Males’ mental health disadvantage: An estimation of gender-specific changes in service utilisation for mental and substance use disorders in Australia

Harris, Meredith; Diminic, Sandra; Reavley, Nicola; Baxter, Amanda J.; Pirkis, Jane; Whiteford, Harvey

doi:10.1177/0004867415577434

Cited by 101 publications

(45 citation statements)

References 31 publications

(62 reference statements)

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“…While not specifically suggested by the majority of men, it may be worth considering a more resource‐intensive process, which involves adapting or creating specialised services for male suicide support, alongside existing but indirectly related support networks, such as Men's Sheds . Given the tension reported by family/friends in understanding normal vs risky behaviour change, the men's desire for autonomy and the well‐established fact that men report lower rates of help‐seeking than women for suicidality, this approach has important benefits in reaching men in environments they already participate in. This is especially true for those men who wish to cope in a manner consistent with masculine values such as self‐sufficiency, problem‐solving and independence or those men who do not (at present) have the capacity to directly challenge culturally entrenched expectations about male behaviour.…”

Section: Discussionmentioning

confidence: 99%

Tensions in perspectives on suicide prevention between men who have attempted suicide and their support networks: Secondary analysis of qualitative data

Fogarty

Spurrier

Player

et al. 2017

Health Expectations

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BackgroundMen generally have higher rates of suicide, despite fewer overt indicators of risk. Differences in presentation and response suggest a need to better understand why suicide prevention is less effective for men.ObjectiveTo explore the views of at‐risk men, friends and family about the tensions inherent in suicide prevention and to consider how prevention may be improved.DesignSecondary analysis of qualitative interview and focus group data, using thematic analysis techniques, alongside bracketing, construction and contextualisation.Setting and participantsA total of 35 men who had recently made a suicide attempt participated in interviews, and 47 family and friends of men who had made a suicide attempt took part in focus groups. Participants recounted their experiences with men's suicide attempts and associated interventions, and suggested ways in which suicide prevention may be improved.ResultsFive tensions in perspectives emerged between men and their support networks, which complicated effective management of suicide risk: (i) respecting privacy vs monitoring risk, (ii) differentiating normal vs risky behaviour changes, (iii) familiarity vs anonymity in personal information disclosure, (iv) maintaining autonomy vs imposing constraints to limit risk, and (v) perceived need for vs failures of external support services.ConclusionTension between the different perspectives increased systemic stress, compounding problems and risk, thereby decreasing the effectiveness of detection of and interventions for men at risk of suicide. Suggested solutions included improving risk communication, reducing reliance on single source supports and increasing intervention flexibility in response to individual needs.

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Section: Discussionmentioning

confidence: 99%

Tensions in perspectives on suicide prevention between men who have attempted suicide and their support networks: Secondary analysis of qualitative data

Fogarty

Spurrier

Player

et al. 2017

Health Expectations

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“…Globally, prevalence estimates of depression in men vary between 3.8% and 6.4%, depending on the measurement and definition [ 2 ]; in 2012, the rate of male suicide (15 per 100,000) was nearly double the rate in women (8 per 100,000; [ 7 ]). In Australia, the estimated 12-month prevalence of mental or substance use disorders among men is 20.4% [ 8 ], and men die from suicide at nearly 4 times the rate of women [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Preliminary Evaluation of a Brief Web and Mobile Phone Intervention for Men With Depression: Men’s Positive Coping Strategies and Associated Depression, Resilience, and Work and Social Functioning

et al. 2017

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BackgroundPrevious research has identified that men experiencing depression do not always access appropriate health services. Web-based interventions represent an alternative treatment option for men, are effective in reducing anxiety and depression, and have potential for wide dissemination. However, men do not access Web-based programs at the same rate as women. Programs with content explicitly tailored to men’s mental health needs are required.ObjectiveThis study evaluated the applicability of Man Central, a new Web and mobile phone intervention for men with depression. The impact of the use of Man Central on depression, resilience, and work and social functioning was assessed.MethodsA recruitment flier was distributed via social media, email networks, newsletters, research registers, and partner organizations. A single-group, repeated measures design was used. The primary outcome was symptoms of depression. Secondary outcomes included externalizing symptoms, resilience, and work and social functioning. Man Central comprises regular mood, symptom, and behavior monitoring, combined with three 15-min interactive sessions. Clinical features are grounded in cognitive behavior therapy and problem-solving therapy. A distinguishing feature is the incorporation of positive strategies identified by men as useful in preventing and managing depression. Participants were directed to use Man Central for a period of 4 weeks. Linear mixed modeling with intention-to-treat analysis assessed associations between the intervention and the primary and secondary outcomes.ResultsA total of 144 men aged between 18 and 68 years and with at least mild depression enrolled in the study. The symptoms most often monitored by men included motivation (471 instances), depression (399), sleep (323), anxiety (316), and stress (262). Reminders were scheduled by 60.4% (87/144). Significant improvements were observed in depression symptoms (P<.001, d=0.68), depression risk, and externalizing symptoms (P<.001, d=0.88) and work and social functioning (P<.001, d=0.78). No change was observed in measures of resilience. Participants reported satisfaction with the program, with a majority saying that it was easy (42/51, 82%) and convenient (41/51, 80%) to use. Study attrition was high; 27.1% (39/144) and 8.3% (12/144) of the participants provided complete follow-up data and partial follow-up data, respectively, whereas the majority (93/144, 64.6%) did not complete follow-up measures.ConclusionsThis preliminary evaluation demonstrated the potential of using electronic health (eHealth) tools to deliver self-management strategies to men with depressive symptoms. Man Central may meet the treatment needs of a subgroup of depressed men who are willing to engage with an e-mental health program. With further research, it may provide an acceptable option to those unwilling or unable to access traditional mental health services. Given the limitations of the study design, prospective studies are required, using controlled designs to further elucidate the effect of...

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“…There has been some improvement. For example, the proportion of Australian men seeking help for mental health problems increased between 2006 and 2012 (Harris et al, ). However, public health efforts to normalise men's help‐seeking for mental illness does not guarantee services are providing appropriate and engaging treatment for men.…”

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confidence: 99%

Men In and Out of Treatment for Depression: Strategies for Improved Engagement

Seidler

Rice

Oliffe

et al. 2018

Australian Psychologist

105

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Objective: While the prevalence of major depressive disorder continues to rise, many men are reticent to seek and sustain psychotherapy. The current study explored Australian men's experiences with treatment for depression with a view to guiding recommendations for improving treatment engagement. Method: Twenty men (23-64 years) who had received psychotherapy for depressive symptoms in the past 3 years took part in individual, semi-structured interviews. Interviews were transcribed verbatim and coded in line with interpretive descriptive methodologies. Results: Findings suggested men's preference for a transparent orientation to treatment, including the provision of a clear structure for therapy. Men's preferred structure included focusing on individualised goals and expected progress, establishment of trust, and a sharing of decisional control. Providing an action-oriented functional treatment with targeted skills attainment was recommended as most engaging. The focus on "doing" in treatment, as distinct from pure talk therapy, engendered feelings of strength and empowerment in the men, bridging self-management of symptoms and wellness. Most participants, however, did not receive a treatment style that properly engaged them, and articulated clear recommendations for changes needed. Conclusions: Findings highlight the potential for development and dissemination of gender sensitive, strength-based clinical training and treatment options for better engaging men in psychotherapy for depression.As a cross-institutional and cross-continental research team, the authors of this manuscript make up a unique mix of early, mid-career and longtime leading experts in the men's mental health field. This team was responsible for the first systematic review of the area and continues aiming for rigorous, innovative empirical contributions.Additional supporting information may be found in the online version of this article at the publisher's website: http://onlinelibrary.wiley.com/doi//suppinfo. Appendix S1. Qualitative Interview Schedule-Men with Depression Study. ZE Seidler et al.Engaging men in treatment for depression Australian Psychologist 53 (2018) 405-415

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Males’ mental health disadvantage: An estimation of gender-specific changes in service utilisation for mental and substance use disorders in Australia

Abstract: Recently implemented initiatives have improved males' likelihood of service utilisation, particularly their use of specialised mental health services. Although the gender gap may have narrowed, improving males' access to services should remain a policy priority.

Cited by 101 publications

References 31 publications

Tensions in perspectives on suicide prevention between men who have attempted suicide and their support networks: Secondary analysis of qualitative data

Tensions in perspectives on suicide prevention between men who have attempted suicide and their support networks: Secondary analysis of qualitative data

Preliminary Evaluation of a Brief Web and Mobile Phone Intervention for Men With Depression: Men’s Positive Coping Strategies and Associated Depression, Resilience, and Work and Social Functioning

Men In and Out of Treatment for Depression: Strategies for Improved Engagement

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