Mens mental health – when to get therapy and how it works
Kate Evans offers some insight to dispel myths about men seeking therapy.
I’m a counsellor for the NHS Cornwall talking therapies team, which I am passionate about. As well as my role as a counsellor, I am also the men’s mental health champion for the service which means I look into ways that we can best support men in the service. Through my work and research I have discovered that there is a gap in getting men to assess help and so my work at the moment is looking into why this is and ways to overcome this. I have collated some of the information below and ways to assess help.
Statistics
• 75 percent of all suicides are males.
• In Cornwall one person every five days dies from suicide, this is higher than the national average.
• Suicide is the biggest killer of men under 50, with middle aged men being the most likely to die by suicide.
• 40% of men won’t talk to anyone about their mental health
These are shocking statistics. I’m sure most of us have been affected by mental health and even lost loved ones to suicide, so we need to work together to educate around how we can help and what signs we can look for because suicide is preventable.
Why men do not assess help
Keeping the above figures in mind, it would make sense that the majority of our client base would be men given that we can see that men are struggling and yet only 36% of all talking therapies referrals are males. Why is this?
A variety of reasons but toxic masculinity plays a huge part ‘Boys don’t cry’ and ‘Man up’ are messages that boys often hear and feel they need to adhere to in order to be accepted. We can not ignore that this is a strong message to break free from. As well as the above we know that men deal with stress differently. They tend to use escapism techniques such as throwing themselves into work or hobbies, or drinking alcohol and taking drugs and often avoiding how they feel until they reach crisis point and this is what we want to avoid, as suicide happens at crisis point. The problem is men are not conditioned to talk about their problems. While women naturally talk to their friends as a way of communicating men will often deal with their problems alone and will often want a practical way to ‘fix’ something. With all of this in mind it is easy to see why men don’t natural feel like they can reach out for help.
Recognising when help is needed
Sometimes even recognising the signs of depression can be hard to spot, men may dismiss it and think they are just stressed or tired and yet there is a difference between normal everyday stress that we all experience and depression. There are a range of common symptoms that people may experience when they are depressed, and it is worth noting that depression can range from being mild to severe so severity of symptoms will be unique, and this is not an exhaustive list.
Some signs you are depressed may include:
• Sleep problems- this can include finding it hard to get to sleep, frequently waking or over sleeping
• Feeling tired/ having little energy
• Lack of motivation
• A lack of interest in hobbies
• Isolation from people
• Low mood/ sadness/hopelessness
• Once you recognise these symptoms then it is the time to get help
Help is out there and what to expect
Firstly, it is important to recognise that depression is common, affecting 1 in 6 people in the UK. It is an illness and is treatable, seeing depression as an illness is helpful and it gives hope of recovery and for men it can be a ‘problem to be fixed’, also fitting in with their model of working there are also practical steps that can be taken to achieve recovery.
Research has shown that men do not often know what to expect about therapy and what it entails and find it hard to understand how talking can help and so it is important that this is something we are clear about.
What happens when you refer into talking therapies?
It is important to clarify at this point that everyone can self-refer, you do not need to go to your GP, the service is open to anyone living in Cornwall over the age of 16, you can self-refer online here or via telephone 01208 871 905
A range of conditions are treated in our service including Depression, anxiety, OCD and PTSD to name a few. Once you have referred in you will shortly be offered a date for an assessment.
At assessment a qualified professional will ask you a serious of questions to establish what has been happening for you and the issue you are currently facing; you will also complete a set of questionnaires to look at symptoms you are presenting with. The assessment is usually over the phone and will take around 30-45 minutes.
At the end of the assessment, you will have a discussion around what your goals are and between you and the therapist will collaborate to decide on the best treatment option.
We work within a stepped care model which means in the variety of instances after assessment most people will be offered a place on a psycho-educational group.
Most people hear the word ‘group’ and want to run a mile, but this is not ‘group therapy’ and at this point you are not expected to talk. They are groups that run between 1.5- 2 hours weekly for usually 4-6 weeks although some are longer. They are usually online but some run face to face at a variety of locations.
All the groups are a place where a trained professional will offer education and support around that subject. Some of the courses include dealing with stress and anxiety, dealing with depression, a course for the over 65s, we also have mindfulness courses, sleep courses and PTSD courses to name a few.
The courses have excellent recovery rates and most people will finish a course having gained valuable insight of how to deal and cope with their anxiety/depression. There are also short waits on the course so your help would usually begin within a month or two of assessment. If after the course you are still struggling then you will have a discussion with the course facilitator and if appropriate would be stepped up to one to one therapy.
If at assessment it is deemed that another service would best suit your needs you will be signposted out. It is important to clarify that no one that refers in will be left, they will be treated with empathy and respect and will be working in a collaborative way to help.
Therapy and what to expect.
So, what is it about therapy and talking that is so helpful? For men this can be difficult to understand and I think therapists working with men need to hear the men and understand what it means for them to be a male and how assessing help may feel difficult for them. It is important that we bring this into the room and do not shy away from it because it is playing a part in the help men are receiving.
32% of men who are offered treatment will not complete sessions and so it is clear that as professionals we need to be working in a different way and part of this is having conversations about what it means to ask for help when it goes against what you think you should do.
The main thing about therapy and the success of it is down to the relationship between the client and the therapist and this is the case regardless of the modality of therapy so if you were to have CBT or counselling which are very different approaches research shows that it is the relationship that facilitates most of the change.
Why is the therapeutic relationship so unique and how does it bring about change?
Imagine telling someone your story and not feeling judged, to be able to reach inside and say the things that you never thought you’d be able to say. Or even not say those things because you are not ready to but knowing that if and when you did you would not be shamed for it, your emotions and feelings are valid and valued. It is a place that you discover alongside your therapist why certain things may trigger you. It’s a place you gain insight into yourself and a place to learn self-compassion. It is not simply sitting in a room and talking. Of course this is a part of it but it is what is learnt in the exchange and the things you begin to notice that make the change. I can not deny it is a scary place, when I began therapy for myself many years ago I was scared to go and I was afraid of what would come up. This is natural and most people will feel this way. It is a vulnerable place to be and it needs to be recognised that it is not easy and takes great bravery to ask for help and to face the things that typically we want to hide from.
My hope
I hope that I have offered some clarity of what happens when you reach out and what to expect. After the reading I have done it seemed clear that dispelling some of these myths and educating men on what happens once you make these steps seemed like the most important thing. So I hope that it has allowed anyone suffering to know that there is help out there, you can self-refer, you will be offered treatment in the majority of cases in a relatively short amount of time and no one will be left.
Depression is an illness and so it needs a period of recovery and therapy can help with that recovery. It is also important that people reach out to their GPs if they also feel like they need additional help such as medication and of course speaking to loved ones has been shown to help, but it is important to recognise that this is difficult for people.
From a counsellor’s point of view and a personal one let me assure you that I do want to help and I do care that people get to live the life they deserve.
For help hit the website cornwallft.nhs.uk
For Carves mental health tool kit and uplifting stories go here.
