AndroLabs Module 3.2: Promoting health literacy in clinical settings

Explore our extensive list of toolkits and resources for healthcare professionals and patients to promote health literacy in clinical settings.

November 18, 2024

Overview

Health literacy is defined as the “personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health. Health literacy includes the capacity to communicate, assert and enact these decisions” (1). Individuals and communities include not just patients, but also healthcare professionals, wider clinical staff, and the families and friends of patients. As highlighted by the NHS, health literacy is a two-sided issue; individuals need to be able to understand and use information, whilst also considering the complexity of health information and the healthcare system (2). 

Several studies show that males tend to have poorer health literacy than women (3–5). Poor levels of health literacy are associated with lower use of healthcare services, including preventative care and screening (6,7). Poorer health literacy is also linked with only engaging with healthcare services as a much more advanced stage of illness (8,9).

Over the past few modules, we have outlined the prevalence and impact of poor male mental health. Regardless of healthcare profession, we all have a duty to look after the patients under our care, and our colleagues. Whilst we by no means will be able to solve these problems ourselves, having the awareness of men’s mental health conditions and their symptoms, as well as knowledge of relevant resources that can be used to signpost patients and colleagues in need to the organisations and services that can help them can make all the difference.

This module will enhance your health literacy, by equipping you with knowledge and resources to use in your own practice to raise awareness of men’s mental health, and when interacting with patients who may be showing signs of poor mental health. In turn, we hope this will benefit the health literacy of males and their family, friends and carers.

Key Resources

Before we begin, a few key resources that cover knowledge of mental health and access to mental health services include:

  1. NHS Mental Health Services
  2. Mental Health First Aid (MHFA) England's Instructor Training programme 
  3. CALM directory of national mental health organisation services 
  4. Hub of Hope directory of local community services

Pseudoscientific and non-evidence-based information

It is important to state early on in this submodule, that may online resources carry a high risk of misinformation. Health misinformation can be particularly common on social media platforms, including X, Tik Tok and Facebook. Other websites such as YouTube and general health blogs, also carry high risks of misinformation. It is important that healthcare professionals are patients alike make use of medically accurate resources from the NHS and appropriate health organisations and charities.

Mental Health First Aid

We are all familiar with First Aid. However, this has largely focussed on physical first aid to date.  If someone cuts their finger or breaks their arm, we all know how to initially help with these physical injuries. But, there is increasing awareness of the need for Mental Health First Aid, to initially support individuals who may be suffering from a mental health crisis (panic attack, suicidal thoughts), or developing a mental health problem (10). The aim of MHFA is to raise awareness of symptoms (and not to diagnose), to provide initial support, and then to guide individuals towards professional support.

Does your department, practice or team have a qualified Mental Health First Aider? If not, a first step should be for one of your team to participate in the Mental Health First Aider training programme: Mental Health First Aid (MHFA) England's Instructor Training programme 

This will ensure that your team includes at least one member who is trained to spot, support and signpost individuals to the help they need.

Practical toolkits

For improving communication skills, Movember also provide resources on ALEC: Ask, Listen, Encourage Action and Check In, including conversation practice. 

Mental Health UK provide conversation infographics for talking to someone about mental health, and for talking to someone about suicide.

Organisations

Key General Mental Health Organisations and Charities:

There are several Mental Health Organisations and Charities that provide general resources and support, but are not specifically focussed on males:

For general mental health:

Specific mental health disorders:

Men’s Mental Health Organisations and Charities

The above organisations are not male-specific. However, there are several mental health organisations that focus specifically on men’s mental health and male suicide:

This is not an exhaustive list, and there will be many other mental health resources tailored for men, particularly regional organisations (e.g. Man Health for Northeast England). These can be found using the Hub of Hope directory.

Education and Resources

Whilst many of the organisations above provide quick facts or snippets of detail about conditions, some provide detailed educational materials that can be useful for both patients and healthcare professionals. Below, we provide men’s mental health training programmes, online education hubs, risk checkers, and support lines.

For healthcare professionals
Academic/clinical resources

For academic or clinical summaries on mental health conditions, you can try:

Royal College of General Practitioners (RCGP) Mental Health toolkit: A toolkit of national and international guidelines, non-guidelines resources for practitioners, and patient/carer information. It is intended for use by any primary care professional or general practice in the UK.

NICE Clinical Knowledge Summaries on mental health:  For use by NHS clinicians for patients only.

BMJ Best Practice on Psychiatry: For healthcare professionals to stay up to date on the latest medical research and guidelines, to support healthcare professionals in making informed decisions. Requires institutional access (e.g. NHS employment) or an individual subscription.

WHO International Classification of Diseases (ICD) ICD-11, Mental, behavioural or neurodevelopmental disorders: a common language on health conditions for healthcare professionals.

Nature Reviews Disease Primers, Psychology: Academic papers published by Nature, and written by world-leading experts for a range of mental health conditions. However, note that some reviews were published 5-10 years ago.

MIND have also produced a detailed visual report on men’s mental health.

Training courses for healthcare professionals

Whilst these materials can be very helpful in increasing awareness and knowledge, we know how busy clinical practice can be. Without time set aside to read materials, the above source may be underused. Therefore, it can often be more beneficial for teams to have formal training. Several organisations offer in-person or online training sessions for teams:

The NHS also provides MindEd Hub, a learning and education elearning tool which provides quick access for health and education professionals learning, with a number of training courses.

BMJ Learning: Continuing medical education for mental health for healthcare professionals, and collect Continuing Professional Development (CPD) points. BMJ Learning courses on mental health conditions can be found here, and include courses such as clinical pointers on recognising a range of mental health conditions.

Maudsley Learning: part of South London and Maudsley NHS Foundation Trust (SLaM). Training courses for a range of healthcare sectors, delivered in a range of formats, such as short courses, simulations, virtual reality and elearning. Courses include Mental Health Training for Nurses and Mental Health Training for Primary Care.

Mental Health First Aid (MHFA): for face to face and online training courses in Mental Health First Aid. A qualified Mental Health First Aider involves a two-day course.

Beat Eating disorders training courses: for healthcare professionals. Courses are tailored to professions, including clinicians, medical students, dietitians and nurses.

FREED resources for eating disorders, developed by academics and healthcare professionals at Kings College London and SLaM. Free for NHS staff.

Men’s Minds Matter, Suicide Prevention Training Courses: aimed at psychological practitioners.

There are other training courses not specifically aimed for healthcare professionals, but may be beneficial:

MIND: Mental health training: in-person or virtual group sessions, and eLearning: courses can be provided on an organisational basis.

Mental Health UK provide a range of training and consulting options, Men Who Talk provide corporate workshops, and CALM Mental Health Champion: a one-hour online course to provide basic skills (it is not a professional qualification).

Assessment tools

The BMJ provides a list of calculators, assessment tools and screeners for a number of mental health conditions. Key tools include:

For NHS staff, NHS check my wellbeing can be used to for self-assessment with direct link to mental health support resources. NHS practitioner health can be used to get free and confidential NHS primary care mental health treatment for healthcare professionals.

For patients
Patient-friendly educational materials

A key aspect of health literacy is acknowledging the varying needs of patients to understand health information. To educate patients on mental health conditions, a number of organisations provide useful resources.

First, the NHS provides a range of Mental Health resources, including patient-friendly written materials on mental health conditions, understanding feelings, symptoms and behaviours that can affect mental health, how to perform self-help support, and understanding the Mental Health Act. There are also NHS Self-help guides for a range of conditions, written by NHS Clinical Psychologists. These are in multiple formats, including leaflets, easy read format, and audio.

The BMJ provides a range of patient-friendly materials, including for mental health conditions. These are easy to read summaries that can be used as part of shared decision making. Several guides for conditions such as depression and anxiety include materials that help patients understand which treatments work, as well as providing some questions that a patient may wish to ask their doctor. 

Mental Health UK have patient-friendly written materials for a range of mental disorders, including their definitions, symptoms, diagnosis, types, causes, treatments, useful links and FAQs for each disorder. They also have a dedicated page for men’s mental health, with facts and resources.

Mental Health Foundation also has patient-friendly written materials for a range of mental health disorders, also with definitions, symptoms, types, causes, and treatments including self-help resources, for each disorder.  

Beat Eating disorders provide detailed materials on eating disorders. The information is in written format, and is more detailed than the above resources.

Rethink Mental Illness have simplified information on Mental Health Laws, and information on a range of mental health conditions. Written in simple language, the resources provide a brief overview of each condition, and cover what they are about, causes, symptoms, treatments, self-care and management, risks, useful contacts, resources and information for carers, family and friends.

Movember provide a useful FAQ overview of how males can access therapy, as well as a video series on what therapy is. This can be useful to break down stereotypes around talking therapy, and to ensure they obtain therapy from an accredited provider, if choosing private therapy.

Physical patient resources for visual learners

Particularly for mental health, which can be a difficult topic to discuss for many individuals, appropriate communication is particularly important for health literacy. The above patient resources are generally text heavy, and may not suit individuals with a more visual learning style. You may wish to have printed materials available in your waiting room or posters in the ward, which can also help to support awareness and discussions. The following organisations provide printable, patient friendly resources:

MIND have a range of printed mental health resources for organisations, including booklets on mental health conditions, and quick tips leaflets on topics including stress, relaxation and sleep.

Men’s Minds Matter provide a booklet titled ‘How to help a friend: Suicide Prevention’.

Rethink Mental Illness provide printable versions of the webpages for each condition, which can be downloaded from the top of the page for each condition. They also provide and easy read factsheet: ‘Worried about your mental health’. 

Mental Health Foundation have a useful booklet on their best mental health tips, including around healthy eating, sleep and exercise. It does not provide information on specific mental health conditions. They also have a number of easy-read articles on looking after your mental health by sleeping better, exercising, mindfulness, and how to reduce and manage stress, which can all be downloaded as pdf documents. 

BEAT have a range of downloadable leaflets on eating disorders, including guides for speaking with GPs, self-help techniques and leaflets for helping someone else with an eating disorder.

C.A.L.L. have a vast number of leaflets available for delivery for free, to residences in Wales.

Services for patients

Of course, what patients often require, particularly for males who frequently underuse mental health treatments, is awareness of the services available to them through health organisations, charities and the NHS, both online and in the community.

Quick access numbers for obtain immediate help and support:

A number of the charities and organisations outlined above offer quick or even immediate access to mental health support. We have provided their contact details and services below.

For individuals in an emergency or needing urgent help, contact the NHS: 

  1. Call 999
  2. Go to A and E if you or someone else is in danger.
  3. Call 111 for urgent help with mental health, select option 2 to access mental health support with 24/7 access.

Make use of Find a Helpline. Enter your country (UK, or England, Wales, Scotland or Northern Ireland) and condition/topic for quick access to a list of leading helplines, including text, call or online chat options. 

CALM has a comprehensive directory of organisations that provide mental health services, with contact details, including instant helplines, suicide, and specific mental health conditions

More broadly, the Helplines Partnership provides a directory of helplines for many conditions (Find A Helpline directory), which can be filtered for mental health helplines, and filtered by region of the UK. 

Other key organisations and their quick access helplines/chat centres are detailed below:

Samaritans:
  1. 116 123some text
    1. Freephone 24/7
  2. Email: jo@samaritans.org 
  3. Online web chat
MIND: 
  1. Support line: 0300 102 1234some text
    1. A safe space to talk about your own mental health; not a crisis service
  2. Info line: 0300 123 3393, or email info@mind.org.uk some text
    1. Ask about mental health, where to get help and treatment options
  3. Both open from 9am to 6pm, Monday to Friday (except bank holidays), charged at local rates.
CALM:
  1. Freephone: 0800 58 58 58some text
    1. For support for suicidal thoughts or suicide
    2. Open 5pm - midnight every day, confidential and anonymous.
  2. Alternatively, use their webchat or Whatsapp. 
  3. Offload your thoughts: a simple page allowing users to instantly write their thoughts. The writing is not read, accessed or stored by anyone, and is only visible to the user.
C.A.L.L (Wales only); mental health helpline for Wales:
  1. 0800 132 737 some text
  2. Freephone, 24/7
  3. Or email call@helpline.wales 
SANEline:
  1. 0300 304 7000
  2. Specialist emotional support, available 4-10pm every day of the year.
Shout: 
  1. Text SHOUT to 85258 some text
  2. For contact by text and not phone, 24/7 and free
MIND: 
  1. Side By Side: online community of peer support, available 24/7. 
Beat Eating Disorders:
  1. Phone:some text
    1. England: 0808 801 0677 
    2. Wales: 0808 801 0432
    3. Scotland: 0808 801 0433
    4. Northern Ireland: 0808 801 0434some text
      1. Open 3-8pm, Monday to Friday.
  2. Webchat
  3. Email:some text
    1. England: help@beateatingdisorders.org.uk 
    2. Wales: Waleshelp@beateatingdisorders.org.uk
    3. Scotland: Scotlandhelp@beateatingdisorders.org.uk
    4. Northern Ireland: NIhelp@beateatingdisorders.org.uk
National Gambling Helpline: 
  1. 0808 8020 133some text
  2. Freephone, 24/7.
  1. Webchat
National Suicide Prevention Helpline:
  1. 0800 689 5652some text
  2. Open every day from 6pm to midnight.

NHS Mental Health Services

As highlighted throughout these modules, men generally do not get help or receive treatment for their mental health conditions. 

One of the core services provided by the NHS for mental health is the NHS Talking Therapies service (previously the Improving Access to Psychological Therapies (IAPT) service). 

NHS Talking Therapies can be used to treat a wide range of mental health conditions, including anxiety, depression, OCD, PTSD, panic disorder and body dysmorphia. Talking Therapies are available to individuals living in England and over 18 years old, and accessible from GP referral, or by self-referral. To self-refer, individuals must be registered with a GP. Link to NHS Talking Therapies self-referral. However, speaking with your GP will allow you access to a wider range of mental health services, and they can help to recommend the right service for your needs. In England, you also have a right to choose your mental health service provider via the NHS. 

Besides your GP or self-referral, other options to access support include:

  • Through work: for occupational health services
  • Through college/University

Local/Community-based services and activities

There are many ways that we can support males suffering with poor mental health. Some men may instead prefer to seek out support in the local area, or prefer to speak with men who have similar experiences. Below are a range of resources to find and join local mental health services.

The NHS has a link to find local mental health services. 

The Hub of Hope is an excellent resource for finding a range of community-based services. The Hub of Hope is promoted by the NHS and Movember. Based on your postcode and mental health concern/topic, The Hub of Hope lists the most relevant and local support services in your area. You can also filter by service types.

Several men’s charities and health organisations also run support group sessions:

Men Who Talk: 
  1. Online talking groups for men (not therapy or counselling)
Andy’s Man Club:
  1. Free in-person nationwide support groups, every Monday from 7pm. 
MANUP?: 
  1. Therapy Sessions
  • Free, held every two weeks via Zoom.

Other community support groups are available that are open to all individuals:

Rethink Mental Illness:
  1. In-person local Community Support Services
  2. Free Online community support (Clic) 
  3. In-person local Peer Support Group
Alcoholics Anonymous:
  1. In-person local support meeting
Narcotics Anonymous:
  1. Online and in-person meetings 
NHS
  1. Local alcohol addiction services via the NHS
Gamble Aware:
  1. In-person local Gambling Support

Movember have several local community-based projects for men to get involved with.

Mental health promoting activities

There are several behaviours that we can perform on a daily basis to benefit our mental wellbeing. However as mentioned earlier, many profiles, including those with academic or clinical credentials, may claim that mental health promoting activities such as good sleep and exercise can do far more than the evidence suggests (e.g. treating or ‘healing’ a number of mental health conditions). Whilst these activities are indeed beneficial, their value should not be over-hyped, such that highly effective treatments are dismissed. 

There are several NHS resources, and other mental health charity resources that provide practical tips and advice on mental health promoting activities.

The NHS Every Mind Matters website and NHS Live Well website are particularly useful for patient-friendly, evidence-based resources for a healthy lifestyle, such as tips for mental wellbeing.

The NHS also lists five steps to mental wellbeing (and echoed by MIND):

  1. Connect with other people
  2. Be physically active
  3. Learn new skills
  4. Give to others
  5. Mindfulness

Both the NHS and MIND guides provide a number of ideas and examples on how to connect with other people, learn new skills and give to others to improve mental wellbeing.

Below outlines educational resources, useful apps, and community-based ideas for health behaviours and mental health.

Mindfulness

Read the NHS guide on mindfulness, and make use of the NHS Meditation for Beginners guide. Apps to help with mindfulness include HeadSpace and Unmind, which can both be accessed for free by NHS staff.

Sleep

Read the NHS guide on sleep quality for mental health, or the MIND guide on sleep and mental health. Apps which can help with sleep include Sleepio, which is free on the NHS. The NHS also have a bedtime meditation video.

Diet

For advice on a healthy, balanced diet, first take a look at the NHS guidance, the Eatwell Guide. There is also an NHS guide providing eight Healthy Eating Tips. For meal ideas, look at NHS recipes. Mind also have a guide on a healthy diet for mental health. There is much talk in the media about gut health, and links with mental health. For evidence-based insights, read the NHS guidance on diet for gut health. Apps to help with eating a healthy diet include the free NHS Food Scanner App.

For local community activities, try joining local cooking classes, or hosting healthy dinner parties with family and friends, to connect and try new recipes.

Physical activity and exercise

For advice on being physically active, take a look at the NHS physical activity recommendations, or for a simplified guide, the UK government has a visual infographic on physical activity recommendations. The NHS also has a full set of exercise and activity ideas, and a resource covering exercise for wellbeing.  

MIND have a whole section dedicated to helping get more physically active, and overcoming barriers to be active. 

There are plenty of ways to be more physically active in the local area or even in the home.

The NHS have plenty of exercise videos if you are unable to leave the house, and We Are Undefeatable list a number of free ways to be active. There are also plenty of outdoor gyms that can be used for free, and can be found via The Great Outdoor Gym Company’s map (TGO). Local councils also offer free gym and/or swim passes on select days of the week. MIND have a list of active challenges that could be joined. Also have a look at local sports clubs in the area. Apps to help with being more physically active include the NHS Couch to 5K, NHS Active 10 and the TGO app to find free outdoor gyms.

Smoking

For smoking advice, take a look at the NHS guidance on smoking and benefits to mental health. For help with stopping smoking, take a look at the NHS stop smoking services, or join the Stoptober campaign. Apps to help with smoking include the NHS Quit Smoking app.

Alcohol

For alcohol advice, take a look at the NHS guidance on alcohol, and tips for cutting down on alcohol intake. Pubs and drinking are an important part of many individual’s social lives. Therefore, when out with friends at a bar or restaurant, consider having an alcohol-free drink, or non-alcoholic beers, wines or spirits.

Key dates for the diary:

There are also some key dates which you may want to consider using as days to promote men’s mental health in your department, with posters, education or social media posts:

Research

There is still so much more we need to understand about mental health conditions in men. Help us to understand more, by raising awareness of ongoing clinical trials at your hospital, health centre or organisation:

Perhaps one of these trials may be of interest to you to participate in, if they are recruiting.

Summary

This submodule equips you with a range of resources and tools to identify and raise awareness of men’s mental health conditions, including accessible training and educational materials for all abilities, how to support patients through immediate support services, long-term treatment pathways and self-help community activities.

Other:

Mental Health Act 1983:

References

1. NHS England. Health literacy how to guide [Internet]. 2020 [cited 2024 Sep 30]. Available from: https://library.nhs.uk/wp-content/uploads/sites/4/2020/08/Health-literacy-how-to-guide.pdf

2. NHS England. Enabling people to make informed health decisions. [cited 2024 Sep 30]. Enabling people to make informed health decisions. Available from: https://www.england.nhs.uk/personalisedcare/health-literacy/

3. Simpson RM, Knowles E, O’Cathain A. Health literacy levels of British adults: a cross-sectional survey using two domains of the Health Literacy Questionnaire (HLQ). BMC Public Health. 2020 Nov 30;20(1):1819. 

4. Christy SM, Gwede CK, Sutton SK, Chavarria E, Davis SN, Abdulla R, et al. Health Literacy among Medically Underserved: The Role of Demographic Factors, Social Influence, and Religious Beliefs. J Health Commun. 2017 Nov;22(11):923–31. 

5. van der Heide I, Rademakers J, Schipper M, Droomers M, Sørensen K, Uiters E. Health literacy of Dutch adults: a cross sectional survey. BMC Public Health. 2013 Feb 27;13(1):179. 

6. Coughlin SS, Vernon M, Hatzigeorgiou C, George V. Health Literacy, Social Determinants of Health, and Disease Prevention and Control. J Environ Health Sci. 2020;6(1):3061. 

7. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011 Jul 19;155(2):97–107. 

8. Shahid R, Shoker M, Chu LM, Frehlick R, Ward H, Pahwa P. Impact of low health literacy on patients’ health outcomes: a multicenter cohort study. BMC Health Services Research. 2022 Sep 12;22(1):1148. 

9. Aljassim N, Ostini R. Health literacy in rural and urban populations: A systematic review. Patient Educ Couns. 2020 Oct;103(10):2142–54. 

10. Keil K. Mental health first aid. Can Vet J. 2019 Dec;60(12):1289–90.

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