World Mental Health Day: The Importance of Therapy for Men

As World Mental Health Day approaches (10th October), Tim Panagos, Clinical Lead at The Edge, The Cabin Group’s residential Young Men’s Programme in Crete for men aged 18 to 29, stresses the critical role of therapy for men and the power of shared experience in recovery and wellbeing.

The clearest example of lived experience changing men’s mental health is the peer groups men have built for themselves. The most urgent gap is what sits behind those groups when talking is not enough.

At seven o’clock every Monday evening, in more than 350 rooms across the country, men sit down and talk. Andy’s Man Club, a peer support charity, says more than 6,500 men attend each week, in groups run by over 3,500 volunteers.2 In Eccles, a father who says drink and drugs nearly cost him his marriage now runs free boxing sessions followed by an hour of group conversation.3 

In Solihull, men meet on Thursday evenings to walk together in Brueton Park, on the basis that talking side by side is easier than talking face to face.4

None of this was designed by a health service. It was built by men who had been through it, for men going through it. If this year’s theme asks what happens when lived experience is heard, this is one of the clearest answers British men’s health has: it gets men through the door.

Tim Panagos comments: “For years we said men would not talk. Then men with lived experience built places where men do talk, every week, in their thousands. The willingness was never missing. The right room was.”

Why these rooms work

The groups share features that formal services rarely have. There is no referral, no waiting list and no diagnosis needed to walk in. The format is often active or informal, so talking is not the declared purpose of the evening. And the person running it has usually been where the newcomer is now, which removes the fear of being judged by someone who cannot understand.

Those are not small advantages. Around three times as many men as women die by suicide in the UK,5 and nearly a third of men say they do not know where to turn for help.6 A room with no barriers to entry, led by someone who has been there, speaks to both problems at once.

Where the room runs out

The best of these groups are clear about what they are not. Andy’s Man Club describes itself as peer-led and non-clinical, and points men in crisis to Samaritans, CALM and emergency services.2 That honesty is right. It also exposes a gap nobody owns.

Some of the men in those rooms will need more than a conversation. Their drinking has moved from habit to dependence. Their cocaine use has stopped being occasional. Their gambling is hidden from the people closest to them. Their low mood sits on top of trauma that talking among peers cannot safely reach. For these men, the peer group has done the hardest part: he has said something out loud. What happens next is left almost entirely to chance.

Tim Panagos says: “The man who stands up on a Monday night and says ‘I think my drinking is out of hand’ has done something brave. If the next step is a six month wait or a leaflet, we have taught him that speaking up leads nowhere.”

What clinicians see

Many of the young men who arrive at The Edge have already talked: to friends, to a partner, in a group, online. Talking was not the step they skipped. The missing step was structured treatment that matched how they engage, with therapy delivered alongside physical challenges to build resiliency and confidence, over weeks rather than an hour, by people who understand what they are dealing with.

That is why the programme is built the way it is. The training is not the therapy. The therapy is CBT, DBT and trauma work delivered by clinicians. The training is what makes the therapy reachable for men who would not otherwise sit still for it.

Five things that would turn a casual men’s group into a pathway for deeper support:

• Build the handover. Every established peer network should have a named clinical partner and a simple route for a man who needs more, agreed in advance rather than improvised in a crisis.
• Equip peer leaders to spot when it is beyond the room. Dependence, withdrawal risk, gambling harm and trauma all present in ways a trained volunteer can recognise and a caring one can miss.
• Let lived experience shape services, not just campaigns. No referral, active formats and facilitators who have been there should be written into how new services are commissioned.
• Measure where men go next. Attendance shows that men will turn up. It does not show what happened to the ones who needed treatment, and that is the number that tells us whether the pathway works.
• Take treatment to where men already are. Clinics that wait for men to arrive will keep recording their absence. Clinicians who show up in the rooms men have built will not.

Tim Panagos comments: “A big theme this year is lived experience, and men have already shown us what it can do. They built rooms where other men talk. What they could not build on their own is what sits behind the room when talking is not enough. That is the job of treatment services, and it is the part we have not yet done well. If World Mental Health Day achieves one thing for men this year, it should be a serious conversation between the people running these groups and the people providing treatment.”