Problems experienced by young men and attitudes to help-seeking in a rural Irish community

Adolescent Suicide Ideation, Depression and Self-Esteem: Relationships to a New Measure of Gender Role Conflict

Among 15-24 year olds in Ireland, completed suicide was responsible for 4.1 times more male deaths than female deaths in 2014 (World Health Organization [WHO], 2017). Few international research studies have investigated the relationship between masculinity [as assessed by a measure of gender role conflict (GRC)] and suicide ideation, and none have done so with Irish adolescents. Therefore, the purpose of the current study was to investigate the relationships between a new measure of GRC developed specifically for use with Irish adolescents (I-GRCS-A; O'Beaglaoich et al., 2016), and depression, self-esteem, and negative/protective suicide ideation. A sample of 176 adolescent boys (M = 16.9, SD = 0.94) from a non-clinical population participated in the study. Regression analyses and tests of mediation revealed that depression significantly mediated the relationship between GRC and negative suicide ideation, whilst self-esteem and depression significantly mediated the relationship between GRC and positive suicide ideation. Implications and limitations of the current study are outlined and directions for future research are discussed.

". . . If You're Not Part of the Institution You Fall by the Wayside": Service Providers' Perspectives on Moving Young Men From Disconnection and Isolation to Connection and Belonging

There have been increasing calls for more gender-specific service provision to support young men's (20-29 years) mental health and well-being. In Ireland, young men are the demographic group that are most likely to die by suicide but among the least likely to seek help. This study sought to investigate service providers' perspectives on the factors that support or inhibit young men from engaging in services targeted at supporting their mental/emotional well-being. Qualitative methodologies (focus groups, n = 9; interviews, n = 7) were used for this study. Disconnection from family and community was identified as a key indicator of "at-risk" groups of young men who, more typically, had experienced significant disruption in their lives. The discord between demands and expectations facing young men on one hand, and insufficient life-management and coping skills on the other, left many young men vulnerable and bereft. The desire to save face and preserve one's masculine identity was linked to young men's reluctance to seek help when feeling down. There was a strong consensus that there could be no shortcuts to [re]connecting with young men. While sport, technology, and social media were cited as appropriate media in which to engage young men, the essence of sustained connection revolved around creating safety, trust, rapport, and meaningful relationships. The findings from this study have informed the development of a Train the Trainer program ("Connecting with Young Men"), which is currently being delivered to service providers in Ireland and which may have implications for service provision elsewhere.

Young men's access to community-based mental health care: qualitative analysis of barriers and facilitators

BACKGROUND

Young men experiencing mental ill health report the lowest rates of professional help-seeking of any demographic group across the lifespan. This phase of life (i.e. adolescence and emerging adulthood) also corresponds to a period of disconnection from healthcare services for young men.

AIMS

The present exploratory qualitative study aimed to identify barriers and facilitators to mental health care, as identified by a sample of young help-seeking men and staff involved in mental health service provision.

METHOD

Interviews and focus groups were undertaken with 25 young males (mean = 18.80 years, SD = 3.56) and four service providers. Participants were recruited from headspace enhanced primary care early intervention centres in Australia.

RESULTS

Thematic analysis indicated four overarching barriers and facilitators. The identified barriers were male role expectations, talk therapy as unknown territory, difficulties navigating the system and intake processes. The identified facilitators were positive initial contact, effective cross-sector partnerships, availability of male practitioners and use of targeted messaging.

CONCLUSIONS

Given the ongoing low rates of help-seeking, high rates of suicide and other adverse outcomes for young men, priority research and clinical attention is needed for this group. Recommendations are offered for future research, including suggestions for implementation of targeted strategies addressing gender-based health needs.

Psychological health and well-being among young Irish adults

Objectives: The aim of this study was to examine and describe levels of psychological health and well-being in a group of young people living in Dublin.

Method: A sample of 97 young people (50 males, 47 females) were assessed for psychological status, suicidal ideation, substance misuse, contact with the law, self-esteem and locus of control as well as various social indicators such as educational attainment and social connectedness. A screening version of the Structured Clinical Interview for DSM-IV Axis Diagnosis (SCID) was used to assess psychological functioning and the Beck Scale for Suicide Ideation was employed to ascertain suicidal ideation. Self-esteem was measured using the Rosenberg Self-Esteem Scale and locus of control was measured using a scale devised by Pearlin, Menaghan, Lieberman and Mullan (1981).

Results: Symptom levels were high and approximately one fifth of respondents had a probable psychiatric condition (most commonly depression or anxiety). Yet, only a small percentage was receiving treatment for psychiatric difficulties. Over half of the participants had used nonprescription drugs at some time. Alcohol consumption was high, especially amongst male respondents. Over half of those interviewed were categorised as misusing alcohol and/or drugs and participants greatly underestimated their level of alcohol use. Approximately one-quarter had had some contact with the law which was related to deficits in educational attainment and the latter variable was associated with childhood economic disadvantage.

Conclusions: These findings suggest that among a sample of 97 young Irish people, a high level of psychiatric symptomatology and excessive use of alcohol is evident. This remains largely untreated as only a small percentage of the group had sought help for psychological difficulties which suggests a need to address the issues of mental health awareness, alcohol use and the accessibility of services. The paper also underlines the association between economic disadvantage and lack of educational attainment with associated linkages to offending.

Providing meaningful care: learning from the experiences of suicidal young men

Little is known about young suicidal men's preferences for care. Using a broad interpretive approach, we interviewed 36 formerly suicidal young men in a study addressing the development and provision of mental health services. Our analysis yielded three core categories: widening access and bolstering proactive outreach, on becoming a man, and equipping young men for future challenges. Collectively, these categories suggest key features and processes of appropriate service configuration and clinical care: (a) services that reach out proactively serve to encourage young men's initial and ongoing engagement; (b) care delivered over the long term ensures a necessary focus on a meaningful future life; (c) mental health professionals (MHPs) are centrally involved alongside significant others, including those with personal experience of suicide; and (d) the development of a vital interpersonal connection is based on MHPs actively communicating their empathy, open-mindedness, and interest in a young man's unique biography.