Men's mental health and suicide prevention service landscape in Australia: a scoping review

Men represent the majority of suicide deaths globally and men are more likely to die by suicide without contact with formal mental health services. In Australia, three-quarters of suicide deaths are men. If services were better able to meet their needs, men might be more likely to seek help. In this scoping review, we sought to describe the formal and informal service landscape for men at risk of suicide in Australia, and to determine the extent of research evidence for the effectiveness of these in lowering suicidality, and improving mental health or help-seeking behaviours. We limited our investigation to Australian services, in order to comprehensively identify all community and health system services.

Relevant services and initiatives in Australia were identified through multiple methods: (1) a hand search of key websites and directories; (2) a systematic search of PsycINFO, Cochrane Central, EmBASE, and PubMed; and (3) suggestions by researchers, consumers and clinicians. Evaluations were also identified using multiple methods, including the initial systematic search, targeted website searches, and via multiple search engines. Findings are presented using narrative synthesis.

Included services and initiatives (N = 88) were diverse in their characteristics (e.g., cost to the user, mode of delivery, location), however, there was considerable overlap in the types of components offered. Awareness and education were the most commonly offered (84.1% of services and initiatives). Only 22.7% of services and initiatives had been formally evaluated and existing evaluations varied in quality. Pre-post intervention designs were most often used, and only three evaluations assessed outcomes in a randomised controlled trial.

The service landscape for Australian men is broad. However, there appears to be substantial overlap in the components offered by services and initiatives. The prevalence of awareness and education-based offerings is disproportionate to evidence about men's preferences for support. There is a lack of high-quality evaluations. We conclude that the cohesiveness of men's suicide prevention approaches must improve through service development and policy.