Sam Delaney 

‘Our goal is to halve the male suicide rate’: why no-frills therapy works for men

Every week, around the country, groups of men meet for some straight-talking therapy. Could this be the answer to the male mental health crisis?
  
  

Luke Ambler
Luke Ambler, a former rugby league pro, started a weekly meetup after his brother-in-law, Andy, took his own life. Photograph: Stephen Burke/The Guardian

A stranger has just thrown a ball at me and asked me how my week has been. It’s Monday night, and I’m sitting in a circle of a dozen men in a chilly community centre. This ball obliges me to tell the gang about my current emotional state. I have spent my entire adult life carefully avoiding situations like this. I came to Andy’s Man Club with my eyes open, thinking I was ready to share. But that’s because I expected a different sort of group therapy session; a place where normal blokes could open up without the corny bullshit that puts so many of us off this sort of thing. No one said anything about a ball.

These men are mostly working class and middle-aged; a few are in their 20s. There is one much older bloke, who chuckles: “I used to deal with my frustrations by wrapping a pool cue round someone’s head.” When I tell them that I have travelled here from out of town to take part in the group, they seem touched (to protect their privacy, I won’t say exactly where the meeting takes place).

Over the two-hour session, the group share the ups and downs of their week: from battling for custody of their kids to a row with a boiler engineer. One bloke lost his wife last year and is just starting to date other women. One of the younger men says he was about to dump his girlfriend this morning when she suddenly announced that she loved him. It is sad, but compelling. The atmosphere is warm, matey, and devoid of the earnestness that I (rightly or wrongly) associate with a discussion about mental health, feelings and all the other subjects I tend to avoid. This is plain-speaking therapy.

As I squeeze the ball and blink back at the circle of men waiting for me to speak, I feel embarrassed and self-conscious. A bit annoyed, to be honest. But I open my mouth and start to tell them all about my week. I tell them about why I stopped drinking, and how sober life has been treating me for the past few years. I share a bit about a big argument I recently had with someone close to me. They listen and nod. And it feels OK.

Every Monday night at 7pm, 1,200 men nationwide attend one of 18 Andy’s Man Clubs. Their logo – printed on an array of merchandise, including baseball caps, wristbands and keyrings – is a hand making the “OK” sign. Their slogan is “It’s Okay To Talk”. Andy’s Man Clubs have received endorsements from Ricky Gervais and Danny Cipriani, among others.

“We’ve made talking about this stuff cool,” says Luke Ambler, a 28-year-old former rugby league pro who started the club in 2016. That was the year his brother-in-law, Andy, took his own life. There had been no warning; his family and friends were aware that Andy had been struggling, but had no idea the situation had become so severe. Ambler believes that if Andy had been able to talk more openly then he would still be alive today. So he started a weekly group in his home town of Halifax, to provide an environment for ordinary blokes to share their thoughts and feelings without it being, you know, weird.

“We keep it real and we keep it simple,” says Ambler, when we meet in a bar in London’s King’s Cross. He is constantly travelling the country giving motivational talks – sometimes to boardroom directors, sometimes to violent offenders. He wears a baseball cap and shorts, and speaks in a broad Yorkshire accent. He is funny and passionate; I can see why therapy-averse men would find him disarming. “There aren’t many rules,” he says. “We don’t talk religion and we don’t talk about medication, because we’re not qualified. We base each meeting around five questions: ‘How’s your week been?’; ‘Name one positive thing that has happened to you this week.’; ‘Anything to get off your chest?’; ‘What’s your goal between now and next week?’; and ‘Tell us about someone you appreciate in your life and why?’ We want to help the men see their lives in a better light.”

There are no mental health professionals working at Andy’s Man Clubs. This, Ambler says, is part of the appeal. “There is no hierarchy. We have people who facilitate the meetings by posing the questions and putting the chairs out – but they are also there for the same reasons as everyone else: to share experiences, talk things over, try to give each other support.” His methods might be modest but his ambitions are not: “Our goal is to halve the male suicide rate in this country. We’re trying to save lives,” he says.

Suicide is the biggest single killer of men under 45 in the UK. A Samaritans study last year found that men in the UK remain three times as likely to take their own lives as women, and in Ireland four times as likely. The need for greater government investment in mental healthcare provision is clear; what form it should take is less so. “There was a big gap we wanted to fill,” says Ambler. “It was for ordinary blokes who want to cut all the crap and just speak normally about what is going on in their lives.”

“Ordinary blokes” and “speaking normally” are both pretty vague terms. But I know exactly what he means. While discussion of mental health is now more widespread than ever, the language and culture that surround it remain overridingly feminised and middle-class in tone. What if you do like beer and football and “banter”? What if you do shout the loudest in the pub? What if the lexicon of mental health and emotional sharing doesn’t trip off your tongue? What if you have grown up in an environment where the stigma associated with mental health is as strong as ever?

Self-help books and column inches are filled with people stewing over anxiety triggered by social media or Brexit existentialism; about modern masculinity and its compatibility with feminism. These are real issues, yes, and legitimate sources of pain for lots of people. But they don’t address the more practical and dreary preoccupations that can trigger many of us day to day, such as bills and arguments and loneliness and excessive boozing, for example.

Because I have low-level dread running through my mind pretty much all of the time, I follow anxiety and mindfulness hashtags on Instagram and Twitter. As a result, my social media feeds are riddled with memes offering abstract advice, such as: “Are you ready for a miracle in your life today?” or “Sometimes life doesn’t want to give you something, not because you don’t deserve it but because you deserve more.” There are images of sunsets and silhouettes of people in complicated yogic positions against lilac backgrounds. There’s nothing wrong with any of it, of course, but it doesn’t help me much.

It is significant that Andy’s Man Club initially took off in towns and cities in the north of England. After Halifax, clubs swiftly followed in the rugby league heartlands of Bradford and Huddersfield, spreading out to Manchester, Oldham and Leeds – areas where traditional working-class values are still prevalent among many men. There are groups in Peterborough and Devon, too, but for now they are the exceptions to the rule.

“My view is that mental health discussions have been monopolised by the middle classes,” says the campaigner Natasha Devon, who has toured schools and universities for the past decade. “I’ll give you one example: a few years ago there was a piece of research by the Department Of Education that said that middle-class girls were more likely to develop anxiety and depression. There were all these op-eds saying: ‘What is it about affluence and being female that makes life harder?’ How did they actually collate that data? There are all kinds of reasons why, if you are a working-class boy, you are not going to be counted. Middle-class girls have got the vocabulary, they’ve got the education and they’ve got the lack of stigma; they are not peculiarly afflicted, they’re just able to express it in a way that’s understood.”

Telling boys and men to catch up – to learn the vocabulary of mental health, to shed their macho notions of strength and drop their stigmatised perceptions of mental illness – is just victim blaming, says Devon. “I think we need to be more aware, because there is this myth that boys don’t have mental health needs. I think we need to change the focus from making boys talk to what we can do to notice them.”

When I was suffering from stress and anxiety in my mid-30s, I was unable and unwilling to apply those labels to myself. I had grown up in a single-parent family, the youngest of four brothers. We communicated almost entirely through loud piss-taking and football-related arguments. From an early age I was exposed to a lot of heavy boozing and drug taking by my brothers, their mates, my mum’s boyfriend, sometimes random strangers who just seemed to be hanging around in our front room. By early adolescence I was enthusiastically involved in all of the drinking, most of the arguing and some of the drugs. None of it seemed bleak or depressing at the time; it was just knockabout fun. I was loved. But emotional sharing was not a big part of my youth. I thought feeling miserable or stressed out was something you tried to ignore, or distract yourself from – usually with drink and drugs.

It was one of my older brothers who intervened. The wakeup call, he told me, came when I received a routine letter from the Inland Revenue and started acting like Alan Partridge when he submitted a rogue receipt for a dressing gown that was actually a gift from Bill Oddie, and went into meltdown. My response to the letter was part of a behavioural pattern: an obsessive compulsion to worry about the most trifling of day‑to‑day challenges.

I had been acting like this for six months. Even though things objectively were fine – I was happily married with a healthy kid and another on the way, busy with work, financially OK – my imagination relentlessly churned out doomsday scenarios: I was never going to work again; I was going bankrupt; I had three kinds of cancer. I knew that these worries were not rational, and I was reluctant to talk to anyone other than my wife about them. Which, of course, made it all worse. I was masquerading as the confident and energetic loudmouth most people knew me as, while feeling on the verge of a tearful outburst that never arrived.

One day, as we stood on a fire escape outside his offices, my brother – eight years older than me, shaven-headed and permanently angry-looking – looked me in the eye while tugging on a Marlboro, and said: “You’re fucking nuts, mate, and you need to go to the doctor about it.” This was just what I needed to hear. His bluntness might have been upsetting or unhelpful to others, but it was a quick chat that probably changed my life.

I have been sober for the past three and a half years. I also have a therapist and work hard on my day-to-day mental health. I am luckier than most: I have had access to the help and support I need. It turned out that the people in my life were not as judgmental as I feared. I am lucky enough to afford a therapist, and to live in an area where I can see my NHS GP pretty easily. My problem didn’t get the chance to grow into something more dangerous. It does for thousands of men who aren’t as lucky or privileged.

At the moment, the way we communicate about mental health is unhelpful to a large number of men. “Counselling is basically a female-friendly activity,” says Martin Seager, a clinical psychologist specialising in male mental health. “It’s not the standard way a bloke deals with his feelings, sitting down eyeball to eyeball and being asked: ‘Tell me how you feel.’”

Seager has 30 years’ experience in the NHS and is a partner in the Men And Boys Coalition, which aims to foster positive public discussion about masculinity. Their website is big on discrimination against men and boys, citing “structural challenges faced by men as parents, particularly new fathers and separated fathers; institutional responses to male victims of rape and domestic violence; and the disparity in approaches to male and female prisoners”.

I meet Seager in a cafe in central London. He is passionate about what he sees as the unjust narrative surrounding modern men. “I hate this term ‘toxic masculinity’,” he says. “The narrative goes that men are too preoccupied with being perceived as strong and that they need to soften up a bit to help themselves. What I am saying is, let’s change the narrative. So we still use the strong male archetype but suggest that seeking help and discussing your problems is the truly strong thing to do.”

What we really need, I suggest, is a few simple solutions for men who are struggling. Seager agrees. “Men need things to be practical and active,” he says. “You might have a gymnasium where, if a guy wants to break down in tears and tell you something, there’s a side room. It’s creating an environment where you’re just doing stuff with other people – you’re bantering, you’re belonging, you’re getting some input but without directly saying: ‘I feel this, I want you to hear it.’ Men can be very direct when they are ready, but you can’t go straight in with them.”

Some men are simply lonely and need guidance on how and where to make the sort of friends who might be able to help. A 2015 YouGov poll showed that the chances of friendlessness nearly trebled for UK men between their early 20s and late middle age. Over half of men in the survey said they had two or fewer friends outside the home to talk to about serious issues like health or money. One in eight said they had no one at all. Married men were a third more likely than singles to have no one outside the home they could turn to for friendship or support.

Increasingly, voluntary groups are finding imaginative ways of encouraging men to socialise with each other. In Newcastle, Men’s Pie Club brings isolated men together to bake pies and form friendships; in Peterborough there is the Brothers Through Boxing project – both backed by the Movember Foundation. In Torquay, barber Tom Chapman started the Lions Barber Collective after losing a friend to suicide. Now he has established a national network of barbers trained in therapy, so that their customers can share their troubles in a relaxed way.

The comedian and writer Jake Mills founded the mental health charity Chasing The Stigma after attempting to take his own life in 2013. A straight-talking scouser, Mills says he grew up feeling emasculated by the idea of depression, dealing with it through drinking and fighting. “For a long time I didn’t realise I was depressed,” he says. “I spent ages struggling to justify my feelings. I thought, ‘What have I got to be depressed about, really?’ So I didn’t share. I had to hit a real rock-bottom moment before deciding to seek help. I don’t want other people to have to reach the same point.”

Now, Mills and his charity have built Hub Of Hope, an app that allows access to a national network of mental health groups and resources. So whether you’re the sort of person who wants to catch a sponge ball or bake a pie, you will find something in your area that works for you.

“We want people to understand that no one is ever really alone,” he says. “And talking about feelings doesn’t have to be in the sort of intense environment that can put a lot of men off. It might be through a football club. It might be through a comedy club.”

Slowly, people like Mills and Ambler are showing men we must all pay attention to our mental health – but that we don’t have to fundamentally change the way we talk, think or act to find a way of doing so.

“Really, Andy’s Man Club is just about connecting you with other blokes who understand what you’re going through,” says Ambler. “If someone does say, for instance, that their wife found them with a rope around their neck, someone else in the group will say: ‘Mine did, too. That’s why I came here and why I’m still taking this group. And now it’s a year later and I’m back at work. Everything that seems shit now will get better.’ That’s why it works. Because there will be someone in that room who has been through debt, someone whose wife is cheating on them, someone who has lost their job, or someone who is gay but struggling to come out – and they’ve come through it. It gives people hope. And when you feel better, you want to return and help others. It goes round in a circle, which is a beautiful model.”

Samaritans.org; andysmanclub.co.uk; hubofhope.co.uk.

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