Beyond+Blue+-+Fighting+for+the+promotion+and+treatment+of+depression+in+Men+across+Australia.


 * Name:** Kurt Tomkins
 * Student number:** 7201524
 * Tutor:** Emily Mann
 * Topic:**

** ' Green, Gold and Blue ' ** ** How well does Australia deal with mental health in 2011? **

** Beyond Blue - Fighting for the promotion and treatment of depression in Men across Australia. **  **Cultural Artefact:**

media type="youtube" key="bdgWrQwjUdQ" height="480" width="853"

This clip is one of the many hard-hitting and effective pieces of promotional awareness advertising that BeyondBlue uses to advocate its views and purpose. This specific clip focuses on the prominent but far less deliberated issue of depression in men, and lights in quick succession a series of major problems; that men will tend to suppress and hide their Mental illness, pursue other self-destructive behaviors to dull the pain, such as alcoholism and eventually succumb until it cripples them completely, both physically and emotionally.

**Public Health Issue:**

Depression is one of the most common forms of Mental illness in Australian society, so much so that there a myriad of initiatives and events which aim to contribute to increasing awareness and promotion. According to the World Health Organization (2011): ‘Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. These problems can become chronic or recurrent and lead to substantial impairments in an individual's ability to take care of his or her everyday responsibilities. At its worst, depression can lead to suicide, a tragic fatality associated with the loss of about 850 000 lives every year’. In order to combat such a huge issue in contemporary Australian society initiatives such as Beyondblue exist. Beyond blue is a not-for-profit entity who plainly states in their mission statement their intentions with regard to combatting depression: ‘ Our mission is to provide a national focus and community leadership to increase the capacity of the broader Australian community to prevent depression and respond effectively’.

**Literature review:**

Depression is a serious issue that becomes increasingly difficult to diagnose when it comes to men. According to Brownhill, S et al: ‘Most [men] consider it appropriate to turn to their physician for help with emotional distress’. However, some estimate that primary care physicians overlook or do not recognize the symptoms of about half of their patients who suffer with depression. In concert with physicians' low detection rates, less than half of patients disclose health-affecting psychosocial problems to their physicians.’ Obviously, this is a distressing trend when we take into consideration the sheer number of Australian males committing suicide per year. According to the Australian Bureau of Statistics (2008) the median suicide for males of ages 20-24 years old during 2008 was approximately 15 per 100,000, compared to 5 per 100,000 for females of the same age. While this is alarming, what is more shocking is the fact that this rate increases exponentially with age with men aged 40-44 years old exhibiting a suicide rate of 26 per 100,000 males alongside males aged 85 and over who also display the same rate.

Depression of course, is the main motivator behind these statistics, and changes must be made in order to rectify the issue. As identified by Lyon, Z et al (2009): ‘Underdetection is more common in male patients compared with females. General practitioner gender and difficulties in communicating with male patients may play a role’. This is an immensely important aspect to consider, as the first step in addressing the issue of depression in an individual is to actually make the condition known to practitioners who can assist with the problem. It has been found that most General Practitioners find diagnosing depression in male patients difficult (64% of respondents, or 73% of female and 58% of male GPs) and that there is a huge need for General Practitioners to communicate with their patients more effectively to efficiently prevent further repercussions (Lyon, Z. 2009). Reasons for this gross inability to diagnose patients comes from a variety of factors, these include: A physicians’ reluctance to explore non-biological aspects of illness, a belief that psychological intervention will not help or be time intensive, or even the fact that a General Practitioner uses emotional distancing from their patients to ensure that their stress levels are kept to a level that guarantees effectiveness while working effectively causing a GP to overlook symptoms of depression (Brownhill, S. 2002).

Australian men are also a major contributor to this problem, as their cultural perceptions, emotional repression and unwillingness to share anything more than somatic issues make diagnosis increasingly difficult; however, this will be discussed in-depth in the next section (Brownhill, S. 2002). Another far more contributive factor is a male’s willingness to turn to harmful behaviors as coping mechanisms, such as alcohol and substance abuse instead of actually realizing that they have a problem that they need to seek help with (Wilhelm, K.A et al (2009)). These self-destructive behaviors are not only caused by mood disorders, but are effectively a catalyst in their progression, as found in studies by Lyon, Z et al (2009): ‘The diagnosis of depression in men can be further complicated by substance use disorders. In Australia, men experience higher rates of these disorders compared with women (7.0 vs. 3.3%2) and comorbidity between substance use disorders and mood disorders is common’.

It is of course, important to keep these figures in perspective. According to Lyon, Z et al (2009) depression is one of the most common diagnoses by Australian GPs, with around 10.4% of all Clinical visits during the 2006-2007 year concerning Mental illness related issues, which amounted to around 10.7 million encounters during that year, with nearly one third (34%) of those encounters specifically involving depression. Still, there is more than can be done to counter the problem, a small but vital step towards this is included in the research methodology conducted in the article Diagnosis of male depression: Does general practitioner gender play a part? By Lyon, Z et al (2009) where the use of a ‘For men only’ prompt list which resulted in 60% of men finding it easier to discuss emotional issues with their doctor and behaviors resulting from it. 71% of GPs said the list helped retain clarity with their patients and 86% of GPs reporting it was useful in all-important building rapport. Though, it should be stated that limitations of this study include a select proportion of GPs and patients in a specific geographical area, and may not be indicative of all regions.

As we can see, in order to rectify this issue, a joint effort between individuals suffering from serious Mental illness such as depression and the General Practitioners responsible for their treatment is needed. This is where initiatives such as BeyondBlue play such an important part in building awareness and providing encouragement and support. Programs such as the National Men’s Shed Project, which provides a kit to promote awareness of male depression and anxiety for middle aged men, alongside the MaturityBlues project for older men which provides a support structure and makes individuals aware of the support programs available to them should they need it are just a small selection of the programs displayed on their website.

**Culture and social review:**

Perhaps the largest contributing factor to this issue is the prevalence of old-style attitudes about masculinity and the fear of social stigma with relation to Mental Illness and third-party disapproval, particularly in middle aged men in contemporary society (Brownhill, S. et al 2002). ‘As found in further studies conducted by Brownhill, S et al (2002): [Through] the consequence of social conditioning, these men influenced and were influenced by other men not to express emotions that revealed a weakness or vulnerability. They discouraged it, downplayed it, or did not allow it. Other men were shown to be insensitive to, or not able to tolerate, other men's pain. If men did express emotion, they ran the risk of being victimized or ostracized by other men’. This is a general observation of the obvious social stigma attached to mental illness and a culturally held belief that the proper masculine way of dealing with Mental Illness and/or depression was simply to be strong enough to cope with absolutely anything that faces an individual. If finally forced to seek professional help, a patient preferred to be forwarded to ‘someone who actually has time to deal with it (depression)’, which further alludes to a masculine attitude that the Mental illness and emotional issues a patient is facing is deemed unimportant by the patient in relation to somatic illnesses, and not something a GP should be focusing their time on (Brownhill, S. 2002).

It should be mentioned that because of this cultural expectation, outbursts of violence and risk-taking behaviors generally only increase with time, as an individual presses more and more emotional pain down, the ability to operate at an appropriate emotional level decreases exponentially. Having been taught no real method of dealing with mental illness or depression in general, an outburst is almost certain to occur. This is evident in the following quotes and recollections from two individuals located in the case study performed by Brownhill, S et al (2002):

‘Some people can cop a lot of shit off other people, but the people that are giving shit don't realize that they're about to snap. And when they do, they don't snap in a small way. They'll take 'em out, sort of thing, in a big way.’ – S.

‘Men tend to let things build up...hold it all in until we can find an outlet.’ – T.

‘They let it build up, and then they just snap.’ – S.

These observations nearly ubiquitously showed that the emotional buildup of stressors while suffering from depression led to anger-driven outbursts of a violent nature in response to negative external events. All because the culture these men have developed in has provided no alternate way of dealing with these emotions.

This long-standing cultural trend is one of the most important aspects of this issue. If the patient is actively able to identify symptoms of depression in themselves and also socially comfortable in seeking assistance with the issue before it builds up to unmanageable levels and causes a problem, mortality rates and generally speaking the suffering of affected individuals, will decrease. This is why Health promotion is such a vital aspect of this issue, without it, changes in interpersonal and greater social attitudes simply will not happen.


 * Analysis of Artefact: **

The artefact I have selected is directly related to the issue itself, and shares the viewpoint of three men all deeply affected by depression. These are the very men I have been discussing with you throughout this article, men who don’t know what’s going wrong with them, men that are too scared of the illogical social repercussions of their illness to try and help themselves, men that may end their lives if not for initiatives such as BeyondBlue. I will examine each individually, as they each represent a major stage in depression in men in increasing order.

The first displays the generally expected cultural attitude; the speaker can be quoted as saying: “Men don’t get depressed; you don’t want people to think you’re weak, so you just keep it to yourself”. His age and (what can be assumed to be) profession both indicate his cultural attitudes; that his masculinity is at stake if he actually is depressed.

The second indicates the tendency of men to turn to risk-laden and harmful behaviors in order to escape and repress emotional pain, alongside the introduction of lethargy and listlessness that comes with avoiding the issue and letting it take hold completely. What also should be considered is that the individual is likely in the 20-24 year old range, one of the age ranges with higher than normal suicide rates and also the range that are more likely to engage in these behaviors.

The third and last portion displays succinctly the third and final stage of depression, which has only been reached because of the individual’s complete inability to face the issue, as he falls completely into helplessness.

**My Personal Reflection:**

Personally, I find this terrifying; we have all been depressed to some extent at some point in our lives. To have reached the age of these men, to have faced the things that they have faced, worked as hard as they have, and loved and been loved as they have, to have it all stripped away by the less important but all consuming aspects of their lives, to even end their lives in absolute sorrow, their last moments in complete misery. Is quite simply something I never want to face, something that no one should ever face, and yet people do when it is completely preventable.

In my future career as a Paramedic, I will be in the position to do some ‘guesswork’ of my own in this area, and the knowledge I have gained during the creation of this wiki, is only going to make me better at what I’m meant to do. Hopefully I will be able to help many men and woman in this regard over the years to come, and perhaps improve a few lives, it’s the least I can do.

**References:**

Brownhill, S., Wilhelm, K., Barclay, L., & Parker, G. (2002). Detecting depression in men: A matter of guesswork. //International Journal of Men's Health, 1//(3), 259-259. Retrieved from @http://search.proquest.com/docview/222803686?accountid=13380

BeyondBlue (2011). //Mission Statement.// Retrieved from: []

McLaren, S., Jude, B., & McLachlan, A. J. (2007). Sexual orientation, sense of belonging and depression in australian men. //International Journal of Men's Health, 6//(3), 259-259-272. Retrieved from @http://search.proquest.com/docview/222803065?accountid=13380

Lyons, Z., & Janca, A. (2009). Diagnosis of male depression: Does general practitioner gender play a part? //Australian Family Physician, 38//(9), 743-743-6. Retrieved from @http://search.proquest.com/docview/216291552?accountid=13380

Wilhelm, K. A., A.M. (2009). Men and depression. //Australian Family Physician, 38//(3), 102-102-5. Retrieved from @http://search.proquest.com/docview/216276686?accountid=13380

World Health Organization (2011). //Mental Health: Depression//. Retrieved from: []

Seidman, S. N., & Walsh, B. T. (1999). Testosterone and the depression in aging men. //The American Journal of Geriatric Psychiatry, 7//(1), 18-18-33. Retrieved from @http://search.proquest.com/docview/195983058?accountid=13380

**Peer Reviews/ Reflections:** Kurt Tomkins – 7201524
 * Drinks and Gen Y? – Bloody Idiots**

I really enjoyed reading this, like anything on Generation Y, really, after all you are writing about me, about you, about most everyone in this unit.

Your wiki is well written and well referenced, and also somewhat confronting, I find that although I cannot simply argue with hard statistics I also cannot agree with everything stated. This is the nature of statistics however; they focus on the entirety and then point on the proportions that are undesirable. Then fact that such a large portion of regular ‘binge-drinkers’ injure themselves or others on a frequent basis is not surprising, but it is also something I do not take into consideration often, and I suppose would be less of a surprise if I was a part of a different social group. Regardless, you are correct, we have been raised and released into a culture where drinking is synonymous with celebration, relaxation and depression, it is our ‘escape’ if you will and perhaps even something that brings us closer together as we destroy ourselves.

Since according to this I am a ‘Binge-drinker’, I find it important to point out that complete deterrence and avoidance of an aspect of one’s chosen culture and lifestyle is not always the best course of action, drinking is fun and typically consequence free if done with the right attitude and social setting.

Your artefact however, is the perfect example of all the things we should hate about that culture and the aspects we should guard from, not in my opinion, the reason we should stop drinking altogether.

Great work though, this is just my opinion, I do understand when it comes to these wiki articles you need to take a hard stance in one direction or another. Kurt Tomkins – 7201524 This being one of my favourite movies of all time, I of course, came straight here to review this. I was not disappointed. I expected nothing less than a perfect examination of the key aspects of the film, and I got it. Of course the artefact you’ve used has one of the less probable solutions as its ending point; the real life consequences are still pretty frightening. We already have people killing each other to sate these instincts, and even then it’s practically just a quick fix for a growing and never ending addiction. Hell at the very base levels we have people stealing cars and mugging each other, the life of a human being eventually becomes secondary. The fact that people can draw similar conclusions to the one’s you’ve made here and still cannot resist the urge of our completely consumer-driven society tells us enough. Unfortunately in order to survive we are forced to do so, this is how the capitalist world works. Overall, a great job, as you can see it brings up a myriad of thoughts and opinions for me.
 * Gen Y - Is consumption really bringing us any closer to happiness? Or has Western Culture conditioned us to be eternally dissatisfied with what we have, and by some perverse extension, how we are perceived by society? **