Mental health professionals view about the impact of male gender for the treatment of men with depression - a qualitative study.

BACKGROUND: The underestimation of depression among men may result from atypical depression symptoms and male help-seeking behaviour. However, higher suicide rates among men than among women indicate a need for gender-specific services for men with depression. In order to develop gender-specific services, it is essential to examine professionals' attitudes towards men's depressive symptoms and treatment needs as well as barriers to and facilitators of treatment. This study examined gender-specific treatment needs in male patients and treatment approaches to male patients from a professional perspective. METHODS: Semi-structured face-to-face interviews were conducted with 33 mental health professionals (MHPs) from five German psychiatric institutions. The study assessed the characteristics and attributes of male patients with depression risk factors for the development of depression among men, their condition at the beginning of treatment, male patients' depressive symptoms, the needs and expectations of male patients, the importance of social networks in a mental health context, and MHPs' treatment aims and treatment methods. Transcripts were analysed using qualitative content analysis. RESULTS: The professionals' reference group of male patients were men who were characterised in accordance with traditional masculinity. Attributes reported as in line with this type of men were late initiations of inpatient treatment after crisis, suicidal ideation or attempted suicide, and high expectations towards treatment duration, success rate in recovery and therapeutic sessions. In contrast, male patients who deviate from these patterns were partially described with reference to female stereotypes. Professionals referred to psychosocial models in their explanations of the causes of depression and provided sociological explanations for the development of masculine ideals among men. The consequences of these for treatment were discussed against the background of normative expectations regarding the male gender. From the professionals' point of view, psychoeducation and the acceptance of depression (as a widespread mental illness) were the most important goals in mental health treatment. CONCLUSIONS: In order to improve mental health among men, gender-specific services should be offered. Awareness of the role of gender and its implications on mental health treatment should be an integral part of MHPs' education and their daily implementation of mental health treatment practices.

[Men with Depression and Inpatient Mental Health Treatment: Professionals' Perspectives on Treatment Needs and Aims]. / Männer mit depressiven Erkrankungen in der stationären Behandlung: Bedarf und Behandlungsziele aus Sicht psychiatrischer Fachkräfte.

OBJECTIVE: To meet mental health needs in men with depression, gender sensitive services are needed and recommended. Therefore, mental health professionals' views on care needs among men with depression that should be met by gender-sensitive services were assessed and consequences for inpatient treatment are considered. METHODS: Semi-structured interviews were conducted with 33 mental health professionals focusing on men's specific needs in depression treatment against the background of male gender role expectations. Qualitative Content Analysis was performed using MAXqda-Software. RESULTS: Men with depression benefit from individual talk with staff and structured activity during treatment. Men-only groups are assessed as enabling critical reflection of aspects of masculinity. Physical activities and handicraft enable men to examine their performance level. Services focusing on men's specific needs are assessed as helpful but largely inexistent. CONCLUSION: Expectations of social gender roles and their implications for mental health treatment should be considered in both mental health professional training and mental health treatment.

[Effects of a psychosocial education programme to improve doctor-patient interaction with cancer patients]. / Effekte eines psychosozialen Fortbildungsprogramms zur Verbesserung der Arzt-Patient-Interaktion mit Krebspatienten.

OBJECTIVES: The quality of medical care by somatically treating physicians has considerable influence on the coping process in cancer patients. In outpatient psychosocial care, information supply and doctor-patient interaction are often considered difficult by the patients. This study therefore investigates the effects of a teaching and training programme on interactional skills of experienced physicians in dealing with cancer patients. METHODS: In a pre-post comparison design, the effects of a 6-hour and a 24-hour interaction and teaching programme were compared. To measure the effects, interviews with standardised patients were carried out and analysed using the Medical Interaction Process System (Ford 1998). RESULTS: About one third of all physicians practicing in the area of Mönchengladbach, Germany, could be motivated to participate in the programme. The physicians who received the 24-hour training showed a substantial improvement in interaction skills whereas no marked changes were seen in those physicians who had participated in the 6-hour training. CONCLUSIONS: Interactional skills of experienced physicians can be improved by teaching and training programmes. Therefore, doctor-patient interaction training should be integrated into continuing medical education.