The Signalling Model of Male Help-Seeking Behaviour

Abstract

Research into male mental health help seeking has become an important focus in recent decades, due to increased awareness of men’s mental health issues. Only a third of Australian men who met the diagnostic criteria for a common mental disorder sought professional help. Existing theoretical models of male help seeking focus on masculinity as an inhibitive factor, potentially downplaying the influence of contextual factors. Theoretical models are also yet to incorporate contemporary definitions of masculinity and of help seeking. This thesis aims to identify theoretical limitations in the male help-seeking literature, and to develop and test a new theoretical model of male help seeking aimed at addressing these limitations. The findings are presented in three articles intended for publication. The first is a critical review of the literature on male mental-health help seeking, which identifies theoretical limitations and presents a new model of male help seeking based on Signalling Theory. The Signalling Model defines help seeking as an interaction between the man seeking help, the help provider, the behaviour itself, feedback from previous help seeking, and the environment. Properties of these five components and the interactions between them can affect the perceived benefits and costs of seeking help. The Model predicts a positive association between help seeking and the perceived benefits. The review collates existing evidence and determines that existing literature is consistent with the Signalling Model. This thesis also aims to empirically test relationships predicted by the Model, across two papers, using large datasets. Consistent with the Model, the second paper (n = 2002) finds a positive relationship between ratings of the benefits of therapy and both men’s initial motivation to attend (β = .541, p < .001) and their attitudes towards future therapy (β = .826, p < .001). The relationship between three types of therapist behaviours, aimed at improving men’s engagement, and men’s attitudes towards future help seeking is mediated by men’s ratings of the benefits of help seeking, explaining 64.2% of the variance, which is also consistent with the Signalling Model. The third paper, using data from the national Ten to Men study (n = 2071), found that bond with help providers is positively related to formal help seeking when distress is included in the model, which explains 3.3% of the variance. Another structural equation model revealed that distress, previous help seeking, and informal help seeking are all positively related to formal help seeking, altogether explaining 19.8% of the variance. These results are consistent with the Signalling Model and demonstrate that the Model can be applied to male help seeking to model complex relationships between a wide array of predictor variables. The strengths of the thesis, including the robust samples, are discussed along with some limitations, including the lack of purpose-designed measures. Future research directions are suggested, including testing the full Model using purpose-designed measures. Clinical and policy implications are also discussed. Policy should adopt a holistic approach that optimises all components of the Model, rather than focusing solely on the man seeking help, to facilitate help seeking.