Open mind: Changing face of men's mental health

Open mind: Changing face of men's mental health

Sports stars are encouraging a growing number of young men to seek help with their mental health.

However, the message is not getting through to older males, says Helen O'Callaghan.

Over the past 10 years, a new message to men — to talk, to express their feelings, to show vulnerability — has emerged out of the macho environment of Ireland’s locker rooms.

Eight years ago, former Munster player Alan Quinlan opened up about his depression.

In 2016, Rugby Players Ireland launched their Tackle Your Feelings campaign, with some of Ireland’s rugby heroes sharing challenges they’ve faced and urging other men to do likewise.

Bressie, Brent Pope, and David Beckham have all opened up about issues that affected their mental landscape — topics that men kept well under wraps only a few short decades ago.

This drive to liberate men from a view of masculinity that endorsed being strong, stoic, and independent was much needed. And it still is.

Dr Eddie Murphy, clinical psychologist and adjunct associate professor at UCD School of Psychiatry — and Operation Transformation psychologist — sees a “bigger impetus in under-30s men to reach out for counselling”, for help with emotional/mental health difficulties, but he finds men older than that are still more likely to adopt a buttoned-up approach when it comes to expressing tough emotions.

“Men who conform to that traditional male role model — putting up with things, wanting to feel ‘strong’ and in control — are less likely to reach out when they’re in distress,” he says.

Until very recently, the ‘boys don’t cry’ view of manhood was the dominant narrative here — men’s anxiety and distress weren’t seen as acceptable airing — yet, societally, it was OK for men to express rage and anger, points out Dr Colman Noctor, psychotherapist with St Patrick’s Mental Health Services.

“These two emotions — anger and rage — fall into the more macho, alpha-male category and were seen as acceptable,” says Noctor, adding that celebrity ambassadors from the locker room environment stepping forward to say ‘I didn’t feel able to talk about this, and then I did, and it helped’ have communicated a strong message that has permeated down, giving men permission to express difficult feelings.

But Noctor isn’t sure these campaigns, urging men to be more open about their feelings, have made a tidal change.

“These are important messages, but it only takes one news headline to the contrary to undo all the impact of the positive campaigns,” he says, citing the example of Roy Keane’s reference to Jonathan Walters “crying on the TV about his family situation” after the former Ireland international talked about tragedy in his personal life.

“Any return to what was part of the stigma can undermine the anti-stigma work.”

EMOTIONAL INTELLIGENCE

Noctor worries about a culture that’s overly invested in emotional expression but that doesn’t encourage emotional intelligence.

He sees women having a wider language around emotional topics because this is part of their discourse, something which isn’t generally true of men.

“Men come to me and say ‘I feel crap’, or ‘I don’t feel complete, I don’t feel enough’. When I ask why, they say they don’t know.

Then you might find the man had a relationship break-up the year before that he hasn’t got over — he hasn’t processed it.

"He’s trying to find happiness through running, going out more, going to the gym.

"He’s self-medicating with alcohol and it’s not apparent because everyone’s doing it — culture can hide harm in plain sight.”

Seeing the meaning behind the feeling, being able to tune into your own and others’ emotional world, are indications of emotional intelligence — something that’s vital, says Noctor.

“If you just feel and do and don’t think about it, you’ll be reactive and impulsive.

"It’s what much of therapy is about — helping you to understand what you feel and why and how you can cope with that.”

STRESS POINTS

The My World Survey 2 (2019), conducted by UCD School of Psychology and the Jigsaw charity, is Ireland’s largest, most comprehensive study of young people’s mental health and wellbeing.

It consulted with more than 19,000 young people across Ireland and is a follow-up to the 2012’s My WorldSurvey 1.

The 2019 study found 58% of 18 to 25-year-olds were outside the normal range for depression and anxiety, i.e. they were in the moderate, severe, or very severe ranges.

In the adolescent group, 40% reported levels of depression and 50% reported anxiety levels.

Compared to the 2012 survey, both adolescents and young adults reported ‘significantly higher levels’ of depression and anxiety.

Open mind: Changing face of men's mental health

So what’s troubling young people? Looking at the male end of it, Noctor sees “a multitude of stressors” in contemporary society for young adult males.

“The rental crisis and poor prospects for many of owning their own home, of having security — it’s a fairly anxious environment that young adults are coming into.

"But if, as a man, you have a narrative that you should be able to provide and be a breadwinner, stresses around home-ownership could impact you, on your expectations of who you should be.”

That ‘expectations-versus-reality’ gap creates potential for unhappiness, points out Noctor, who sees “stuff creeping in” for young men that earlier generations didn’t have to contend with — issues around body image, and social comparisons enabled by social media.

“There’s this constant capacity to compare with people you perceive as doing better than you, as more successful than you. And instinctively, males don’t like feeling behind the curve.”

PORN INFLUENCE

Murphy points to the “massive” use of porn — and to the My World Survey 2 finding that 73% of 18 to 25-year-old men watch porn once a week or more.

“Pornography’s dominated by sexism, violence, dehumanisation, and objectification. So it can create problems within relationships.

"It creates false expectations — men don’t understand normal relationships,” he says, adding that pornography — and gaming too — can disconnect people from relationships.

Lorcan Brennan, training and development officer with Men’s Development Network, says fast-paced modern living is challenging for many young men.

Social media, gaming, are all part of the life of the young and seem to run 24/7. It’s a world with a lot of stimulus.

"Many young people have a very packed agenda. It’s hard to find down-time, space to find their own voice and vision of who their best self might be.”

He adds that “youthfulness and moderation don’t often sit at the same table” and that youth equals high energy, Brennan says the challenge for young men is to be mindful and careful of these factors so as to mind their transition into adulthood.

MIDDLE-AGE CHALLENGES

Dr Noel Richardson, director of the National Centre for Men’s Health at IT Carlow and lead author on the National Men’s Health Policy, says men struggle with difficult transitions.

And tragically, men in most distress — who’ve had job loss or relationship breakdown — very often don’t reach out for help.

“Their circumstances often compound their inability to seek help. They may not have support structures or they’ve disengaged from their families, which makes it more challenging.”

Richardson co-authored the 2018 Middle Aged Men & Suicide Report.

With men four times more likely to die by suicide than women and the highest suicide rate among those aged 45-54, Richardson says the men surveyed talked about the ‘stigma’ of mental illness and not wanting to be a burden on others, so that often they only sought help when at crisis point.

Middle age brings particular challenges, Richardson points out: declining physical health, awareness of one’s mortality, diminishing employment opportunities, and difficulties re-training, as well as pressures around the provider role with children going to college.

Realisation can also hit that you haven’t fulfilled life expectations around career/family, and that time’s running out.

“These are all compounded by societal challenges — zero-hour contracts, men’s role no longer as clear-cut as it was,” says Richardson.

“Many men also feel let down by traditional pillars of society, by scandals in church, politics, and the financial crisis. Much has unravelled in the last 20 years.”

But there are signs of change — and grounds for hope.

Murphy points to A Lust for Life, which aims to ‘empower future generations to be effective guardians of their own minds’ and to ‘destroy the stigma that attempted to destroy previous generations’.

The charity’s now looking at supporting children in fifth and sixth classes around managing their wellbeing.

“The key is to get in early,” says Murphy.

Noctor says our male heroes today are more rounded figures.

“When I was growing up, the heroes were Stallone and Schwarzenegger. There’s a shift in that.”

Brennan sees the emergence of different expressions of masculinity.

“In the past, there was one way to be a man. Now there are many different ways to be a man and there’s a freedom in that for young men.”

He sees his 16-year-old son in conversation with friends and notes how they’re tuned into issues connected with mental health in a way he wasn’t at that age.

GOVERNMENT ACTION

Ireland is very proactive around men’s health, says Richardson, pointing out that we were the first country in the world to have a national men’s health policy in 2009.

The HSE Health & Wellbeing section funds a range of programmes, like ENGAGE, the National Men’s Health Training Programme, which supports service providers to engage more effectively with men.

Feedback is very positive. The vast majority of service providers (93%) said that ENGAGE had impacted their work practice up to five months post-training, with almost 40% having formally committed to men’s health in their work plans and/or conducting men’s health initiatives within their services.

Training’s currently in development for agricultural advisers to broach the topic of health with farmers.

“We’re not trying to make GPs out of them, just give them the skills to signpost farmers to where they can get help and to ask a simple question, like ‘how are you doing?’”says Richardson.

Open mind: Changing face of men's mental health

Other male-oriented initiatives funded by HSE Health & Wellbeing section include Men on the Move (community-based physical activity programme targeting overweight men), Sheds for Life (health promotion programme delivered in Men’s Sheds) and Farmers Have Hearts (outreach cardiovascular disease prevention programme).

“Sometimes we put mental health in a box, but all these programmes have huge benefits for men’s mental health. They bring men out of isolation, helping them forge strong connections and enhance their wellbeing,” says Richardson.

There’s a lot happening, Brennan agrees, citing the national men’s summer school run by the Men’s Development Network over a weekend — “we sit and talk in groups and support each other to live our best lives” — and International Men’s Health Week, in June every year.

Murphy wants men to know that there’s strength in vulnerability and in asking for help.

Brennan would like men to live more conversationally and relationally.

“If we could, as men, conversationalise our hopes and aspirations, issues and challenges — if we could talk about whether it was a good week or a bad one — that would be a really great way to live.”

mhfi.org

mens-network.net

menssheds.ie

'I wanted to hide from the world'

Open mind: Changing face of men's mental health

Kilkenny-based Paul Clifford, 50, is a co-ordinator at his local Involvement Centre (a peer-led group offering a warm, welcoming place for people with mental health issues).

“Seven or eight years ago, things got on top of me. I was in a very low, dark place. I’d done counselling for a year.

"Counselling was the best and worst thing I ever did — I went in with one thing and it brought up everything.

"A lot came up from my younger life — it was too much. I was kind of overwhelmed.

“I couldn’t sleep or relax so I went to the doctor, first for sleep medication and then for help to cope with what was coming up. I was on anti-depressants for a while.

"They got me through the day but I didn’t feel right on them. I was very much staying in the house.

I walked out of a job, though I’d been well supported in it. I wanted to hide from the world. It went on over a year.

“I was married with four sons and the pressures of being a husband and father and trying to be the best I could, I’d say I wasn’t minding myself enough. I was drinking too much.

“It was small steps got me out of it — getting out, exercise like walking, talking — slowly, over time, I started building back up.

"I’d been involved in men’s groups in the late ’90s and I’d drifted away from them.

"Through the counselling, I realised I’d been carrying stuff that I’d have shifted in the men’s groups — I’d have probably minded myself better.

“I now know I need to be talking to somebody very close to me, to get things out of my head. If I don’t, it’s with me all the time.

"Eventually, after the counselling, I reconnected with the men’s groups. I’ve grown and I’m still growing.

"Part of my recovery was discovering I’m still finding out who I am.

The biggest thing I’ve discovered is how simple and precious life is and how easy it is to love ourselves, and others, when we’re in the right frame of mind.

“Men feel vulnerable around sharing that they’re struggling, whereas it’s strong to get support.

"There are enough places to go for support — reach out to an organisation, group, counsellor, men’s shed, or friend.

"People have been in low places and they can get out. The future can look very bleak but there’s always a spark.

“It takes huge courage to say ‘I need a hand here — can someone help?’ but there’s strength in that.”

WARNING SIGNS

Open mind: Changing face of men's mental health

Depression charity Aware uses FESTIVAL acronym to highlight symptoms of depression.

Someone experiencing five or more of these symptoms for a period of two weeks or more should speak to their GP or mental health professional.

  • Feeling – sad, anxious, guilty;

  • Energy – low energy, feeling tired/fatigued;

  • Sleeping – under or over-sleeping, any change to normal sleep pattern;

  • Thinking – poor concentration, thoughts slowed down;

  • Interest – loss of interest in hobbies/family/social life;

  • Value – low self-esteem;

  • Aches – physical aches and pains with no physical basis;

  • Life – loss of interest in living, thinking about death, suicidal thoughts.

    If you or someone you know has been affected by the issues discussed in this article, please get in touch with one of the below services:

    Pieta House - 1800 247 247

    Samaritans Ireland - 116 123

    Aware - 1800 80 48 48.

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