Encouraging men to talk about their health is no mean feat. It's been well reported that men are much less likely to visit the doctor with a health concern than women. Combine this with the social stigma that is still associated with mental health issues, and it's no surprise that many men find it difficult to accept and talk about emotional difficulties. Encouraging men to be more open about their mental health is seen as a widespread problem that clinicians, academics, charities, celebrity campaigners and even the Royal Family are all trying to tackle. The #HeadsTogether and #ItsOkayToTalk campaigns are typical examples. As a result, men are bombarded with imperatives to 'talk' about their emotions. They are told that bottling up their feelings can lead to a range of problems, especially suicide. So the stakes are high.
However, it is rarely appreciated that the imperative to 'talk' masks many complexities. Talking, and not talking, can be about power and powerlessness. As is the way we talk, and what we decide to talk about. This is often related to social factors such as social class and status. For example, working class men are rarely offered, able to access or afford, therapy and may find professional clinical settings alienating. In addition, the demand to talk can inadvertently set up new ways for men to fail. Not only might they feel inadequate by 'failing' conventional masculine expectations if they are unemployed, on benefits, or suffer mental health problems for example. But then the pressure to talk can make them feel even worse, especially if they feel they can't articulate their feelings in 'acceptable' ways. So rather than just telling people it's ok to talk, and admonishing them if they don't, perhaps we need to pay more attention to the context and framing of the conversations we do have.
I've become interested in using football as a way to engage men in mental health support, an interest which was piqued after evaluating a project called "It's a Goal!" which used football metaphors as a way to frame a group therapy programme. Whilst sexism remains rife in football, and it is often seen as one of the last bastions of male domination, the sport still embodies much of what is positive in working class cultures: such as loyalty, commitment, solidarity and community. Paradoxically, these qualities can be channeled into articulating the powerlessness and vulnerability that men often feel, but are reluctant to express. Importantly, it is possible to achieve this, without reasserting a toxic form of masculinity that is often associated with sport.
Men frequently express their distress indirectly and in a language that is not immediately recognised by others. As a result, they often don't get the support they need. This may account for the high suicide rate amongst men and the fact that many men who commit suicide have had no previous contact with support services. Sometimes it helps to talk about personal struggles indirectly, through something which feels safer, familiar and shared. As our national sport, football can act as an ideal intermediary language to express feelings that may be difficult to articulate in other ways.
For example, whilst the clinical language of depression may be alienating, it may feel easier to say that life has left me 'on the bench'. This may actually say a lot more about how a person feels, and allows others to connect with them and relate to their situation. That is, if we are attuned to listening to the different languages of distress, which are often expressed through an individual's culture, interests and affinities. When personal situations are discussed through the medium of football-related stories that many men can relate to, it helps them to open up about their feelings and consider different choices in a way that they may not be able to if they are discussing issues directly related to themselves.
I remember one man recalling how he was very isolated but resistant to admit to anyone he was struggling or to seek help. Yet when he was encouraged to relate his experience to a goalkeeper he admired, he was able to acknowledge that 'even he' needed support sometimes and that it was acceptable to ask for help from others - he realised that similarly to how a goalie in a football game has a defence to help them, in life everyone needs some kind of support network.
Of course, these initiatives require careful thought, sensitivity and time. They may not be suitable for everyone and certainly can't solve the social problems which may affect men's lives - violence, poverty, unemployment and so on. However, these techniques can help some men to articulate their psychological concerns so we are more able to understand and address them. Unfortunately, however, instead of programmes like "It's a Goal!" being commissioned across the country, they are likely to be curtailed due to austerity measures.
Therefore, whilst not excusing our health services from providing mental health care, perhaps it's time the football industry invests more time and effort when it comes to mental health in the communities they serve. 'The beautiful game' could do a lot more good. For example, clubs could work with mental health services to help provide culturally appropriate services to their local communities. And as a whole, we could all pay more attention to the language we use and be more understanding when we expect people to just to 'talk' about their mental health.