Making Mental Health Services work for Men Chris Stein, Senior Project Officer, Men s Health Forum
MAKING MENTAL HEALTH SERVICES WORK FOR MEN Where have we been and where are we now? What do effective services look like? Tools, support and looking forward
WHERE WE HAVE BEEN AND WHERE WE ARE NOW Barriers to access Health Outcomes System Behaviours
Health Outcomes HEALTH OUTCOMES 1 in 5 die before the age of 65 Life expectancy 79.1 years, as opposed to 83 for women Men account for 71% of CVD deaths under the age of 65 Men are nearly three times more likely than women to become alcohol dependent 78% of all suicides are men
Social Outcomes SOCIAL OUTCOMES 95% of prison population is male 72% of male prisoners suffer from two or more mental health disorders 87% of rough sleepers are male Men commit 86% of violent crime
HOW DOES THIS HAPPEN? Relationship between Political Cultural System Practical
CULTURAL Stigma Being Strong Help Seeking How men are viewed Workhorse Less informed and less likely to follow advice Crazy or dangerous Weakness Seek help at a later stage
POLITICAL Fatalism Belief that we can t change men and we can t change services False perception of gender equality Cultural confusion Belief that only men are privileged, only women are disadvantaged About what we want from men Political reluctance To engage with men s issues Differing standards Of cultural sensitivity to the representation of men and women Absence of sympathy and understanding For men with mental health problems, who may even be regarded with fear
PRACTICAL Drivers and Barriers to taking time off work to see a GP Drivers - Self-employed - Workplace culture: confidence to confide in colleagues about health issues Barriers - Masculinity - Importance of work in life - Ethnicity: white - Annual income < 20 000
PRACTICAL What is the experience of employed men with mental health concerns? Men with mental health concerns 28% UNCONCERNED they would be thought badly of by employer for taking time off work for a mental health appointment. 20% neither concerned nor unconcerned 52% CONCERNED their employer would think badly of them if they took time off work for a mental health appointment Male working population 37% UNCONCERNED 23% neither concerned nor unconcerned 41% CONCERNED
PRACTICAL What is the experience of employed men with mental health concerns? Levels of embarrassment. Men with mental health concerns 32% not embarrassed to take time off work for a mental health appointment 20% neither embarrassed or not embarrassed 48% embarrassed to take time off for a mental health appointment Male working population 41% not embarrassed 24% neither embarrassed or not embarrassed 35% embarrassed
SYSTEM CHALLENGES KNOW THY DATA! JSNA Gender disaggregated Not disaggregated [PERCENTA GE] [PERCENTA GE]
SYSTEM CHALLENGES KNOW THY DATA! JSNAs reporting by gender on Mental Health Indicators IAPT referral Generalised anxiety disorder incidence Hospital admissions for self-harm Mixed anxiety and depression Hospital admissions for self-harm Depression Incidence Dementia Incidence Suicide 0% 10% 20% 30% 40% 50% 60% 70%
IMPROVING ENGAGEMENT OF AND SERVICE DELIVERY TO MEN Written by David Wilkins, former Policy Lead for the Men s Health Forum. Delivering Male Effective Practice in male mental health Based on research conducted by Professor Steve Robertson and the team from the Centre of Men s Health at Leeds Beckett University Written by David Wilkins, Men s Health Forum and Mariam Kemple, MIND
WHAT ELEMENTS SHOULD EFFECTIVE DELIVERY CONTAIN? Untold Problems Preceded Delivering Male Provides an overview of the issues in the mental health of men and boys Delivering Male Follows on from Untold Problems Central question: What can be done to make sure we meet the mental health needs of men and boys more effectively in the future?
WHAT DO EFFECTIVE SERVICES LOOK LIKE? The 7 Big Ideas Treat men as individuals Gender fundamental to person s sense of self Interagency working Focus on boys and early years Stigma More research needed on the impact of gender Individuals - groups Develop shared objective for health This relates to other areas of the presentation
WHAT DO EFFECTIVE SERVICES LOOK LIKE? The 7 Big Ideas Promoting Services More nuanced approach required Third Parties Engage friends and families Services can change to meet needs Facilitate and support the role of third parties
WHAT DO EFFECTIVE SERVICES LOOK LIKE? The 7 Big Ideas Joined up approach Compounding challenges Training and improved knowledge base Promotion of equality issues Whole-life problems need whole-life solutions Development of professional and academic knowledge base
MAKING MENTAL HEALTH SERVICES WORK FOR MEN Top 10 Tips Understand the obstacles Setting Respect men s maleness Peer support Be positive about men and boys Publicise positive examples Clear objectives that users understand Look beyond the intervention Make use of shared activities to offer support Evaluate and disseminate
MAKING MENTAL HEALTH SERVICES WORK FOR MEN Obstacles Respect Unhealthy coping mechanisms Men s sense of themselves Remove them where possible Compounding distress Particular communities Understanding and respect
MAKING MENTAL HEALTH SERVICES WORK FOR MEN Positivity Clear objectives Solution-focussed Core value in effective interventions Goals Enthusiasm CBT
MAKING MENTAL HEALTH SERVICES WORK FOR MEN Activity-based Setting Consistently successful in engagement Safe male space Address stigma Familiarity Give and take Virtual settings
MAKING MENTAL HEALTH SERVICES WORK FOR MEN Peer support Publicise Experiences in common Encourages help seeking Reduced threat to masculinity Mutual benefits Role of those admired
MAKING MENTAL HEALTH SERVICES WORK FOR MEN Beyond the intervention Evaluate and Disseminate Positive social change Shortage of research Challenges to other services Data and outcomes Challenge stigma and exclusion Share
CASE STUDY MEN IN SHEDS Milligan et al 2013 of Lancaster University Centre for Ageing Research Systematic review of Men s Sheds and other gendered interventions for older men Noted limitations but a qualitative sense of benefit, especially in combatting isolation
TOOLS, SUPPORT AND LOOKING FORWARD Organisation
TOOLS, SUPPORT AND LOOKING FORWARD System Service providers Local Authorities and CCGs Grant Makers
Organisations TOOLS, SUPPORT AND LOOKING FORWARD Toolbox Talks out of the box sessions to get men talking about their health through discussion points and quizzes John Ryan comedian, health through laughter and allowing health to be spoken about Publications manuals and How to guides Slide Shows presentations on health Training tailor made men s health training
TOOLS, SUPPORT AND LOOKING FORWARD Individuals
One man in five dies before 65. Together we can change that