In this blog, the second in the series about the Beat Stress, Feel Better project being delivered by the Men’s Health Forum, I will be sharing the vision of what will be delivered and why.
Presenting to services:
Having set the tone of the challenge of men’s health in the previous blog by looking at both health and social outcomes, it feels as if a logical question to ask is, what might be the barriers faced by men in accessing services? The question is framed to demonstrate the answer will differ for each individual, but through looking at statistics some patterns emerge that might point to some of the answers. Wang et al (2013) in the British Medical Journal detailed that male GP presentation rates were broadly 32% less than for females in 2010, the year from which the data was extracted. The research took into account presentations related to reproductive health, finding this accounted only marginally for this difference. The largest divergence in presentation rates emerged between the ages of 16 and 60, according to the research and were broadly similar both before and after those ages. Looking back at the previous blog, it is noted that men make up only 36% of referrals to Improving Access to Psychological Therapies, in 2012/13 (HSCIC), though they made up 78% of suicides in 2013 (ONS).
Employment patterns:
What might be underlying these differences? Discussion of stigma, the impact of gender roles and other psychosocial factors are massively significant, but I have decided to leave that discussion out of the scope of this blog. Instead, I have decided to look at a prevalent and pragmatic barrier to accessing services for many men between the ages of 16 and 60: employment! According to figures published by the Office for National Statistics (ONS) across February to April 2014, 75% more men work full-time than women. From the same report, men work longer hours (36.7 as opposed to 26.9 for women) and are three times more likely to work 45 hours or more. All of which is to say that having the time to go to services is a barrier to accessing them, potentially as much as other impediments.
That gives a picture of a practical barrier to accessing service, one that leads to the suggestion of exploring digital or online services that can tackle the challenges of time and space; but what does research say about the suitability of digital mediums and the best means of engaging men?
Engagement:
In 2014 the Men’s Health Institute at Leeds Beckett and the Men’s Health Forum were commissioned by the Movember Foundation to examine how to make mental health services work for men. The report was published as a manual and is available here to read in full or purchase from the Men’s Health Forum’s website. The report produced ten tips for mental health services looking to engage men. While each of the tips speaks to the Beat Stress, Feel Better project I wanted to highlight three tips in particular.
Communicate with men in a way that respects their maleness: mental health services must respect the difficulties that some men may experience through psychological distress that might impact their sense of themselves as men. Ensuring this respect is likely to lessen the impact of self-stigma in accessing services.
Make sure the setting is right: ensuring services can be delivered from spaces that are broadly ‘male friendly’ can support engagement through familiarity. This can include virtual settings where people are at liberty to access a service wherever they are, thereby allowing them to be in a comfortable space for them.
Incorporate peer support: the impact of this can be holistic. That is to say that a positive impact can also be experienced by the person supporting as well as the person being supported. Peer support can have the impact of reducing the perceived threat to masculinity through a shared experience.
Strength of the digital platform:
Since 2013 the Men’s Health Forum has offered Man MOT, an anonymous and confidential digital support service connecting service users with GPs through webchat and email services, allowing access - at no cost, 24 hours a day - to high quality health information and signposting. The service was evaluated by a PhD student from City University in 2015 and the findings showed how the digital offer was supporting service users. Through qualitative research conducted via interviews with service users, the researcher, Hollie Ingoldby, found service users were accessing Man MOT to be reassured that their concerns warranted the input of a GP. Accessing Man MOT was a way of granting the service user permission to going to their GP. Searching the internet for health information is not a new activity for men, however in making use of Man MOT service users were searching out an authority figure, a highly qualified medical professional with the knowledge and experience to support them. This was a key feature of Man MOT noted by service users. It was reported that contact with Man MOT provided the context for further contact with medical professionals including empowering them to know what to ask for. All of the above is not to take away from the benefits of a digital platform in terms of addressing the barrier to access posed by a lack of time.
Service:
Beat Stress, Feel Better will draw on the learning from above research to deliver: a one-to-one service staffed by experienced mental health professionals, contactable via webchat and email, trained in engaging men through the right approach and language; a landing page with targeted information, support and guidance; access to the Men’s Health Forum’s Beat Stress, Feel Better manual and support through a moderated peer-to-peer platform where service users will be able to share experiences and strategies.
In the next blog, I will be sharing some of the less exciting project management stuff that we have used to help get to this point.