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opinion: a men's health strategy depends on reaching men before crisis, not after
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"i spent most of my career being told that prevention is unaffordable. but i now believe the opposite is true," says canada's former minister of health mark holland.
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what took me to the edge of my life was not an event or diagnosis. it was shame.
shame that i wasn’t enough. that i should have been stronger. that there was something weak in me and my job was to hide it. i didn’t learn that in a crisis. it was absorbed so early that i mistook it for my own character. men are taught this in a thousand small ways before anyone thinks to ask.
when i lost my seat in the house of commons in 2011, most people assumed that was where it started. it wasn’t. by the time the votes were counted, i had already spent months coming apart, quietly, on the road and in hotel rooms. shame did what shame does. it told me the answer was to hide it better.
i didn’t seek help, and it nearly cost me my life.
i have told that part before. what i have said less often is how ordinary it felt. there was no single catastrophic moment. it was a slow accumulation, a quiet talking myself out of it, and a script handed down through generations that quietly costs us the people we love. it does its worst work in the stretch before anyone would think to look.
canada’s first men and boys’ health strategy is expected this fall. that is a genuine milestone. the minister and her team deserve real credit for getting it this far. but whether it saves a single life depends entirely on a decision that has not yet been settled: do we build a system that waits for men to arrive in crisis, or one that reaches them before the crisis?
right now, we wait. our systems only respond when a man reaches the emergency room, an addictions program or a coroner’s report. it doesn’t focus on reaching him at 17, entering the trades and losing his support network; at 24, isolated and spending more time with algorithms than people; or at 29, becoming a father and most open to help.
for younger men, the greatest risks are not chronic diseases but suicide, overdose and the slow loss of connection that often comes before both. the pattern is consistent: distress is recognized only when it’s most severe – and costly to treat.
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i recently joined the canadian men health foundation’s board because they’re doing the unglamorous part: reaching men where they are, before anything has gone visibly wrong, in trades and workplaces, in sports and schools, and in the digital spaces where many young men socialize, and where radicalization is often ready to fill the gap.
that experience has made it clear what the national strategy needs to get right.
first, reach young men through people they trust. a peer who has faced the same struggles will connect better with a 22-year-old than the best clinician he never sees. embedding trained peer supporters in schools, workplaces and trades programs is not an add-on. it is the front line.
second, treat the digital environment as a health issue. young men are shaped daily by online spaces that often deepen isolation and resentment. digital literacy, credible content and peer-led engagement online are forms of prevention.
third, recognize fatherhood as an opportunity. becoming a father is one of the few times when men are genuinely open to change. a father who learns to name what he feels doesn’t just help himself. he raises children less likely to inherit that silence.
none of this is a moonshot. ireland built the world’s first national men’s health strategy in 2008, improving men’s life expectancy and reducing male suicide through sustained, upstream prevention. we know what works. what we have lacked is the will to fund the invisible part, the part with no ribbon-cutting, where success looks like a crisis that never happens.
i spent most of my career being told that prevention is unaffordable. but i now believe the opposite is true. these men are our fathers, sons, brothers and friends. we can keep building the system that meets them at the bottom or build the one that reaches them on the way down.
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mark holland is a board member of the canadian men’s health foundation and canada’s former minister of health.
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