Term of Graduation

Spring 2009

Date of Publication


Document Type


Degree Name

Doctor of Philosophy (Ph.D.) in Social Work and Social Research


Social Work




Masculinity, Primary care (Medicine) -- Research



Physical Description

1 online resource (2, 158 pages)


Suicide completion in the United States is a public health problem that claims over 30,000 lives annually. Most of these suicide victims are white males who die by firearm, and who typically are not taking antidepressant medication and are not involved in mental health treatment at the time of death. Depression is closely linked to suicide death, and treatment for depression is provided mainly within primary health care settings where most suicide decedents have been seen at some point in the year prior to their death. The rate of male depression is likely under-reported, partly due to gender-bias within primary care and also due to the lack of gender-specific assessment instruments and interventions.

This study was conducted to better understand primary care providers' experience of treating depressed males. A grounded theory approach explored the contradiction that males in the U.S. complete suicide four times as often as females, yet females are diagnosed with depression twice as often as males. This study is guided by the proposition that gender roles are socially constructed, and it is shown that common masculine gender-role stereotypes influence males' sense of self in ways that can limit their ability to engage with others in times of need, and consequently increase their risk for depression and suicide. The influence of shame and violence on suicide completion involving males is also reviewed.

Semi-structured interviews were conducted with 16 primary care providers to elucidate their subjective experience of treating patients who present with complaints of depression and suicidal risk. Participants described two alternative ways of treating depression, one that adhered to the medical model review of systems, and one that focused on the patient-provider relationship. There is also within this study an outline of an approach to the treatment of depression and suicidal risk that involves more collaboration between primary care and mental health providers. It is suggested that further integration of those two disciplines/professions can be enhanced by the efforts of social workers because of their mental health training and expertise: related implications for social work practice are discussed.


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