Clear objectives and goals for men

In the last decade there has been a drive to engage men in mental health promotion. Many organisations and campaigns have raised awareness and provided support for men, who have begun to fight against societal expectations they will be 'tough' and to 'take on their problems by themselves'. Yet as Assistant Psychologists working with males, we still hear of males feeling 'unmanly' and 'ashamed' of themselves because they are reaching out to services.

We have found that many men, particularly those aged 30 and older, still have an out-dated view. Many want opportunities to talk, yet common 'pitfalls' within services lead them to disengage. With these pitfalls in mind, we would like to put forward progressive ways to engage and support men's mental health.

The first step is to reduce stigmatisation of mental health not only on an individual level, but on a systemic level. Let's change the narrative around depression, suicide, and poor mental health, so that getting help is a 'show of strength' not a 'sign of weakness'. As acknowledged in the World Health Organization's recent 'Comprehensive mental health action plan', it takes true power to dis-empower societal expectation and social constructs.

Then we must become more open about the 'typical coping strategies' used by men around their mental health. We have come a long way in conversations around mental illness and substance misuse – think of the 'Talk to Frank' campaign – but many service users still end up in a cycle of destruction as they can't engage in substance misuse services and mental health services simultaneously, or one service does not address the issues raised by the other.

"Men generally prefer to have clear objectives and personal goals, rather than a generalised 'helping process."

More choice in intervention is needed, tailored towards men and their needs. The evidence shows that men respond better when professionals communicate so that they feel respected, their difficulties understood and their struggles not minimised (e.g. Rebecca Gosling and colleagues' work on community support groups for men living with depression). Language is important – even as we look to move beyond stereotypes, we have witnessed that men do show a willingness to engage in services that are framed to highlight masculine qualities, giving them 'tools' to use to 'build' and 'reconstruct' their resilience.

More broadly, men generally prefer to have clear objectives and personal goals, rather than a generalised 'helping process'. Simon Rice and others emphasised this in a qualitative analysis of barriers and facilitators to young men's access to mental health care, also showing that community-based support can reduce risk factors such as social isolation and shame. Interventions that are more activity-based – for example art therapies or sports – may also be more beneficial for men. Other work has found that older men may prefer social activities such as gardening clubs, which fits with the push for 'social prescribing' as alternative access opportunities to mental health services. Integrating mental health into lifestyle programs also shifts the perspective to prevention, pulling in those who may be reluctant to engage in services.

Looking beyond interventions, it is important that we look towards positive social change. Politics and psychology have a notable overlap. Policies are meant to protect the public, and in their 2019 book chapter 'Should clinical psychologists be political?' Masuma Rahim and Anne Cooke argue that Psychologists should use their professional insight and knowledge to proactively engage in changing policies. This includes reducing stigma and exclusion for men, ensuring clinicians take a step back and avoid looking through the lens of professional privilege.

Through working in mental health services, we have seen how policy and practices can help to normalise these conversations and help-seeking behaviours for men. We believe future policy development should consider men as a vulnerable population, and articulate specific strategies to address the known risk factors that increase mental health risk among them.

Lucy Wilkinson
Higher Assistant Psychologist in Cumbria, Northumberland, Tyne, and Wear NHS Foundation Trust

Rachel Nolan
Assistant Psychologist in Mersey Care NHS Foundation Trust