Making sense of sadness: eliciting illness meaning and experience of depression in rural Irish males

Abstract

BackgroundTo analyse and understand the illness experience of depression in rural Irish males. Secondary objectives are to identify their explanatory models of depression, inform mental health service provision in rural areas, and identify suitable interventions for future research.AimIsolation and rural masculinities are thought to predispose rural Irish males to depression. Despite high levels of depressive symptoms among men in rural areas, lack of awareness and a different language around depression, coupled with stoicism, social isolation, and feminized mental health services, results in reduced help-seeking, under-reporting and under-treatment of depression in this population.MethodA purposive sample, selected through the West Cork and Galway/Roscommon Mental Health Services, and General Practitioners, of fourteen men, aged between 25 and 64 years of age, were interviewed in their homes. Data was collected through face-to-face interviews, using the McGill Illness Narrative Interview schedule. These interviews were recorded, transcribed to text, and analysed using a thematic content analysis. Results were integrated using the model of qualitative description.ResultsMost of the fourteen men reported alcohol and social isolation as precipitating factors of their depression. Suicidal intent and a stubborn attitude were common. Recovery-promoting behaviours included good social and family support, peer-support groups, religious practice and, universally, physical work.ConclusionRural Irish men view their depression as a disconnection from community, masculinity can be engaged in a positive way to improve mental health, and a sense of belonging is key to recovery. Future research should focus on the development of interventions incorporating these findings, such as community farming initiatives.