Depresión masculina: barreras para la búsqueda de ayuda en hombres adultos en Chile
Resumen
En Chile, los hombres representan tan solo un 16,2 % de quienes se atienden por depresión en la Atención Primaria en Salud en el sistema público. Si bien uno de cada diez hombres presenta síntomas de depresión cada año, estos escasamente acuden a los servicios de salud mental. El objetivo de este estudio fue analizar la construcción narrativa de la depresión masculina en adultos y las barreras para la búsqueda de ayuda. Se realizó un estudio cualitativo de relatos de vida que exploran los procesos depresivos en la biografía de los entrevistados y los obstáculos para buscar ayuda en el área de salud mental. Los resultados muestran barreras importantes tanto institucionales, relacionadas con los servicios de salud, como con nociones de la masculinidad que dificultan el reconocimiento de la depresión y sus síntomas, el estigma, así como con tensiones de los valores de la masculinidad. Finalmente se discuten algunas implicancias para las políticas de salud mental.
Palabras clave
Masculinidades, Depresión, Depresión masculina, Salud de los hombresCitas
Addis, Michael E. (2008). Gender and depression in men. Clinical Psychology: Science and Practice, 15(3), 153-168. https://doi.org/10.1111/j.1468-2850.2008.00125.x
Affleck, William; Carmichael, Victoria, & Whitley, Rob. (2018). Men’s mental health: Social determinants and implications for services. Canadian Journal of Psychiatry, 63(9), 581-589. https://doi.org/10.1177/0706743718762388
Aguayo, Francisco. (2022). La depresión masculina y sus síntomas: Un estudio cualitativo con hombres adultos chilenos. Salud Colectiva, 18. https://doi.org/10.18294/sc.2022.3942
Apesoa-Varano, Ester Carolina; Barker, Judith, & Hinton, Ladson. (2016). Shards of sorrow: Older men’s accounts of their depression experience. Social Science & Medicine, 124, 1-8. https://doi.org/10.1016/j.socscimed.2014.10.054
Baker, Peter; Dworkin, Shari L.; Tong, Sengfah; Banks, Ian; Shand, Tim, & Yamey, Gavin. (2014). The men’s health gap: Men must be included in the global health equity agenda. Bulletin of the World Health Organization, 92(8), 618-620. https://doi.org/10.2471/BLT.13.132795
Bertaux, Daniel. (1997/2005). Los relatos de vida. Perspectiva entnosociológica. Bellaterra.
Bidell, Markus. (2016). Mind our professional gaps: Competent lesbian, gay, bisexual, and transgender mental health services. Counselling Psychology Review, 31(1), 67-76. https://doi.org/10.53841/bpscpr.2016.31.1.67
Call, Jarrod B., & Shafer, Kevin. (2018). Gendered manifestations of depression and help seeking among men. American Journal of Men’s Health, 12(1), 41-51. https://doi.org/10.1177/1557988315623993
Centro de Estudios de Conflicto y Cohesión Social. (2018). Radiografía del cambio social. Análisis de resultados longitudinales. Estudio longitudinal social de Chile. ELSOC 2016-2018. COES.
Charmaz, Kathy. (2006). Constructing grounded theory: A practical guide through qualitative analysis. SAGE.
Cleary, Anne. (2017). Help-seeking patterns and attitudes to treatment amongst men who attempted suicide. Journal of Mental Health, 26(3), 220-224. https://doi.org/10.3109/09638237.2016.1149800
Connell, Raewyn. (1995/2003). Masculinidades. Universidad Nacional Autónoma de México.
Departamento de Estadísticas e Información de Salud [DEIS]. (2019). Reportería programa salud mental. Año 2014-2019. Departamento de Estadísticas e Información de Salud, Ministerio de Salud. Recuperado en julio de 2021, de http://www.deis.cl/wp-content/2018/gobCL-sitios-1.0/assets/Dashboard_SaludMental.html
Farrimond, Hannah. (2011). Beyond the caveman: Rethinking masculinity in relation to men’s help-seeking. Health, 16(2), 208-225. https://doi.org/10.1177/1363459311403943
Galasiński, Dariusz. (2008). Men’s discourses of depression. Palgrave.
Gomes, Romeu. (2011). Saúde do homem em debate. Editora FIOCRUZ.
Gómez, Luis, & Núñez, Alicia. (2021). Vigilancia del acceso a la salud en Chile: un sistema de indicadores para monitoreo multidimensional. Revista Médica de Chile, 149(1), 62-75. https://doi.org/10.4067/s0034-98872021000100062
Gosling, Rebecca; Parry, Sarah, & Stamou, Vaiselios. (2022). Community support groups for men living with depression: Barriers and facilitators in access and engagement with services. Home Health Care Services Quarterly, 41(1), 20-39. https://doi.org/10.1080/01621424.2021.1984361
Gough, Brendan, & Novikova, Irina. (2020). Mental health, men and culture: How do sociocultural constructions of masculinities relate to men’s mental health help-seeking behaviour in the WHO European Region? World Health Organization. https://www.ncbi.nlm.nih.gov/books/NBK559706/pdf/Bookshelf_NBK559706.pdf
Hammer, Joseph, & Vogel, David. (2010). Men’s help seeking for depression: The efficacy of a male-sensitive brochure about counseling. The Counseling Psychologist, 38(2), 296-313. https://doi.org/10.1177/0011000009351937
Hayward, Anna, & Honegger, Laura. (2018). Perceived barriers to mental health treatment among men enrolled in a responsible fatherhood program. Social Work in Mental Health, 16(6), 693-709. https://doi.org/10.1080/15332985.2018.1483464
Henderson, Claire; Evans-Lacko, Sarah, & Thornicroft, Graham. (2013). Mental illness stigma, help seeking, and public health programs. American Journal of Public Health, 103(5), 777-780. https://doi.org/10.2105/AJPH.2012.301056
Johansson, Eva; Bengs, Carita; Danielsson, Ulla; Lehti, Arja, & Hammarström, Anne. (2009). Gaps between patients, media, and academic medicine in discourses on gender and depression: A metasynthesis. Qualitative Health Research, 19(5), 633-644. https://doi.org/10.1177/1049732309333920
Johnson, Joy L.; Oliffe, John L.; Kelly, Mary T.; Galdas, Paul, & Ogrodniczuk, John S. (2012). Men’s discourses of help-seeking in the context of depression. Sociology of Health and Illness, 34(3), 345-361. https://doi.org/10.1111/j.1467-9566.2011.01372.x
Kohn, Robert. (2014). La brecha de tratamiento en la Región de las Américas. Documento técnico. Organización Panamericana de la Salud. https://www3.paho.org/hq/index.php?option=com_docman&view=download&category_slug=documentos-nivel-regional-7363&alias=23177-brecha-tratamiento-americas-177&Itemid=270&lang=en
Krumm, Silvia; Checchia, Carmen; Koesters, Markus; Kilian, Reinhold, & Becker, Thomas. (2017). Men’s views on depression: A systematic review and metasynthesis of qualitative research. Psychopathology, 50(2), 107-124. https://doi.org/10.1159/000455256
Kvale, Steinar, & Brinkmann, Svend. (2009). Interviews: Learning the craft of qualitative research interviewing. SAGE.
Latalova, Klara; Kamaradova, Dana, & Prasko, Jan. (2014). Perspectives on perceived stigma and self-stigma in adult male patients with depression. Neuropsychiatric Disease and Treatment, 10, 1399-1405. https://doi.org/10.2147/NDT.S54081
Li, Tianyi, & Gal, David. (2021). The Marlboro men don’t cry: Understanding the gendered perceptions of people seeking mental health care. Journal of Experimental Psychology: Applied, 28(2), 1-15. https://doi.org/10.1037/xap0000360
Mahalik, James, & Dagirmanjian, Faedra. (2019). Working-class men’s constructions of help-seeking when feeling depressed or sad. American Journal of Men’s Health, 13(3). https://doi.org/10.1177/1557988319850052
Martin, Lisa A.; Neighbors, Harold W., & Griffith, Derek M. (2013). The experience of symptoms of depression in men vs women: Analysis of the national comorbidity survey replication. JAMA Psychiatry, 70(10), 1100-1106. https://doi.org/10.1001/jamapsychiatry.2013.1985
McLeod, John. (2010). Case study research in counselling and psychotherapy. SAGE.
Messerschmidt, James W. (2017). Adolescent boys, embodied heteromasculinities and sexual violence. Center for Educational Policy Studies Journal, 7(2), 113-126. https://doi.org/10.26529/cepsj.172
Ministerio de Salud [MINSAL]. (2011). Informe encuesta nacional de salud, ENS 2009-2011. Ministerio de Salud. https://www.minsal.cl/portal/url/item/bcb03d7bc28b64dfe040010165012d23.pdf
Ministerio de Salud [MINSAL]. (2018). Encuesta nacional de salud 2016-2017. Segunda entrega resultados. Ministerio de Salud. https://redsalud.ssmso.cl/wp-content/uploads/2018/02/2-Resultados-ENS_MINSAL_31_01_2018-ilovepdf-compressed.pdf
Ministerio de Salud [MINSAL]; Dirección del Trabajo, & Instituto de Seguridad Laboral. (2011). Primera encuesta nacional de empleo, trabajo, salud y calidad de vida de los trabajadores y trabajadoras en chile. ENETS 2009-2010. Gobierno de Chile. http://www.dt.gob.cl/portal/1629/articles-99630_recurso_1.pdf
Minoletti, Alberto, & Zaccaria, Alessandra. (2005). Plan nacional de salud mental en Chile: 10 años de experiencia. Revista Panamericana de Salud Pública, 18(4-5), 346-358. https://doi.org/10.1590/s1020-49892005000900015
Montiel, Coretin; Duhoux, Arnaud; Tremblay, Gilles; Villeneuve, Raymond; Roy, Jacques; Lavoie, Brigitte, & Houle, Janie. (2022). Psychological distress and help-seeking facilitators in quebec men: Findings from a province-wide survey. International Journal of Men’s Social and Community Health, 5(1), 1-26. https://doi.org/10.22374/ijmsch.v5i1.57
Morales, Alejandra; Catalán, Angélica, & Pérez, Felipe. (2018). Los padres también se deprimen en el postparto: Comprendiendo el fenómeno desde la voz de sus protagonistas. Polis (Santiago), 17(50), 161-181. https://doi.org/10.4067/s0718-65682018000200161
Morison, Linda; Trigeorgis, Christina, & John, Mary. (2014). Are mental health services inherently feminised? The Psychologist, 27(6), 414-416. https://cms.bps.org.uk/sites/default/files/2022-11/kinger12.pdf
Nazar, Gabriela; Gatica-Saavedra, Mariela; Provoste, Alvaro; Leiva, Ana Maria; Martorell, Miquel; Ulloa, Natalia; Petermann-Rocha, Fanny; Troncoso-Pantoja, Claudia, & Celis-Morales, Carlos. (2021). Factores asociados a depresión en población chilena. Resultados encuesta nacional de salud 2016-2017. Revista Médica de Chile, 149(10), 1430-1439. https://doi.org/10.4067/s0034-98872021001001430
Oliffe, John L.; Broom, Alex; Rossnagel, Emma; Kelly, Mary T.; Affleck, William, & Rice, Simon M. (2020). Help-seeking prior to male suicide: Bereaved men perspectives. Social Science and Medicine, 261, 113173. https://doi.org/10.1016/j.socscimed.2020.113173
Patrick, Sarah, & Robertson, Steve. (2016). Mental health and wellbeing: Focus on men’s health. British Journal of Nursing, 25(21), 1163-1169. https://doi.org/10.12968/bjon.2016.25.21.1163
Patton, Michael. (1990/2002). Qualitative research and evaluation methods (3rd ed.). SAGE.
Piña, Carlos. (1988). La construcción del “si mismo” en el relato autobiográfico (Documento de Trabajo 383). FLACSO Chile.
Piña, Carlos. (1999). Tiempo y memoria. Sobre los artificios del relato autobiográfico. Proposiciones, 29, 1-5.
Rice, Simon M.; Oliffe, John L.; Kealy, David; Seidler, Zac E., & Ogrodniczuk, John S. (2020). Men’s help-seeking for depression: Attitudinal and structural barriers in symptomatic men. Journal of Primary Care and Community Health, 11. https://doi.org/10.1177/2150132720921686
Rice, Simon M.; Telford, Nic R.; Rickwood, Debra J., & Parker, Alexandra G. (2017). Young men’s access to community-based mental health care: Qualitative analysis of barriers and facilitators. Journal of Mental Health, 27(1), 59-65. https://doi.org/10.1080/09638237.2016.1276528
River, Jo. (2018). Diverse and dynamic interactions: A model of suicidal men’s help seeking as it relates to health services. American Journal of Men’s Health, 12(1), 150-159. https://doi.org/10.1177/1557988316661486
Rochlen, Aaron B.; Paterniti, Debora A.; Epstein, Ronald M.; Duberstein, Paul; Willeford, Lindsay, & Kravitz, Richard L. (2010). Barriers in diagnosing and treating men with depression: A focus group report. American Journal of Men’s Health, 4(2), 167-175. https://doi.org/10.1177/1557988309335823
Roxo, Luis; Silva, Manuela, & Perelman, Julian. (2021). Gender gap in health service utilisation and outcomes of depression: A cross-country longitudinal analysis of European middle-aged and older adults. Preventive Medicine, 153, 1-8. https://doi.org/10.1016/j.ypmed.2021.106847
Sarikhani, Yaser; Bastani, Peivand; Rafiee, Mohammad; Kavosi, Zahra, & Ravangard, Ramin. (2021). Key barriers to the provision and utilization of mental health services in low-and middle-income countries: A scope study. Community Mental Health Journal, 57, 836-852. https://doi.org/10.1007/s10597-020-00619-2
Seidler, Zac E.; Dawes, Alexei J.; Rice, Simon M.; Oliffe, John L., & Dhillon, Haryana M. (2016). The role of masculinity in men’s help-seeking for depression: A systematic review. Clinical Psychology Review, 49, 106-118. https://doi.org/10.1016/j.cpr.2016.09.002
Seidler, Zac E.; Rice, Simon M.; Kealy, David; Oliffe, John L., & Ogrodniczuk, John S. (2020). Getting them through the door: A survey of men’s facilitators for seeking mental health treatment. International Journal of Mental Health and Addiction, 18(5), 1346-1351. https://doi.org/10.1007/s11469-019-00147-5
Seidler, Zac E.; Rice, Simon M.; Oliffe, John L.; Fogarty, Andrea S., & Dhillon, Haryana M. (2018). Men in and out of treatment for depression: Strategies for improved engagement. Australian Psychologist, 53(5), 405-415. https://doi.org/10.1111/ap.12331
Staiger, Tobias; Stiawa, Maja; Mueller-Stierlin, Annabel S.; Kilian, Reinhold; Beschoner, Petra; Gündel, Harald, & Krumm, Silvia. (2020). Masculinity and help-seeking among men with depression: A qualitative study. Frontiers in Psychiatry, 11, 1-9. https://doi.org/10.3389/fpsyt.2020.599039
Stake, Robert. (2006). Multiple case study analysis. The Gilford Press.
Stiawa, Maja; Müller-Stierlin, Annabel; Staiger, Tobias; Kilian, Reinhold; Becker, Thomas; Gündel, Harald, & Krumm, Silvia. (2020). Mental health professionals view about the impact of male gender for the treatment of men with depression: A qualitative study. BMC Psychiatry, 20(1), 1-13. https://doi.org/10.1186/s12888-020-02686-x
Thornicroft, Graham; Chatterji, Somnath; Evans-Lacko, Sara; Gruber, Michael; Sampson, Nancy; Aguilar-Gaxiola, Sergio, & Kessler, Ronald C. (2017). Undertreatment of people with major depressive disorder in 21 countries. British Journal of Psychiatry, 210(2), 119-124. https://doi.org/10.1192/bjp.bp.116.188078
Vicente, Benjamin; Saldivia, Sandra, & Pihán, Rolando. (2016). Prevalencias y brechas hoy: Salud mental mañana. Acta Bioethica, 22(1), 51-61. https://doi.org/10.4067/s1726-569x2016000100006
Whittle, Erin L.; Fogarty, Andrea S.; Tugendrajch, Siena; Player, Michael J.; Christensen, Helen; Wilhelm, Kay, & Proudfoot, Judith. (2015). Men, depression, and coping: Are we on the right path? Psychology of Men and Masculinity, 16(4), 426-438. https://doi.org/10.1037/a0039024
Publicado
Cómo citar
Descargas
Datos de los fondos
-
Agencia Nacional de Investigación y Desarrollo
Números de la subvención 21180911
Derechos de autor 2025 Francisco Aguayo, Guillermo Rivera-Aguilera

Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.