Background: In Australia, less than half of all men who experience a mental health difficulty access any mental health care from a healthcare professional. Online mental health (eMH) programs have received attention for their potential to provide mental health care to men in a format that avoids or reduces common barriers to care for men as well as aligning with men’s preferences for mental health care (e.g., desire for privacy, self-management). However, little is known about eMH for men, including the efficacy of these programs and factors that may promote their engagement or attrition in this population.
Methods: We carried out systematic searches in six research databases (2000-2020) to identify relevant studies with extractable data from men/males aged 18+ years, and conducted (1) a narrative review and meta-analysis of 7 papers that presented quantitative trial data on the effects of men’s use of eMH; and (2) a meta-synthesis of 8 papers that reported qualitative data on men’s experiences of using and preferences for eMH.
Results: In the meta-analysis, all three randomised controlled trials reported no post-trial difference in men’s depression symptoms between intervention and control participants. All four treatment studies presenting pre-post data reported significant post-intervention improvements in depression or anxiety symptoms; this was supported by our meta-analysis, which found a medium, positive, pre-post effect on depression symptoms. In the meta-synthesis, we generated three findings: (1) Facilitators of men's eMH use included finding apps and technology motivating and convenient, support and encouragement from others, and interventions allowing men to take action and gain control; (2) Barriers to men's eMH use included lack of time, predicted or experienced lack of benefit from use, and technical difficulties; (3) What men want in eMH: personalised, tailored interventions that are easy to use, with information presented in different formats, psychoeducation, exercises, self-monitoring, and the option of clinician involvement.
Conclusion: There is urgent need for the co-design, dissemination, and evaluation of eMH designed to suit the preferences, needs, and circumstances of diverse populations of men.