Abstract
Objectives: The under-utilisation of mental health services by men has been widely reported, despite men experiencing comparable prevalence of mental health difficulties to women. Research has focused on promoting mental health services directly to men to address these inequalities. This study extends this evidence base through the evaluation of new male-sensitive leaflets. In addition, this study evaluates the utility of the Theory of Planned Behaviour model (Ajzen, 1991) to explain the relationship between conformity to masculine norms and help-seeking intentions in the context of psychological distress. Design: An experimental cross-sectional online questionnaire design was utilised. Participants were exposed to one of three experimental stimulus leaflets which described local mental health services. One leaflet (the masculine-framed leaflet) described support services using language which conforms to masculine norms identified by Parent and Moradi (2009). The second leaflet used the same language as the masculine-framed leaflet and included photographs of men who met stereotypically masculine ideals. The third control leaflet used the same structure and content as the masculine-framed leaflets and addressed men directly, but used more traditional language to describe services. Methods: Young men aged between 18 and 25 years old studying at a British University took part (N=191). Participants were randomly presented with one of the three stimulus leaflets. Next they completed questionnaire measures of attitudes, subjective norms, perceived behavioural control and intention in the context of help-seeking. Participants also completed a measure of conformity to masculine norms. Results: Analysis using General Linear Modelling showed that leaflet condition did not have a significant impact on intention to seek help, irrespective of the degree of conformity to masculine norms. However, higher conformity to masculine norms was related to more negative help-seeking intentions. Examination of the indirect effects using Bootstrapping techniques showed that attitudes and subjective norms mediated the relationship between degree of conformity to masculine norms, and specifically the norms of emotional control and self-reliance, and intention to seek help. Conclusions: These findings show that framing messages to complement traditional masculine ideologies and including photographs of stereotypical masculine men do not improve men's help-seeking intentions. The results also demonstrate that the masculine norms of emotional control and self-reliance have a significant effect on help-seeking intentions and that these relationships are significantly mediated by attitudes and subjective norms. These findings suggest opportunities for intervention to encourage young men's help-seeking behaviour.