I’m not going to let post-traumatic stress run my life anymore. —Josh Hansen, veteran
SALT LAKE CITY — Like the macho character in "Parks and Recreation," a mustachioed, Ron Swanson-like man sits in a leather armchair in his wood-paneled office. A moose head is hanging on the wall, as is a small hand ax.
Dr. Rich Mahogany is a "real man." That means that he's not very good at identifying emotions, has a predilection for swearing loudly and sometimes listens to a tape of a car revving to relax.
But Dr. Mahogany will also admit that there are things that "real men" could use some help with — like talking about their mental health.
"Pissed off? Stressed out? Burned out?" he asks. "All of these are common feelings men experience. But if felt regularly, or ignored, these emotions can fester like an untreated battle-ax wound."
Welcome to “Man Therapy,” an online program that the Utah Department of Health is launching to target the stigma around mental health that persists among men.
It's "completely different" than anything the department has done before, according to suicide prevention coordinator Andrea Hood. "It uses more humor and more of a racy, kind of a bold approach to addressing these issues."
In 2013, Utah had the third-highest suicide rate in the nation, after only Montana and Alaska, according to the American Foundation for Suicide Prevention.
And in Utah, as in the nation, the highest suicide rates are found among men — mostly middle-aged men, said Kimball Gardner, a prevention program director with the National Alliance on Mental Illness in Utah.
"Just saying, 'Get up and deal with it' — that's real," said Gardner, who helped bring Man Therapy to Utah. "That is real. And that's real among men. We need to do things to help ourselves, but sometimes we get in places where we don't even see that there's others around us who care about us."
That’s where Josh Hansen found himself after returning to Utah, haunted by his experiences in war.
Hansen is a lot like the fictional Dr. Mahogany, played by John Arp. The 44-year-old retired U.S. Army sergeant did two tours in Iraq, detecting and disabling roadside bombs. Hansen still uses military time, his language can be a little salty and he hates the term “disorder” — as in “post-traumatic stress disorder.”
"You can tell a veteran, 'You got the post-traumatic stress disorder,' they can't get past that," Hansen said. "None of my guys have a disorder. They just have post-traumatic stress. And they're driving on."
Driving on. That's a phrase left over from his time in the Army — a soldier's ethos, a way of saying, "Suck it up and drive on."
Hansen said many veterans are steeped in the stigma that it's unmanly to seek help.
Hansen, dogged by depression and feelings of uselessness after suffering injuries in Iraq, started drinking, getting into fights and landing in jail. He gained 45 pounds. He stopped going out because groups of people made him nervous. He lost the small business he started when he was still a teenager, a motocross racing company.
Fellow veterans were going through the same thing, but Hansen didn't know it.
It wasn't until he lost his fourth friend to suicide — all veterans — that he realized he needed to take action.
He got a boost from his father, a Vietnam vet who waited years to get professional help and told his son not to make the same mistake.
“Everyone looks up to their dad, right?” said Hansen. “My dad’s not weak. Anybody calls my dad weak, I’d punch them in the nose,” he joked. “So if my dad went in and got help and said it worked, hey, it’s got to be all right.”
A little over a year ago, Hansen started Continue Mission, a non-profit that reaches out to veterans and gets them active. It could be cycling or skiing or just a workout session. The trick is to get veterans out of the house and talking to each other. So far, nine veterans Hansen met through Continue Mission have gone on to seek professional help, he said.
Continue Mission is listed as a resource on the Man Therapy website. Hansen recalled showing the site to a group of veterans recently.
“They were listening to some of the stories of civilians on there talking about the depression they’ve been through, and the veterans are nodding their heads going, ‘Wow, these guys are having the same symptoms I’m having,’” Hansen said.
Man Therapy and its stern host are lampooning the impossible ideals of manliness while simultaneously drawing people in. There's something comforting about Dr. Mahogany, who comes off like an old friend who will just as soon talk you through your feelings as he will hand you a cigar and a back slap.
On the website, users can watch video testimonials from other men who have struggled with depression and substance abuse. An "18-point head inspection" gently asks users how much they've been sleeping, how often they self-blame and how often they drink. Dr. Mahogany even demonstrates "subtle, yet manly" breathing exercises.
And the site links people to local therapists, with the option to filter them by specialization, like men’s issues.
Hood acknowledged that the humorous, offbeat approach to suicide prevention may raise some eyebrows.
"Because we are kind of a conservative state, that was something we took into consideration,” Hood said. According to her, officials decided to take the risk because “what we've normally been doing hasn't been having the effects we want it to have."
Last year, 555 Utahns died from suicide, she said. About a dozen go to the emergency room each day for self-inflicted injuries.
Man Therapy, developed in Colorado as a partnership between the public health department and a Denver-based ad agency, has now spread to Idaho, Wisconsin, Ohio, Pennsylvania and Massachusetts.
To date, more than 85,000 people have taken the "18-Point Head Inspection" and 25,000 have clicked on the national suicide crisis line phone number, Hood said.
Gardner acknowledged that just because someone clicked on a link and took a quiz doesn’t mean they’ll seek help. This program isn’t meant to solve the suicide crisis, but to give men their first entrée into thinking about mental health, he said.
"There is the notion that 'I think I can work this out myself,' but then there's also a notion that 'I don't know where to turn, I don’t know who to talk to,'" Gardner said.
As for Hansen, there are still times when he falls back into old habits, when he doesn't want to leave the house, when he finds himself lost in memories of war. But instead of staying home, Hansen hops in his car, gets on his bike or calls someone to talk.
And he refuses to be embarrassed about that.
“Part of me will always be there. Part of me will never leave Iraq," Hansen said. "But I’m not going to let post-traumatic stress run my life anymore."
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