This mixed methods review synthesizes the evidence of acceptability, effectiveness and gender-responsiveness of participatory arts interventions (PAIs) in promoting mental health and wellbeing amon...

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.

This study sought to explore the relationship between sociodemographic-, mental health-, knowledge-, attitudinal-, and conformity to masculine norms variables with suicide literacy, suicide stigma, and help-seeking attitudes among men in a university setting (n = 471) in Ireland. Multiple linear regression with backward elimination was used to determine the independent variables associated with suicide literacy, suicide stigma, and help-seeking attitudes. Lower suicide literacy was associated with an ethnic minority background, living in a rural community, postgraduate students compared to undergraduate students, no depression symptoms in the past year, decreasing loneliness, greater suicide stigma, more negative help-seeking attitudes, lower resilience, greater conformity to the masculine norm power over women and lower conformity to the masculine norm emotional control. Greater suicide stigma was associated with a non-ethnic minority background, all departments of study compared to health and sports science, lower suicide literacy, more negative help-seeking attitudes, and greater conformity to the masculine norms of power over women, dominance, and heterosexual self-presentation. More negative help-seeking attitudes were associated with no generalized anxiety disorder symptoms in the past year, depression symptoms in the past year, greater suicide risk, lower suicide literacy, greater suicide stigma, greater resilience, and greater conformity to the masculine norms emotional control, self-reliance, violence, and heterosexual self-presentation. Findings highlight a need for gender-responsive psychoeducational programmes to target suicide literacy, suicide stigma, and/or help-seeking attitudes among men in university settings. They also highlight that such initiatives need to be co-produced alongside ethnic minority and rural-dwelling men to ensure they are culturally sensitive and acceptable.

Background: Suicide among male construction workers are reported to be disproportionally high compared to the working age population. However, there is minimal understanding of the prevalence and associated factors for suicidal ideation, non-suicidal self-injury, and suicide attempt among this occupational group globally. Methods: A cross-sectional study was conducted on a large sample of male construction workers in Ireland (n = 1,585). We investigated the prevalence of suicidal ideation, non-suicidal self-injury and suicide attempts and sociodemographic, occupational, and mental health factors associated with these three outcomes. Multivariable Poisson regression was performed to estimate the prevalence rate ratio of suicidal ideation (model 1 primary outcome), while multivariable logistic regression was used to estimate the odds ratio of non-suicidal self-injury (model 2 primary outcome), and suicide attempt (model 3 primary outcome). Results: The lifetime prevalence rate for suicidal ideation was 22%, 6% for non-suicidal self-injury, and 6% for suicide attempt. In univariate modelling, socio-demographic and occupation-specific factors associated with the three outcomes included younger age (suicidal ideation and non-suicidal self-injury), not being in a relationship (suicide attempt) and working 35–44 h per week (suicidal ideation and suicide attempt). The mental health factors generalized anxiety disorder, depression, and suicide bereavement were significantly associated with increased risk of the three outcomes. In fully adjusted multivariable models, increasing severity of generalized anxiety disorder and depression were associated with an increased prevalence rate ratio of suicidal ideation, and a higher odds ratio of non-suicidal self-injury and suicide attempt. Conclusion: Suicidal ideation, non-suicidal self-injury and suicide attempt are significant issues for male construction workers that require specific attention. Findings highlight a need to support younger male construction workers and those bereaved by suicide. They also highlight the need for the early detection and treatment of generalized anxiety disorder and depression in order to intervene in, and potentially prevent, suicidality among male construction workers.

Arts engagement is gaining recognition as a non-clinical approach to promote mental health and well-being. However, the perceived utility of the arts to promote mental health among men with low socioeconomic status (SES) and how to best engage them is underexplored. This study explores the lived experiences of men with low SES who engage with the arts in Northern Ireland (n = 41). Data collected via focus groups (n = 5) and interviews (n = 11) were analysed using reflexive thematic analysis to inductively derive four themes. Theme 1 highlights how the arts facilitated friendship, a collective identity, peer support and a reason to socialize. Themes 2 and 3 explore how the arts enhanced self-esteem and emotional regulation by developing a routine, purpose, sense of mastery, a sense of catharsis through immersion in a soothing endeavour and an alternative outlet for self-expression. Theme 4 covers strategies that facilitate male engagement in the arts such as using a familiar space, delivering to an existing male group, framing the programme around male interests not health or creativity, building on existing strengths and capacities, enabling ownership, using tangible action-orientated activities, and being non-authoritative and flexible with delivery. This is one of the first studies to highlight the gendered dimensions in which men with low SES engage with and experience mental health benefits through arts engagement. This study points towards relevant theories to further understand the pathways between the arts and improved mental health among men which can inform development of tailored arts programmes for men.

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.