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Objective: To describe key considerations for working with men experiencing distressed and disrupted intimate partner relationships., Methods: Individual Zoom interviews were conducted with help-seeking men (n = 25) who had experienced an intimate partnership break-up, and health service providers (n = 30) working with men in the relationships space. Interpretive Description methodology was used to generate considerations for working with men in distressed and disrupted relationships., Results: Three thematic findings were inductively derived; 1) A whole life approach for deconstructing relationships, wherein men engaged in discussions about their broader experiences and circumstances within the context of intimate partnerships; 2) Affirming men's relationship emotions and vulnerabilities as normative and changeable, comprising coaching for embodying transformative masculinities; and 3) Tangible 'to do's' in and after a relationship, outlining men's present and prospective self-work with action-oriented strategies., Conclusion: Strategies tailored to men's receptivity and needs can increase connection with professional services and providers to bolster the mental health of men in and after disrupted intimate partner relationships., Practice Implications: With men increasingly accessing professional mental health services, the present study offers key considerations and recommendations regarding assessment, communication, and treatment for health service providers working with men in the relationships space., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Anxiety is the most prevalent mental disorder experienced by young men, and when untreated, is predictive of co-morbid mental health challenges and suicide. Despite the rising prevalence, there is a conspicuous absence of qualitative research to distil and theorise young men's anxiety. Twenty-five young Australian men (15-25 years), who had been diagnosed with an anxiety disorder or self-reported anxiety symptoms, took part in individual semi-structured interviews. Interviews were transcribed verbatim and analysed using a constructivist grounded theory approach. A three-process grounded theory (Resisting-Reckoning-Responding; Triple R Anxiety Model) depicted young men's experiences of anxiety, gilded and guided by their masculine socialisation. Initially, young men noticed somatic symptoms (i.e., headaches, nausea and myalgia) but did not connect these symptoms to anxiety. Avoiding anxiety (e.g., denying, distracting) proved unhelpful in the longer term and as symptoms diffused, a subsequent process of reckoning anxiety (i.e., meaning making) ensued. As young men gained insight to the life limiting bounds of their anxiety, some were prompted towards actions of acceptance, seeking help proactively and employing strength-based adaptive coping strategies. This theoretical conceptualisation of young men's anxiety has the capacity to enhance identification and treatment efforts, improving young men's mental health outcomes across the lifespan., (© 2023 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for the Sociology of Health & Illness.)

Abstract: Self-reliance features as one of the notable male norms espoused by traditional masculine socialization. Strict adherence to a self-reliant attitude has been found to confer risk for depression and suicidality among men. Yet, little research has investigated the factors that may contribute to self-reliance having a negative impact for men. Using data from a large sample of Canadian men (N = 530), the present study examined the association between self-reliance and depression, while also assessing the roles of loneliness and not feeling understood as contributing factors in this process. Findings indicated that the moderated mediation model was significant, pointing to loneliness as a significant mediator in the association between self-reliance and depression. Furthermore, the findings revealed that not feeling understood moderated the relationship between self-reliance and loneliness, indicating that this association applies mainly to those men who do not feel understood by at least one important person in their life., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Aim: Anxiety disorders are amongst the most commonly diagnosed mental illnesses amongst men; however male-specific anxiety research is lacking. This review explores men's anxiety symptoms and disorders including help-seeking, coping and the role of masculinity., Method: Four electronic database searches identified 8,333 citations, with 25 studies meeting inclusion criteria. Nineteen studies employed quantitative methods, five studies reported qualitative research, and one utilised mixed methods., Results: Unique profiles of anxiety, including psychosomatic symptoms, were identified and persisted over extended periods of time. Men commonly reported self-reliance over formal help-seeking, and typically managed anxiety symptoms through problem-based coping. Masculinity was related to anxiety in complex ways; adherence to norms of toughness could be protective against anxiety onset, while adherence to emotional restrictiveness and heterosexual presentation norms were positively associated with anxiety. The experience of, and help-seeking for anxiety transgressed many men's adherence to masculinity norms resulting in significant social and self-stigmas., Limitations: The anxiety measurement scales utilised were inconsistent across included studies and there was limited scope of research into panic disorders, phobias and agoraphobia., Conclusion: Findings demonstrate the enduring nature of anxiety for men and a potential under-reporting of symptoms, especially amongst younger men. To better tailor clinical care and public health resources to the needs of men with anxiety disorders, targeted research examining men's lived experiences of (and coping strategies for) anxiety is essential., (Copyright © 2021. Published by Elsevier B.V.)

Growing interest in gender-sensitive assessment of depression in men has seen the development of male-specific screening tools. These measures are yet to be subject to longitudinal latent modelling, which limits evidence about the ability of these tools to detect change, especially relative to established screening scales. In this study, three waves of data were collected from 234 men (38.35 years, SD = 14.09) including 3- and 6-month follow-up. Analyses focused on baseline differences and symptom trajectories for the Patient Health Questionnaire (PHQ; prototypic symptoms) and the Male Depression Risk Scale (MDRS; male-type symptoms). At baseline, men not accessing treatment reported higher MDRS scores relative to treatment-engaged men. There was no group difference for the PHQ. Internal consistency (α, ω) coefficients indicated comparable reliability for both measures across the three waves. Multidomain latent growth modelling, including current treatment engagement as a covariate, reported good model fit (CFI = 0.964, TLI = 0.986, RMSEA = 0.081, SRMR = 0.033) with differential findings for the PHQ and MDRS. Consistent with the baseline between-group analysis, current treatment effects were observed for the MDRS, but not the PHQ. Trajectory modelling for the MDRS indicated that greater severity resulted in slower improvement by 6 months. In contrast, there was no difference in the PHQ rate of change between baseline and 6 months. Findings support the psychometric utility of the MDRS as a male-specific symptom domain measure sensitive to both longitudinal change and potential treatment effects for symptomatic men, in ways not discernible by the PHQ. The MDRS may be a useful adjunctive screening tool for assessing men's depression.

Men's tendency to conceal their distress has been linked with increased depressive symptoms. Although interpersonal connectedness has been associated with distress concealment and depression, it is unclear how connectedness mediates this association. The aim of the present study was to examine the mediating effects of feeling understood and loneliness-two facets of interpersonal connectedness-in the association between distress concealment and depressive symptoms in men. A sample of 530 Canadian men was selected based on age- and region-stratification that reflects the national population. Participants completed measures of depression symptoms, distress concealment, loneliness, and feeling understood. Mediation analyses were conducted. Results supported a sequential mediation model: concealing distress was associated with not feeling understood, not feeling understood was associated with loneliness, and loneliness was associated with depressive symptoms. These findings shed light on how distress concealment is associated with depressive symptoms among men. Implications for practice and theory are discussed.

Background: This study describes barriers to accessing mental health services among men currently experiencing a mental health concern., Methods: Mental health help-seeking survey data from 778 male respondents who self-reported experiencing a mental health concern were analyzed., Results: Of these men, 65% ( n  = 513) wanted treatment and 35% ( n  = 265) did not want treatment. The most frequently endorsed barriers to mental health treatment were believing that a lot of people feel sad and down (80%; n  = 620), not knowing what to look for in a psychotherapist (counselor; 80%; n  = 618) and needing to solve one's own problems (73%; n  = 569). Compared with men who wanted help for their mental health concern, those men who did not want help were significantly more likely to be unsure if psychotherapy (counseling) really works or is effective, not tell their physician if they were feeling down or depressed and prefer to solve their own problems., Conclusions: The high endorsement of both structural (e.g., cost) and attitudinal (e.g., beliefs) barriers by respondents suggests that service delivery must adapt to better respond to dominant masculine ideals while also improving men's ease of access into a transparent treatment process.

Alexithymia has been hypothesised to elevate risk of negative mental health outcomes for men. The growing literature related to the role of men's experience of self-conscious emotions (i.e., shame and guilt) suggests that these aversive affective experiences may be important in the relationship between alexithymia and negative mental health outcomes. The present study used parallel mediation models to determine the mediating roles of shame and guilt in the relationships between alexithymia and psychological distress and suicide-related behaviours. Online self-report data was collected from a sample of Canadian men ( N = 1,000; M age = 49.63, SD  = 14.59). Participants completed measures of alexithymia, guilt, shame and depression. Adjusting for current depression symptoms, bias corrected bootstrapping (95% CIs) indicated that both shame and guilt were mediators between identification of feelings and distress ( R 2  = .67), and description of feelings and distress ( R 2  = .39). Results indicate that men's difficulties identifying and describing their feelings and corresponding distress are particularly explained by shame - an aversive maladaptive emotion that promotes concealment of a perceived defective self. Conversely, guilt was more salient for men's suicide-related behaviours.R 2  = .38), and description of feelings and suicide-related behaviours ( R 2  = .39). Results indicate that men's difficulties identifying and describing their feelings and corresponding distress are particularly explained by shame - an aversive maladaptive emotion that promotes concealment of a perceived defective self. Conversely, guilt was more salient for men's suicide-related behaviours.

Objective: Men present with complex, diverse and often contradictory expressions of masculinity that are relevant to their health status. This article argues for the inclusion of masculinity into mental health curricula in Australia. Masculinity mediates health outcomes by influencing help seeking and engagement with treatment., Conclusion: An online curricula audit of publicly available information from Australian medical programs and their professional bodies reveals increasing awareness of the needs, but limited practical inclusion of masculinity models in training and practice. Described are the elements essential to training and subsequent clinical practice to curb the poor mental health outcomes of Australian men.

Tailoring psychological treatments to men's specific needs has been a topic of concern for decades given evidence that many men are reticent to seek professional health care. However, existing literature providing clinical recommendations for engaging men in psychological treatments is diffuse. The aim of this scoping review was to provide a comprehensive summary of recommendations for how to engage men in psychological treatment. Four electronic databases (MEDLINE, PubMed, CINAHL, PsycINFO) were searched for articles published between 2000 and 2017. Titles and abstracts were reviewed; data extracted and synthesized thematically. Of 3,627 citations identified, 46 met the inclusion criteria. Thirty articles (65%) were reviews or commentaries; 23 (50%) provided broad recommendations for working with all men. Findings indicate providing male-appropriate psychological treatment requires clinicians to consider the impact of masculine socialization on their client and themselves, and how gender norms may impact clinical engagement and outcomes. Existing literature also emphasized specific process micro-skills (e.g., self-disclosure, normalizing), language adaption (e.g., male-oriented metaphors) and treatment styles most engaging for men (e.g., collaborative, transparent, action-oriented, goal-focused). Presented are clinical recommendations for how to engage men in psychological treatments including paying attention to tapping the strengths of multiple masculinities coexisting within and across men. Our review suggests more empirically informed tailored interventions are needed, along with formal program evaluations to advance the evidence base.

Aim: Conformity to traditional masculine gender norms may deter men's help-seeking and/or impact the services men engage. Despite proliferating research, current evidence has not been evaluated systematically. This review summarises findings related to the role of masculinity on men's help-seeking for depression., Method: Six electronic databases were searched using terms related to masculinity, depression and help-seeking. Titles and abstracts were reviewed and data systematically extracted and examined for methodological quality., Results: Of 1927 citations identified, 37 met inclusion criteria. Seventeen (46%) studies reported qualitative research; eighteen (49%) employed quantitative methods, and two (5%) mixed methods. Findings suggest conformity to traditional masculine norms has a threefold effect on men experiencing depression, impacting: i) their symptoms and expression of symptoms; ii) their attitudes to, intention, and, actual help-seeking behaviour; and, iii) their symptom management., Conclusion: Results demonstrate the problematic impact of conformity to traditional masculine norms on the way men experience and seek help for depression. Tailoring and targeting clinical interventions may increase men's service uptake and the efficacy of treatments. Future research examining factors associated with men's access to, and engagement with depression care will be critical to increasing help-seeking, treatment uptake, and effectual self-management among men experiencing depression., (Copyright © 2016 Elsevier Ltd. All rights reserved.)