“You’ve gotta be that tough crust exterior man”: Depression and suicide in rural-based men.

Suicide rates in Canada are highest among rural men. Drawing on photovoice interviews with 13 women and two
men living in a small rural Canadian town who lost a man to suicide, we inductively derived three themes to describe
how contextual factors influence rural men’s experiences of depression and responses to suicidal thoughts: (a) hiding
depression and its cause, (b) manly self-medicating, and (c) mobilizing prevention. Further discussed is how gender
relations and ideals of masculinity within rural milieu can inhibit men’s acknowledgment of and help seeking for mental
illness issues. Participants strongly endorsed a multifaceted approach to the destabilization of dominant ideals of
masculinity that likely contribute to depression and suicide in rural men.