Working with Men & Boys:Setting the scene

9th November 2010

Dr Steve RobertsonReader in Men’s Health Centre for Men’s Health

Leeds Metropolitan University

With thanks to Prof. Alan White

Some background data

Men die earlier than women

Patterns of mortality in men and women, 15-44 years, UK, 2002

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Calculated from White, AK, Holmes, M, (2006) Patterns of mortality across 44 Countries among men and women aged 15-44. Journal of Men’s Health & Gender 3(2): 139-151

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Malignant neoplasms

Diseases of thecirculatory system

Accidents and adverseeffects

Suicide and self-inflicted injury

Chronic liver diseaseand cirrhosis

Homicide and injurypurposely inflicted byother persons

These early deaths include: road traffic accidents, suicide, violent death, drug and alcohol related deaths.

Two-thirds of all deaths in teenage boys are due to Road traffic accidents

Early Deaths

Men exceed recommended drinking limits more than women (though this is less marked in younger age groups)

(ONS, Focus on Gender, Sept 2008)

Some background data (cont)

• Men are three times more likely to become alcohol dependent

• About one in three young men use illegal drugs.

• Men are more than twice as likely to use Class A drugs.

• 78% of drug-related deaths occur in men.

Office for National Statistics, Social Trends 34 (The Stationery Office; London, 2004).

‘Risk’ taking & socio-economic status

Some background data (cont)

Men commit the majority of crime including violent crime and 95% of the prison population are male

ONS 2006

Some background data (cont)

84% of children excluded from school are boys.

Girls continue to outperform boys at all levels of education

(ONS, Focus on Gender, Sept 2008)

Pupils achieving five or more GCSE grades A*–C or equivalent: by sex

BUT…

This is not the whole story

Young men’s lives are more complex and contradictory

…the young men in Harland’s (2000) inner city Belfast study (aged 14-16 years) clung desperately to narrow and contradictory interpretations of masculinity, believing that men should be powerful, strong, brave, intelligent, healthy, sexy, mature, and in control of every aspect of their lives. In reality, however, their lives were full of ‘contradictions’ as most young men felt powerless; feared the threat of daily violence; were labelled ‘stupid’ in school; did not pay attention to their health needs - particularly their mental health; had limited sexual education; rarely asked for support; and felt they were perceived by adults as being ‘immature.’

Ken Harland. Acting Tough: Young Men, Masculinity and the Development of Practice in Northern Ireland (http://www.mensproject.org/issues/kenspeech.pdf) accessed July 2010

McDowell, L. (2002) Masculine discourses and dissonances: strutting ‘lads’, protest masculinity and domestic respectability. Environment & Planning D: Society and Space 20: 97-119

Need to conform to rebellious performances of masculine actions

Envisage a settled future - steady partner, house work & children

We often fail to recognise this desire in men for ‘domestic respectability’ and how this might be utilised as a lever for moving away from the more negative aspects of ‘protest masculinity’.

Taking responsibility - “as soon as you cut them (risks) down you’re doing something, you’re controlling your life.”

Good judgement - “Also knowing that they’ve not been in trouble with the police…cos that’s when people know they’re not being stupid, that they ain’t got stupidity.” S.4, Q.1a, CA15);

Trust - “because people see more in you, they trust you more…and you earn their trust more.”

Loyalty/faithfulness - “Yea, he (Jeremy Kyle) did actually cheat on his wife as well.” “I know yeah, “Don’t cheat on your wife.”

Respect - “Gotta treat a girl right.”…”Just gotta be dead nice to the girl if you’re going out with them”

Humour - “Just like have a laugh and stuff like that, like be happy and get on with everyone.”

Being Popular - “Good personality, you’ve gotta be alright with everyone.”

Generosity - “Offering to buy them a drink every now and again.”

This desire for domesticity is reflected in some positive views about relationships and responsibility (that are often juxtaposed to public performances of sexual banter and misogyny)

Professionals & Gender

Female physicians spend longer with patients then male physicians and spend more time talking about health-related lifestyle and social issues (Roter et al 2002, JAMA)

Men receive less time than women in consultations with doctors and explanations given are fewer in number and briefer than those given to women (Courtenay 2000, Journal of Men’s Studies)

Ask yourself two things (and be honest!):

1)How do I see men?2)What do I feel about working with them?

Men, vulnerability and relationships

There is a vulnerability about men in terms of relationships and emotions that is not fully understood.

Men account for 75% of suicides in England and Wales (ONS 2009) Suicides

Single, divorced and widowed men are three times more likely than their married counterparts to take their own lives. Griffiths C, LadvaG, Brock A and Baker A. “Trends in suicide by marital status in England and Wales, 1982–2005”. 2008: Health Statistics Quarterly no. 37.

Men and suicide, 2008

Calculated from: ONS (2008) Mortality statistics: Deaths registered in 2008. Review of the National Statistician on deaths in England and Wales, 2008 . Series DR

The role of emotions

“As men we learn to live a lie. We learn to live as if our emotional lives do not exist, at least as far as the ‘public world’ is concerned [. . .] We learn to live in our minds as the source of our identities. If we had our way as men it would be that our emotional lives did not exist at all.” (Seidler 1994: 19)

BUT they do exist and have to find expression somehow

Male coping strategies (or not!)

• Men are half as likely to go to a counsellor or therapist to talk about their feelings

• Twice as many men as women drink alcohol to cope with feeling down

• Men are half as likely as women to talk to friends about their problems and less likely to talk to family

• Young men are the group most likely to tell a friend to “pull themselves together” if they were feeling low

MIND (2009) Men & Mental Health: Get it off your Chest

Men are more prone to ‘instrumental’ rather than ‘communicative’ forms of action. i.e. Men are more likely to ‘act out’ rather than ‘talk out’ feelings.

Men’s reaction to feeling down, stressed or depressed

Men’s Health Forum 2006

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The ‘big build’: the upward trajectory of the masculine enactment of emotional distress.

After Brownhill et al, 2005 in Branney & White (2008) Advances in Psychiatric Treatment 14 pp 256–262

“Acting out” - Extremes

“Acting out” - Positive

Successful factors in work with young men

• A proactive approach that focuses on developing young men’s self confidence

• An appreciation of masculinity and how this impacts upon young men’s behaviour

• Identification of issues affecting young men and using creative ways to address these

• Programmes that offer a combination of reflection, activity and emotion

• The practitioner’s skills, knowledge and empathy towards young men

• Appreciation of the qualities that young men look for in a practitioner – trust, genuineness, respect, humour, support, non-judgemental, acceptance

Ken Harland. Acting Tough: Young Men, Masculinity and the Development of Practice in Northern Ireland (http://www.mensproject.org/issues/kenspeech.pdf) accessed July 2010

Steve RobertsonCentre for Men’s Health

Leeds Metropolitan University Leeds LS2 8NU

UK

email: s.s.robertson@leedsmet.ac.uk