BACKGROUND To ascertain gender-specific determinants of antidepressant and mental health (MH) service use associated with suicidal ideation. METHODS Data used in this study came from the ESA (Enquête sur la Santé des Aînés) survey carried out in 2005-2008 on a large sample of community-dwelling older adults (n = 2,004). Multivariate logistic regression analyses were carried out. RESULTS The two-year prevalence of suicidal ideation was 8.4% and 20.3% had persistent suicidal thoughts at one-year follow-up. In males, the prevalence of antidepressant and MH service use in respondents with suicidal ideation reached 32.2% and 48.9%, respectively. In females, the corresponding rates were 42.6% and 65.6%. Males were less likely to consult MH services than females when their MH was judged poorly. Male respondents with higher income and education were less likely to use antidepressant and MH services. However, males using benzodiazepines were more likely than females to be dispensed an antidepressant. Among respondents with suicidal ideation, gender was not associated with service use. Younger age, however, was associated with antidepressant use. CONCLUSIONS Increased promotion campaigns sensitizing men to the prodromal symptoms of depression and the need to foster access to MH care when the disorder is manageable may be needed.