10/10/2021
This year's theme on World Mental Health Day is - Mental Health in an unequal world.
Much can be said about parity of esteem between mental health and physical health, or the correlation between mental health and wellbeing and socio-economic status. It’s essential that funding for Mental Health Services, free at the point at access, be increased to meet the staggering levels of need. But what next? Will it be more services delivered in the same way?
To illustrate this point - As a male therapist, I’ve often wondered about the structure and delivery of mental health services for men. We are aware of the difficulties….
- Boys are performing less well in all levels of education.
- Boys are around three times more likely to receive permanent or fix period exclusion than girls.
- Men have measurably lower access to social supports such as friends, relatives and community.
- 34% of men report feeling embarrassed or ashamed to take time off work for mental health concerns, such as anxiety or depression, compared to 13% for a physical injury.
- They are more likely to wait until a point of crisis/emergency to access support.
- Overall men are less likely to access psychological therapy than women.
- Only 36% of referrals to psychological therapy services in the UK (IAPT) are men.
Noticing these difficulties should invite a system that changes and flexes to meet this need. Yet Statutory Mental Health Services make limited attempts to modify and adapt services to support men access them. The voluntary sector takes up this mantel but the spread and reach of services can increase an already fragmented support network.
Men make up less than 20% of graduate psychology, social work, or counseling courses, and only 1 in 3 on the clinical doctoral training are men. This is part of a large and complex narrative. Referral pathways can put specific barriers in the way for men, particularly where shame and embarrassment are features. And this is even before we think about the way we deliver therapy. Having a plurality of therapeutic approaches is key, but we can perhaps also wonder about how we work with men outside the traditional office-based nature of therapy. Having the flexibility and willingness to take therapy sessions outdoors and even alongside physical activity, for example, may open up the process to more men in a way that makes sense and feels more accessible.
I appreciate that this is just one example of the unequal world of mental health but the principle is the same - how can we support psychological flexibility and mental health when our services are overwhelmed and inflexible.
