Jason was in Grade 5 when he started having feelings for other boys. Because of those feelings he was called names, beaten up in school and even sexually assaulted. Since high school, Jason has been diagnosed with depression, anxiety, borderline personality disorder and post-traumatic stress disorder. He has also survived a suicide attempt. Through the Man-Up Against Suicide project at the University of British Columbia, Jason created an installation project that allowed him to open up about his experiences. In Canada, men account for three out of every four suicides -- with seven men dying by suicide every day. And the risk is even greater for gay and bisexual men. Gay men are four times more likely to attempt suicide than heterosexual men. Which isn't surprising since they also experience higher levels of harassment, discrimination in the workplace and are more likely to be the victims of violent crime. Evidence suggests that interventions, like the Man-Up Against Suicide project, work to facilitate conversations around men's mental health. Art creates a space for men such as Jason to open up about mental illness and suicide. The process of creation can be therapeutic, and the product facilitates dialogue so others who are similarly challenged can speak out or seek help.

(Photo: Gettystock) These artistic methods help to destigmatize mental illness. Research has also shown that people are more likely to engage and participate in outreach programs and projects that are held in alternative spaces -- by getting away from the traditional clinic based therapeutic settings, programs can help combat self-stigma and shame. In fact, when recruiting for the Man-Up Against Suicide project, there was so much interest the study had to be expanded to include everyone who was interested. It's not the only Canadian success story. Another project, a theatre piece featuring Canadian Armed Forces veterans who share their own stories, has been featured across Canada and internationally. The performances have resulted in several audience members coming forward and seeking help. Veteran suicides are well documented in the United States with approximately 20 veterans dying by suicide daily. The numbers in Canada are less transparent. A Globe and Mail investigation revealed that at least 71 veterans from the Afghanistan war have died by suicide. But the numbers don't reveal the true scale of the issue since Canada only releases data for Regular Force male suicides, which does not include veterans or the Reserve Force. However, we know among Canadian veterans it is estimated that nearly 50 per cent of all regular force personnel in Canada will experience symptoms associated with a mental and/or alcohol overuse disorder. "Government agencies across Canada need to support and scale up such targeted community-based programs which can advance the mental health of vulnerable subgroups of men." The performance piece, Contact! Unload, focuses on raising awareness about veteran mental illness, including suicide risk, post-traumatic stress disorder, anxiety, depression and substance and alcohol overuse. Through the performance, veterans are able to express the complexities of their experiences with war and coming home. These types of programs take a targeted approach to addressing male suicide -- they take into account diverse social factors that put men at higher risk for mental illness and suicide. They work within communities, and in collaboration with the men, to create programming that has an understanding of the unique lived experiences and efforts toward remedying the accompanying challenges. Community based approaches can also work well for Indigenous men, a sub-group who face disproportionately high rates of suicide. They are five to six times more likely to die by suicide than non-indigenous men, and are 25 times more likely to die by suicide than non-indigenous women. They are also at a higher risk for a multitude of mental illnesses including depression, post-traumatic stress disorder and substance and alcohol overuse.

(Photo: Gettystock) Through the DUDES Club in British Columbia, a program that is expanding Canada-wide, men can get together, share stories and address their health issues with the support of other men. A recent documentary highlighting the work of the DUDES Club demonstrates the importance of community approaches to health care and highlights the need for culturally sensitive men's mental health services. When Jason revealed his artwork for the first time he said he needed people to know the long-term effects of bullying and harassment. And the soldiers from the Contact! Unload play said that if they can prevent even just one more suicide then all of their hard work will have been worth it. Guys attending the DUDES club talk to the benefits of leaving their armour at the door and engaging in authentic conversations about their vulnerabilities and strategies for reducing suicide. Government agencies across Canada need to support and scale up such targeted community-based programs which can advance the mental health of vulnerable subgroups of men. The benefits from these investments will reach many women, children and other men by reducing male suicide.