Alternative interventions for young men's mental health

The main aim of this thesis was to explore the effectiveness and acceptability of alternative interventions for facilitating help-seeking and improving the mental health of young adult males. Based on recommendations for innovative ways to develop interventions that facilitate mental health help-seeking specific to men (Addis & Mahalik, 2003), the interventions employed in this thesis integrate exercise and psychotherapeutic strategies, and make use of sport as a vehicle for mental health promotion. Findings from the Randomised Controlled Trial (RCT) comprising study 1 provided support for a team-sport/psychosocial intervention (Back of the Net; BTN programme) for improving depressive symptoms among men. Employing qualitative methodology, study 2 explored men’s perceptions and experiences of receipt, implementation and acceptability of the BTN programme. Findings from this process evaluation reported positively on the use of sport as a vehicle for accessing and engaging men in a mental health intervention. The RCT employed in study 3 found that the combined strategies of exercise and a sports-based psychotherapeutic intervention delivered via the internet were not beneficial for mental health beyond the effects of exercise alone. Thus, the studies comprising this thesis further provide both quantitative and qualitative evidence in support of the effectiveness of exercise for improving mental health. With respect to the therapeutic processes that may mediate the antidepressant effect of exercise, study 4 reports on exercise self-efficacy, physical self-concept and global self-esteem as potential mechanisms of change. Temporal findings from study 4 suggest that these psychosocial mechanisms may be important factors associated with the effect of exercise on depression. Overall, the findings from this thesis advance our understanding of the effectiveness and acceptability of exercise and CBT-based interventions delivered within the context of sport for young men’s mental health

“It’s made me feel less isolated because there are other people who are experiencing the same or very similar to you”:Men’s experiences of using mental health support groups

This article explores men's experiences of using peer support groups for coping with mental distress. Support groups are organised groups in which people come together to mutually support each other with a shared health concern. There has been increasing research on men's mental health help seeking, but men's use of support groups for mental health difficulties, and the ways support groups could benefit men, is not well understood. Drawing upon 19 interviews from a South Wales, UK qualitative study which explored men's mental health help seeking, coping and management, this article explores the perceived benefits of support groups for men experiencing emotional difficulties. Findings highlight how men who attended groups valued the sense of shared understanding of experiences and the mutual respect that group settings presented them with. Support groups provided a safe space with opportunities to reconstruct traditional masculine norms through reciprocating unique and tailored mental health support to others and developing a certain role within that group. This gave men a sense of purpose which further facilitated mental health management. Findings also indicated the social benefits that support groups can have to men who may have limited social networks or be experiencing isolation. This article adds to the growing literature that focuses on men's mental health experiences and illustrates the benefits of support groups for men in distress. The author suggests that primary services need to be aware of how support groups can positively support men and promote them as an opportunity for connection and unique support

Promoting mental health in men

Health promotion is essential to improve the health status and quality of life of individuals. Promoting mental health at an individual, community and policy level is central to reducing the incidence of mental health problems, including self-harm and suicide. Men may be particularly vulnerable to mental health problems, in part because they are less likely to seek help from healthcare professionals. Although this article discusses mental health promotion and related strategies in general, the focus is on men's mental health

The impact of social relationships on men's mental health and wellbeing

Section A: Presents a systematic search and narrative review of research into the association between social relationships and depression in men. Social relationships are defined with reference to three key areas of research, and some proposed causal links with depression are outlined. A review of relevant studies identifies some patterns in findings, but also substantial limitations of the extant literature. Implications for clinical practice are considered, including a need to consider the quality of men’s relationships during the assessment of depression and as a target of therapeutic interventions. Recommendations for future research include the need for well-designed longitudinal studies, and qualitative research exploring how men draw on relationships to maintain their emotional wellbeing. Section B: Presents a study in which grounded theory methodology was used to generate a model of contemporary men’s talking groups. The model first describes the experiences leading men to seek out and attend a group. Processes operating in the group are defined, with an emphasis on creating a safe space for men to self-disclose, interrogate the concept of manhood, and create authentic, deep relationships with one another. The perceived benefits of these processes beyond the group are described. The model is linked to theories of group psychotherapy, social identity and social relationships. Implications for practice and research are considered

Impact of COVID-19 restrictions on men's mental health services in Australia

Introduction: Mental health services in Australia have faced significant challenges during the COVID-19 pandemic in adopting the new changes to reach service users. The rapid changes in the situation and surge in the number of people seeking help or in crisis have led services to use many strategies which they would not have considered in normal situations. The services working with men were especially experiencing the difficulty in fulfilling the needs of their clients as the evidence shows that Australian men’s help seeking behaviour is lower than women. Materials and Methods: A survey was conducted online to ascertain the level of impact on their services, their client groups and the lessons learned during online service delivery. The survey was conducted by Australian Men’s Health Forum with 20 questions, both with multiple choice and narrative answer options.  Results: In total, 53 male-specific services have responded. 81% made changes to their services; 43% enabled their staff and volunteers to work from home; 84% adopted strategies to conduct their meeting virtually with clients. Conclusion: Most services made significant changes such as phone/video counselling, but felt that this cannot be the norm post-pandemic as it lacks the empathic human touch to service delivery. Innovative strategies were developed to reach men living in remote/rural areas with no cost or travel time. However, there are many concerns about vulnerable groups such as older adults, Aboriginal and Torres Strait Islanders and men living in remote areas, who have limited access to electronic devices and reliable internet access. Implications: These findings have implications for reorienting frontline health services, particularly in times of widespread crisis when service delivery models need to change. There is, therefore, a direct consequence for building healthy public policy in relation to the health of men and boys from marginalised/vulnerable groups that incorporates healthy environments and positive social connections

Masculinity, Social Connectedness, and Mental Health: Men's Diverse Patterns of Practice.

Men's mental health has remained undertheorized, particularly in terms of the gendered nature of men's social relations. While the importance of social connections and strong supportive networks for improving mental health and well-being is well documented, we know little about men's social support networks or how men go about seeking or mobilizing social support. An in-depth understanding of the gendered nature of men's social connections and the ways in which the interplay between masculinity and men's social connections can impact men's mental health is needed. Fifteen life history interviews were undertaken with men in the community. A theoretical framework of gender relations was used to analyze the men's interviews. The findings provide rich insights into men's diverse patterns of practice in regards to seeking or mobilizing social support. While some men differentiated between their social connections with men and women, others experienced difficulties in mobilizing support from existing connections. Some men maintained a desire to be independent, rejecting the need for social support, whereas others established support networks from which they could actively seek support. Overall, the findings suggest that patterns of social connectedness among men are diverse, challenging the social science literature that frames all men's social relationships as being largely instrumental, and men as less able and less interested than women in building emotional and supportive relationships with others. The implications of these findings for promoting men's social connectedness and mental health are discussed

Can lifestyle interventions improve Canadian men's mental health? Outcomes from the HAT TRICK programme.

Engaging men in mental health promotion can be difficult because of reticence about help-seeking, especially for gender neutral programmes. Developments in men's health research has pointed to the success of gender-sensitized programmes to increase men's engagement in healthy lifestyle interventions targeting physical activity and healthy eating; however, less is known about the impact of these interventions on men's mental health. This study explored changes to men's depression risk and health-related quality of life at post-intervention (12 weeks) and 9-month follow-up, after participating in HAT TRICK, a gender-sensitized lifestyle intervention for overweight men. Participants completed validated self-report measures of mental health at baseline, post-intervention (12 weeks) and 9-month follow-up. Men's scores on the Male Depression Risk Scale (MDRS) and the SF-12 questionnaire, including physical health (PH12) and mental health (MH12) composite scores, were analyzed using mixed linear models to assess linear trends. At baseline, men (N = 62) had a mean age of 50.98 (SD = 10.09) years and BMI of 35.87 (SD = 5.51) kg/m2. Results show that both the MDRS and the MH12 showed improvements in participants' mental health, with significant linear trends (p = 0.003; p = 0.003) qualified with significant quadratic trends over time (p = 0.02; p = 0.03). There were no significant changes in the PH12 over time. Gender-sensitized programmes for overweight men, such as HAT TRICK, are a promising approach to positively influence components of men's mental health, with the potential for sustained improvements over the long term

Exploring the effectiveness of an integrated exercise/CBT intervention for young men's mental health

Objective. This pilot study investigated the effectiveness of a team-based sport/psychosocial intervention (Back of the Net, BTN) with an individual exercise (IE) and a control condition for the mental health of young men. Design. Ten-week randomized control trial and eight-week post-intervention follow-up. Methods. A total of 104 sedentary males aged between 18 and 40 years were recruited and randomly assigned to the BTN, IE, or a control condition. The BTN programme integrated team sport (i.e., football) and cognitive-behavioural techniques. IE sessions included aerobic and resistance training. The control group refrained from exercise. Participants completed the Beck Depression Inventory – 2nd Edition (BDI-II), the Social Provisions Scale (SPS) and a short qualitative questionnaire at pre-intervention, week 5, post-intervention and at 8-week follow-up. Results. Participants in both the BTN and the IE condition demonstrated a significant decrease in BDI-II scores compared to the control condition at post-intervention and at 8-week follow-up. The IE condition demonstrated significantly greater perceived social support than the BTN condition at week 5 and the control group at 8-week follow-up. Qualitative data support the main empirical findings. Conclusion. Exercise-based interventions were effective in reducing symptoms of depression in a non-clinical community sample of young men. The BTN programme demonstrated potential for improving the mental health of young men however larger scale community-based research is warranted to further examine the effectiveness of this type of intervention

Men, masculinity and male gender role socialisation: implications for men's mental health and psychological help seeking behaviour

The work comprises of three sections, Section A: Literature review This section reviews men's underutilisation of professional health care services and brings together the extant literature on men's help seeking for psychological difficulties. This is discussed specifically in relation to theories of male gender role socialisation and male development. Section B: Empirical Paper. Introduction: Men’s reluctance to access health care services has been under researched even though it has been identified as a potentially important predictor of poorer health outcomes among men. Male gender role socialisation and male development may be important in accounting for men’s underutilisation of mental health service in the UK. Method: A cross-sectional online survey was used to administer standardised self-report measures that were subject to regression analysis. Five hundred and eighty-one men from the UK general population completed the survey and 434 participants formed the final regression model sample. Results: Men who score higher on measures of traditional masculine ideology, normative alexithymia and fear of intimacy reported more negative attitudes towards seeking professional psychological help. Normative alexithymia accounted for the variance in help seeking previously observed by fear of intimacy during regression modelling. Sexuality and ethnicity also significantly accounted for a proportion of unique variance in men’s help seeking attitudes. People who had received previous support from a mental health professional showed more positive attitudes towards seeking psychological help. Conclusions: Men’s attitudes towards seeking psychological help were closely related to traditional masculine ideology and normative alexithymia. A degree of content or construct overlap may exist between normative alexithymia and fear of intimacy in men. Limitations of this study and implications for future research are discussed. Section C: Critical Review. This section provides critical appraisal and reflection on the study and research process. Personal learning is discussed alongside clinical implications and ideas for further research