Category: Mental Health

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Mental Health

Adverse Childhood Experiences

Adverse Childhood Experience

The experiences we have in childhood affect how we cope with life as an adult. A nurturing and protective environment growing up gives us the skills and confidence to make healthy choices and cope with the challenges that come our way. But having adverse childhood experiences (ACEs) can have the opposite effect. They increase the risk of physical and mental health problems. 1 in 3 diagnosed mental health conditions in adulthood directly relate to ACEs.

What is an Adverse Childhood Experience?

An Adverse Childhood Experience (ACE) is a stressful or traumatic event which happens in childhood and can negatively affect people into adulthood.

ACEs can include the following:

  • Verbal abuse
  • Physical abuse
  • Sexual abuse
  • Physical neglect
  • Emotional Abuse – emotional abuse can be many things, including: ridiculing, belittling, blaming, isolating, restricting social interactions, shouting, threatening, ignoring and rejecting
  • Parental separation
  • Domestic violence – there are strong links between domestic violence and child abuse
  • Mental ill health
  • Alcohol or drug misuse

This powerful video illustrates the impact ACEs can have.

What are the impact of ACEs?

ACEs can take a huge toll on all aspects of wellbeing. Children are less able to manage emotions, form relationships and learn effectively. They may develop communication and behaviour problems. These problems impact into adulthood.

ACEs increase the risk of developing health-harming behaviours. Compared with people with no ACEs, people with four or more ACEs are:

  • 2 times more likely to binge drink and have a poor diet
  • 3 times more likely to be a smoker
  • 5 times more likely to have had sex while under 16
  • 6 times more likely to have had or caused an unplanned teenage pregnancy
  • 7 times more likely to have been involved in violence in the last year
  • 11 times more likely to have used heroin/crack or been incarcerated
How common are ACEs in the UK?

ACEs are common. In a 2014 UK study on ACEs, 47% of people experienced at least one ACE with 9% of the population having 4+ ACES (Bellis et al, 2014)

ACEs occur across society although they are far more likely to occur in isolated, poor or deprived circumstances. Social inequalities amplify the effect of ACEs and so structural inequalities need to be addressed for strategies to help combat them effectively to work. For example, low family income can be a stronger predictor of poor physical health than many of the ACE categories.

Becoming ACE aware

The FrameWorks Institute conducted research into how to increase public understanding of adverse childhood experiences.

They identified a number of communication challenges that need to be overcome:

  • help people to think beyond individual-level causes of maltreatment and adversity to see the importance of societal-level solutions
  • deepen understandings of cycles of maltreatment
  • expand people’s understanding of the effects of poverty to include other social drivers
  • help people see that addressing child maltreatment and reducing early adverse experiences is possible.
Useful resources for further learning

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Mental Health

Yoga for Stress

yoga for stress

I’ve worked as a yoga teacher in the field of mental health for almost 20 years.  In that time I have taught yoga for mental health in the NHS, for mental health charities and also for some of the worlds leading mental health and addiction services.

One of the best ways of improving someone’s mental wellbeing is by helping them to manage stress.

Stress is something that we all have and actually need.  It drives us to overcome obstacles and motivates us to achieve.  However, too much stress over long periods of time can have a huge effect on us physically, mentally, emotionally and socially.

Stress is a predictor and risk factor for most common mental health conditions and also suicide.

We get used to stress.  We have so many demands, so many responsibilities, things that drain our resources and time.  Stress slowly creeps up on us, it builds and builds until we find ourselves overwhelmed.  In my experience people often don’t acknowledge just how much stress they have to deal with day to day.

The good news is there are many ways to practically manage stress and yoga is one of the best.

So how can we use yoga to help us manage stress?

Conscious breathing can take us from a state of stress and anxiety to relaxation and calm.

At times of stress chemicals in your brain are released and we enter the fight, flight, freeze part of our autonomic nervous system (ANS) called the sympathetic nervous system (SNS).

When this happens stress hormones are released, your heart rate increases, your pupils dilate, blood is taken from your gastrointestinal system and directed to your skeletal muscles.  In short it prepares you to respond to imminent danger.

The parasympathetic nervous system (PNS) is the relaxation response.  Rest, digest, feed and breed – nice things, and the PNS is related to the exhale.

So, one of the simplest and most effective ways to go from this state of heightened arousal to a state of relaxation is to change the breath.

The next time you find yourself stressed out, take your focus to your breath, count the length of your inhale and exhale and then simply inhale slightly more than you already are and make the exhale slightly longer than the inhale.  It’s very important that you don’t fight with your breath.  Extend the breath but keep it satisfying.  If you find yourself straining or gasping you’re doing too much, so slow down and take your time.

You can learn more about stress and how to manage it on the Youth and Adult Mental Health First Aid and Mental Health Aware Courses.

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Mental Health

Loneliness Awareness Week

loneliness

It’s Loneliness Awareness Week 2022, a campaign run by Marmalade Trust.

Loneliness affects us all from time to time and some people are naturally happy with their own company and find that ‘alone’ time is their way to recharge.  For others, being alone and isolated is a terribly worrying and uncomfortable experience.

What is loneliness?

Loneliness is not a mental health condition. It’s the emotional impact of our social needs not being met.  You can have lots of friends, work colleagues, social media followers, be in a room full of people eager to talk with you and still be lonely.  It’s about meaningful connection.

When we are lonely we may feel unsafe, un-cared for and unloved and this has wider negative implications on all aspects of our health and wellbeing.  Loneliness can lead to anxiety, depression and poor self-care.  The effects of loneliness are often compared to smoking or obesity.

A survey conducted in 2019 of more than 2,000 UK adults found that:

  • Nearly nine in ten (88%) Britons aged from 18 to 24 said they experience loneliness to some degree with a quarter (24%) suffering often and 7% saying they are lonely all of the time.
  • In comparison, 70% of those aged over 55 also say they can be lonely to some extent, however, only 7% are lonely often and just 2% say they are lonely all the time1.

The pandemic further increased loneliness, with young people reporting a negative impact by not being able to see their friends and we know that social interaction is vital for young people.

Scientific reviews have established that loneliness is associated with future mental health problems with depression being the most strongly linked and also anxiety.  The duration of loneliness seems to be the biggest factor in determining symptoms of poor mental health rather than the intensity of the loneliness felt.   

Loneliness in children

Although though we’re out of lockdown, even for me personally things I used to take for granted, such as going shopping or to a gig feel like some big adventure.  Children especially need time to rebuild connections so we won’t know the full impact the pandemic has had for years to come.

The symptoms seem to be different for boys and girls with depression most strongly associated with girls2 and social anxiety in boys3.

In previous studies young people from lower socioeconomic backgrounds seem to be adversely affected.  This could be because of not being able to do things their friends are doing, such as going out to the cinema or having the latest video game or trainers.  The Children’s Society 2019 Loneliness in Childhood Report looked further into the links between household income and loneliness.  Rather than just focussing on poverty they looked at all incomes and found that there was a similar pattern in not just low but also very high income households. The report highlights the importance young people place on “fitting in”. It says “Income inequality can be experienced in both subtle and explicit ways by both wealthy and poorer children”.

Social media can also cause problems with young people often feeling left out/isolated or not good enough.  But it can also have a positive effect. Many people are able to stay connected with friends when gaming, through chats or online wellbeing communities such as Kooth.

So what can we do?

If you suspect someone is lonely or isolated, reach out to them, say hello and make a connection.

Try a sport, do some yoga, maybe a hobby or find a peer support group, join a union or professional association. Reach out to loved ones, an old friend you’ve lost touch with or spark up a conversation with a stranger. Try not to get upset and take it personally if it doesn’t go so well. Try again and just remember communication is a two way thing.

As a mental health first aider, one of the most important things we can do is encourage support from family, friends and community

Human connection is so important.

Further resources

Young Minds

British Red Cross

Age UK

References
  1. Ibbetson, C. Young Britons are the most lonely. https://yougov.co.uk/topics/relationships/articles-reports/2019/10/03/yo….
  2. Liu, H., Zhang, M., Yang, Q. & Yu, B. Gender differences in the influence of social isolation and loneliness on depressive symptoms in college students : a longitudinal study. Soc. Psychiatry Psychiatr. Epidemiol. (2020) doi:10.1007/s00127-019-01726-6.
  3. Mak, Hio Wa, Gregory M. Fosco, M. E. F. The Role of Family for Youth Friendships: Examining a Social Anxiety Mechanism. J Youth Adolesc. 47, 306–320 (2019).

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Mental Health

Money Worries and Mental Health

money and mental health

We are living in such turbulent times. So many things have happened which have put a strain on our pockets.  Years of poor government, benefit cuts, tax rises, Brexit, the pandemic, unaffordable housing, rising fuel costs, the cost of living crisis.  And now the war in Ukraine, making everything even more expensive.

Debt stress

Do you feel anxious when thinking about money?  Maybe you are having sleepless nights?  Are you eating less/overeating?  Do you feel isolated, sad, withdrawn and maybe even completely overwhelmed by financial worries?

If so, then you could be suffering from debt stress.  

Financial hardship is a major cause and risk factor for mental ill health.  As you sink into financial difficulties your mental health suffers.  And then you feel less able to deal with these financial matters.  And then this can spiral into chaos.  

I know, I’ve been there.  I left my job in the City due to poor mental and physical health.  Once my statutory sick pay ran out, I found myself on benefits.  Creditors were chasing payments I could no longer make and I ended up in a big mess which had a huge impact on my mental health for years to come.  This could all have been avoided with financial help which my bank just didn’t give.

Where to get help

There are lots of charities out there which can help you with debt, even before you get to the crisis stage.  Maybe with all these rising costs, you’re just worried about how you’re going to meet your payments in the near future?  If so you should really start to get some advice now.

There are many charities that can help and Mental Health UK (the sister charity to Rethink Mental Illness) has lots of great advice on mental health and money, from benefits to paying for mental health care.  I really like their budget planner.

The Money Advice Trust run the National Debt Line where you can get help to find solutions to your debt problems.

Step Change are a national charity who do great work and are fully committed to helping those in debt and who may be suffering with poor mental health. Highly recommended!

You can’t go wrong with the good old CAB (Citizens Advice Bureau).   

If you’re having problems with housing, Shelter are great.  I’ve used them recently and saved myself a few hundred pounds in solicitors fee’s (and sleepless nights).

Martin Lewis’s Money and Mental Health Policy Institute are doing great work aiming to change policy and help break the link between financial and mental health problems.

I also really like Money Nerd, lots of great tips and advice on a range of things.

If you’re suffering with poor mental health you should always seek professional help so go and see your GP. If however the source of your poor mental health is financial worries, you need to seek professional financial advice. The main thing is don’t be afraid to ask, there’s no shame and help is there.

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Mental Health

Talking to Young People About Their Mental Health

It’s really important to normalise conversations about mental health with our children and delegates on our Youth MHFA courses often ask:

“How do I talk to young people about their mental health?”

“What language can I use and how can I get them to open up in the first place?”  

These are really good questions and there is no one simple answer but here are a few things to keep in mind.

Time the conversation

Nobody likes to see their child upset and it’s natural to want to dive in and try to fix it.  But sitting down with them and directly asking them about their feelings may cause further distress.  Children don’t always understand what’s happening to them and they may not have the language to describe their feelings, making it difficult for them to open up.  

One thing you can try is doing a fun activity with them and then start to talk about their feelings.  This may be colouring or lego with younger children, and maybe a physical activity such as a kick about or cooking a meal with older kids.  This takes the pressure off and can help start the conversation.

Use appropriate language

Always use kind and respectful language.  Don’t let your own stress colour the conversation. Think about what you’re saying and how you would feel if another adult said that to you.

Younger children probably won’t know what anxiety is though they may describe it as a tummy ache or my back hurts.  Use very simple sentences and age appropriate language.  You could say “ok, so on a scale of 1-10, ten is when you’re really, really happy and 1 is when you’re really, really sad, where are you now?”  Then you can maybe find out what are the things making them sad and what can we do to make them happier.

Not all children like to talk, but the conversation doesn’t have to be verbal.  You could try writing notes, email or text.

And if they really don’t want to talk to you, help them find someone else they can talk to.

Encourage peer support

Self-esteem is really important for good mental health so involving them and empowering them in any decisions about their wellbeing is a great thing to do.  In adolescence, young people become more withdrawn from their parents.  It’s just part of growing up.  Kids need to make their own decisions and their peers become the most important people.

Encouraging peer support therefore can be really useful.  People of their own age who may be experiencing similar things will be able to communicate using their own language.  Let’s face it, it doesn’t matter how ‘hip’ or ‘cool’ you were when you were younger you’re a dinosaur to a teenager.

Abbie Mitchell, peer mentoring manager at Fitzrovia Youth In Action says, “This program really brings conversations about mental health and looking out for each other to life for young people.  When discussions are had between youth of a similar age, using their language, vocabulary and creativity, there is something really special about the peer support that can take place.  Young people listening to each other, relating to one another and offering empathy in a designated safe and supportive space can really make a difference to how they talk about mental health, normalising conversations about it and also supporting them to feel able to reach out and get professional help if needed.”

Resources

Fitzrovia Youth In Action run peer mentoring, education and support programs which help normalise talking about poor mental health and empower young people to be able to take action, helping others and helping themselves.

Kooth is a fantastic online counselling and self-help app which young people find a really useful source of support.

Being a parent is a wonderful thing but also a stressful experience in itself, the NSPCC are there to support parents as well as children.

Young Minds parent helpline is specifically to help parents and is a fantastic resource too.

Learn more about supporting children’s mental health.

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Mental Health

The Children’s Mental Health Crisis

children's mental health

Children’s mental health is in sharp decline.  The number of children likely to have a mental health problem has risen by 50% in the last three years from one in nine to one in six.  That’s five children in every classroom.

Not surprisingly, the pandemic has taken its toll on young people.  And an estimated quarter of a million children have struggled with the loss of their usual support mechanisms.  Not being able to see friends and family caused the most distress.

But even before the pandemic, there has been a worrying downward trend in children’s happiness.  The latest Good Childhood Report by the Children’s Society reported that an estimated 306,000 10-15 year olds in the UK are unhappy.  That’s over 76% more than ten years ago.  School life and worrying about appearance caused the most unhappiness. 

The Millennium Cohort Study (MCS) follows the health and wellbeing of people born around the turn of the century.  The latest sweep of the MCS found that one in four 17 year olds had self-harmed in the last year and 7% had attempted suicide.  With numbers for young people attracted to the same or both genders much higher at 51% for self-harm and 19% for attempted suicide.

How can we support children’s mental health?

Half of all mental health problems manifest by the age of 14 and three quarters by age 18.  Early support is vital, but 75% of the young people who need help don’t get it.  Waiting lists for NHS treatments are long and 34% of those referred are not accepted for treatment as their condition is not considered severe enough.  But children should not have to wait until they are at crisis point to receive help.

Things you can do:

  • If you are a parent or carer worried about a child, talk to them, listen to them and let them know you can work through any issues together.   If they don’t want to talk, try text or email.
  • Speak to your GP for advice.
  • Write to your MP and support the Young Minds Fund the Hubs campaign to increase funding for early mental health and wellbeing hubs for young people.
  • Attend a Youth Mental Health First Aid course and learn more about supporting children’s mental health.
  • Supporting someone struggling with mental health is hard, so make sure you look after yourself.  Take some time every day to do something just for you. 

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Mental Health

Mental Health at Work: Millennials and Generation Z

mental health at work

It may not come as much of a surprise that in a recent report by Deloitte on mental health at work, 48% of Millennials (born 1981-1996) and Generation Z (born 1997-2012) reported that they have felt more stressed since the start of the pandemic.  For many of us this has been a really difficult time.

Worryingly, despite more discussion about mental health in the media in the last 18 months, 60% have not felt able to tell their employers about their increase in stress or anxiety.  Which means that even among the younger workforce, mental health stigma endures.

31% of Millennials and 35% of Gen Zs have taken time off work for mental health reasons. But astonishingly 49% and 47% (respectively) of these have given their employer a different reason for their absence.  And for those who have never requested time off for mental health reasons, 46% and 51% of them said that they would not give their employer the real reason if they did. 

When you look at the figures above, it’s not surprising that one in four Millennials and Gen Zs feel that their employer is poor when it comes to supporting workers to be their true selves.  And nearly four in ten gave their employers a poor grade when it comes to supporting mental health during the pandemic. 

Fear of discrimination due to mental ill health in the workplace is still rife. With 50% of millennials and 53% of Gen Zs believing that this frequently happens.

Prioritising Mental Health at Work

As employees, socially conscious young people are demanding their concerns around mental health and inequality are addressed in the workplace.  In another recent report from The Purpose Pulse, Gen Z and Millennials are clear on diversity and inclusivity which includes mental health. 69% (almost 7 in 10) want employers to encourage them to bring their whole self to work.

Being authentic and being able to show or be your whole self includes being able to discuss concerns about mental health with your employer.  Psychological safety is one of five key elements that allow a team to excel.  Google’s Aristotle study found that when people feel safe and connected they work better together. 

The research also showed that 66% (two thirds) want to work for an organisation that actively promotes diversity and inclusion.

There are set to be rewards for brands that have a clear social purpose and a good record on workers rights.  Over two thirds of young people (68%) are looking to buy from brands that treat their employees well. With 61% saying a brand having a clear social purpose is important in their purchasing decisions. 

Just over two fifths (43%) of Millennials and Gen Z in the UK have boycotted a company over the past 12 months because they don’t agree with their values or behaviour. This is an increase of 9% from last year.

Clearly more needs to be done to end the stigma around mental ill health.  Employers must now make mental health a priority to ensure that workers can be their whole self and to help strike a better work-life balance.

The rewards for doing this are clear.  Not only a happier, healthier and more productive work force but also a more positive image for customers too.

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Mental Health

The Strands of Equality

strands of equality

Sometimes referred to as ‘The Six Equality Strands’, these are the characteristics which are protected by law under The Equalities Act of 2010.  Despite this, we still have discrimination and this can have a huge impact on mental health and the treatment of mental ill health.

Mental Health and Sexuality

LGBTIQ+ stands for lesbian, gay, bisexual, trans, intersex, queer or questioning. 

The LGBTIQ+ communities face discrimination, stigma, bullying, hate crimes and social isolation.  Because of this, mental health conditions such as depression, anxiety, suicidal thoughts and substance abuse are more common.

It’s quite frightening to think that up until as recently as 1990 homosexuality was classed as a mental illness by the Word Health Organisation. So it’s not surprising that even now one in eight LGBTIQ+ people report feeling discriminated against when accessing health services.

Transsexualism has only just been removed from the ICD11 (international classification of diseases) which is good news for the transgendered community as it is no longer viewed as a mental health illness.

Mental Health and Gender

There are many differences in the way that men and women experience mental distress.

Men are more likely to die by suicide than women and women are more likely to experience depression. There are a variety of complex reasons for this so I’ve listed a few below.

Men are more likely to suffer from substance abuse which increases the risk for suicide.  They’re also less emotionally literate than women and will bottle things up.

Women are the largest single group of people affected by PTSD because of the massive amount of sexual violence they are victims of.

Women are also more likely to be diagnosed with depression because of patriarchal society but also because of gender bias in treatment. I.e. they are more likely to be diagnosed with depression even when scoring the same as men on standardised tests.

Mental Health, Race and Ethnicity

Institutional racism exists in society which negatively impacts the mental health of those from Black and Minority Ethnic backgrounds and the help that they receive.

Mental Health and Age

As people age, their role in society changes and so does their health.  Friends and relatives may pass away, children leave home, there may be money worries and they may feel isolated or not useful anymore.  

Suicide is more prevalent in men aged 44-49 and depression is more prevalent in older people.

Among younger people, self-harm and eating disorders are more common.  Schizophrenia is more common in young people aged 16-25.

Mental Health and Disability

Physical disability can have a negative impact on someone’s mental health. They may feel isolated because they cannot participate with other people in physical activities such as sport.  There may be problems accessing buildings or transport. And for those with learning disabilities, there may also be problems with communication and coping skills.  A person with a mental health condition that significantly impacts their life for 12 months or more is considered a disability and so that means they are protected from discrimination by law.

Mental Health and Religion or Belief

Having a religion, belief or spiritual practice is actually a protective factor for many. People who have a strong spiritual belief are less likely to die by suicide, suffer from depression or abuse substances.

There can be negative effects though, including feeling guilt and the need for forgiveness.  There can be stigma in expressing poor mental health in many religious communities.  A few religious groups have extreme ideologies and if you suffer from poor mental health, you’re more vulnerable to their extremism and more likely to become a victim of radicalisation.

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Mental Health

What is Schizophrenia?

schizophrenia

National Schizophrenia Awareness Day on 25 July 2021 brings attention to this much misunderstood condition. But exactly what is it?

One of the most common misconceptions about schizophrenia is that it means having a split personality. But that is a completely different illness called dissociative identity disorder.  People also mistakenly think schizophrenics are violent. But again this is not true, as schizophrenics are more likely to harm themselves than others.

Psychosis is an umbrella term for a number of conditions including schizophrenia. The word schizophrenia actually means split mind.

It is a long term medical condition where the main symptoms are:

  • delusions (losing touch with reality),
  • thought disorders (muddled thinking & speech)
  • hallucinations (auditory, visual, taste, touch & smell)

The exact cause is unknown, but it could be a combination of genetic and environmental factors. Stressful events can be psychological triggers such as bereavement, losing a job, the end of a relationship, physical, sexual or emotional abuse.  Drug use is linked to schizophrenia and there is also some research to show that people who have had complications at birth may be more susceptible.

It is a debilitating condition affecting 1 in 100 people.  Worldwide it is ranked as one of the highest causes of disability. It is one of the most expensive illnesses through physical co-morbidities (related illnesses), social impairment, inability to work and hospital admissions.

Can Schizophrenia Be Treated?

The main treatment includes anti-psychotic drugs and cognitive behavioural therapy.  Eight out of ten areas in the UK have an Early Intervention in Psychosis (EIP) team whose aim is to get people in treatment within two weeks.  Early intervention is vital, as treatment outcomes are good when this is caught early on.

One in five people with schizophrenia recover completely with treatment. But others may have times when symptoms return and it is important to learn to recognise the signs and have support in place.

Living with Schizophrenia

Here Antonio speaks about his experience of living with schizophrenia

Find out more about schizophrenia.

And if you are worried for yourself or someone you know, please speak to your GP.

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Mental Health

Let’s talk about Men’s Mental Health

Three times as many men as women die by suicide and it is the biggest cause of death for men under 50.  Men report lower levels of life satisfaction than women but are less likely to discuss or seek help for their mental health concerns.  Often they don’t even recognise them.  

We live in a society that expects men to be strong and in control, making it difficult for men to reach out for support, instead turning to unhealthy coping mechanisms.  Men are three times more likely than women to become dependent on alcohol or drugs.

It’s important that we have safe spaces where men can share their health concerns.  In my own journey, a weekly men’s group was fundamental in helping me to turn my life around. I was an angry young man with physical and mental health problems.  I was off sick from work and struggling with life.  And like many men, anger was an emotion that was both familiar and something I found easy to access and express.

But what was behind the anger?

In my men’s group one day, the facilitator challenged me on my anger.  He asked me to close my eyes and said that he would say things that would make me angry but that I should not react, just stay with the emotions.  He began to speak and I found the anger building, my knuckles clenched and my jaw tightened.  He continued and I began to shake.  After a few minutes (and it may have been much less than that) I started to cry and it wasn’t just a few tears, it was uncontrollable as the years of sadness that I’d been hiding behind my anger came out.

This couldn’t have happened had there been women present for two good reasons.  Number one, and the main reason, is that I wouldn’t have let my guard down in front of females.  And number two is safety. The facilitator probably wouldn’t have tried this just in case I lashed out. So this is one example but there are many subjects that men need a safe space to talk in.

Reach out if you are worried about your mental health.  Connect with friends and talk about your concerns.  Don’t let it build up until it becomes unmanageable.  There is help out there.

And if you are worried about someone else
  • Let them know you are there for them and keep in touch, listen without judgement.
  • Encourage them to get help from their GP or find a men’s group in your area
  • Learn more about the signs and symptoms of mental ill health and how to support someone in distress by taking a mental health first aid course.
  • Check out Men’s Health Forum for more information on men’s health