The focus groups comprised people who often surrounded men in crisis: employee assistance professionals, human resource professionals, members of various faith communities’ pastoral care, spouses, and other mental health professionals. The in-depth interviews were conducted with men who had experienced a suicide crisis (attempt or aborted attempt) as an adult and who were now at least two years past this event and considered to be thriving. After a thematic analysis of the transcribed interviews and focus groups, the Man Therapy team concluded that the following approaches would increase success in reaching high-risk men of working age.
- Approach #1: Soften the mental health language for the initial communication with men. Many at-risk men were not seeing their problems through a mental health lens, so communication such as, “if you are depressed, seek help,” was missing an important subgroup.
- Approach #2: Show role models of hope and recovery. The men suggested that stories of men with “vicarious credibility” who have gone through tough times and found alternative ways to healing would offer hope that change is possible.
- Approach #3: Connect the dots: physical symptoms with emotional issues. Men were more willing to acknowledge changes in energy, sleep patterns, and appetite, but they did not always recognize how those changes were tied to mental health concerns.
- Approach #4: Meet men where they are instead of trying to turn them into something they are not. The research participants emphasized the importance of compelling messaging using humor—especially dark humor— to break down social barriers.Rather than expecting men to find information in mental health centers, the messages needed to show up in locations men frequent and through media targeting men. Research revealed that an approach to reach men using an Internet-based strategy allowed for anonymity and self-assessment.
- Approach #5: Offer opportunities to give back and make meaning out of the struggle. Even men conditioned to never ask for help often do so when they have an opportunity to return the favor – one helps another clean the gutters knowing next weekend he will return the favor and help move the dishwasher to the dump. The research indicated that having children and a desire to leave a positive legacy were often important barriers to engaging in suicidal behavior. Volunteering, spiritual growth, and strengthened relationships were also helpful in finding meaning after despair and creating a sense of belonging. For these reasons, the team looked for ways men could engage in reciprocity in the help-seeking, help-giving cycle.
- Approach #6: Coach the people around the high-risk men on what to look for and what to do. Several points of research indicated that intimate partners were both the most likely cause for suicidal distress (eg, divorce, separation, death) and the most likely person to intervene and influence a man to seek help. In addition, research uncovered that workplaces needed training, as with cardiopulmonary resuscitation, to help coworkers identify suicidal distress and refer to helpful resources (www.WorkingMinds.org). Because of these discoveries, the mental health program needed not only to target men but also to work to reach the people who surrounded men in crisis.
- Approach #7: Give men at least a chance to assess and “fix” themselves. As one participant in an in-depth interview said, “Show me how to stitch up my own wound like Rambo.” The blueprint for change needed to offer mastery-oriented intervention strategies that demonstrate progress and are time-limited. Simple, self-help strategies would allow men to take action in smaller, concrete steps.
Man Therapy®: Scope and Outcomes
The program was launched in 2012 with a fully integrated media campaign involving billboards and bus shelter posters, television and radio public service announcements, YouTube videos, and social media to drive audiences to a web portal (www.ManTherapy.org). Once engaged with the website, men interact with Dr. Mahogany, learn about Gentlemental Health®, complete an “18-point head inspection” (self-assessment), and get “manly mental health tips.” When men indicate their level of distress is high, Dr. Mahogany refers them to the National Suicide Prevention Lifeline or “the Pros,” a vetted list of professional mental health service providers.