Is 'toxic masculinity' stopping boys seeking mental health support?
As a charity finds teenage boys and young men are reluctant to ask for help, Abi Jackson talks to clinical psychologist Dr Nihara Krause about how parents can help
ARE you a parent or guardian concerned about how you can help teenage boys to open up? There is growing awareness around supporting young people's mental health and wellbeing - laying the foundations for them to be able to ask for help when they need it.
But this can be particularly tricky for males, and youth mental health charity stem4 says 'toxic masculinity' is still playing a part.
The charity surveyed 1,068 boys and young men aged 14-21 during October and found 37 per cent are experiencing mental health difficulties.
Stress was the most common difficulty reported (47 per cent), followed by depression or low mood (33 per cent) and anxiety (27 per cent).
Other problems included eating disorders (11 per cent), anger and behavioural issues (10 per cent) and self-harm behaviours (9 per cent).
Of those experiencing difficulties, just one in five said they were receiving treatment, while 51 per cent had not spoken to anyone.
Meanwhile, 46 per cent of all respondents said they wouldn't ask for help with a problem that was making them feel upset, anxious or depressed 'even if things got really bad'.
When asked why, 36 per cent said they didn't have the courage, 32 per cent said they 'don't want to make a fuss' and 30 per cent said they would feel weak or ashamed. Plus, 21 per cent are worried people would laugh or think less of them, and 14 per cent said they would 'feel less masculine' if they asked for help.
The survey also looked at where these beliefs might be coming from: 70 per cent of the respondents said boys and young men are negatively portrayed in the media, and almost half (46 per cent) said 'pressure from peers to behave in a dominant masculine way' was having a negative impact on the mental health of this group.
"We live in a culture that puts huge pressure on boys and young men to behave in particular ways, many of them damaging to their mental health," says Dr Nihara Krause, consultant clinical psychologist and stem4 founder.
"Our survey shows exactly why this is so damaging with many suffering in silence, even when they're approaching crisis point."
Stem4 works with students, parents and teachers in secondary schools and colleges, and with health professionals such as GPs and school nurses.
As well as delivering workshops and toolkits, there's lots of information on their website. The charity has also developed four NHS-approved smartphone apps designed to help young people managing mental health difficulties, which have been downloaded more than a million times since the pandemic started.
Spotting the signs
It may not be immediately obvious when a teenager or young person is experiencing mental health difficulties or how this is affecting them, and chances are they won't be able to just tell you.
Krause says it's helpful for parents and guardians to "learn how to spot any signs and listen to how boys may express how they feel, because they may not express it in the same way as others might express a concern".
"For example, it might be that they express it through their behaviour - and that might come across as very difficult to manage behaviour, but actually it might be that they're feeling quite anxious," Krause adds.
"Or that they are quite unhappy but want to be left alone to deal with that unhappiness in not necessarily the best way possible. So, try and translate what's really going on."
Think about your own language and expectations
"Issues like 'toxic masculinity' are often deeply ingrained in our culture and we may not realise how much they're influencing us," says Krause.
"It might be helpful to be aware of the phrases we use - common things like 'man up' - which can be so unhelpful."
How we respond to children and young people expressing difficulties is another factor.
"It's so easy to be dismissive, saying things like 'what problems could you possibly have at your age?' or 'when you're older you'll realise that's not a big deal'," says Krause.
This can result in them feeling more isolated and ashamed and less likely to speak up in future.
"It's also about looking at changing your expectations," says Krause.
"So, do you almost expect somebody, if they haven't done well, to just get on with it? [Rather] than focusing a bit more attention on someone if they're feeling a bit upset?"
Provide opportunities for them to open up
She suggests thinking about how you can "provide opportunities for boys and young men to open up about vulnerabilities", without them feeling "too exposed".
For example, putting them on the spot, making them sit down and trying to force them to reveal everything that's going on for them might not be the best approach.
"The message that has come up consistently is that boys feel like they're not meant to open up and be vulnerable," says Krause.
"So [it's helpful] if parents can provide opportunities - and those opportunities might just be the talking ones. They might be activity days, for example, where they'd be able to bring up any particular concerns."
Keep in mind they may need time, and this probably isn't going to be a one-off conversation. "Be prepared to raise something a few times," says Krause, "rather than just the once and then letting it drop off the radar."
Focus on listening
If they do talk to you, try not to rush in with your own reaction. Whilst it's natural to want to make things better, or perhaps want them to stop behaving in a certain way, remember the aim is to help them learn they can open up and ask for support when they need to.
"If you rush in to try and fix the problem, and maybe even share the problem, then the person on the other end may end up not feeling listened to," says Krause.
"The whole thing about listening, is providing them with listening without telling off. And then reflecting back to them what you think you've heard, and maybe asking them to expand on what they think the issue might be and what they feel might be helpful."
Think about who's best placed to support them
It can be very difficult and upsetting if they're not opening up to you.
Try to remember this is quite normal - it doesn't mean you're 'failing' as a parent.
"Think about who might really be best placed to support them, whether it can continue to be done in the house and, if so, who is the best person," says Krause.
"Or is there somebody external who could help?"
She says it can be "difficult for boys to feel like they'll be taken seriously" - and if the first person they speak to responds in a way that reinforces this belief, they may end up not trying again.
"So parents might need to do a bit more homework here. Whether it's finding out if there's a particular GP at your practice that is approachable and a good fit, or somewhere else they may possibly be able to refer to," says Krause.
"Ultimately, what we want is for the young person to feel able to open up, instead of it feeling like it's all building up in them."
For further information and resources, visit stem4.org.uk