Early and effective intervention in male mental health.

Abstract

Although high numbers of men report mental health difficulties, many do not seek professional help. Jim Pollard of the Men's Health Forum highlights the new approaches needed to ensure that men feel comfortable accessing and using mental health services .Although 12 men kill themselves every day in the United Kingdom, it is not widely discussed. Suicide is the single most common cause of death in men aged under 35 years, and rates for middle-aged men (45-59 years) are at record levels,[1] with three-quarters of the 6,122 people who took their own lives in the United Kingdom in 2014 being men. Suicide is often the end of a long battle with mental health, and the intention of mental health services is to intervene long before a person becomes suicidal. In trying to improve these figures, National Health Service (NHS) England, since 2010, has provided Improving Access to Psychological Therapies (IAPT); despite these services being under pressure, in March 2016, over 118,989 referrals were received by IAPT.[2] A continuing concern is that in spite of high figures for men's mental health difficulties, around two-thirds of IAPT referrals are for women.If significant numbers of men are reaching crisis point without accessing traditional services, it suggests two things: new services must be considered, and new ways of communicating with men must be investigated to allow men to feel comfortable using both new and existing services. This process will need to consider how men talk about mental wellbeing and acknowledge that there may be challenges in getting men to engage in these discussions.Traditional public health messaging can present a binary approach that is not always applicable to real life. These messages - whether around smoking, drinking, diet or mental wellbeing - have had limited effectiveness with men. For example, men are three times more likely to report frequent drug use and nearly three times more likely to become alcohol dependent than women.[3] Certainly, mental health messaging does not seem to be reaching men.[4]Taboo around mental health begins long before discussing suicide. In a survey conducted by Opinion Leader for the Men's Health Forum for Men's Health Week 2016, 34% of men said that they would be embarrassed or ashamed to take time off work for a mental health concern such as anxiety or depression, compared to 13% for a physical injury. This feeling was higher among men already facing mental health challenges, where 46% were embarrassed or ashamed, 38% were concerned that their employer would think badly of them if they took time off work for a mental health concern and 26% were concerned about a physical injury. Again, among men with existing mental health concerns, the figure was higher at 52%.[3]Finding a New LanguageAlthough medication provides an aid for many with mental health challenges, IAPT is based on the view that talking therapies are less prone to side effects than drugs in the treatment of mental health conditions such as depression and anxiety.In order for talking therapies to be effective, the user must be engaged, meaning language must be chosen carefully to enable the user to talk about mental wellbeing as comfortably and early as possible. This can appear challenging as men have been shown to be more reluctant to discuss mental wellbeing than women.[4] Stress, on the other hand, is a word in everyday use, which is used as a blanket term referring to usually external factors bearing down on the individual, the sort of pressures that impact at the start of a potential mental health issue. Because of its quotidian nature and the sense of stress as being external to the individual, the hypothesis is that discussing stress could be a gateway for engaging men.The Men's Health Forum developed the concept of talking to men about stress during Men's Health Week 2016 posing the question 'what do you do to beat stress? …