Men's Health

Part of the debate – in Westminster Hall at 11:00 am on 28th June 2006.

Alert me about debates like this

Photo of Howard Stoate Howard Stoate Labour, Dartford 11:00 am, 28th June 2006

The evidence of men's and boy's poor mental well-being is all around us. Some 75 per cent. of people who kill themselves are men, most of them young men, among whom suicide is the commonest cause of death. One man in eight is dependent on alcohol and 72 per cent. of male prisoners suffer from two or more mental disorders, while boys are five times more likely to be diagnosed with attention deficit hyperactivity disorder than girls.

Alarming numbers of men are unhappy, anxious, stressed and depressed. The results of a recent YouGov survey for the Men's Health Forum show that more than 18 million men in the UK could be affected by common mental health problems. The survey found that men in the UK experience very high stress levels, with nearly half—46 per cent.—suffering from moderate or extreme stress in a normal week. Just over half— 51 per cent.—said that they felt down, stressed, depressed or anxious at least once a month, while one in 10 felt that way a few times a week or even every day. Up to 76 per cent. of men have experienced depression or anxiety in their lives. The study also shows that while mental health is a major problem, nearly one fifth of men suffer in silence and do not turn to anyone for help.

What causes such men to feel stressed, depressed and down? Some 48 per cent. of men blame work or study as the key trigger for mental health problems, while 44 per cent. blame financial worries. Fast-paced living was mentioned as the cause by 27 per cent. of men, and relationship problems by 25 per cent.

Earlier this month, during national men's health week, the all-party group on men's health, which I chair, held a meeting with the all-party group on mental health. We heard from experts in the field of men's and boys' mental well-being. David Wilkins, from the Men's Health Forum, presented a new report on the issue, "Mind Your Head: Men, boys and mental well-being", which argues that although women are more likely to be diagnosed with a mental disorder, problems in men are massively under-diagnosed.

According to the report, in many cases that is simply because we do not fully understand the differences between how mental health problems manifest themselves in men and women. The report concludes that

"men's mental well-being as a whole is poorly understood and seriously undervalued."

That conclusion is at odds with the importance given to mental well-being by the general public. The publication of the White Paper, "Our health, our care, our say", followed an extensive consultation programme, in which a focus on mental well-being was ranked second on the general public's list of priorities for the NHS. Only regular preventive health checks were considered more of a priority.

Specialists recognise that importance too. The National Institute for Mental Health in England is explicit about the benefits to the nation of working to enhance mental well-being. In "Making it possible: improving mental health and well-being in England", the institute wrote:

"The skills and attributes associated with positive mental health lead to improved physical health, better quality of life, reduced crime, higher educational attainment, economic well-being and personal dignity."

At the meeting of the all-party groups, we also heard from Dr. Phil Timms of the Royal College of Psychiatrists, who told us that men tend to like being in control, which can prevent them from seeking help. However, if that can be turned around so that men see that they are taking control of their own health, it might be positive.

Men's mental health problems are often missed by GPs and friends because they are covered up. Dr. Timms also spoke about a friend of his who committed suicide while at medical school and had not spoken to anyone about his feelings. He also noted that that is not uncommon. Instead, men start drinking, take risks and become angry or complain of headaches, rather than admitting that they are feeling distressed or depressed.

National men's health week looked at men's mental well-being. At national level, the Men's Health Forum worked closely with 40 other organisations to make the week a success and to show what can be done to improve men's mental well-being. I shall not list all 40 organisations, but partners in the week included the Royal Mail, which is the country's biggest employer of men, the TUC, and charities such as the Mental Health Foundation, the Samaritans and the Afiya Trust. The Department of Health and NHS organisations were also partners. They all did some great work, showing what can be done to improve men's mental well-being.

The partners also worked with Haynes Publishing to produce the "Brain Manual", which was compiled by a good friend of mine, Dr. Ian Banks. He is not only president of the Men's Health Forum, having done a huge amount of work in support of men's health, but has recently been appointed as one of only two professors of men's health in the country. About 2,000 local events took place in national men's health week too. These events—run by NHS professionals, voluntary groups and occupational teams—undertook an extremely broad range of activity in an even broader range of settings. Activities ranged from display stands and father-and-son days to a five-a-side football competition and everything in between.

In my constituency in Dartford, the primary care trust health promotion team worked with pharmacists on a leaflet that they could either give to clients as a takeaway or use to prompt conversations on health issues. The overall aim is to engage men in promoting activities in ways that are local and flexible. Pharmacists, as we know, are both local and flexible. I am delighted that my local PCT and local council were able to get involved in men's health week.

I had the good fortune to chair a recent men's health supported conference on men's mental well-being, at which the Minister also spoke. That conference and the "Brain Manual" received financial support from the Government, for which I know the Men's Health Forum was extremely grateful. The Government were also supported by the Mental Health Foundation and the Football Association.

The wide range of factors that positively and negatively influence a man's mental well-being were explained and discussed at the event. The Football Association highlighted how sport can help to improve mental well-being. It has announced that it has appointed former England captain Tony Adams as a new football for all ambassador, with specific responsibility for mental health.

The FA's Simon Johnson also called on the mental health practitioners at the conference to become involved in the new football for all project, which uses football as a tool to help service users. That is clearly a welcome development. As the conference was supposed to have taken place in the new Wembley stadium, the FA could have spoken also about its experience of managing workplace stress.

Many gay men in particular face challenges to mental health well-being. There is still widespread homophobic bullying in schools, for example, and many mainstream religions regard homosexuality as sinful. Homophobia results in depression, anxiety, fear, apathy, mistrust and other mental health problems. There is also an impact on heterosexual men who might fear being labelled gay. That limits personal expression and creates fear of closeness with other men.

The conference held workshops run in London by PACE, which is London's largest gay and lesbian organisation. Evaluation shows that 96 per cent. of participants found the workshops useful, 71 per cent. felt more assured and 40 per cent. felt less unhappy about being gay.

Many of the lessons of that work could be used to help men in general. The "Mind Your Head" report from the Men's Health Forum is heavily influenced by Professor Richard Layard's work on happiness. A key area here is the effect of work on well-being. Far more men than women work full-time, and experiencing satisfaction at work is an important predisposing factor for positive mental well-being in men.

We usually associate higher earning power and higher status for men at work as representing a disadvantage for women, but this is a double-edged sword. The traditional role of breadwinner brings its own stresses, and long working hours can harm good family relationships, which are crucial for the mental well-being of future generations.

Lack of job satisfaction, work-related stress, the pressure to work long hours and unemployment are all damaging to mental well-being and, for numerical reasons, more likely to affect men than women. Men in the UK work the longest hours in Europe; 27 per cent. of men with full-time jobs in the UK work more than 48 hours a week, and 11 per cent. do more than 60 hours a week.

According to the TUC, 5 million people work more than seven hours of unpaid overtime every week. Most of those are likely to be men. The TUC work on this suggests that almost half the UK work force want to work fewer hours, with 10 per cent. willing to accept a pay reduction to do so.

Perhaps that has an influence on some of the other statistics highlighted by the YouGov survey published during men's health week. For example, stress, anxiety or depression are causing a third of sufferers to drink more alcohol. A further 18 per cent. start or increase smoking, and 4 per cent. admit to using illegal drugs in a bid to make themselves feel better. Nearly a fifth say that that makes them feel more aggressive.

We also know that 73 per cent. of adults who go missing are men. Let us remember that the reverse of that issue—unemployment—is also a common factor in poor mental well-being. Last year, the Health Development Agency reported that

"there is a strong association between unemployment and psychological and psychiatric morbidity... Upon re-employment, there appears to be a reversal of these effects."

Just last week, the Journal of Occupational and Environmental Medicine reported that the stress caused by job loss in the over-50s doubled their chances of suffering a stroke or heart attack.

As I have said, understanding and valuing of men's mental well-being are low, but the position is even worse when it comes to ethnic minority men. There is little awareness among health care professionals of how to engage effectively with black and minority ethnic men. Young African-Caribbean men are much more likely to receive a diagnosis of schizophrenia, more likely to be detained under the Mental Health Act 1983 and less likely to be offered psychological treatments. Asian men have high incidence of compulsory admissions to psychiatric institutions and low uptake of aftercare services. Irish men have a particularly high suicide rate, while Chinese men are generally reluctant to express emotions or to seek help with emotional problems.

Black and minority ethnic organisations, including Destigmatize and SIRI Counselling, were also partners in national men's health week. I am particularly pleased that the Men's Health Forum is continuing to work with those organisations and others on a project on the mental well-being of BME men. It is good news that the Department of Health is providing the majority of the funding needed for the project, and I hope that a sponsor can soon be found to provide the remainder.

I know that the forum has had a long relationship with Professor Kamlesh Patel, chair of the Mental Health Act Commission and director of the ethnicity and health unit at the university of Central Lancashire. In fact, I would like to congratulate Professor Patel on his recent appointment to another place, and I look forward to welcoming Lord Patel of Bradford to meetings of the all-party group on men's health.

There are isolated examples of innovative work going on in Kilburn. Brent council, the local child and adolescent health service, and the charity Corum Family run the boys2MEN project, which aims to give young African-Caribbean men healthy relationships with men when many do not have a father figure in their household. Last year, they won an award for that work.

Another groundbreaking project is CALM, the Campaign Against Living Miserably. CALM has been successful in working with the music industry in clubs and local radio. Its telephone helpline and website also allow young men to talk about problems and find local support.

I urge the Minister to ensure continuing and increasing support for such projects. Those charities, councils and local NHS bodies are helping young men to avoid alcohol abuse, suicide and aggression. Others have had success too. Dr. Phil Timms has noted that in New Zealand, 10 to 12-year-olds are taught about mental well-being. That is proving very successful.

The Men's Health Forum survey identified relationship problems as troubling a quarter of men. It is often claimed that men will not seek help for such problems, but the national Mensline scheme in Australia shows that that is simply not true. By offering a male-friendly, male-specific service, it has attracted 400,000 callers since 2001 in a culture internationally known for its macho men. That suggests that with a little encouragement and by respecting men's maleness, we might help large numbers of men suffering marital breakdown. That would have knock-on effects, helping men and women to tackle some troublesome problems of relationship breakdown that can be so damaging for children.

I think I have shown that on a range of measures men's mental well-being is poor, and that despite the successes of isolated and small-scale initiatives, no one really knows how to tackle things comprehensively. As the Men's Health Forum told the all-party groups on men's health and on mental health:

"Men are less likely to be diagnosed with depression because male specific symptoms may not be taken into account."

We need to understand that. We need to tackle it. We need to stop men's physical health, those in relationships with them and society at large suffering through men's poor mental health.

The first step must be a detailed investigation of levels of male psychological distress in all its manifestations. I believe that the Government should fund and start that work now. Specialists at the National Institute for Mental Health in England should examine the key risk factors, establish good practice and make recommendations for new and more flexible male-friendly services. They should also consider how we deal with the significant inequalities such as those affecting gay men and those from BME communities.

I hope that the Minister can announce progress on that important work. Such a gender-sensitive approach will soon be mandatory, when the new gender duty, introduced by the Equality Act 2006, becomes operational next April. I am also concerned that the public sector as a whole, not least the NHS, is not yet preparing for its new responsibilities, even though they have the potential dramatically to improve service delivery for men and for women.

We must avoid at all costs a society in which chronic poor mental health, as well as its effect on other areas of health and society, is endemic in men and repeated from generation to generation.