Meandering male – conference ruminations

MHF Conference 08 - 10 - 15Earlier this month Mengage were pleased to have the opportunity to participate in a conference held at the Haynes International Motor Museum in Yeovil – Putting Men into Mental Health, organised by the Men’s Health Forum and Somerset Public Health. If you were one of the many people we spoke to in the marketplace who expressed an interest in Mengage’s work and signed up for our newsletter – thanks, we’ll be in touch.

The conference’s intention was to raise awareness amongst professionals about male mental health issues and to explore support and services available to men, both locally and on a wider scale. There were inspiring examples of work and much for participants to take away to consider. Conferences can be great awareness raisers, both for professionals who are mindful of the issues – and for those who have not previously considered them; however conferences and workshops can only go so far and what is required is action – taking ideas away, considering how they can help to achieve locality or national health targets and developing and implementing them. We’d stretch that to add if you do implement something that is effective in addressing a male health concern, then please document and disseminate it. There are many examples of good practical work that have been lost through inadequate funding, poor management, or a lack of understanding of how gender-based health work can help to address targets. Until a dedicated male health policy is put into place as a driver for work, men’s health improvement work in the UK is likely to remain a fragmented area of practice. Documenting good work adds to the men’s health knowledge-base – and helps others to implement their own work.

Men’s mental health: stress as a social determinant

An issue raised at the conference was the affect of stress on men and the support available to men who experience this. Stress is recognised as one of the social determinants of health, yet in a UK context there is a paucity of support for men experiencing mental distress. One conference speaker bravely commented on how he had been fortunate enough to be able to afford appropriate support to enable him to move forward when he experienced a breakdown in his own mental health; the same commentator, a man in a position of workplace seniority, acknowledged that for many men being able to pay for similar support is not an option and expressed concern for men in less favourable circumstances. Another social determinant of male health raises its head in this instance – the social gradient. If you have the education and if you have the finance then help and treatments are easier to access. Men’s health is about more than work focused on masculinities; recognition of the social determinants of male health in a UK context, in academia and in policy and practice, is limited. More can be done.

A salutogenic approach?

The conference demonstrated the rationale for action on men’s mental health – and provided examples of innovative health improvement work. Media headlines proclaim frontline mental health services are overstretched, yet preventative work that could assist in taking the strain off frontline work is itself lacking and under-resourced. There is a good rationale  for implementing sustainable preventative health initiatives, and to encourage those factors that support health and wellbeing – for strategic thinkers in the UK to consider the salutogenic approach to male health advocated by Professor John Macdonald at University of Western Sydney and adopted in the Australian National Male Health policy.

The word salutogenic can be loosely defined as health enhancing. A salutogenic approach is one that is focused “on the creation and promotion of health as a necessary balance to the “pathogenic” (illness) focus where the current emphasis, resources and prestige in the health (i.e., medical) world are to be found” (Macdonald, 2011). Considering men’s health this enables an approach that creates environments where health can flourish, an approach that is strengths-based and positive about men – not a deficiency view that holds that there is something at fault with contemporary Western masculinity and hence needs to be addressed. This should not ignore that a minority of men are problematic, but that this should be considered in a much wider context.

Policy into practice?

Considering the fostering of environments that allow health to flourish, the UK could learn much from government male health policies implemented in both Ireland and Australia; an aspect of a salutogenic approach to male health would include the development of male-friendly services. Men’s sheds are often mentioned in this respect in terms of a mutually supportive, ‘health-by-stealth’ approach – and sheds were promoted at the conference by representatives of local sheds. Yes, we certainly do need more sheds, but there are also other examples of work where the UK should pay heed; this includes training for GPs and other primary healthcare staff in Australia on work with men (a bad back may be hiding other issues), dedicated telephone helplines specifically aimed at males on a range of health issues (Australia), or Mind Ur Mate suicide prevention services (Ireland) – taking targeted services out to where men are, whether that’s in the pub or club, or sports-based work with younger men, or sports clubs acting as hubs as information centres for work on male depression (Australia). There are many examples of work internationally that could translate into men’s health improvement work in the UK- and vice versa.

The UK has provided some fine, creative examples of male health improvement work – sports-based work provides examples of health improvement initiatives by professional football clubs, but there is much to learn and much that can be done. Strategic thinking on men’s health in the UK is behind that of Ireland and Australia; the Men’s Health Forum has recently called for a national policy on men’s health. We wouldn’t be the first to second that, other organisations will also have realised the need for a policy, but Mengage are certainly supportive of it. Single silo policies on areas such as sexual health or mental health are not enough on their own –  dedicated gender-based policy is required. Part of the work towards that policy is about turning the tanker mindset of health policy makers both at local and national level; which is why conferences such as the Somerset example are a vital part of the process with regard to demonstrating the rationale for a male health policy. More please – and let’s see some action too!

Reference:

Macdonald, J. (2011). Building on the Strengths of Australian Males. International Journal of Men’s Health, 10: 3- 5.

Further reading: Macdonald, J. (2005). Environments for Health: A Salutogenic Approach. London. Earthscan. Includes a chapter on a salutogenic approach to male health.