The Health Implications of Fatherhood: A Comprehensive Literature Review.

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? …

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.

The clinical content of preconception care: preconception care for men

The Intersection of Medicine and Urology: An Emerging Paradigm of Sexual Function, Cardiometabolic Risk, Bone Health, and Men’s Health Centers

All nurses have a responsibility to ensure that they actively promote both mental and physical health and wellbeing. This article aims to bring together current thinking and evidence about nursing and men's mental health promotion. Key areas of concern outlined are the high rate of suicide in men, the expression of depression in men and the problems of masculinity when related to seeking help for mental health. The article highlights the importance of language and the normalising of distressing feelings when working with men and suggests that nurses need to recognise how men can experience depression differently, actively identify and address suicidal thinking, and provide gender-sensitive interventions. Additionally, nurses working with men need to demonstrate 'male-positive' values and offer future-focused and action-oriented interventions (such as solution-focused, coaching or cognitive behavioural therapy approaches) that contribute to a sense of agency, promote hope and are more engaging for many men.

Urological disorders impact men's physical health and mental wellbeing, necessitating integrated mental health support within urology. This article examines the psychological distress associated with conditions like prostate cancer and erectile dysfunction, compounded by societal expectations that often discourage men from seeking help. It highlights the importance of a holistic care model that addresses physical symptoms and psychological impacts. The authors advocate for a paradigm shift towards comprehensive care, enhanced training for urologists and dismantling societal stigma to improve patient outcomes and establish a new standard in men's health care.

Historically, the specialty of urology has focused on single-system diseases. In recent years, however, there has been increasing recognition of the interconnectivity between the various systems, such as cardiovascular disease, metabolic syndrome, erectile dysfunction and prostate cancer. This constellation of disease/syndrome and dysfunction may place urologists at the centre of men's overall health concerns. As urologists considering taking on a leadership role in men's health, they should also consider their potential in helping men suffering from the significant burden of a mental health disorder. Urologists may have a unique opportunity to identify mental health issues in their male patients, influence healthy behaviour change, and successfully refer men, who might otherwise not seek help, to appropriate medical/psychological care.

Designing community sports-based programmes for men with mental illness: A qualitative study of the Offload rugby league programme

Despite rising mental health problems worldwide, engaging men to seek mental health support is challenging. Male-only lifestyle interventions have shown promise for improving men's physical health, but the overall impact of these programs on psychological outcomes is unclear. This review aimed to evaluate the impact of male-only lifestyle interventions on men's mental health and to identify if any study or intervention features were associated with effectiveness. A systematic literature search with no date restrictions was conducted across four databases and returned 15 946 citations. Nine studies were eligible for inclusion, representing 1427 participants. Risk of bias was generally low across studies, although none were specifically powered to detect changes in mental health. Overall, significant group-by-time effects were reported for 26% of mental health outcomes examined. In the fixed-effects meta-analyses, small-to-medium intervention effects were observed for mental health-related quality of life (SMD = 0.24), self-esteem (SMD = 0.51), and positive affect (SMD = 0.58). Insights into effective study or intervention features were limited because of the low number of heterogeneous studies. Although male-only lifestyle interventions have improved men's mental health in some circumstances, studies that are specifically powered to detect long-term changes are urgently required, particularly in groups with pre-existing mental health concerns.

Despite men's health playing a significant role in the well-being of infants, children, and women, there is a gap in maternal and child health research which more broadly considers men's health as a component of family's and community's overall well-being and for the sake of men's own health and well-being, particularly from the perspective of men with marginalized identities, such as Black men, and community members. Therefore, our community-based participatory research study aimed to explore what community members perceive as protective and risk factors for the general health of men in a low-income community using a generic qualitative approach with focus groups and thematic analysis. We identified six protective factor themes (health behaviors, economic stability, expected male responsibilities, healthcare engagement, social network, and faith, spirituality, and driving forces), as well as six risk factor themes (health behaviors, impact of mentorship, experience of driving forces, healthcare avoidance, mental health concerns, and systemic bias, racism, and social inequity). There are actionable steps public health practitioners and policymakers should prioritize, including addressing structural barriers to men's health, such as by combating discrimination and increasing access to healthcare, removing barriers to mental health care, and creating opportunities for increased social support. These strategies can give way to greater opportunities for men to engage in protective behaviors that can both improve their health across the life-course and positively impact the health of mothers, infants, children, and communities.

Men's poor mental health outcomes and heightened risk for suicide have been linked to their maladaptive responses to life stressors. In this photovoice study of 21 New Zealand-based men who experienced depression, anxiety, and suicidality, participants' home emerged as an important place and resource for dealing with their mental health challenges. Utilizing the therapeutic landscapes "enabling places" framework combined with masculinities theory, we explored the affective, material, and social resources of home for determining how men's mental health challenges play out behind closed doors. Reflexive thematic analysis was used to analyze individual photovoice interviews, revealing how home served along a continuum of enabling and disabling spaces. In this context, home could be a place of refuge, despair, and self-care for participants, and the specificities of those inhabiting forces are described thematically. In terms of refuge, the materiality of home created an affective sense of safety that afforded men spaces to privately conceal and deal with their mental health challenges. Home could also invoke despair in being a risky or disabling place where men felt trapped and isolated, heightening self-harm risks. These same spaces could also promote men's self-care practices in the context of managing their anxiety, depression, and/or suicidality. The current study findings confirm the need for more research that is place and space based to inform mental health supports for men. Implications for men's mental health promotion are discussed.

Three years have passed since the Australian Government's Department of Health released its National Men's Health Strategy 2020-2030. Presently, little evidence is available to show whether the strategy has achieved success in rectifying men's mental-ill health, particularly the experience of stigma when expressing vulnerable emotions such as grief. Concurrently, research within the field of psychology continues to show that men experience significant pressure to conform faithfully to their socialised gender role. Given the focus to better men's mental health in Australia, this study ascertained people's perceptions of men experiencing grief. The study adopted social constructionism to explore how participants perceived a fictious character living with grief using a hypothetical vignette by way of convenience sampling. Nine males and seven females who resided in Australia participated in answering seven questions concerning the character's experience of grief. Inductive thematic analysis yielded three themes which collectively represented perceptions of masculinised grief. Notably, avoid stigma by fixing grief, avoid stigma by quickly getting over grief, and avoid stigma by suppressing the expression of grief. SO WHAT?: The study suggests that a stronger research focus should be targeted towards rectifying stigma resulting from men's expression of vulnerable emotions by incorporating in depth interviews in order to create worthwhile public awareness initiatives. Such initiatives should seek to minimise societal pressures that are placed upon men to ensure conformity to dominant masculine ideologies and their socialised gendered role when experiencing and expressing vulnerable emotions such as grief.

There is a critical need for community advocates to understand the mental health needs of Black or African American (BA) men and the hesitancy in regard to accessing mental health services. Traditional, western masculinity powerfully influences how BA men perceive mental health struggles and vice versa, how reaching out for help and support affects an individual is perceived as being a man. Racial discrimination, marginalization and institutional oppression need to be taken into account when exploring mental health among BA men, especially in how these experiences interact with the enactment of masculinity. There is a great need for those who work with BA men to be aware of the mental health trends of this population, and the sociopolitical dynamics in the United States that contribute to them, equipped to effectively employ gender-adapted strategies with BA men, and familiar with evidenced-based approaches for promoting BA men's health and wellbeing in a way that is culturally responsive.

Suicide in men: the time is ripe for active scientific investigations.

This study investigated whether men's mental and physical health problems during the middle years may be attributed, in part, to the influence of varying levels of, and changes in, work control among members of a rural midwestern cohort. Specific study objectives were to examine (a) how trajectories of work control influence men's mental and physical health outcomes and (b) how this influence is mediated by the trajectories of personal control during the middle years. The study used four waves of data on 318 employed men across 10 years of midlife. Variables included self-reported work control, personal control, and mental and physical health. The results supported the hypothesis that both the initial level and change in work control contribute to men's mental and physical health outcomes during the middle years. This influence was mediated by the initial level and change in personal control. Our results demonstrate the dynamic nature of work experiences, personal control beliefs, health, and long-term health consequences due to work conditions in a sample of middle-aged men. We discuss the theoretical implications of this.