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      Understanding Men’s Engagement and Disengagement When Seeking Support for Mental Health

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          Abstract

          Men are less likely to utilize health care services compared with women. When it comes to mental health, men have been reported to hold more reluctant attitudes toward engaging with mental health services. Current studies have predominantly been quantitative and focused on understanding effective strategies to promote men’s engagement and why men may avoid help-seeking or may not seek help early; few studies exist of men’s disengagement from services. Much of this research has been undertaken from the services’ perspective. The study reported here attempts to gain better insight into the reasons men give for their disengagement from mental health services and what men say will reengage them back into the system. This research was a secondary analysis of data collected by a national survey conducted by Lived Experience Australia (LEA). Responses of 73 male consumers were gathered and analyzed. Analysis of the responses was split into two themes with associated subthemes: (1) Why men disengage : (1.1) Autonomy; (1.2) Professionalism; (1.3) Authenticity; and (1.4) Systemic Barriers; and (2) What will help men reengage : (2.1) Clinician-driven reconciliation, (2.2) Community and Peer Workers; and (2.3) Ease of reentry. Findings highlight strategies to prevent disengagement such as creating open and honest therapeutic environments and improving men’s mental health literacy while providing care. Evidence-based approaches to reengage male consumers are suggested along with an emphasis on men’s strong preferences for community-based mental health services and peer workers.

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          Most cited references26

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          Epistemic Petrification and the Restoration of Epistemic Trust: A New Conceptualization of Borderline Personality Disorder and Its Psychosocial Treatment.

          A new developmental model of borderline personality disorder (BPD) and its treatment is advanced based on evolutionary considerations concerning the role of attachment, mentalizing, and epistemic trust in the development of psychopathology. We propose that vulnerability to psychopathology in general is related to impairments in epistemic trust, leading to disruptions in the process of salutogenesis, the positive effects associated with the capacity to benefit from the social environment. BPD is perhaps the disorder par excellence that illustrates this view. We argue that this conceptualization makes sense of the presence of both marked rigidity and instability in BPD, and has far-reaching implications for intervention.
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            • Article: not found

            Dropout from individual psychotherapy for major depression: A meta-analysis of randomized clinical trials.

            Dropout from mental health treatment poses a substantial problem, but rates vary substantially across studies and diagnoses. Focused reviews are needed to provide more detailed estimates for specific areas of research. Randomized clinical trials involving individual psychotherapy for unipolar depression are ubiquitous and important, but empirical data on average dropout rates from these studies is lacking. We conducted a random-effects meta-analysis of 54 such studies (N=5852) including 80 psychotherapy conditions, and evaluated a number of predictors of treatment- and study-level dropout rates. Our overall weighted dropout estimates were 19.9% at the study level, and 17.5% for psychotherapy conditions specifically. Therapy orientation did not significantly account for variance in dropout estimates, but estimates were significantly higher in psychotherapy conditions with more patients of minority racial status or with comorbid personality disorders. Treatment duration was also positively associated with dropout rates at trend level. Studies with an inactive control comparison had higher dropout rates than those without such a condition. Limitations include the inability to test certain potential predictors (e.g., socioeconomic status) due to infrequent reporting. Overall, our findings suggest the need to consider how specific patient and study characteristics may influence dropout rates in clinical research on individual therapy for depression.
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              What do we know about men's help-seeking and health service use?

              Men seek help and use health services less frequently than women do. Men's help-seeking practices and health service use are complex issues involving biological, psychological and sociological considerations. Most discussion on men's help-seeking positions them as reluctant consumers or "behaving badly" with respect to their health. Few studies have explored whether health service providers are equipped to deal with men's health issues appropriately. The current health system appears not to be tailored to meet the health needs of men. Better collaboration is required across disciplines, to further investigate men's health using both qualitative and quantitative research methods.
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                Author and article information

                Journal
                Am J Mens Health
                Am J Mens Health
                JMH
                spjmh
                American Journal of Men's Health
                SAGE Publications (Sage CA: Los Angeles, CA )
                1557-9883
                1557-9891
                7 March 2023
                Mar-Apr 2023
                : 17
                : 2
                : 15579883231157971
                Affiliations
                [1 ]College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
                [2 ]Lived Experience Australia, Adelaide, South Australia, Australia
                Author notes
                [*]Minjoo Kwon, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia 5042, Australia. Email: minjoo.the.kwon@ 123456gmail.com
                Author information
                https://orcid.org/0000-0001-5963-8330
                Article
                10.1177_15579883231157971
                10.1177/15579883231157971
                9996733
                36880329
                7b71d7d5-ce51-4933-8f35-24461762ea24
                © The Author(s) 2023

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 12 August 2022
                : 24 January 2023
                : 31 January 2023
                Funding
                Funded by: Flinders University Advanced Studies Funding, ;
                Categories
                Mental Health and Wellbeing
                Original Article
                Custom metadata
                March-April 2023
                ts1

                men’s health,mental health,engagement,disengagement,access to care

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