Improving Mental Health Service Utilization Among Men: A Systematic Review and Synthesis of Behavior Change Techniques Within Interventions Targeting Help-Seeking

Abstract

Compared to women, men are less likely to seek help for mental health difficulties. Despite considerable interest, a paucity in evidence-based solutions remains to solve this problem. The current review sought to synthesize the specific techniques within male-specific interventions that may contribute to an improvement in psychological help-seeking (attitudes, intentions, or behaviors). A systematic review identified 6,598 potential articles from three databases (MEDLINE, EMBASE, and PsycINFO). Nine studies were eligible. A meta-analysis was problematic due to disparate interventions, outcomes, and populations. The decision to use an innovative approach that adopted the Behavior Change Technique (BCT) taxonomy to synthesize each intervention’s key features likely to be responsible for improving help-seeking was made. Of the nine studies, four were engagement strategies (i.e., brochures/documentaries), two randomized controlled trials (RCTs), two pilot RCTs, and one retrospective review. Regarding quality assessment, three were scored as “strong,” five as “moderate,” and one as “weak.” Key processes that improved help-seeking attitudes, intentions, or behaviors for men included using role models to convey information, psychoeducational material to improve mental health knowledge, assistance with recognizing and managing symptoms, active problem-solving tasks, motivating behavior change, signposting services, and, finally, content that built on positive male traits (e.g., responsibility and strength). This is the first review to use this novel approach of using BCTs to summarize and identify specific techniques that may contribute to an improvement in male help-seeking interventions, whether engagement with treatment or the intervention itself. Overall, this review summarizes previous male help-seeking interventions, informing future research/clinical developments.

COVID-19 Experiences and Parental Mental Health

“…Fathers may also feel added pressure to provide for their families in the face of economic hardship and rising unemployment rates, due, in part, to existing social norms and structures, while also taking on more childcare responsibilities than before the pandemic (Strauss, 2020). Studies show that men are less likely to seek out mental health services, and, therefore, it is crucial for social workers to employ a targeted approach for reaching out to fathers (Sagar-Ouriaghli et al, 2019). Conversely, parents between the ages of 18 and 34 had a lower likelihood of experiencing moderate or severe mental distress than those of aged 35 to 44.…”

Improving Mental Health Help-Seeking Behaviours for Male Students: A Framework for Developing a Complex Intervention

“…In response to this, a systematic review investigating help-seeking interventions specifically in males was conducted [22]. This systematic review identified nine interventions targeting mental health help-seeking in men of different age groups, two of which were delivered to male students [23,24].…”

“…As the systematic review conducted by Sagar-Ouriaghli et al [22] consisted of nine interventions with heterogenous clinical populations and dissimilar designs, a meta-analysis could not be conducted [34]. To provide a coherent summary, a novel method that identified the Behavioural Change Techniques (BCTs) was used [35].…”

“…Due to poor help-seeking in male university students and their increased risk of suicide, universities are faced with increasing pressure to implement mental health initiatives, which may mean they are not necessarily evidence based or gender appropriate [21]. Only a handful of evidence-based interventions targeting help-seeking for men have been evaluated [22], with even fewer targeted specifically towards male university students [23,24]. When such strategies are published, the intervention development process is not reported.…”

Self-identified barriers to rural mental health services in Iowa by older adults with multiple comorbidities: qualitative interview study

“…First, patients in this study were largely female and nearly exclusively white. This may reflect the gender and race differences in help-seeking patterns,40 41 healthcare utilisation41 42 and diagnosis rates,43 44 which has been well-documented in other studies. Further, the barriers to access experienced by Iowans of other racial and ethnic backgrounds may not be represented in these findings, indicating a need to research the experiences of racial and ethnic minorities obtaining rural mental healthcare, specifically.…”