jane pirkis 19 february 2015 depression and suicidality in males
TRANSCRIPT
Jane Pirkis19 February 2015
DEPRESSION AND SUICIDALITY IN MALES
Key questions
1. Are depression and suicidality problems for males?
2. Are males likely to seek help for these and other mental health problems?
3. Can the media play a role in encouraging males to seek help?
4. Are there other ways the media can help protect males against depression and suicidality?
1. Are depression and suicidality problems for males?
Ten to Men
• Longitudinal study funded by the Department of Health under the National Male Health Policy
• Involves 16,000+ males aged 10-55 recruited from across Australia
• Seeks information on participants’ health, and on the many and varied factors that may influence it
• Wave 1 conducted in 2014; Wave 2 to be conducted in 2016
Ten to Men
Ten to Men
Adults (18-55)14,016 Young men (15-17)1,016 Boys (10-14)1,084
Total16,116
Selected indicators of depression/suicidality
Indicator Adults Young men
Boys
Answered YES to ‘Has a doctor or other health professional ever told you that you had depression?’
19.7% 8.8% 4.5%
Answered YES to ‘Have you been treated for or had any symptoms of depression in the past 12 months?’
13.0% 6.3% 3.5%
Met criteria for current moderate, moderate-severe or severe depression according to the Patient Health Questionnaire (PHQ-9)
13.0% 12.3% 9.3%
Answered YES to ‘Have you ever seriously thought about killing yourself?’ (Suicidal ideation)
18.3% 18.3% 7.1%
Answered YES to ‘Have you ever made a plan about how you would kill yourself?’ (Suicide plan)
10.9% 10.7% 2.7%
Answered YES to ‘Have you ever tried to kill yourself?’ (Suicide attempt)
5.5% 4.5% 0.5%
Concerning trends?
• Many of the figures for young men are quite similar to those for adult males
• Many of the figures for adult males are higher than those for males in the National Survey of Mental Health and Wellbeing, conducted in 2007
• There may be alternative explanations, but one interpretation of this is that there is a relatively vulnerable cohort of young men coming up through the age ranks
1. Are depression and suicidality problems for males?
YES
2. Are males likely to seek help for mental health problems?
Patterns of help-seeking
• Funded by Movember to look at males’ help-seeking and service utilisation
• Used data from the 2007 National Survey of Mental Health and Wellbeing, a nationally representative household survey of 8,841 Australians aged 16-85
• Also used other epidemiological survey data, routinely-collected administrative data, and published evaluations
Method
• Focused on 17.7% of male respondents (and 22.2% of female respondents) who met ICD-10 criteria for a past-year affective, anxiety or substance use disorder
• Split these respondents into mutually exclusive groups:– No health professional consultation or use of informal sources of
help (support services or self management)– Health professional consultation (with or without use of informal
sources)– Use of informal sources only
• Also considered severity of disorders and types of professionals consulted
Bad news
• Overall, 51% of males with mental or substance use disorders sought professional help or used support services, compared with 73% of their female counterparts
• After controlling for age, males were 35% less likely than females to consult a health professional and 24% less likely to rely solely on support services or self-management strategies
More bad news
• The gender differential was greatest among those with severe disorders
• Males’ underutilisation of health professionals was largely accounted for by their lower probability of GP-only care; this is of concern given that GPs are more accessible geographically than specialist mental health care providers, and GPs provide a gateway to other parts of the mental health system
Some good news
• Most correlates of help seeking among males were need related:– Severity– Disability– Comorbidity– Past-year suicidality– Past-year reaction to a traumatic event– Family history of mental health problems– Self-assessed poor mental health
2. Are males likely to seek help for mental health problems?
NO
3. Can the media play a role in encouraging males to seek help?
Harnessing the potential of the media
• The media has been shown to have negative effects (e.g., perpetuating stigma about mental disorders), but it also has the potential for positive effects (e.g., encouraging help-seeking)
Is there a relationship between constructive and affirming (positive) newsprint stories about depression and/or anxiety in men and their use of helpline services?
Method
Develop criteria to select 10 newsprint
stories
Identify and briefly describe
10 newsprint stories
Compare volume of contacts with helplines before and after each
story
Conduct detailed
qualitative analysis of
stories
Consumer Reference Group
Time 1: Selection of media stories Time 2: Interpretation of findings
Criteria for selecting stories (1)
Story should not:• Feature government
announcements or research findings
or• Be about women
Story should:• Feature a celebrity or other
male role model disclosing depression or anxiety or advocating for people with mental disorders
• Describe symptoms of depression or anxiety
• Be one men can connect with (not necessarily be hopeful or about recovery)
and/or• Provide information about
pathways to help
Criteria for selecting stories (2)
Story should:• Provide accurate information about specific mental
disorders • Use appropriate language, including using medical terms
correctly• Break down myths about mental illness• Avoid stereotypes• Allow people to tell their own storiesand/or• Encourage people to seek help (e.g., by providing helpline
numbers)
Identifying and describing the 10 stories
• Searched Newsbank database over 13 month period (July 2012 to July 2013)– Daily email alert service (‘mental health’)
yielded 10 stories– In-depth search of two weeks before and
after each story (‘depression’, ‘anxiety’) yielded 13,324 articles, 105 of which related to the 10 stories
• Coded each of the 105 articles– Date– Newspaper– Brief description of content– Whether helplines were mentioned
Collating helpline data
• Obtained contact data from four helplines– Lifeline– Mensline– SANE– beyondblue
• Data included– Date and location of call– Gender of caller
• Examined number of calls in the two weeks before and after each story during the 13 month observation period
• Also considered seasonal variation over a five year period
Story Date of first article
No. articles
Summary of story No. articles mentioning helplines
Helplines or websites mentioned
Ian Thorpe television interview
8 July 2012
8 Ian Thorpe is an Olympic swimmer. The eight articles described Thorpe's TV appearance in which he discusses his depression.
0 None.
David Smiedt 9 Sept 2012
1 David Smiedt is a comedian, blogger and newspaper contributor. One long article appeared in a NSW paper written by Smiedt within which he describes his depression.
1 R U OK day website
John Cantwell 22 Sept 2012
6 John Cantwell is a retired army Major. Cantwell's PTSD and depression are described in six articles in the context of his book release. The story became controversial as he was quite vocal about the negative impact active duty can have on soldiers.
0 None.
Edward Fernon 1 Oct 2012
5 Edward Fernon is an Olympic pentathelete. Five articles describe Fernon's horse ride that retraces the steps of the historically significant horse Archer, from Braidwood to the Melbourne Cup, to raise awareness of depression.
0 None.
Ian Thorpe book release
13 Oct 2012
3 Three articles describe Thorpe's book release with a focus on his 'inner demons' of depression and alcohol use.
2 Suicide helpline, Lifeline, MensLine Australia, beyondblue helpline.
Story Date of first article
No. articles
Summary of story No. articles mentioning helplines
Helplines or websites mentioned
Matthew Mitcham
17 Nov 2012
10 Matthew Mitcham is an Olympic diver. The ten articles describe Mitcham's drug use and depression, but mostly focus on his drug use. The story coincides with 'Movember' (a male mental health campaign) for which there were 27 articles).
0 None.
Ruby Rose 1 Apr 2013
16 Ruby Rose is a female DJ. The 16 articles report on Rose's cancellation of her DJ tour due to her depression.
3 Lifeline.
beyondblue 'Get to Know Anxiety' Campaign
6 May 2013
13 The 13 articles describe beyondblue's Anxiety campaign. The campaign features celebrity advocates. Garry McDonald (actor) discusses his anxiety and Ben Mendelsohn (actor) features in campaign material. The campaign initially focussed on men and then broadened its focus to include women.
5 beyondblue helpline and website.
beyondblue 'Man Therapy Campaign'
5 Jun 2013
15 The 15 articles describe beyondblue's Man Therapy campaign, which targeted men and featured the comical fictional character Dr Ironwood. The campaign encourages men to get help for mental health problems.
13 Man Therapy website (beyondblue), beyondblue helpline, Lifeline, headspace, Kids helpline, Suicide call back line.
Harry O'Brien 9 July 2013
28 Harry O'Brien is a well known footballer. The 28 articles describe his revelations of many personal troubles including depression. The story started supportively and then turned more into a discussion about the impact of his behaviour on his football team.
8 Lifeline, MensLine Australia , beyondblue helpline.
Key findings
After taking into account seasonal variation:• 4 stories were followed by an increase in calls
by males to helplines• 5 stories were followed by no change in calls
by males to helplines• 1 story was followed by a decrease in calls by
males to helplines
Stories that were followed by increased calls by males to helplines
• Ian Thorpe television interview– 7,145 calls before, 7,630 calls after, IR=1.07 (1.03-1.10)
• Ian Thorpe book release– 7,477 calls before, 7,882 calls after, IR=1.05 (1.02-1.09)
• beyondblue Get to Know Anxiety Campaign– 8,625 calls before, 9,433 calls after, IR=1.09 (1.06-1.13)
• beyondblue Man Therapy campaign– 9,444 calls before, 9,911 calls after, IR=1.05 (1.02-1.08)
Common features:• Optimistic focus on recovery• Featured men who were role models or could be
easily identified with
3. Can the media play a role in encouraging males to seek help?
YES, AT LEAST IN SOME CIRCUMSTANCES
4. Are there other ways the media can help protect males against depression
and suicidality?
Resilience
• Resilience is the ability to adapt in the face of stress and adversity, or the capacity to rebound from, and find meaning in, negative events
Resilience
• Resilience has been shown to protect against mental health problems
• Boosting resilience in males in order to protect them against mental heath problems is crucial because:– Depression and suicidality are common in males– Males with these problems have a tendency not to
seek help
A documentary to promote resilience in males
• Our documentary will feature 8-10 males of different ages, backgrounds and life circumstances, all facing some key transition point in their lives
• These males will take part in a range of evidence-based resilience-building exercises that are amenable to being presented in an interesting, dynamic and appealing way for large television audiences
• Alongside the documentary, we will create an interactive website that allows males (and females) in the community to take part in the same sort of resilience-building exercises as those shown in the documentary
• The documentary and website will be created in conjunction with Ten to Men
Evaluation
1. Examination of ‘resilience trajectories’ of males who take part
in the documentary
2. Trial to test whether resilience of males who see the documentary (with or without the online exercises) improves
relative to those who don’t
3. Examination of ‘resilience trajectories’ of males who use the
online exercises
4. Follow-up of cohort of males involved in Ten to Men to see
whether changes in their resilience are associated with
viewing the documentary and/or taking part in the online exercises
4. Are there other ways the media can help protect males against depression
and suicidality?
REMAINS TO BE SEEN, BUT WE’RE HOPEFUL!
Conclusions
• Our data suggest that male mental health is a priority• Fortunately, we’re not the only ones who think this:
– There is an increasing policy emphasis on the unique mental health needs of males (e.g., National Male Health Policy identifies men as a hard-to-reach and underserviced group in mental health care; LiFE Framework identifies men as a priority population for suicide prevention)
– Investment in government-funded male mental health initiatives has increased (e.g., Australian Men’s Shed Association)
– Not-for-profit sector organisations have targeted efforts to reduce stigma and improve males’ help-seeking (e.g., beyondblue, Movember)
• These moves are welcome but we must keep up the momentum
