Mental ill-health and suicide represent a significant proportion of the burden of global disease among men. Connell’s relational theory of masculinities provides a useful framework to explore how mental health literacy, mental health stigma, and delayed help-seeking and help-offering behaviors are associated with mental ill-health among men, particularly within male-dominated industries. To address the high incidences of mental ill-health in male-dominated industries, several workplace interventions targeting these outcomes have been implemented. No review to date has examined the current state of evidence for these interventions or identified the behavior change techniques used. This review was restricted to empirical, quantitative research reporting on psychosocial interventions targeting mental health literacy, stigma, and help-seeking and help-offering behaviors in male-dominated industries. Quality appraisal was completed using the Effective Public Health Practice Project and a narrative synthesis was conducted. Twelve articles were included for review which reported on four distinct interventions. The methodological quality of two articles was strong, three moderate and seven weak. The strongest evidence of intervention effects related to mental health literacy and help-seeking intentions. There was less evidence relating to help-offering and help-seeking behaviors and mental health stigma. Sixteen behavior change techniques were identified across interventions that are discussed in relation to the wider men’s health literature. The evidence on psychosocial interventions in male-dominated industries is limited due to methodological and conceptual issues. Recommendations for future research include standardized reporting of intervention descriptions, the use of theory to guide intervention development, and utilizing validated and reliable outcome measures.

Stigma surrounding mental health, particularly among men, remains a significant barrier to men engaging with support services for their mental health. Despite increasing evidence of interventions targeting different aspects of stigma reduction, there is a notable gap in the literature concerning male-specific mental health stigma reduction interventions and on the underlying behavior change techniques (BCTs) used to reduce stigma. The purpose of this review is to synthesize the evidence relating to the impact of mental health stigma reduction interventions among men and to explore the underlying BCTs associated with each intervention. The review was restricted to empirical research reporting on interventions targeting mental health stigma in male-dominated populations. The quality appraisal was conducted using the Mixed Methods Analysis Tool and a narrative synthesis was conducted. Fourteen articles reporting on 11 interventions were included for review, while 20 outcome measures were used. Perceived public stigma attracted the largest number of interventions with a lesser focus on self or personal stigma. Nineteen BCTs were identified across the interventions with information about health consequences and self-monitoring of behavior being the most common followed by credible source, social contact, and behavior practice/rehearsal. This is discussed in relation to the wider literature. The methodological issues highlighted in the articles limit the conclusions and recommendations that can be drawn from the review. Recommendations for further research include standardizing the scales used in stigma measurement, in-depth reporting of intervention descriptions, and greater use of theory to guide intervention development.

Men have a higher risk of suicide compared to women, with those in male-dominated industries such as construction being particularly vulnerable. These industries are typically characterised as ‘macho’ environments, endorsing traditional masculine norms that reinforce mental health stigma and delay help-seeking. The workplace is a promising setting for engaging men with issues around their mental health. Although managers can play a key role by connecting workers in distress with mental health supports, research exploring their experiences of this is limited. This study sought to address this gap by exploring the barriers to and the facilitators of help-offering behaviour among managers in the construction industry in Ireland. Five focus groups were conducted with construction industry managers (n = 33) to explore their perspectives on supporting and offering help to workers in distress. Reflexive thematic analysis was used to analyse the data. The findings indicated three key themes: (1) creating the right environment with sub-themes focused on fostering an open culture around mental health on-site and overcoming systemic challenges; (2) navigating the practice of help-offering; and (3) using the right tools for the job. The findings highlight the need for manager training tailored to the construction industry as part of a multi-faceted approach to help-offering within the industry.

Men in the construction industry are at a higher risk for suicidality when compared to the general male population. While industry-specific challenges such as excessive working hours and a pressurized work environment are contributory factors, deeply embedded masculine norms within the industry can further exacerbate this risk by discouraging mental health disclosure and help-seeking. Against this backdrop, managers occupy a pivotal position to potentially transform this wider workplace culture. Their dual perspectives—both professionally as gatekeepers and personally as individuals with lived experience of key pressure points within the industry—can provide a nuanced, in-depth understanding of the sociocultural influences affecting construction workers’ help-seeking behaviours for mental health challenges. Despite this, managers’ perspectives are underexplored. Five focus groups were conducted with managers (n = 33) to explore their experiences of the broader cultural influences on help-seeking behaviour within the industry. Reflexive thematic analysis was used to analyse the data. Findings indicated three themes: (i) industry influences on help-seeking, (ii) navigating disclosure of mental health issues in a male-dominated industry, and (iii) negotiating support pathways. Findings highlight the interconnectedness of industry-specific and personal challenges that influence the disclosure of mental health issues and shape help-seeking behaviours among construction workers. Study findings have informed the development of a gender-responsive suicide prevention programme for the Irish construction industry.

Men are at a higher risk for suicide when compared to women, with those in male-dominated industries, such as construction, being particularly vulnerable. These industries are typically characterised as ‘macho’ environments – endorsing traditional masculine norms, higher levels of mental health stigma, and delayed help-seeking. Settings-based approaches to health promotion identify the workplace as a promising setting for engaging men around their mental health. Although managers play a key role in this process by connecting workers in distress with mental health supports, research exploring their experiences of this is limited. Five focus groups were conducted with managers in the construction industry (n=33) to explore their perspectives on supporting and offering help to workers in distress. Reflexive thematic analysis was used to analyse the data. Findings led to three key themes: (1) Creating the right environment with subthemes focused on fostering an open culture around mental health on-site and overcoming systemic challenges; (2) Navigating the practice of help-offering; and (3) The right tools for the job. Findings highlight the need for manager training, tailored to the construction industry, as part of a multi-faceted approach to help-offering within the industry.

Suicide is a leading cause of death among construction workers, particularly younger and lower-skilled employees. Barriers such as stigma, low mental health literacy, and traditional masculine norms hinder help-seeking in this male-dominated sector. Few mental health interventions are tailored to this context. This study developed a co-designed, theory-informed training to improve mental health literacy, reduce stigma, and increase help-seeking among construction workers in Ireland. Using the Medical Research Council’s framework, the training was developed with the Theory of Planned Behavior (TPB), Behavior Change Techniques, and extensive stakeholder co-design. Two systematic reviews, a broad literature review, and focus groups with industry managers informed the content and structure. The training will be pilot-tested using validated measures: the Literacy of Suicide Scale (LOSS), the Stigma of Suicide Scale (SOSS), and the General Help-Seeking Questionnaire (GHSQ), the results of which will be the subject of a separate study. CAIRDE is a promising, evidence-based training that addresses key mental health barriers in Irish construction. Embedding the TPB within a co-design methodology has resulted in the development of a training program that is underpinned by theoretical fidelity and cultural relevance and provides a framework for other male-dominated industries to draw upon. Future work should address remaining challenges related to stigma and help-seeking, and explore broader implementation through integration into mandatory safety training.