A Qualitative Exploration of Men's Experiences of an Integrated Exercise/CBT Mental Health Promotion Programme
McArdle, Siobhan, McGale, Nadine, Gaffney, Paul, International Journal of Men's Health
This study investigated qualitatively the experiences of men who took part in a 10 week integrated exercise/psychosocial mental health promotion programme, "Back of the Net" (BTN). 15 participants who completed the BTN programme were recruited to participate in either a focus group discussion (N = 9) or individual interview (N = 6). A thematic analytic approach was employed to identify key themes in the data. Results indicated that participants felt that football was a positive means of engaging men in a mental health promotion program. Perceived benefits experienced included perceptions of mastery, social support, positive affect and changes in daily behaviour. The findings support the value of developing gender specific mental health interventions to both access and engage young men.
Keywords: men's health, community mental health promotion, qualitative, exercise and mental health
Positive mental health is defined as a state of complete psychological, physical and social well-being (WHO, 2001). Rather than viewing well-being as a fixed state, it is argued that people can fluctuate between well-being and psychological distress at various times in their lives (Horwitz & Scheid, 1999). In a recent population study of distress in Ireland, results indicated that 12% of the 2,711 respondents were experiencing psychological distress at any one time (Tedstone Doherty, Moran, & Kartalova-O'Doherty, 2008). Of these, 40% did not seek help from formal health care services for their problems, with the majority of this subgroup being male. These findings highlight that in addition to those who require clinical and acute services, a broad spectrum of informal support sources are needed for those who are experiencing distress but who do not require statutory services (Tedstone Doherty et al.). Community based innovative programmes that promote well-being, develop coping strategies and increase resiliency are particularly crucial for hard to reach population groups such as young males (Tedstone Doherty & Kartalova O'Doherty, 2010; Department of Health, 2008).
Psychological distress is defined as experiencing unpleasant subjective states similar to sub clinical levels of depression (Barlow & Duran, 2005). In the UK, the National Institute for Health and Clinical Excellence (NICE) recommends a number of interventions for individuals with sub threshold depressive symptoms (NICE, 2009). These include minimal interventions such as guided self-help based on cognitive behavioural therapy (CBT) and structured group physical activity programmes . The utility of the NICE guidelines for young men, however, is limited if those in need either cannot or will not avail of the recommended interventions. The challenge therefore is to develop community based pragmatic interventions incorporating CBT and/or physical activity that is both accessible and acceptable to young males.
In men's health, adherence to masculine ideals and norms has been associated with reluctance to seek help (Lee & Owens, 2002). From an applied perspective, a contextual approach suggests a number of psychosocial structures capable of moderating restrictive masculine norms (Addis & Mahalik, 2003). For example, a man is more likely to seek help for problems he sees as "normal" and "shared" in contexts where interpersonal support rather than self-reliance is endorsed by other men (Addis & Mahalik). Contexts which provide opportunities for reciprocity (e.g., giving help, sharing expertise) and autonomy may also reduce threats to dominant masculinity norms (e.g., strength and competence) (Addis & Mahalik). The use of the sport context and sporting language has shown promise in providing the conditions and opportunities that foster help seeking and engagement in young men (Pringle & Sayers, 2004). For example, research has shown that mental health promotion programmes based in sport contexts normalize the help-seeking process for men (Pringle & Sayers). …