Priorities in male psychology

Like the thousands of others who voted 'For', I was ecstatic to see the ratification of a new Male Psychology Section at the Annual General Meeting of the British Psychological Society held on 30 August. Like so many others, I passionately argued that a Section dedicated to providing engaging, critical discussion around issues which disproportionately or uniquely effect men and boys was desperately needed. Indeed, it is my hope that such a forum provides the support and structure necessary to encourage and develop inquiry amongst psychologists into the lived experiences of boys and men across the UK, and beyond. But what to tackle first? For me, four principle areas exist that warrant our immediate attention.

The first is 'male mental health' and the high male suicide rate, as our understanding of men's experiences of poor mental health and help-seeking are still largely underdeveloped. Moreover, many are still reluctant to identify and assess gender as an important factor in the act of suicide, and it is up to the academic community to lead the way in changing that narrative. Encouragingly, there has been increasing discourse in the popular media regarding the way men experience mental health difficulties, and the challenges they face accessing and engaging with service provision. For example, the storyline detailing Aidan's struggles on Coronation Street, created in collaboration with leading men's suicide charity CALM (Campaign Against Living Miserably), demonstrates how this taboo subject is entering public consciousness. However, we must act to create an evidence base which is similarly reflective of men's experiences.

Equivalent attention in needed in relation to the experiences of fathers, including that of both new and experienced fatherhood. So much time has justifiably been dedicated to understanding the psychology and health of mothers, that the challenges and joys of the fatherhood process, from conception and pregnancy, to birth, new-born life, to later transitions and loss, have been largely overlooked. Particularly important is increasing our understanding of how fathers cope with the stresses of fatherhood, and its impact on mental health. For example, statistics provided by The Fatherhood Institute show that, whilst many dads actively embrace new, 'involved' conceptualisations of fatherhood, they still face unique challenges when it comes to parenting, be it accessing and receiving appropriate support, or being excluded or being ignored in the delivery room. We must do more to highlight and improve their experiences.

The third is the need to focus on 'marginalised men', for example those within the prison system, homeless men, and male victim-survivors of domestic and sexual violence. Again, for so long, damaging narratives and stereotypes have served to erase such men from both public and academic discourse, despite the existence of unique, gendered challenges faced by these groups, which are worthy of exploration. All three groups named here experience difficulties in accessing services or are actively excluded and maligned by society – why? And what can we do to improve the lives of men in these unique and challenging situations? Critical questions indeed, worthy of our effort and time.

Finally, we must invest energy in understanding what could arguably be presented as the starting point of many issues for men and boys – their disengagement from education. Boys are more likely than girls to be excluded, to be labelled as having behavioural difficulties, to get worse grades at all levels of education, and to report a lack of enjoyment in the schooling process. Why? And how do these early difficulties predict later life outcomes? A decent education is so important – and we should lend our immediate efforts to exploring the educational underachievement of boys and its outcomes in an attempt to not only improve their direct experiences of the education system, but their prospects in later life.

Ben Hine
Senior Lecturer in Psychology, University of West London
Co-founder of the Men and Boys Coalition

Chris Millar makes the case for a more compassionate and psychologically informed treatment of prisoners ('Careers', August 2018). We fully support this but would suggest that this is applied equally to male prisoners, because all of the reasons Millar gives for supporting women also apply to men. Even where the figures appear to apply more to women (e.g. '53 per cent [of women] report emotional, physical or sexual abuse as a child, compared with 27 per cent of men'), it is very likely that there is underreporting by male prisoners of such abuse. In addition to societal pressures making it more difficult for men to discuss experiences of victimisation, men are often not asked by staff about abuse to the same degree that women are. However, appropriate investigation can be revealing, for example, Murphy (2018) found that 66 per cent of male sex offenders with personality disorders have a history of childhood sexual abuse, 72 per cent have a history of physical abuse and 80 per cent have a history of neglect.

Having compassion for male offenders is more of a challenge than for female offenders, because men often express their trauma in violence and aggression that is directed at others. Regardless, psychologists should rise to this challenge and see male offenders as equally deserving of psychological healthcare as female offenders. Society has much to gain by the successful treatment of men's mental health issues.

Dr Naomi Murphy
HMP Whitemoor, Cambridgeshire

Dr John Barry
University College London

Reference
Murphy, N. (2018). Embracing vulnerability in the midst of danger: Therapy in a high secure prison. Existential Analysis 29(2), 174–188.

Whilst attending interviews this year, hopeful to be chosen for training as a clinical psychologist in our NHS, I spoke to other candidates. After the textbook icebreaking questions, the next was usually about my gender: 'How does it feel to be the only man here?' No offence was taken, to me it was harmless, but one comment struck me: 'I would love to be male in this process, it's such an advantage.'

I felt awkward, but was it true? I knew clinical psychology was a female-majority profession, and I knew concern was growing about the lack of males in psychology. I also remembered the statement on the clearing house website: 'We welcome applications from people from ethnic minority backgrounds, people with disabilities and men as these groups are currently under-represented in the profession' (my italics). But did this mean my chances of getting a place were higher?

No. What I have recently discovered is that overall, male applicants are statistically and systematically less likely to be accepted onto clinical psychology doctorate courses than females.

The clearing house equal opportunities data shows us that this year 678 males and 3088 females applied, and 83 males and 498 females were accepted. Of course, there are going to be more female acceptances, after all, there are far fewer males applying. However, what deeply concerns me is when we look at this in relative percentages.

Males made up 18 per cent of the total applicants, and female applicants made up the other 82 per cent. Yet, those 83 accepted males only made up 14 per cent of total acceptances, with female acceptances making up the other 86 per cent. Relatively speaking then, last year, females had a 16 per cent chance of being accepted onto training, whilst males only had a 12 per cent chance.

Hoping this was just a one off, I explored previous years. The pattern, however, was almost systematic. Apart from 2011, males had a relatively lower chance of being accepted in every year after 2005.

It is fair to say the NHS could benefit with more male psychologists. It makes sense that men and boys entering NHS psychological services can request to see a male psychologist; after all, we all reasonably expect to be able to see a same-sex GP when we have personal physical health issues. More male psychologists could also inform a more gender-inclusive service, which is critical when we consider that suicide is the biggest killer of men under 50 in the UK, and 75 per cent of suicides are male. It is even more critical when we consider that 25 per cent of these males seek help from a health professional in the week leading to their suicide. Is the NHS meeting their needs effectively?

We are not lacking male applicants. There are enough applying to fill over 50 per cent of places in any given year. Though I do not have enough knowledge of doctorate course selection procedures to evaluate them, I do speculate that male applicants typically have lower academic achievement than their female counterparts. It makes sense that the top scoring candidates get accepted; presumably they would make higher-quality psychologists. However, the entry requirements from the clearing house state you need at least a 2:1 degree that confers graduate basis for chartered membership (GBC) and an unspecified amount of clinically relevant experience. It would be reasonable to assume that all, if not the majority, of male applicants met these requirements before paying £23 to apply. Therefore, it is reasonable to say, some university selection procedures, which are not controlled directly by the NHS, are disadvantaging male applicants.

I think the profession needs to look into this further and consider the implications if it were to continue. More diversity in the profession will only better meet the needs of our diverse range of service users. But things could get worse yet; less success could be further pushing males away from the profession. In the last four years, the number of female applicants has fallen by 2 per cent; however, for males this has fallen a staggering 8 per cent from an already relatively small number applying anyway in 2013.

Given clinical psychology training is funded by public taxpayers' money, directed from our NHS, is it fair to say males should have an equal chance of being trained?

Kane Baker
Bristol