Ask The Expert – Research, Policymaking and Men’s Mental Health

• Professor Ann John – Professor in Public Health and Psychiatry at Swansea University Medical School
• Professor Ellen Townsend – Professor of Psychology at The University of Nottingham
• Rt Hon Norman Lamb MP – Member for North Norfolk, former Minister for State, Department of Health

Men are three times more likely to take their own life than women. Statistics of this nature make for difficult reading. Yet there is little doubt that we are in the midst of a “fascinating cultural change”, as Norman Lamb MP put it, when it comes to the mental health of young men and boys.

Professor Ann John – Professor in Public Health and Psychiatry at Swansea University Medical School

Professor Ann John presented evidence that socio-economic factors play a fundamental role in men’s mental ill health and suicide rates, with men from lower socio-economic backgrounds living in deprived areas being around 10 times more likely to take their own lives than those living in affluent areas.

“Suicide is a matter of socio-economic inequality”, Prof John said, and can interplay strongly with conceptions of masculinity and perceived social expectations.

Of those men who do receive a diagnosis for anxiety or depression, only 1 in 7 will seek further treatment. Instead, Prof John indicated that it is considerably more likely that they will reach the care system at a point of emergency.

Offering some insights into how the debate over men’s mental health can be moved forwards, Prof John argued that when it comes to addressing stigma and perceptions of mental ill health, language matters. Her experiences as a clinical practitioner and public health consultant suggested that many men find it difficult to discuss their mental health because they do not “speak the language of their GP” and struggle to overcome the way mental health has been characterized across our society.

Prof John also pointed to the language of Brexit, often touted as a moment of “national self-harm” or “madness”, as an indication that we are continuing to trivialize and debase mental health challenges. Conservative leadership candidate Jeremy Hunt, for example, recently described a no-deal Brexit as “political suicide”.

Above all, interventions in the education system could prove to be a key avenue for policy reform. 75% of those who will experience mental ill health present with perceptible signs before the age of 24. There are opportunities to counteract this, for example by incorporating education on cyber bulling into wider anti-bullying strategies.

Professor Ellen Townsend – Professor of Psychology at The University of Nottingham

Prof Townsend leads the Self-Harm Research Group at the University of Nottingham and made the case to the SMF that self-harm must be taken more seriously in front-line services.

Prof Townsend illustrated that at no moment in a person’s life are they more at risk of suicide than in their mid-late teenage years. And previous self-harm, a signal of emotional distress and pain, is a key indicator that an individual may be on the pathway towards suicide. Self-harm has now been incorporated into the National Suicide Prevention Strategy, published under the Coalition Government, but Prof Townsend made the case that there is far more research and policymaking still to be done in this area.

Outlining two key ways to improve policymaking outcomes she suggested that:
a) Those for whom research is designed to help must be brought more closely into the production of that research, from the start and not just the end;
b) Questions must be asked as to why available research is either ignored or takes far too long to be transmitted into policy (mental health research takes an average of 17 years to reach practice). For example, Prof Townsend cited evidence that young people exposed to lengthy periods of verbal therapy can produce positive outcomes for patients.

The link between self-harm and suicide is now well recognized by researchers and academics, but policy and practice appear to be lagging well behind. A recent study Prof Townsend referenced found that 55.8% of children and adolescents were not referred to mental health services after self-harming. However, Prof Townsend was positive about the way forwards and called on politicians to work hard to implement research into practice where it is available.

Rt Hon Norman Lamb MP – Member for North Norfolk, former Minister for State, Department of Health

“I regard this as a human rights issue”, Norman Lamb argued in his opening comments. He pointed to the fact that discrimination on the grounds of mental health is embedded in the legal framework of various countries across the world, in some instances preventing marriage or ownership of property.

Drawing upon personal experiences of the mental health care system in England, Norman Lamb suggested that whilst the politically charged NHS target waiting times for cancer treatment is often touted in parliament and the media, no such targets exists for mental health services.

Unequal access to services, excessive stays in institutionalized care, and the “endemic” use of force were all earmarked by Norman Lamb as areas for policy reform. When it came to teenagers and young people, the question of reintegration into friendship groups and the community was highlighted as a major challenge, with lengthy stays in care often proving to do “positive damage” to young people.

Could community care and rehabilitation be a more effective strategy, as opposed to locking young people up in care, often miles from friends and family. Norman Lamb described this as “unacceptable”, indicating that average stays in care in Australia were 10 days, whilst in the UK it is 72 days. Loneliness, isolation and social disconnectedness among young men and boys was central to this problem, something which Prof Ann John also highlighted.

All of the panel agreed that more research, with a specific focus on how mental health impacts boys and young men, is essential for driving policy reform. From cyber bullying to self-harm, there is huge scope for those changes to be made, and both academics and politicians must focus on the implementation of that research.

Want to hear more on this topic? Subscribe to the SMF Ask The Expert podcast and hear from Professor Ann John in conversation with the SMF’s Director, James Kirkup.