The Man Island Project: Engaging men in mental health treatment for depression

Abstract

Understanding the role of masculinity in men’s mental health help-seeking has been a topic of concern for decades, given evidence that many men are reluctant to seek professional treatment. While prevalence rates indicate men are half as likely as women to be diagnosed with depression, men’s low help-seeking rates and poor engagement in mental health treatment may explain this difference. The need to understand help-seeking barriers among men and to overcome them with novel clinical, professional training and policy solutions are clear when considering the economic and social burden of men’s psychiatric illness, suicide, substance misuse and physical violence. Focusing on why men seek help for depression, what does and does not engage them, and alerting clinicians to these critical components of treatment will serve to improve the quality of care—and by extension, the health outcomes of men and their families. The following studies aimed to firstly explore men’s experience in mental health treatment for depression, then to feed this back into actionable strategies for the improvement of practice and training in clinicians working with men. This thesis includes five key studies employing a range of quantitative and qualitative methodologies. Key findings narrow from an initial comprehensive review of the men’s mental health literature and the limitations of its existing deficit-based focus, to insights garnered from men in therapy about what they find engaging that centre on being oriented and educated to the system and receiving goal-focused, structured treatment. The thesis concludes with an expert consensus study of evidence-informed guidelines for working with men and how these can be broadly introduced into a continuing education training program to upskill clinicians on the role of gender competency in their practice.