Interests and technology use
The vast majority of focus group participants indicated that they are enthusiastic and heavy users of technology. Across all focus groups, participants listed at least 10 different technology-based practices they regularly engage in. Most frequently reported was Internet use via computers, computer/console games, mobile phones and portable audio devices for a range of activities (eg. downloading movies and music, reading online news, blogs, watching sport and pornography, listening to podcasts and online shopping). Overall, few group differences were identified. However, older males tended to be more likely to report using technology for reading news, searching for restaurants, as well as for banking purposes than younger males.
Social networking and video sites were universally reported among focus group participants for socialising, pursing general interests and listening to music, although there was some diversity in the particular services being used. As reported by one young male:
“Whenever I go on a computer, the first thing I open is Facebook and YouTube.” (High school student)
Consistent with our quantitative survey results, the vast majority of focus group participants reported using Facebook, with only a small minority using Twitter and MySpace. As highlighted by one participant: “not MySpace; that’s so last year” (High school student). This comment is consistent with the assertion of Boyd that while particular social networking services will come and go, it is the activity of communication and socialising that is important to these young people [
27]. Many participants also indicated that they are enthusiastic about searching “funny stuff” and following a trail of linked videos:
“I just type in ‘lol’ or ‘funny’ and watch like 30 videos…it takes me on a tangent.” (High school student)
Beliefs about mental health
The focus groups explored young men’s beliefs about health and mental health with some very consistent themes emerging. Firstly, consistent with previous research [
28], most focus group discussions of ‘what it means to be healthy’ were dominated by references to physical fitness and diet, revealing that young men generally have a narrow conception of health. However, more educated participants and students studying Personal Development, Health and Physical Education (PDHPE) in high school tended to have a more holistic, multidimensional concept of health. One high school student summed it up well:
“It’s all about being spiritually, mentally, physically and socially healthy.” (High school student)
Secondly, across all 17 focus groups, the term ‘mental health’ had overwhelmingly negative connotations among focus group members and was associated, with things like “insanity”, “being crazy”, “straight jackets”, “mental institutions” and “unstable people”. While most respondents acknowledged that mental health problems are relatively prevalent in the wider community, many of those tended to believe they would never be personally affected a mental health difficulty:
“I can‘t really see it affecting me.” (University student)
“I can‘t really imagine having a mental health problem to be honest.” (Call-centre operator)
In addition, when asked what they know about mental health, many participants said they knew relatively little:
“Mental health? Not that much.” (High school student)
“I don’t even know what mental health means.” (Youth Centre member)
“I don’t know a lot about it.” (University student)
Nevertheless, depression was correctly identified in all but two focus groups as a common mental health condition for young people [
1]. Some participants also noted that depression is experienced mainly by young girls, and to a lesser extent older men. For example, one participant commented:
“I think younger girls [get depressed] more, and older guys…I’ve seen heaps of girls when I was at school that cut their wrists and stuff. And that’s the first indication that they’ve got something wrong to me.” (Trade apprentice)
Attitudes towards help-seeking
Focus group discussions provided insights into the gap between existing help options and young men’s actual help-seeking, which can be summarised in four key themes: (1) notions of masculinity; (2) communication barriers; (3) the role of self-help strategies; and, (4) perceptions of current mental health services.
Firstly, across all 17 focus groups, participants indicated that they would find it difficult to seek help as a result of culturally dominant masculine traits that place an emphasis on males to be
“strong” and to
“not show any emotion”, a finding that is consistent with previous research [
7‐
9]. Participants’ comments highlighted that help-seeking is associated with
“weakness” and a
“loss of manhood”. For example:
“…[to seek help is] almost an admission of weakness. You may not want to show that weakness to certain people, because that might change their opinion of you.” (Graduate accountant)
“The first time you to [to a counsellor] you think ‘I’m not going to be a man anymore’.” (High school student)
One other young male summed it up well:
“…[seeking help] just doesn’t fit the male stereotype.” (Youth centre member)
Across a number of focus groups, there were participants who expressed strong views that they wouldn’t need – or seek – help under any circumstances:
“For me, I just don‘t feel like that there would be any issue that I would need to go to someone externally for.” (Graduate accountant)
Some also expressed a tendency for self-denial in relation to mental health issues:
“…I guess there‘s still a stigma of mental health being a weakness and not something you want to show. I realise that it‘s not but it‘s just something that I‘d find difficult coming to terms with - like ‘that kind of shit doesn‘t happen to me’.” (University student)
A second major theme that emerged related to communication barriers. Regardless of age, geographic location or level of education, many participants indicated that they would be uncomfortable “talking” about their problems with either their friends or a professional:
“For some reason its harder for dudes to open up and express their feeling; maybe the way we communicate is different to girls; we communicate through sport and physical activity and stuff whereas girls will sit down and talk about their problems.” (High school student)
Furthermore, participants’ comments revealed that “talking” is generally considered a feminine characteristic:
“…[Talking about your problems] is not a thing that’s really accepted. Guys don’t want to feel like they’re all girly.” (Trade apprentice)
As well as not wanting to discuss mental health issues themselves, participants across various focus groups indicated that they would not want to hear others talk about mental health issues, particularly if they were talking with someone other than a “best mate”. For example, disclosing personal or sensitive information to someone else who is not their closest friend was described in one focus group as “over-sharing” and strongly discouraged. Participants who held such views indicated they would be unreceptive listeners:
“Even if one of my friends is just whinging about something, I’m like ‘Man, get over it, I don’t want to hear it.” (Call centre operator)
Many other participants explained that they would prefer not to directly raise an issue with a friend showing signs of poor mental health. Rather, they would first attempt to ‘help’ their friend by encouraging them to participate in sport, socialising or drinking as opposed to engaging with the cause of the problem directly. However, participants across virtually all focus groups indicated that would address the issue directly or actively encourage their friend to seek professional help if they felt it was absolutely necessary. Interestingly, these discussions also revealed that some would only see a professional if a close friend or family member actively encouraged them to do so:
“Well, I know that my friends and family would always be honest with me, so even if I couldn’t see it in myself they’d tell me that I need to see someone. I’d like to think that I’d accept that and take on board those thoughts of theirs. So it would probably take that for me to go.” (Graphic designer)
This suggests a ‘catch-22’ situation whereby these young men would tend to resist encouraging a friend to seek help but at the same time would require a close friend’s intervention if they themselves were going through a tough time.
The third major theme that emerged related to the role of self-help strategies. The vast majority of focus group participants expressed the view that dealing with one’s own problems was preferable to seeking help from others:
“People have different mentalities, mine is ‘I can resolve my issues myself’, so I don’t need to seek help.” (Call centre operator)
“I wouldn’t like to speak about my problems. I really like to do things my own way, independently.” (High school student)
Finally, across all focus groups, participants displayed a range of negative attitudes in relation to mental health professionals; specifically, counsellors and psychologists. When asked to list the persons that participants would feel comfortable discussing personal problems with, very few mentioned counsellors; a finding that is consistent with previous research involving young people [
29]. Participants generally expressed low trust and lack of confidence in professionals’ maintaining confidentiality and ability to actually help. Some participants said they would not want to pay for services and were sceptical of the professional’s motives (i.e. professionals have a monetary incentive to keep clients coming to sessions); others believed that they could get the same support for free from close friends, family or online. The logistical issues of seeking professional support were also sighted as a significant barrier. Having to make an appointment, travel to an unfamiliar location and then discuss emotional issues at a specific time were all reasons given for not accessing professional services. Mental health professionals were described as older, with different life experiences and hard to relate to. When asked what would make a professional more appealing participants felt they should be
“down to earth” (eg.
“not use big, medical words”), non-judgemental and have experienced a mental health problem themselves. These factors contribute to the view across all groups that professional support services are the ‘option of last resort’.
Across all focus groups, participants indicated a willingness to seek information and support from the Internet:
“I’d prefer to talk to someone on the Internet and then maybe make my way to a counsellor or a psychiatrist, rather than just jumping straight in the deep end and going to a psychiatrist.” (Trade Apprentice)
In this way, the Internet was seen as a gateway to information and support. Some also highlighted the importance of peer rating and reviews of both online and offline help-options:
“I don’t really have any info on who’s good, who’s not, what’s good, what’s not. I don’t really know anything about it. So I might do an Internet search to see if I can find anyone talking about going to see a counsellor or a psychiatrist.” (Call centre operator)
In line with previous research, most participants indicated the need for online information and support services to be an anonymous process and fears of being identified when seeking help were key themes when the value of seeking information and support online was discussed [
17].
Finally, focus group participants brainstormed strategies for using technology to address some of the barriers to help-seeking. These were grouped under common themes with three key insights emerging. Firstly, most participants indicated that they would be fearful of being judged by their peers, family or a professional but said this could be mitigated by being able to seek information and help anonymously online. Secondly, many participants emphasised the importance of interventions being relevant and relating to their everyday lives and interests. This could include delivering mental health content in young men’s online communities of interest (eg. sports sites, music sites or male magazines). Some also recommended male role models, such as boxers, sports players, and actors. Thirdly, many participants indicated a preference for action-based rather than talk-based strategies. One participant requested the following:
“…really advanced search tool or questionnaire – or self-diagnosing thing… and it would link you to some kind of page with testimonials” (Youth centre user).
Broadly, participants were interested in opportunities to build skills in ‘how’ to identify, discuss and manage mental health issues.