Centre for Youth Mental Health - Research Publications
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Item"I could hang up if the practitioner was a prat": Australian men's feedback on telemental healthcare during COVID-19(PUBLIC LIBRARY SCIENCE, 2022-12-14)The COVID-19 pandemic restrictions, uncertainties and management inconsistencies have been implicated in men's rising distress levels, which in turn have somewhat normed the uptake of telemental healthcare services (i.e., phone and/or video-conference-based therapy). Given past evidence of poor engagement with telemental health among men, this mixed-methods study examined Australian men's use of, and experiences with telemental health services relative to face-to-face care during the pandemic. A community sample of Australian-based men (N = 387; age M = 47.5 years, SD = 15.0 years) were recruited via Facebook advertising, and completed an online survey comprising quantitative items and open-response qualitative questions with the aim of better understanding men's experiences with telemental healthcare services. In total, 62.3% (n = 241) of participants reported experience with telemental health, and regression analyses revealed those who engaged with telemental health were on average younger, more likely to be gay and university educated. Men who had used telemental health were, on average, more satisfied with their therapy experience than those who had face-to-face therapy. Among those who had telemental healthcare, marginally lower satisfaction was observed among regional/rural based relative to urban men, and those who had to wait longer than 2 months to commence therapy. Qualitative findings highlighted positive aspects of telemental healthcare including comfort with accessing therapy from familiar home environments and the convenience and accessibility of telemental health alongside competing commitments and COVID-19 restrictions. Conversely, drawbacks included technical limitations such as crosstalk impeding therapeutic progress, disconnects and audio-visual lag-times and the 'impersonal' nature of telemental healthcare services. Findings broadly signal COVID-19 induced shifts norming of the use of virtual therapy services, with clear scope for improvement in the delivery of therapeutic practice using digital modalities, especially among help-seeking men.
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ItemMale-Type Depression Mediates the Relationship between Avoidant Coping and Suicidal Ideation in Men(MDPI, 2022-09)Despite known links between men's avoidant coping behaviours (e.g., distraction, denial, substance use) and suicide risk, little research has explored the mechanisms underpinning this relationship. This study sought to examine whether male-type depression symptoms (e.g., anger, aggression, emotion suppression), assessed by the Male Depression Risk Scale, mediate the association between avoidant coping and suicide/self-harm ideation in men. Data were drawn from an online survey of a community sample of 606 Australian men (M age = 50.11 years; SD = 15.00), conducted during the COVID-19 pandemic. Mediation analyses were applied to examine the effect of male-type depression on the association between avoidant coping and suicidal/self-harm ideation, controlling for age, resilience and the experience of two psychosocial stressors during the COVID-19 pandemic (financial stress and government restrictions). Avoidant coping was associated with suicidal/self-harm ideation, r = 0.45, p < 0.001. Results supported a mediating role of male-type depression symptoms in this relationship, R2= 0.29, PM = 0.36, p < 0.001, underscoring the importance of screening for male-type depression symptoms to better identify men at risk of suicidal/self-harm ideation. Results also suggest a need to support men to develop effective coping strategies, particularly in the context of common psychosocial stressors experienced during the COVID-19 pandemic and beyond.
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Item"I Called When I Was at My Lowest": Australian Men's Experiences of Crisis Helplines(MDPI, 2022-08)Background: Helplines are an accessible form of support for people struggling with difficulties in their lives and are key services in suicide prevention and intervention. Men's experiences of telephone helplines are not well understood, despite high male suicide rates. Methods: We conducted an online cross-sectional survey with N = 684 Australian men (aged 17-83 years, M = 50.13) using open- and closed-ended questions about their experiences of helplines during the COVID-19 pandemic. Descriptive statistics were analysed to investigate differences between men using and not using helplines. Qualitative responses were analysed using thematic analysis. Results: Within the sample, 100 men (14.6%) had used a helpline service. Men using helplines were more likely to be unemployed and in younger age brackets than those not using helplines. They were also more likely to report experiencing stressors related to COVID-19, including financial stress and job loss, perceived impact on mental health and relationship breakdown. Qualitative analysis indicated varied experiences of helplines, with men shedding light on how their interaction with a counsellor, the structure of services and their expectations of the service impacted their experience. Conclusions: Further in-depth qualitative enquiry in this space is required, with the objective of understanding how helpline services may seek to better engage with male callers.
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ItemProtocol for a randomized controlled trial of the Men in Mind training for mental health practitioners to enhance their clinical competencies for working with male clients(SPRINGERNATURE, 2022-07-15)BACKGROUND: Although the proportion of men seeking professional mental health care has risen over the past two decades, on average, men continue to attend fewer sessions of psychotherapy and are more likely to drop out of treatment prematurely compared to women. Men account for three-quarters of suicide deaths; furthermore, over half of the males who die by suicide have engaged with mental health care in the 12 months prior to their death. These findings highlight a need to equip mental health practitioners with skills to improve male clients' engagement and mental health outcomes. This article reports the protocol for a randomized controlled trial of Men in Mind, a self-paced online training program purpose-built to advance the clinical competencies of practitioners who provide psychotherapy to male clients. METHODS: A randomized controlled trial with two parallel groups will be conducted. Participating practitioners will be randomly allocated, on a 1:1 basis, to the intervention group (Men in Mind training) or a waitlist control group. The primary outcome, efficacy of the training, will be evaluated by pre- to post-training (T1 to T2) changes in scores on the Engaging Men in Therapy Scale (EMITS) in the intervention group, relative to the control group. DISCUSSION: This trial will provide evidence of the efficacy of Men in Mind training, as an interim step towards adjusting content and delivery of the intervention to maximize the potential for sustaining and scaling. TRIAL REGISTRATION: The trial was registered prospectively with the Australian New Zealand Clinical Trials Registry on 3rd December 2021 (ACTRN12621001669886).
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ItemExploring Teacher and Parent Perspectives on School-Based Masculinities in Relation to Mental Health Promotion(FRONTIERS MEDIA SA, 2022-06-13)The capacity for boys' and young men's mental health promotion to act via shifting masculine norms that are linked to poor mental health outcomes, highlights the need to improve the extent to which school-based programs can promote mental health through leveraging more positive embodiments of masculinity. To-date, the perspectives of parents and teachers on such processes are understudied. This qualitative study presents teacher and parent views regarding adolescent masculinities and avenues for school-based developmental programming for boys and young men. In this study, 16 individual qualitative interviews were undertaken with 10 parents (six females, four males), and six teachers (three females, three males), recruited from an independent all-boys' grammar school in Melbourne, Australia. Thematic analysis of parents' and teachers' perspectives indicated their perception of the role of context-dependent "public" and "private" masculinities, the influence of Australian masculinity norms, and the role of private boys' school cultures in the development of adolescent masculinities. Additionally, strategies for development encompassed participants' appetite for boys' exposure to positive role models, in addition to consistent and relevant developmental programming to support positive masculinity development. Findings have implications for efforts to support prosocial masculine identity development via school-based initiatives, as an avenue to promoting mental health of boys and young men.
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Item"Appreciate the Little Things": A Qualitative Survey of Men's Coping Strategies and Mental Health Impacts During the COVID-19 Pandemic(SAGE PUBLICATIONS INC, 2022-05)The COVID-19 pandemic has presented a suite of circumstances that will simultaneously affect mental health and mobilize coping strategies in response. Building on a lack of research specifically exploring men's mental health impacts during the COVID-19 pandemic, this study presents the results of a qualitative survey exploring men's self-reported aspects of the pandemic giving rise to mental health challenges, alongside their diverse coping strategies applied during this time. The sample comprised 555 men from North America (age M = 38.8 years; SD = 13.5 years), who participated via an online survey with two open-ended qualitative questions assessing, respectively, the aspects of the pandemic affecting their mental health, and the strategies used to manage these challenges. Free-text responses were coded using inductive content analysis. Results pertaining to the mental health impacts of COVID-19 were categorized into two overarching themes: far-reaching ramifications of COVID-19 encompassing consequences for lifestyle, work, and functioning, alongside novel anxieties related to health risks and daily uncertainty. In addition, coping strategies reported were categorized into two broad themes: efforts to avoid, dull or distract oneself from distress, alongside adapting and doing things differently, which encompassed largely approach-oriented efforts to flexibly ameliorate distress. Results signal the far-reaching impacts of COVID-19, alongside profound flexibility and diverse enactments of resilience among men in adapting to unprecedented challenges. Findings have implications for mental health promotion that should aim to leverage men's adaptive coping to encourage opportunities for social connectedness in response to the mental health impacts of the various psychosocial challenges of the COVID-19 pandemic.
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ItemNo Preview AvailableAn evaluation of the psychometric properties of the Fear of COVID-19 Scale in a sample of help-seeking men(POLSKIE TOWARZYSTWO PSYCHIATRYCZNE-POLISH SOC PSYCHIATRY, 2022-03)Aim of the study The Fear of COVID-19 Scale is a widely used measurement tool for related anxieties, however previous studies validating the scale report varying fit indices, often below accepted cut-off points. This suggests re-specification of the scale may be required. The present study aimed to examine the psychometric properties of the English-version of the Fear of COVID-19 Scale in a population of help-seeking males using exploratory (EFA) and confirmatory factor analysis (CFA). Subject or material and methods Data from 621 males aged 18-80 years (mean=38.23, SD=13.59) was collected via a cross-sectional open online survey. Along with the 7-item Fear of COVID-19 Scale, the PHQ-4 and PROMIS Anger Short Form were used to measure probable anxiety, depression and anger. Data were randomly partitioned into two subsamples and separate factor analyses were conducted with robust CFA corrections applied for non-normality. Results A 4-item single-factor version of the scale was identified reporting excellent model fit (R-RMSEA=.033, R-CFI=.998, R-TFI=.997, SRMR=.012) and good internal consistency (α=.86). Age and probable anxiety effects were observed. Discussion Relative to existing validation studies of the Fear of COVID-19 Scale, the present study provides improved psychometrics of the 4-item version of the scale, while scale means observed were comparable to other studies. Conclusions This study validates a 4-item version of the Fear of COVID-19 Scale to assess related anxieties in a help seeking male population. Future research should seek to validate the 4-item version in other subpopulations.
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ItemDevelopment of a graphic medicine-enabled social media-based intervention for youth social anxiety(TAYLOR & FRANCIS LTD, 2021-05-28)Objective: The objective of the Entourage project was to develop an innovative digital mental health intervention addressing key barriers experienced by young people in accessing evidence‐based therapy for social anxiety. In particular, Entourage takes a specific focus on reaching young men, given their lower rates of service engagement. Method: This article discusses the theoretical underpinnings, therapeutic mechanisms, persuasive technology elements, and development process of a novel approach incorporating graphic medicine, clinical and peer support, and social networking. Results: Based on an integrated cognitive model of social anxiety disorder and consistent with the principles of cognitive behavioural therapy (CBT), a novel digital intervention for social anxiety was developed (Entourage). Using the moderated online social therapy (MOST) model, Entourage provides young people with a digital strengths‐based platform to overcome social anxiety symptoms. Designed in close partnership with young people with a lived experience of mental ill‐health, and overseen by a steering group of young men, Entourage applies graphic medicine through bespoke therapy comics to help users understand and overcome symptoms. Program e‐mentors (expert clinicians and trained peer workers) work in tandem to maintain engagement, support participant skill acquisition, and promote opportunities for social connectedness. Behavioural experiments and in‐vivo exposure activities facilitate restructuring of maladaptive social anxiety‐focussed cognitions. Conclusions: Entourage represents an innovative approach to managing social anxiety in young people. Intervention elements seek to ensure longer‐term engagement of users, in particular young men, who have unmet service needs. Results of a single‐group clinical trial of Entourage are forthcoming.
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Item"Eventually, I Admitted, 'I Cannot Do This Alone'": Exploring Experiences of Suicidality and Help-Seeking Drivers Among Australian Men(FRONTIERS MEDIA SA, 2021-10-01)While research has explored the intersection between masculinities and men's experiences of suicidality, comparatively little attention has been paid to the stories surrounding suicidal men's decision to seek help. The ways in which men experiencing suicidal thoughts and behaviors embody masculinities alongside their enlistment of mental health services remains largely unknown. The present study explored 262 Australian men's stories surrounding the impetus for help-seeking for suicidal thoughts and behaviors. The sample comprised men ranging in age from 17 to 74 years (M = 40.99; SD = 15.92 years), with most participants residing in a metropolitan area (55.3%), employed full time (43.1%), non-indigenous (95.4%) and heterosexual (73.7%). Participants elaborated on their reasons for help-seeking via an open-text qualitative survey, delivered as part of a larger study exploring help-seeking experiences of Australian men. Thematic analysis of responses generated four themes highlighting the diversity of experience across men, with some highlighting impacts of emasculating early trauma(s) on their suicidality, while others reflected an impulsiveness tied to situational stressors that fractured their masculine identity (e.g., relationship breakdown; job loss). Many men had epiphanies as they reached the limits of their self-reliance and came to terms with their need for help. As their suicidality was witnessed by-and began to impact-those around them, the sight of their previously masked pain by others often facilitated their help-seeking journey. The present findings underscore the complex and multifactorial role of masculinities in men's suicidality and their paths to help-seeking. Important inroads for future public mental health promotion efforts are discussed, in terms of leveraging self-reliant and caring masculinities in helping men to develop healthy coping in the context of suicidality.
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ItemPromoting Healthier Masculinities as a Suicide Prevention Intervention in a Regional Australian Community: A Qualitative Study of Stakeholder Perspectives(FRONTIERS MEDIA SA, 2021-12-08)Regionally-based Australian men have a higher risk of suicide than those in urban centers, with similar trends observed internationally. Adopting a place-based approach to understanding men's suicide and harm prevention provides contextual insights to guide localised opportunities for the development of tailored gender-specific interventions. Men in rural Australia are typically portrayed as embodying idealized masculinity-dominant and tough, upholding strength and stoicism in the face of hardship. Such values can increase suicide risk in men by reducing help-seeking. The Macedon Ranges Shire is an inner regional municipality with a population of approximately 50,000 people spanning across 10 regional towns and surrounding farming areas in Victoria, Australia. Understanding the influence of masculinities on men's wellbeing and help seeking behaviours in a regional context is vital in order to inform effective local suicide prevention efforts. The present research involved in-depth qualitative interviews with 19 community stakeholders (M = 49.89 years, SD = 11.82) predominantly working in healthcare and community services including emergency services and education. Using thematic analysis, interview transcripts were coded and themes inductively derived. Stakeholders identified three key areas for understanding suicide risk and wellbeing for local men; 1) localizing masculinities, 2) belonging in community, and 3) engaging men. Findings illustrate that addressing men's wellbeing in regional areas requires a multifaceted whole-of-community approach. While diverse, local expressions of masculinities were seen as contributors to men's challenges understanding their emotional worlds and reticence for help-seeking. Of vital need is to provide diverse opportunities for men to connect with others in the region, and offer inclusive spaces where men feel accepted, welcomed and able to meaningfully contribute to the community. Not only will this assist by bolstering men's sense of self, identity, and mental wellbeing, it may also provide valuable informal inroads to normalizing healthy communication around mental health and seeking mental health care. These findings offer important suggestions for the promotion of healthier masculinities in regionally-based Australian men, which may help to improve wellbeing of these men and their entire communities.