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What would make it easier to seek help?When asked what would make it easier to seek help if feeling low or worried for a while, menchose the following:25%20%15%10%5%0%22%15%12%11%6%5%Support andinformationavailableonlineAn assuranceof anonymityHelpavailableat moreconvenienttimes of dayAvailabilityof help atplaces otherthan GPsurgeryHelpavailableover thephoneSupportavailable atwork or atjob centresnothing would stop them seeking help hasdecreased by almost a fifth since 2009, from22 per cent to 18 per cent.While these figures are encouraging and suggestthe gap in willingness to seek help might beclosing, ultimately men are still less likely to seekhelp from the NHS for a mental health problemthan women.Accessing servicesIn 2009 there was a large gap between men andwomen’s willingness to see their GP if they feltlow for more than two weeks, with only 23 percent of men saying they would be likely to,compared to 33 per cent of women. This timeround, 35 per cent of both men and women saidthey would be likely to consult their GP. Men alsomade up 31 per cent of callers to Mind’s Infolinein 2018/19, up from 25 per cent in 2009/10.This may reflect that notions of masculinity areslowly starting to change, as it becomes moreacceptable to ask for help. In part, this could bedue to an increased awareness of mental healthin society and the media, with more positive andvaried portrayals starting to normalise mentalhealth problems. Targeted awareness and antistigma campaigns aimed at men, such as Timeto Change’s ‘In Your Corner’ and ‘Ask Twice’campaigns may have also contributed positively.17 per cent of men said they would be likely togo to a counsellor or therapist to talk about theirfeelings if they were feeling worried or low fortwo weeks or more, as opposed to 22 per cent ofwomen. In 2009 our survey showed men werealmost half as likely as women to seek help froma counsellor or therapist (6 per cent of mensought help versus 11 per cent of women). Thisis in keeping with men making up only 35 percent of those accessing Improving Access toPsychological Therapy (IAPT), the NHS’s talkingtherapies service for people with mild to moderatemental health problems such as anxiety anddepression.13Men who took part in a focus group in Sheffieldtold us that for them, the problem was not askingfor help but help not being available. Despitemore investment in mental health services overrecent years, only 39 per cent of people with acommon mental health problem get any supportat all.14Get it off your chest: men’s mental health 10 years on9

As the NHS Long Term Plan isrolled out, the NHS must deliveron its commitments to widenaccess to mental health servicesand monitor whether men are accessingservices in proportion to their needs.There also needs to be a choice ofservices available, and local areas shouldconsult with men to ensure servicesmeet their needs.Alternatives to medicationWe asked men to imagine they’d been feelinganxious or low for a while and were seeinga GP for support. When asked, as analternative to medication, what support theywould prefer, they said: Face-to-face therapy (30 per cent) Physical activity (17 per cent) A social activity (12 per cent) Online therapy (6 per cent) Peer support (6 per cent) Group therapy (2 per cent)When asked to choose their top two preferencesfor prescribed treatment if they had been lowor anxious for more than two weeks, the mostpopular answers were: Counselling (40 per cent, up from 23 percent in 2009)There’s good evidence to suggest that at mostages, for both men and women, being moreactive is linked to a trend for lower rates ofdepression. In fact, one study has found that byincreasing your activity levels from doing nothingto exercising at least three times a week, youcan reduce your risk of depression by up to30 per cent.15Mind’s Get Set to Go programme, funded bySport England and expanded with support fromthe EFL (English Football League), helps peoplewith mental health problems to get more active.In its pilot phase participants felt it improved theirresilience and their ability to deal with anxiety,panic attacks, and even suicidal thoughts.16The University of Essex carried out researchfor Mind, which found that 94 per cent of peoplewho took part in outdoor exercise activities,like walking or even gardening, said that greenexercise activities had benefited their mentalhealth.17 In fact, ecotherapy – activities thattake place in nature – can be as effective asantidepressants in treating mild to moderatedepression.18As part of the NHS Long TermPlan, NHS England has pledgedthat by 2023/24, 900,000 morepeople will have access to socialprescribing. This is a golden opportunityfor men with mental health problems toaccess alternatives to traditional clinicalservices which will support their mentalhealth. This could include physicalexercise on prescription, walking groups,gardening groups, or learning activities. Exercise (29 per cent, up from 23 per cent in2009). Men are also more likely than womento exercise at the gym to cope with feelingworried or down (14 per cent v 9 per cent). Self-help (24 per cent similar with 25 percent in 2009) Time off work (22 per cent, up from 15 percent in 2009) Antidepressants (16 per cent, up from 10 percent in 2009)10Get it off your chest: men’s mental health 10 years on

You tend to find that people whosuffer with mental health problemswill struggle in environments wherethere’s a lot of people around andnoise. So, they actually go where it’sa little bit quieter because they’vealready got a busy mind that’stormenting them every second ofthe day, so they try and connectwith natural beauty by goingoutdoors and going to the parksand out in the Peak District.health problems, who are more likely thanthe general population to have substancemisuse issues.People with a dual diagnosis ofmental health problems andsubstance misuse need to be ableto access holistic support that meetsall of their needs. The UK Governmentshould increase funding to localauthorities for public health to enablegreater investment in substance misuseservices, smoking cessation, as well asmental health prevention and promotion.Sheffield Mind focus group participantSocial support: family and friendsCoping mechanismsMen are more likely than women to useunhealthy coping mechanisms when feeling lowor worried, including drinking more alcohol (15per cent v 10 per cent), smoking more (7 per centv 6 per cent) and taking recreational drugs (2 percent v 1 per cent). When asked to choose threeways they most like to relax when feeling worriedor low, men are also more likely than women todrink alone (13 per cent v 9 per cent), go to thepub with friends (13 per cent v 6 per cent), ortake recreational drugs to relax (4 per cent v1 per cent).Around a third of men in 2019 (34 per cent) wouldbe likely to talk to their friends about theirproblems if they were feeling worried or low fortwo weeks or more, compared to just over half ofwomen (52 per cent). This is an increase of 5 percent among men and a decrease of 2 per cent forwomen, in comparison to 2009. It fits with ourunderstanding that male friendships are oftenbased on shared activity, such as going to thepub or attending sport, rather than sharing theirfeelings and worries, while women are morelikely to confide in their friends when they arefeeling low.20When asked the three things they would be mostlikely to do if a male friend confided in them thatthey were worried or low, men are now lesslikely than they were 10 years ago to take thatfriend to the pub (down from 29 per cent in 2009to 22 per cent in 2019).Sometimes men will self-medicate with alcohol ordrugs as a way of coping with a mental healthproblem. Men are twice as likely as women todrink hazardously and are much more likely tohave drug dependency issues in the generalpopulation.19 People with a dual diagnosis, or asubstance misuse and a mental health problem,often find it difficult to access mental healthservices and find themselves excluded fromsupport. Additionally, cuts to drug and alcoholsupport services in the community have adisproportionate impact on people with mental11

For men in relationships, their partners are oftenthe major source of emotional support, with oursurvey finding that 51 per cent of men would belikely to talk to their partner if they felt worried orlow for two weeks or more.Just over a third of men (36 per cent) wouldtalk to their family about feeling low, comparedwith 43 per cent of women. This is an increasefor men of 5 per cent (31 per cent in 2009) anda decrease of 4 per cent for women (47 per centin 2009), again suggesting the gap in behaviourbetween men and women is narrowing.Criminalising men’s mental health:‘acting out’ and diagnosisThe more ‘feminine’ symptoms are recognisedwithin mental health assessments while men’ssymptoms are more likely to bring them intocontact with the criminal justice system. The latestfigures in 2018 showed that men made up 95 percent of people in prison21 and a further 90 percent of people on probation.22While aggressive or violentbehaviour is never acceptable,there need to be clearerdiagnostic principles in recognisingmental health problems that mayunderpin aggressive or violent behaviourin men to ensure appropriate supportis given.When asked to choose three things that tend tohappen when they are worried or feeling low,one in 10 men said they get angry when theyare worried, compared with 8 per cent of women.This is a 5 per cent drop for men and womencompared to 2009.When experiencing a mental health problem,many men reported that they will externaliseor ‘act out’ their symptoms through disruptive,violent and antisocial behaviour. By contrast,women reported that they are more likely to‘act in’, with mental health problems manifestingas low self-esteem, feelings of guilt andreduced concentration.12Get it off your chest: men’s mental health 10 years on

Factors impacting on men’smental healthWork and unemploymentPhysical appearanceOur previous survey was launched at the heightof the financial crisis and at the start of arecession. Economic growth has remainedsluggish for the last decade, and whileunemployment has remained low, there has beena growth in the gig economy,23 characterised byprecarious short-term and zero hours contracts.The percentage of men who are worried abouttheir appearance has risen from 18 per cent in2009 to 23 per cent. Worries seem to be greatestin 18–24 year olds (39 per cent) and 35–44 yearolds (36 per cent). Overall, 6 per cent of men saidsocial media made them worry about how theylook, but this was much higher among 18–24 yearolds at 19 per cent, falling to 12 per cent of 25–34year olds and 9 per cent of 35–44 year olds.Despite this, the percentage of men currentlyworried about money has fallen from 45 percent to 38 per cent over the decade. Meanwhile,despite workforce changes, only 20 per cent ofmen were worried about job security comparedwith 27 per cent in 2009, and 18 per cent ofwomen were worried compared with 22 per centin 2009. These figures are, however, likely toshift significantly as we enter another recession.This is particularly true for men already facinginequalities, who are likely to suffer a greaternegative impact on their mental health broughtabout by economic uncertainty.Mind recently surveyed people with mental healthproblems to see how the pandemic had affectedtheir mental health. The resulting data, from morethan 14,000 people aged 25 and over, found thatconcerns about employment and finances weresome of several worries that had a negativeimpact on people’s mental health, with 45 percent of men saying that employment worries hadnegatively affected their mental health and 41 percent claiming their mental health was made worseby concerns about finances.24My mum and dad told me, when Iwas a kid, when you used to go out ona date, it might be someone you’d metin the pub, it was a friend of a friend,or people used to put adverts out fordates and stuff like this. Now you’vegot the likes of Tinder, all thesedifferent social media platforms,where in a split second, you arecompletely judged on exactly howyou look, right? Now, it’s as simpleas that, it’s a yes or a no. There’s nogetting to know someone anymore.Sheffield Mind focus group participantWhile having concerns about your physicalappearance isn’t a mental health problem,it can be linked to poor mental health, eatingproblems, over-exercising and, in some cases,steroid misuse.25 A survey by the Mental HealthFoundation found that social media was oneof the key factors that affected the way peoplefeel about their appearance.26Get it off your chest: men’s mental health 10 years on13

Social mediaWhile schools can play a role insupporting young people to usesocial media safely, there is also aneed for evidence-based advice onusing social media for adults.According to our survey, 37 per cent of mensaid social media had a negative impact on howthey feel, and interestingly this varied with age,demonstrated in the graph below. 15 percent ofmen said they would be happier if they usedsocial media less and 4 percent also say socialmedia makes them feel vulnerable because youcan experience abuse online. However, thesefindings also varied between age groups.Social media and the online world can be a usefulsource of information, peer support and digitaltools to manage mental health, however there arealso risks around misinformation, cyberbullying,promoting unrealistic body images and idealisedlifestyles. Many online experiences are designedto be addictive which can interfere with otheraspects of life including people’s sleep patterns,while a culture of ‘likes’ can be damaging toself-esteem.27What we’ve created is a world wherewhat is false now becomes realbecause if you can get as many likeson social media, it all of a suddenbecomes a statement of fact.Sheffield focus group participantThe mental healthFeeling on social media by age group5 0%4 0%3 0%2 0%1 0%0%44%19%Age 18–247%48%27%6%45%Age 25–34“Social media has a negaitive impact on how I feel”“I would be happier if I used social media less”“ Social media makes me feel vulnerable because youcan experience abuse online”Get it off your chest: men’s mental health 10 years on9%Age 35–44Key:1421%38%13%4%Age 45–54

Impact of existing inequalities oncertain groupsBlack, Asian and Minority Ethnic menBeing Asian, my experiences inschool and outside society differedfrom my experiences within thefamily. Traditionally in Asian culture,the expectation is that the man has aresponsibility to look after his familyand when my wife became pregnantI felt I needed support to adjust. Thepressure to be the main breadwinnerwas intense. There was no supportavailable for me to help me copewith the changes.Michael, Mind in Harrow user involvement groupThe Black Lives Matter movement has throwna spotlight on the inequalities faced by Blackpeople, as well as people from Asian and MinorityEthnic (BAME) groups*. These inequalities areacutely visible within a mental health context.Mind worked with a steering group of BAMEpeople, which informed our submission to therecent Independent Review of the Mental HealthAct, the legislation under which people can be* Mind recognises the limitations and problems of usingcatch-all umbrella terms such as ‘Black, Asian and MinorityEthic (BAME)’. We are always open to being challengedand are committed to doing better when it comes tounderstanding and addressing matters of discriminationand privilege. In order to make conclusions which can onlybe drawn from a robust sample size, for the purposes ofpresenting the findings of this research we have includedrespondents from different ethnic groups which fall underthe BAME umbrella. However we recognise that there aredistinct and unique identities and challenges facing differentcommunities referred to as ‘BAME’, which can be obscuredin research that aggregates non-White groups together as‘BAME groups’.detained for mental health treatment. The grouphighlighted the importance of recognising the roleracism plays, not only in service delivery, but alsoas a significant factor in why so many peoplebecome unwell in the first place.28 Experiences ofracism include both interpersonal and

Get it off your chest: men’s mental health 10 years on 3 Introduction In 2009, Mind published ‘Get It Off Your Chest’, a report which drew on YouGov polling data and focus groups to understand the challenges facing men’s mental health. Ten