Mr. Martin Rogan:

It is not unique to mental health but across a range of issues. Men are often reluctant to avail of health services, to which primary care is not necessarily always the best route to take. Last week, for example, we met representatives of Men's Shed which has a really active role in engaging with and mobilising men. It was not designed as a health initiative, but it has many benefits. Unfortunately, one of the primary carers when it comes to mental health is the Irish Prison Service, where many find themselves in difficulty by virtue of having very significant and mental health needs which are under-met in the community. In Ireland approximately 7% of the prison population have a psychotic illness. If someone has a psychotic illness, he or she should not be in prison but availing of a mental health service within the community. Some 80% of those admitted to prison who present with it are already known to mental health services. We need to listen more closely to men and devise models that are attractive to them that do not in any way undermine their masculinity, role or position. Coming back to the point about stigma, it has been found to have a chilling effect on some people's careers or their roles in communities, but we are much more optimistic in that regard as we see more people coming forward with initiatives such as social farming and sports activities in which men engage on mental health topics in a more constructive way. Models that work well for women may not translate easily for use by men. Sometimes men can find talk therapies difficult. The shoulder to shoulder conversation is easier for men than eye to eye contact, which is often considered to be confrontational. Self-medication with drugs and alcohol is far too appealing and accessible for men. We need to find much more progressive and healthier models.