Top

Open Access 14-07-2024 | Review

Why do young men not seek help for affective mental health issues? A systematic review of perceived barriers and facilitators among adolescent boys and young men

Authors: Ayesha Sheikh, Chloe Payne-Cook, Stephen Lisk, Ben Carter, June S. L. Brown

Published in: European Child & Adolescent Psychiatry

Abstract

Men are less likely to seek help for their mental health than women, but less is known about the specific patterns of help-seeking in adolescent boys and young men. This is concerning as adolescent boys and young men have high suicide rates but a low take-up of services. It is therefore of particular importance that the access needs of this group are understood. This review sought to identify the barriers and facilitators faced by adolescent boys and young men in help-seeking for affective mental health disorders. A search of the PubMed, APA PsycInfo, and Cochrane databases identified 3961 articles, of which 12 met the inclusion criteria. Six of the studies were qualitative, five were quantitative and one used mixed methods. Two authors independently extracted data and assessed the quality of the articles. Five key themes were identified, including the impact of social norms, with the subthemes of conformity to masculine norms and self-stigma, limited availability of information about mental health, and ‘male-friendly’ mental health literacy campaigns. Other themes referred to the help-seeking preferences of adolescent boys and young men, in terms of informal or formal and online or offline help-seeking. Some of the factors were well-researched (e.g., conformity to masculine norms as a barrier) whereas other factors (e.g., self-compassion as a facilitator) were less researched. These barriers and facilitators need to be considered in the development of future strategies to improve the help-seeking behaviour of adolescent boys and young men.

Available only for authorised users

NHS Digital (2022) Mental Health of Children and Young People in England 2022—wave 3 follow up to the 2017 survey (Mental Health of Children and Young People Surveys). https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england/2022-follow-up-to-the-2017-survey#

Mental Health Foundation (2023) Uncertain times: anxiety in the UK and how to tackle it. https://www.mentalhealth.org.uk/our-work/public-engagement/mental-health-awareness-week/anxiety-report. Accessed 31st May 2023

Children’s Commissioner (2016) Lightning review: access to child and adolescent mental health services. https://www.childrenscommissioner.gov.uk/resource/lightning-review-access-to-child-and-adolescent-mental-health-services/

Solmi M, Radua J, Olivola M, Croce E, Soardo L, Salazar de Pablo G, Fusar-Poli P (2022) Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol Psychiatry 27(1):281–295. https://doi.org/10.1038/s41380-021-01161-7CrossRefPubMed

Office for National Statistics (2022) Estimating suicide among higher education students, England and Wales: experimental Statistics: 2017 to 2020. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/estimatingsuicideamonghighereducationstudentsenglandandwalesexperimentalstatistics/2017to2020

NHS Digital (2022) Psychological Therapies, Annual report on the use of IAPT services, 2021–22 (Psychological Therapies, Annual Reports on the use of IAPT services). https://digital.nhs.uk/data-and-information/publications/statistical/psychological-therapies-annual-reports-on-the-use-of-iapt-services/annual-report-2021-22

Slade T, Johnston A, Teesson M, Whiteford H, Burgess P, Pirkis J, Saw S (2009) The Mental Health of Australians 2: report on the 2007 National Survey of Mental Health and Wellbeing.

Gao CX, McDonald LP, Hamilton MP, Simons K, Menssink JM, Filia K, Cotton SM (2023) Inequalities in access to mental health treatment by Australian youths during the COVID-19 pandemic. Psychiatr Serv 74(6):581–588. https://doi.org/10.1176/appi.ps.20220345CrossRefPubMed

Rickwood DJ, Deane FP, Wilson CJ (2007) When and how do young people seek professional help for mental health problems? Med J Aust 187(S7):S35–S39. https://doi.org/10.5694/j.1326-5377.2007.tb01334.xCrossRefPubMed

10.

Gulliver A, Griffiths KM, Christensen H (2010) Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry 10(1):113. https://doi.org/10.1186/1471-244X-10-113CrossRefPubMedPubMedCentral

11.

Addis ME, Mahalik JR (2003) Men, masculinity, and the contexts of help seeking. Am Psychol 58(1):5CrossRefPubMed

12.

Mackenzie C, Gekoski W, Knox V (2006) Age, gender, and the underutilization of mental health services: the influence of help-seeking attitudes. Aging Ment Health 10:574–582. https://doi.org/10.1080/13607860600641200CrossRefPubMed

13.

Wendt D, Shafer K (2016) Gender and attitudes about mental health help seeking: results from national data. Health Soc Work 41(1):e20–e28CrossRef

14.

Brown JSL, Sagar-Ouriaghli I, Sullivan L (2019) Help-seeking among men for mental health problems. In: Barry JA, Kingerlee R, Seager M, Sullivan L (eds) The Palgrave handbook of male psychology and mental health. Springer International Publishing, pp 397–415. https://doi.org/10.1007/978-3-030-04384-1_20

15.

Seidler ZE, Dawes AJ, Rice SM, Oliffe JL, Dhillon HM (2016) The role of masculinity in men’s help-seeking for depression: a systematic review. Clin Psychol Rev 49:106–118. https://doi.org/10.1016/j.cpr.2016.09.002CrossRefPubMed

16.

Sagar-Ouriaghli I, Godfrey E, Bridge L, Meade L, Brown JSL (2019) Improving mental health service utilization among men: a systematic review and synthesis of behavior change techniques within interventions targeting help-seeking. Am J Mens Health 13(3):1557988319857009. https://doi.org/10.1177/1557988319857009CrossRefPubMedPubMedCentral

17.

World Health Organization (2022) Mental health. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response. Accessed 5 Apr 2023

18.

Critical Appraisal Skills Programme (2022) CASP Qualitative Studies Checklist. https://casp-uk.net/casp-tools-checklists. Accessed 20 Feb 2023

19.

Herzog R, Álvarez-Pasquin MJ, Díaz C, Del Barrio JL, Estrada JM, Gil Á (2013) Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review. BMC Public Health 13(1):154. https://doi.org/10.1186/1471-2458-13-154CrossRefPubMedPubMedCentral

20.

Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101. https://doi.org/10.1191/1478088706qp063oaCrossRef

21.

Stern C, Lizarondo L, Carrier J, Godfrey C, Rieger K, Salmond S, Loveday H (2020) Methodological guidance for the conduct of mixed methods systematic reviews. JBI Evid Synth 18(10):2108–2118. https://doi.org/10.11124/JBISRIR-D-19-00169CrossRefPubMed

22.

Best P, Gil-Rodriguez E, Manktelow R, Taylor BJ (2016) Seeking help from everyone and no-one: conceptualizing the online help-seeking process among adolescent males. Qual Health Res 26(8):1067–1077. https://doi.org/10.1177/1049732316648128CrossRefPubMed

23.

Burke L, John M, Hanna P (2022) A qualitative exploration of how young men in the UK perceive and experience informal help-seeking for mental health difficulties. Child Youth Serv Rev 137:106440. https://doi.org/10.1016/j.childyouth.2022.106440CrossRef

24.

Clark LH, Hudson JL, Dunstan DA, Clark GI (2018) Barriers and facilitating factors to help-seeking for symptoms of clinical anxiety in adolescent males. Aust J Psychol 70(3):225–234. https://doi.org/10.1111/ajpy.12191CrossRef

25.

Cole BP, Ingram PB (2020) Where do I turn for help? Gender role conflict, self-stigma, and college men’s help-seeking for depression. Psychol Men Masc 21(3):441–452. https://doi.org/10.1037/men0000245CrossRef

26.

Ellis LA, Collin P, Hurley PJ, Davenport TA, Burns JM, Hickie IB (2013) Young men’s attitudes and behaviour in relation to mental health and technology: implications for the development of online mental health services. BMC Psychiatry 13(1):119. https://doi.org/10.1186/1471-244X-13-119CrossRefPubMedPubMedCentral

27.

Heath PJ, Brenner RE, Vogel DL, Lannin DG, Strass HA (2017) Masculinity and barriers to seeking counseling: the buffering role of self-compassion. J Couns Psychol 64(1):94–103. https://doi.org/10.1037/cou0000185CrossRefPubMed

28.

Liddle SK, Robinson L, Vella SA, Deane FP (2021) Profiles of mental health help seeking among Australian adolescent males. J Adolesc 92:34–45. https://doi.org/10.1016/j.adolescence.2021.08.010CrossRefPubMed

29.

Lynch L, Long M, Moorhead A (2016) Young men, help-seeking, and mental health services: exploring barriers and solutions. Am J Mens Health 12(1):138–149. https://doi.org/10.1177/1557988315619469CrossRefPubMedPubMedCentral

30.

Meechan H, John M, Hanna P (2021) Understandings of mental health and support for Black male adolescents living in the UK. Child Youth Serv Rev 129:106192. https://doi.org/10.1016/j.childyouth.2021.106192CrossRef

31.

Ramaeker J, Petrie TA (2019) “Man up!”: exploring intersections of sport participation, masculinity, psychological distress, and help-seeking attitudes and intentions. Psychol Men Masc 20(4):515–527. https://doi.org/10.1037/men0000198CrossRef

32.

Sagar-Ouriaghli I, Brown JSL, Tailor V, Godfrey E (2020) Engaging male students with mental health support: a qualitative focus group study. BMC Public Health 20(1):1159. https://doi.org/10.1186/s12889-020-09269-1CrossRefPubMedPubMedCentral

33.

van der Schyff EL, Amon KL, Ridout B, Forsyth R, Campbell AJ (2023) Mental health help-seeking behavior of male video game players: an online survey. Cyberpsychol Behav Soc Netw 26(9):717–723. https://doi.org/10.1089/cyber.2023.0035CrossRefPubMed

34.

Mahalik JR, Locke BD, Ludlow LH, Diemer MA, Scott RPJ, Gottfried M, Freitas G (2003) Development of the conformity to masculine norms inventory. Psychol Men Masc 4(1):3–25. https://doi.org/10.1037/1524-9220.4.1.3CrossRef

35.

Parent MC, Moradi B (2009) Confirmatory factor analysis of the Conformity to Masculine Norms Inventory and development of the Conformity to Masculine Norms Inventory-46. Psychol Men Masc 10(3):175–189. https://doi.org/10.1037/a0015481CrossRef

36.

O’Neil JM (2008) Summarizing 25 years of research on men’s gender role conflict using the gender role conflict scale: new research paradigms and clinical implications. Couns Psychol 36(3):358–445. https://doi.org/10.1177/0011000008317057CrossRef

37.

Radez J, Reardon T, Creswell C, Lawrence PJ, Evdoka-Burton G, Waite P (2021) Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies. Eur Child Adolesc Psychiatry 30(2):183–211. https://doi.org/10.1007/s00787-019-01469-4CrossRefPubMed

38.

Rickwood D, Deane FP, Wilson CJ, Ciarrochi J (2005) Young people’s help-seeking for mental health problems. Aust e-J Adv Mental Health 4(3):218–251. https://doi.org/10.5172/jamh.4.3.218CrossRef

39.

Rice SM, Purcell R, McGorry PD (2018) Adolescent and young adult male mental health: transforming system failures into proactive models of engagement. J Adolesc Health 62(3, Supplement):S9–S17. https://doi.org/10.1016/j.jadohealth.2017.07.024CrossRefPubMed

40.

Jorm AF (2000) Mental health literacy. Public knowledge and beliefs about mental disorders. Br J Psychiatry 177:396–401. https://doi.org/10.1192/bjp.177.5.396CrossRefPubMed

41.

Crenshaw K (1989) Demarginalizing the intersection of race and sex: a black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 1989(1), Article 8. http://chicagounbound.uchicago.edu/uclf/vol1989/iss1/8

42.

Opara I, Weissinger GM, Lardier DT, Lanier Y, Carter S, Brawner BM (2021) Mental health burden among Black adolescents: the need for better assessment, diagnosis and treatment engagement. Soc Work Ment Health 19(2):88–104. https://doi.org/10.1080/15332985.2021.1879345CrossRefPubMedPubMedCentral

43.

Eylem O, de Wit L, van Straten A, Steubl L, Melissourgaki Z, Danışman GT, Cuijpers P (2020) Stigma for common mental disorders in racial minorities and majorities a systematic review and meta-analysis. BMC Public Health 20(1):879. https://doi.org/10.1186/s12889-020-08964-3CrossRefPubMedPubMedCentral

44.

Bosco N, Giaccherini S, Meringolo P (2020) A gender perspective about young people’s seeking help. J Prev Interv Community 48(2):132–146. https://doi.org/10.1080/10852352.2019.1624353CrossRefPubMed

45.

Hayes D, Mansfield R, Mason C, Santos J, Moore A, Boehnke J, Deighton J (2023) The impact of universal, school based, interventions on help seeking in children and young people: a systematic literature review. Eur Child Adolesc Psychiatry. https://doi.org/10.1007/s00787-022-02135-yCrossRefPubMedPubMedCentral

46.

Neff KD, McGehee P (2010) Self-compassion and psychological resilience among adolescents and young adults. Self Identity 9(3):225–240. https://doi.org/10.1080/15298860902979307CrossRef

47.

Gilbert P (2014) The origins and nature of compassion focused therapy. Br J Clin Psychol 53(1):6–41. https://doi.org/10.1111/bjc.12043CrossRefPubMed

48.

Luoma JB, Platt MG (2015) Shame, self-criticism, self-stigma, and compassion in acceptance and commitment therapy. Curr Opin Psychol 2:97–101. https://doi.org/10.1016/j.copsyc.2014.12.016CrossRef

49.

Riebel M, Rohmer O, Charles E, Lefebvre F, Weibel S, Weiner L (2023) Compassion-focused therapy (CFT) for the reduction of the self-stigma of mental disorders: the COMpassion for Psychiatric disorders, Autism and Self-Stigma (COMPASS) study protocol for a randomized controlled study. Trials. https://doi.org/10.1186/s13063-023-07393-yCrossRefPubMedPubMedCentral

50.

Radez J, Reardon T, Creswell C, Orchard F, Waite P (2022) Adolescents’ perceived barriers and facilitators to seeking and accessing professional help for anxiety and depressive disorders: a qualitative interview study. Eur Child Adolesc Psychiatry 31(6):891–907. https://doi.org/10.1007/s00787-020-01707-0CrossRefPubMed

51.

Kelly CM, Jorm AF, Wright A (2007) Improving mental health literacy as a strategy to facilitate early intervention for mental disorders. Med J Aust 187(S7):S26–S30. https://doi.org/10.5694/j.1326-5377.2007.tb01332.xCrossRefPubMed

52.

Werner-Seidler A, Spanos S, Calear AL, Perry Y, Torok M, O’Dea B, Newby JM (2021) School-based depression and anxiety prevention programs: an updated systematic review and meta-analysis. Clin Psychol Rev 89:102079. https://doi.org/10.1016/j.cpr.2021.102079CrossRefPubMed

53.

Lisk S, Carter B, James K, Stallard P, Deighton J, Yarrum J, BS Collaborators (2022) Brief Educational Workshops in Secondary Schools Trial (BESST): protocol for a school-based cluster randomised controlled trial of open-access psychological workshop programme for 16–18-year-olds. Trials 23(1):935. https://doi.org/10.1186/s13063-022-06830-8CrossRefPubMedPubMedCentral

54.

Hayes D, Moore A, Stapley E, Humphrey N, Mansfield R, Santos J, Deighton J (2019) School-based intervention study examining approaches for well-being and mental health literacy of pupils in Year 9 in England: study protocol for a multischool, parallel group cluster randomised controlled trial (AWARE). BMJ Open 9(8):e029044. https://doi.org/10.1136/bmjopen-2019-029044CrossRefPubMedPubMedCentral

55.

Calear AL, Morse AR, Batterham PJ, Forbes O, Banfield M (2021) Silence is deadly: a controlled trial of a public health intervention to promote help-seeking in adolescent males. Suicide Life-Threat Behav 51(2):274–288. https://doi.org/10.1111/sltb.12703CrossRefPubMed

56.

Bains RM, Franzen CW, White-Frese’ J (2014) Engaging African American and Latino adolescent males through school-based health centers. J Sch Nurs 30(6):411–419. https://doi.org/10.1177/1059840514521241CrossRefPubMed

57.

Granrud MD, Bisholt B, Anderzèn-Carlsson A, Steffenak AKM (2020) Overcoming barriers to reach for a helping hand: adolescent boys’ experience of visiting the public health nurse for mental health problems. Int J Adolesc Youth 25(1):649–660. https://doi.org/10.1080/02673843.2020.1711529CrossRef

58.

Slotte S, Ramsøy-Halle H, Melby L, Kaasbøll J (2022) Facilitating factors for seeking help for mental health problems among Norwegian adolescent males: a focus group interview study. Front Psychiatry 13:1049336CrossRefPubMedPubMedCentral

59.

Best P, Manktelow R, Taylor BJ (2016) Social work and social media: online help-seeking and the mental well-being of adolescent males. Br J Soc Work 46(1):257–276. https://doi.org/10.1093/bjsw/bcu130CrossRef

60.

Do R, Park JR, Lee SY, Cho MJ, Kim JS, Shin MS (2019) Adolescents’ attitudes and intentions toward help-seeking and computer-based treatment for depression. Psychiatry Investig 16(10):728–736. https://doi.org/10.30773/pi.2019.07.17.4CrossRefPubMedPubMedCentral

61.

Gulliver A, Griffiths KM, Christensen H, Brewer JL (2012) A systematic review of help-seeking interventions for depression, anxiety and general psychological distress. BMC Psychiatry 12:1–12. https://doi.org/10.1186/1471-244X-12-81CrossRef

62.

Brown JS, Lisk S, Carter B, Stevelink SA, Van Lieshout R, Michelson D (2022) How can we actually change help-seeking behaviour for mental health problems among the general public? Development of the ‘PLACES’ model. Int J Environ Res Public Health 19(5):2831. https://doi.org/10.3390/ijerph19052831CrossRefPubMedPubMedCentral

Title: Why do young men not seek help for affective mental health issues? A systematic review of perceived barriers and facilitators among adolescent boys and young men
Authors: Ayesha Sheikh
Chloe Payne-Cook
Stephen Lisk
Ben Carter
June S. L. Brown
Publication date: 14-07-2024
Publisher: Springer Berlin Heidelberg
Published in: European Child & Adolescent Psychiatry
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI: https://doi.org/10.1007/s00787-024-02520-9

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Why do young men not seek help for affective mental health issues? A systematic review of perceived barriers and facilitators among adolescent boys and young men

Abstract

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Abstract

Please log in to get access to this content