’s been shared to this point, men want help, but they are told they don’t need help, they shouldn’t want help, but they are crying out,” Greg said. 

As discussed in previous webinars, Greg reminded the audience of the importance of messaging and the necessity to be able to reach men effectively. 

He stressed the need for change in various aspects, including advertisements, social media posts, and literature discussing men’s issues. Greg highlighted how crucial it is to tailor these materials to resonate with men, including the colors, pictures, and verbiage used. He pointed out how Support After Abortion’s media posts, aimed at reaching men, were specifically designed to resonate with men’s issues, reflecting how they talk, think, and receive information. Greg clarified that this approach isn’t to exclude women, but rather to create a separate campaign that is aligned with men’s communication preferences and style. 

The chief executive of The American Psychological Association, Arthur Evans, was quoted as saying, “There is clearly a growing recognition that we have to reframe mental health care in our approach to addressing the mental health needs of men.” Greg emphasized the significance of this statement, highlighting Evans’ suggestion to reframe therapy as an opportunity to become “strong and well,” rather than solely as treatment for mental illness. 

Greg discussed the challenge of engaging men in mental health care, noting that traditional approaches may not resonate with them. He contrasted how men and women typically receive offers of support, saying, “When you go to a man and you say, you seem sad, you lost him. We don’t receive information like that. Whereas, I asked my wife how she would receive that and she said, “If a friend said that to me, I would think she cares and I would most likely open up.” Greg highlighted the importance of this difference and understanding men’s communication preferences. 

Greg introduced the concept of “double jeopardy men,” coined by Dr. Sally Spencer Thomas, president and founder of United Suicide Survivors International, who identified a group of men with multiple risk factors for mental health issues. These men, despite facing a higher likelihood of mental health challenges, paradoxically exhibit a reluctance to seek help. He shared a quote from one of Dr. Thomas’s study participants, who remarked, “You know that message you mental health people put out there? If you’re depressed, seek help. Yeah, that misses on both counts,” illustrating the disconnect between traditional mental health messaging and men’s experiences. 

Greg discussed various online groups he found that cater to men’s mental health, noting their emphasis on providing spaces for connection, healing, and personal growth in a way that appeals to men. These organizations prioritize creating spaces where men feel empowered to confront their challenges and take control of their mental well-being. He mentioned how these organizations advertise nonjudgmental environments where men can feel comfortable opening up and seeking support. 

He said that unlike traditional therapy settings, which often come with various requirements and expectations, these groups offer a more relaxed approach. He said they have minimal requirements to get started, allowing men to engage without feeling overwhelmed by paperwork or rigid structures. 

Their messaging is tailored to resonate with men, employing masculine tones and imagery to inspire them. He noted how one of the groups messaging on their website specifically says, We have no requirements, no creeds, no gurus, and no judgment. He said, “If you get a guy to show up to a group and the first thing you do is hand him a 27-question form on a clipboard, you’ll lose him. He doesn’t need a guru, he doesn’t need somebody telling him what to do. He deals with that in other aspects of his life.” He continued, “He doesn’t need a list of requirements that he has to meet to join the group. And the most important thing is, he doesn’t need judgment.”

Greg said that by embracing masculine-friendly approaches and fostering a sense of empowerment, these organizations effectively engage men in addressing their mental health needs. These methods encourage men to open up and seek support in a way that aligns with their preferences and values.


Greg shared an exchange with his son from earlier in the day, where his son asked Greg, who is fighting a cold, how he was doing. Greg’s response was the typical, “I’m fine.” Greg described this as a “padded response,” highlighting how men often use phrases like I’m fine, or I’m OK as automatic replies. Greg referenced a video on a men’s mental health page on social media where the presenter emphasized that usually when a man says, I’m fine, he is anything but. 

Greg then directed the discussion to an article by the Jefferson Center titled, I’m Fine: How to Talk to the Men in Your Life About Their Mental Health. The article explores strategies for engaging men who may be reluctant to open up about their struggles, emphasizing the importance of making a meaningful impact within a limited window of opportunity. He said, “When a man comes into your building, we all know that we have a very limited time to get them to talk, a very small window to get them to open up at all.”

Greg elaborated on the article, noting that it outlined five specific steps, beginning with making observations. He illustrated this with a scenario: a man entering a center. While it’s natural to simply ask him how he’s doing upon greeting him, Greg suggested delving deeper to foster openness. 

He emphasized the importance of first observing body language and considering the circumstances that have brought him there, then using these cues to pose thoughtful conversation starters. He said, “Listening and observing with both our eyes and ears, watching, reading body signals, paying attention to their non-verbal communication. Bob, it’s nice to meet you, you seem a little tired today. Are you good?” Greg explained how that observation is not the same as a generic question because it conveys that you are noticing something about him, stating, “Why is it different? Because what you’re telling him is, I see you, I see something in you right now. You look tired, man.” 

Using the same scenario, Greg shared another strategy for creating a space that encourages openness through observation. He said, “Another thing you can say is, Man, that chair doesn’t look real comfortable at all. We can move somewhere else if you want to.” He then explained the significance of this approach, highlighting the importance of considering the environment’s impact on a man’s comfort level. 

Greg stated that when a man finds himself in an unfamiliar public space, his immediate concern is typically locating the exits. Placing yourself between the man and the sole exit, such as when you’re sitting by the door in a conference room, can exacerbate his discomfort. 

Additionally, factors such as what is behind him, like open windows or foot traffic, can contribute to his unease. Greg underscored that men in such situations are already feeling uneasy, as they are not in their own space, but rather in someone else’s domain. The suggestion to adjust seating arrangements aims to alleviate some of this discomfort, providing him with a more conducive environment for openness and conversation.

 “One of the biggest problems for men is they feel alone. Nobody understands what I’m going through, nobody’s been through what I’m going through, nobody can relate to me. That’s what keeps men in isolation. After abortion loss, they feel alone,” Greg said. He shared that the next thing to consider, according to the article, is to share your experience. He explained how saying things like, I get it,  I’ve been there, or I understand grief conveys that someone relates to them and they are not alone. 

“Being able to relate to them through sharing about your own experience is enough to make him feel comfortable to talk about it.” 

Greg touched on the next idea from the article, getting men moving to foster open dialogue or to “Walk and Talk. He explained how this could be as simple as asking if they’d like to take a walk, when possible, to get fresh air. He suggested that this technique is usually successful for two reasons. First, it alleviates their discomfort of being in an unfamiliar place, and second, it capitalizes on the natural bonding tendency of men, who often find it easier to open up shoulder-to-shoulder rather than face-to-face, as women mostly prefer. By getting them moving, he explained, it helps shift their focus away from their immediate surroundings, allowing them to concentrate more on their thoughts without feeling scrutinized. Additionally, he shared that the benefits of exercise and outdoor exposure, such as fresh air and Vitamin D from the sun, further contribute to creating a conducive environment for conversation. Offering to go for a walk can gradually help the man feel more comfortable and inclined to share, thus fostering greater openness in communication. He said, “Offer to go out and walk and talk, and you might see them start to open up a little bit because they’ll feel more comfortable and they’ll start to let their guard down.”

“The other thing is, acknowledge difficult situations. Don’t dance around it. Don’t try to avoid it. They’re there for a purpose. Acknowledge the difficult situations,” Greg advised. He provided examples of saying to someone who has experienced abortion loss, I know it’s difficult to lose a child. Or, to someone considering abortion, I know it’s hard to think about being a parent right now, not being fearful of saying the wrong thing. 

Instead, he said, “Directly addressing the issue may be giving validity to what they are already thinking or feeling.” He continued, “Maybe the only people he’s talked to have said either, Oh man, she’s gotta have an abortion, or You gotta man up. Nobody has acknowledged where he’s at at the moment.” He explained how giving him that validity will encourage him to open up and talk. 

The last recommendation that Greg shared for talking to men about mental health was to ask twice. He explained, “Most men’s knee jerk reaction to how are you doing? is, I’m fine or I’m good, so ask twice.” Greg recounted an old church acquaintance who followed this practice, squeezing every man’s hand and asking, How are you doing? If the response was I’m fine or something similar, he would persist with, No, really though, how are you doing? 

Greg adopted this approach 15 years ago, not limited to recovery situations, but in general interactions. He shared a story that took place at a restaurant recently, where a flustered server responded with I’m fine initially, but upon Greg asking him again, opened up about feeling tired. Greg engaged in a 30-minute conversation with him, demonstrating that sometimes all it takes is a genuine interest and a willingness to ask twice to foster meaningful connections. 

He emphasized the importance of being open, authentic, and understanding that the initial response may not reflect the true feelings of the individual. He said, “It all boils down to something we’ve mentioned many times in this space: be open, be authentic, be honest. Then understand that the first response is that the man doesn’t trust you yet.”


Greg highlighted the “4×4 Method,” a sales technique he adapted for engaging with men. He explained that it involves asking four questions wide and four questions deep to uncover their underlying issues. 

The method hinges on active listening, letting each answer guide the next question. Greg emphasized the need to avoid scripting the conversation, as authenticity is crucial. By employing this approach, Greg discovered that within a few minutes, men often reveal profound struggles, rooted in fear, hidden beneath surface-level emotions like anger. He shared how this deeper understanding enables him to offer more tailored support, emphasizing the importance of avoiding assumptions. He offered a few sample dialogues to illustrate the benefit of using the 4×4 Method.


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