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Promoting Men’s Mental Health TThhiiss ppaaggee iinntteennttiioonnaallllyy lleefftt bbllaannkk Promoting Men’s Mental Health Edited by DAVID CONRAD Specialty Registrar in Public Health, Liverpool PCT Associate Member, Centre for Men’s Health Leeds Metropolitan University and ALAN WHITE Professor of Men’s Health, Centre for Men’s Health Leeds Metropolitan University Forewords by ALASTAIR CAMPBELL Mind Champion 2009, author of All In The Mind Spokesman and Chief Strategist to the Prime Minister, 1994–2003 and LOUIS APPLEBY National Clinical Director for Mental Health Radcliffe Publishing Oxford (cid:129) New York CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2010 by David Conrad and Alan White CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20160525 International Standard Book Number-13: 978-1-138-03115-9 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publish- ers. The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently verified. The reader is strongly urged to consult the relevant national drug formulary and the drug companies’ and device or material manufacturers’ printed instructions, and their websites, before administering or utilizing any of the drugs, devices or materials mentioned in this book. This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copy- right.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Contents Foreword by Alastair Campbell vii Foreword by Louis Appleby ix Preface x About the editors xii About the authors xiii About the Men’s Health Forum xxi 1 Introduction 1 Alan White 2 On the edge? An introduction to men’s mental health 7 Peter Branney and Alan White 3 Cultural representations of masculinity and mental health 18 David Conrad and Louise Warwick-Booth 4 Social capital and men’s mental health 26 David Conrad 5 Urban distress and the mental health of men 39 April MW Young 6 Rural men’s mental health 57 Steve Robertson, Keith Elder and Ruth Coombs 7 Fatherhood and mental health diffi culties in the postnatal period 74 Svend Aage Madsen and Adrienne Burgess 8 Marketing masculinities: a social marketing approach to promoting men’s mental health 83 Paul Hopkins and Jeremy Voaden 9 Men and suicide 96 Pete Sayers 10 Men bereaved through suicide 106 Mike Bush 11 Grumpy Old Men? Older men’s mental health and emotional well-being 111 Toby Williamson 12 Combat-related stress 125 Walter Busuttil 13 Anger management and violence prevention with men 142 Sue and Pete Dominey 14 Tackling stress in the workplace 150 Andrew Kinder and Steve Boorman 15 Gay men’s mental health 160 Justin Varney 16 Delivering healthy sexuality programmes for young men 170 Tricia Dressel 17 Working with dads and lads 177 Dennis Jones 18 Tackling racial and cultural bullying in schools 187 Merv Pemberton 19 Working with prisoners and young offenders 195 James Woodall 20 Service provision for homeless men 204 Jo McCullagh 21 Working with drug users 212 Barry Langham and Nick Davy 22 The mental health of men with cancer 219 Martin Neal and David Conrad 23 Running a counselling service for men 230 Christian Scambor 24 Using helplines and the internet 241 Stephen Anderson 25 Promoting men’s mental health services: building from the ground up 247 Jane Powell 26 Conclusion 256 Alan White and David Conrad Index 263 Foreword Alastair Campbell This book is a welcome and important contribution to a thankfully growing debate. Mental illness remains in some ways the last great taboo in our society, a taboo which leads directly to stigma and discrimination which for some can be even worse than the symptoms of their illness. If it is true that one in four of us will at some point have direct experience of mental illness – and sometimes I believe this widely quoted fi gure is an underestimation – then as a society we have to be far more open and honest about the issues that fl ow from that. It is also the case, in very general terms, that men are more likely than women not to be open, and not to reach out for help when they may need it. Good mental health isn’t simply an absence of mental health problems, but a positive state of well-being that enables us to realise our own abil- ities, contribute productively to society and cope with the normal stresses of life. The term ‘mental health’ for many people though is simply another way of talking about mental illness; something which, for men especially, largely remains off limits. Men’s reluctance to acknowledge emotional pressures to others, or frequently even to themselves, can create a build-up of pressure which often only fi nds release at the point of crisis. When the crisis hits, the stigma of mental illness and its incompatib- ility with dominant notions of masculinity mean that men are more reluctant than women to seek the help that they may need. This book in part is about encouraging men who have reached crisis point to seek help. Equally it’s about prevention, and sets out some of the excellent work being done on that. As well as practical work which is happening in communities around the coun- try, there is also much work to be done to change representations of mental health issues in the media – to help de-stigmatise mental illness. Too often, mental illness in the media is linked to violence, whereas in truth the mentally ill are more likely to be the victim than perpetrator of violence. While a lot of good work is already being done, the targeted promotion of men- tal health to men and boys is still in its infancy. In highlighting some of the work already being done, I hope it can inspire practitioners and policy-makers to initiate vii viii FOREWORD BY ALASTAIR CAMPBELL similar interventions, develop new ones and lift the promotion of men’s mental health much higher up the agenda, both in the UK and abroad. Alastair Campbell Mind Champion 2009, author of All In The Mind Spokesman and Chief Strategist to the Prime Minister, 1994–2003 March 2010 Foreword Louis Appleby Men’s health in general is poor in comparison to women’s. Male life expectancy at birth in England is fi ve years less than women. Men are worse at using the health service than women, and more likely to use anonymous sources of health advice like websites. Our challenge is persuading men to take their health more seriously, and to make better use of the services available. We also know that men are three times more likely than women to take their own lives. From the 1970s to the 1990s, whilst the suicide rate fell in older men and in women it was rising in men under the age of 35. That is why, in developing our national suicide prevention strategy, we made sure it included measures aimed at young men. We set out to tackle risk factors such as depression; alcohol problems; drug misuse; unemployment; family and relationship breakdown. The suicide rate in men under 35 is now falling. However, we still need to know more about why men fi nd it diffi cult to talk about their problems; why they are more resistant to health promotion messages; and why they were reluctant to seek help when in distress. We need to be more innovative in the way we try to reach men. We can do this by moving out from more traditional health settings – I have seen mental health teams working in sports halls and high streets. Most importantly, we need to listen to what men, and young men in particu- lar, are saying to us so that we can provide services that they will access when they need them. This book will help stimulate further discussion and hopefully encourage men to seek help or support. It also highlights some positive work going on in the United Kingdom and elsewhere which could be replicated further. Professor Louis Appleby National Clinical Director for Mental Health March 2010 ix

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