Men’s Health Peer Education
HEALTH MANAGEMENT
Mental health and mental illness (Tab 26)
Mental health and mental illness: put
your mind At-Ease
Contents
Learning outcomes...................................................................................................... 2
Acknowledgments....................................................................................................... 3
Introduction ................................................................................................................ 4
Depression .................................................................................................................. 6
Anxiety ........................................................................................................................ 9
Talking with someone who may have a mental health problem ............................. 11
Further information .................................................................................................. 13
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Mental health and mental illness: put
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Learning outcomes
On completion of this module, and with further directed activities, MHPE
volunteers should be able to:
 differentiate mental health and mental illness
 state four examples of ways to maintain good mental health
 describe four main symptoms of depression
 list three self-help strategies that may be useful for depression
 describe simply the difference between normal anxiety and an anxiety disorder
 list two self-help strategies that may be useful for anxiety disorders
 suggest three useful sources of information for a veteran experiencing mental
health problems.
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Acknowledgments
Information in this section has been obtained from the following sources:

Beyondblue, the National Depression Initiative, website 2015
Beyondblue website (www.beyondblue.org.au)

Beyondblue: A Guide to What Works for Depression (2013)
Beyondblue website
(http://resources.beyondblue.org.au/prism/file?token=BL/0556)

Beyondblue: A Guide to What Works for Anxiety Disorders (2013)
Beyondblue website
(http://resources.beyondblue.org.au/prism/file?token=BL/0762)

Department of Veterans’ Affairs, At-Ease website 2015
At-Ease website (www.at-ease.dva.gov.au)

Veterans and Veterans Families Counselling Service (VVCS), services website
2015
VVCS website (www.vvcs.gov.au)

Mental Health First Aid guidelines 2009-15
MHFA website (https://mhfa.com.au/resources/mental-health-first-aidguidelines)
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Introduction
Staying mentally and physically healthy helps men deal with life’s inevitable
challenges, big and small, now and in the future. We know that men who eat well,
exercise regularly, get enough sleep, don’t smoke and don’t overdo alcohol and
other drugs have the best chance of staying well. This is true for mind as well as
body.
Our mental health is as important to our wellbeing as our physical
health.
Maintaining good mental health
The most important thing for many men is to not try to deal with everything
themselves. This might seem obvious, but many blokes have got through life with a
philosophy of ‘if you want something done, do it yourself’. Military training
emphasised the need to be self-reliant and to ‘harden up’ to get through tough
times. When it comes to mental health, the evidence tells us that men who stay
connected to other people, and talk about problems, do best.
Tips for good mental health

Spend quality time with friends and family.

Have fun: find at least one pleasurable thing to do each day, and have a good
laugh sometimes.

Exercise and nourish your mind (as well as your body); try crosswords, Sudoku
or debating your mates about current affairs.

Maintain interests and hobbies (or find new ones); this might also result in
more social contacts.

Connect with your community; your local council, church, club, ex-service
organisation, men’s shed, group Facebook pages or neighbourhood centre will
be sources of ideas for participation or volunteering.

Don’t avoid difficult situations; they can teach you new coping skills. Occasional
episodes of increased stress are part of the challenge of life. Persistent stress,
however, can have negative health effects that are best addressed early.

Accept that it’s normal to react emotionally to difficulties—don’t be too hard
on yourself if you struggle sometimes. Talk to someone about how you are
feeling, use a 24 hour help line such as VVCS or Lifeline, or try an online
resource like At-Ease, Hi Res or VVCS.
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Mental health problems and mental illness
Life is full of ups and downs. The experiences men have in dealing with challenges
are what help them build resilience, that capacity to face the next problem. In
other words, tough times can be good for our long-term mental health.
All of us have periods where things get us down, or cause more worry. Sometimes
this is due to an event or relationship, and in other instances there may seem to be
no apparent reason. These are the times when we can start to experience some
symptoms or signs that concern us, or those around us. The term mental health
problem may be used when these signs and symptoms increase or become more
obvious and are of concern.
A mental illness (or mental disorder) occurs when there are sufficient physical,
emotional, thinking or behavioural signs and symptoms that a doctor can diagnose
(identify and name) the problem. The most common mental illnesses in Australian
men are anxiety disorders, substance use disorders and depression.
Mental illness is the largest cause of disability in Australia.
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Depression
Feeling down?
Most of us feel unhappy if we are disappointed, argue with a friend or are
frustrated at work. Sickness or the death of someone close can cause immense
grief and sadness. Sometimes we feel down for no apparent reason. These are
normal emotional reactions that tend to last a limited time.
What if I feel sad all the time?
Prolonged feelings of sadness, low energy and hopelessness could be a sign of a
mental illness such as depression. Depression gets in the way of doing everyday
activities effectively. If these feelings are preventing you from going about your
normal routine, it’s time to talk to someone.
Depression and the veteran community
Depression affects many veterans and their families, just like the general
community. Some studies have shown that the additional stress of active service,
multiple deployments and exposure to trauma can increase the risk of depression
and some other mental illnesses.
At least one in eight Australian men will experience depression at some
stage in their life. Anyone can develop depression.
Signs and symptoms of depression
When people are depressed they may experience some of the following:

little interest or pleasure in usual activities

feeling sad or irritable most of the time

tiredness and lack of energy

feeling guilty or worthless

difficulty concentrating

trouble falling asleep, waking too early or sleeping too much

worrying and negative thinking

thinking about death a lot

loss of or excessive interest in food

increased use of alcohol or other drugs.
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If you have been experiencing a number of these feelings for more than two weeks,
or are concerned about a mate who has, then you or he should talk to a GP, the
Veterans and Veterans Families Counselling Service (VVCS) or a helpline.
What help is available for people with depression?
The most successful treatments for mild depression involve talking to a skilled
counsellor, such as a psychologist. VVCS or a GP are the best place to start for most
veterans. Practical talking therapies, such as cognitive behaviour therapy and
mindfulness, are very helpful for many. Your GP also might prescribe
antidepressant medication, especially if the depression is moderate to severe.
Depression is an illness and can be treated. Like any illness, depression
responds best to early professional help and the right treatment for
that person.
The veteran himself, his family and mates can also make a difference in his
recovery. Other things that evidence suggests can help include:

learning as much as possible about depression

exercise—go for a walk with your mate, play golf or take him to the gym for a
workout

reading and applying strategies from good self-help books, websites or apps.
VVCS or a mental health professional can recommend which ones. At-Ease is a
good place to start

getting out in the sunlight, even better if it is while exercising with a mate

group programs and other services provided by VVCS.
Things that don’t help include: Ignoring depression and hoping it will go away;
using more alcohol or other drugs; or telling someone (or being told) to ‘pull your
socks up’, ‘get over it’ or ‘toughen up’.
Perhaps most importantly, learn about the illness, talk about it, and resist the urge
to avoid your mate with depression, even though he mightn’t be the best company
at the moment. Depression can leave a person very isolated: he may withdraw
from company, and friends, workmates and family often lose touch. His ‘self-talk’ is
likely to be that he just brings everyone down, and so they are better off away from
him.
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Depression is a primary risk factor for suicide. Men have much higher rates of
suicide than women at all ages. If you are concerned about a mate who you think
may be suicidal (or if you have suicidal thoughts), don’t ignore those worries. Ask
him directly if he is suicidal, stay with him if you feel safe to do so, and promptly
seek professional help. Call 000, VVCS 1800 011 046, Lifeline 13 11 14, his GP or
psychologist, or take him to hospital.
VVCS offers Operation Life workshops focusing on suicide prevention. The
Operation Life Online website will help you to understand the warning signs of
suicide and provide information and resources to help keep you and others safe
from suicide. The site also offers help for those bereaved by suicide.
See Resources for information.
Most people with depression get better, and many never get the illness
again. Never give up on depression!
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Anxiety
Feeling anxious?
It’s normal and healthy to feel anxious when facing threatening situations. Anxiety
prepares you for action (‘fight or flight’), and a bit of anxiety can improve
performance. Relationship problems, serious illness, accidents or the death of
someone close also cause anxiety, but these anxious feelings tend to diminish over
time. Anxiety in everyday life is so common that the potential signs of an anxiety
problem can be missed.
How can I tell if the anxiety is a problem?
A man with an anxiety disorder may have the same indicators of normal anxiety
(see below), but these are likely to be more severe and longer lasting. If his level of
anxiety interferes with his ability to cope with daily life, undertake normal work, or
with relationships, he should talk to his GP, VVCS or a mental health professional.
If you experience an anxiety disorder, you are not alone. More than
one in ten Australian men experiences an anxiety disorder in any year.
Anxiety disorders are the most common mental illness, yet most
Australian men with an anxiety disorder do not seek professional
help.
Anxiety disorders and the veteran community
Anxiety affects many veterans and their family members, just as it does the general
community. Exposure to trauma, in particular, can lead to posttraumatic stress
disorder (PTSD) depression, anxiety disorders, as well as other mental illnesses.
Many veterans learnt to be ‘on alert’ during military service; not all were able to
leave that vigilance behind.
Signs and symptoms of anxiety disorders
People with anxiety problems may experience:

physical indications, such as: pounding and rapid heartbeat, breathlessness,
dizziness, sweating, tingling, dry mouth, nausea, shaking and muscle aches

psychological symptoms, such as: excessive fear and worry, racing thoughts,
reduced concentration, irritability or anger, edginess, sleep problems or vivid
dreams

behaviour changes, such as: avoidance of situations, distress in social settings,
or increased use of alcohol or other drugs.
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These signs and symptoms can be similar to normal anxiety, but tend to be more
severe, longer lasting and interfere with usual activities. There are many different
anxiety disorders, including PTSD, social anxiety disorder, agoraphobia, generalised
anxiety disorder, panic disorder and obsessive-compulsive disorder. Only an
appropriately trained health professional can diagnose an anxiety disorder.
What helps for anxiety disorders?
The most successful treatments for anxiety disorders involve talking to a skilled
counsellor, such as a psychologist, who then works with the veteran to tailor a
specific plan for recovery. Commonly used treatments are cognitive behaviour
therapies and exposure (or behaviour) therapy, which helps the person to change
his anxious thinking and associated behaviours. VVCS or a GP is the best place to
start for most veterans. The GP or a psychiatrist might prescribe medication if
required. The earlier diagnosis and treatment occur, the better.
The veteran himself, his family and mates can also make a difference in his
recovery. Other things that evidence has proven helpful include:

education to help better understand the causes, effects and available
treatments

learning a relaxation technique

reading and applying strategies from good self-help books, apps and websites.
VVCS or a mental health professional can recommend which ones. At-Ease is a
good place to start

group programs and other services provided by VVCS.
Things that don’t help include ignoring anxiety problems and hoping they will go
away, using more alcohol or other drugs, or avoiding the things that bring on the
anxiety. Avoidance will alleviate the symptoms, but will not aid recovery.
The potential for recovery from anxiety disorders is substantial. The starting
point is to recognise there is a problem, and then decide to do something about
it. The support of a mate can make all the difference.
The MHPE health promotion message is great for all blokes who may
be struggling at an emotional or psychological level. Choose a healthy
diet, get regular exercise, stop smoking, limit use of alcohol and other
drugs, sleep soundly and stay connected to mates, family and health
professionals.
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Talking with someone who may have a mental health
problem
The most important message is that it usually helps to talk about mental health
issues. A man with depression or anxiety may not feel like talking for a variety of
reasons, including:

he has rarely talked about thinking and feeling issues

he has problems putting his concerns and feelings into words

he feels like a failure for not managing to cope

being worried that he may be judged or negatively affected in some way

being worried that you may laugh at him or tell others.
While these reasons may seem irrational, depression and anxiety can lead to
unrealistic thoughts and difficulty in reasoning.
Mental health first aid
Mental health first aid teaches people to help in a mental health crisis
or in a developing problem. It emphasises five actions by the helper:
 Approach the person, assess and assist in any crisis
 Listen non-judgmentally
 Give support and information
 Encourage appropriate professional help
 Encourage other supports.
www.mhfa.com.au
If you want to talk to a mate, choose a time and place that you won’t be
interrupted. ‘What about a game of golf?’ Prepare for the discussion by getting any
information that you need (e.g. At-Ease brochures). Let him know that you are
concerned about his mental health, you are comfortable talking about whatever he
wants to talk about, and that you respect his privacy and confidentiality. If he
doesn’t want to talk, be clear that you are willing to listen whenever he wishes.
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During the conversation you should be listening non-judgmentally; in other words,
do your best to avoid letting your thoughts and opinions get in the way. Simple,
open-ended questions, such as ‘What can I do that would help?’ and ‘What has
helped in the past?’ are great.
Offer your mate support, and provide him with information. The latter is usually
better than advice, as given the right information he can often make a decision
about what to do next. Acknowledge what you don’t know and help him to find
out, rather than guessing, e.g. ‘Do you think starting my tablets again would help?’;
‘I’m not sure, mate. How about you ask your GP?’
Encourage him to seek professional help, and present him with some (acceptable)
options, e.g. ‘My GP is great. Would you prefer to see him? VVCS have been really
good for my mate Brian.’ If he is not ready to speak to a professional, ask him what
else he would find helpful. Discuss involving family, friends or workmates as
appropriate. Look to other sources of support and information, such as help lines,
Beyondblue and the At-Ease website.
Most importantly, remind him that there are always options, and you are willing to
help find the right one for him. Don’t make promises you can’t (or won’t) keep, but
let him know you are willing to talk and listen in his own time, location and way.
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Further information
Lifeline
For immediate counselling assistance, contact 13 11 14
Veterans and Veterans Families Counselling Service (VVCS)
Individual, couple and family counselling and the 24-hour Veterans Line
1800 011 046
VVCS also provides Operation Life workshops across Australia, depending on
demand. The workshops focus on suicide prevention. More information about the
Operation Life Suicide Prevention workshops can be found on the VVCS website
(www.vvcs.gov.au).
Operation Life Online
Operation Life Online is a website to raise awareness about—and help prevent—
suicide in the veteran community. Along with useful contacts and resources, the
site offers learning tools, case study videos, a mobile app and a comprehensive
quiz.
Operation Life Online website (www.at-ease.dva.gov.au/suicideprevention)
At-Ease
A DVA website about mental health and wellbeing, with relevant, extensive
resources and information for veterans and professionals.
At-East website (www.at-ease.dva.gov.au)
High Res
A website to assist serving and ex-serving ADF personnel, and their families,
manage day-to-day stressors, build resilience and learn about the SMART (selfmanagement and resilience training) approach. The website features self-help tools
and a goal setting plan to help build resilience. It provides case studies to help
users learn how the tools can be useful for their particular circumstances.
High Res website (www.at-ease.dva.gov.au/highres)
Beyondblue
Funded by Australian and state governments, beyondblue has an extensive range
of information and resources, and supports many practical initiatives regarding
depression, anxiety and related disorders. Information line 1300 22 4636
Beyondblue website (www.beyondblue.org.au)
Mental Health First Aid
Evidence-based information and education to guide members of the general public
in helping a person with a mental health problem.
MHFA website (www.mhfa.com.au)
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Clinical Research Unit for Anxiety and Depression
An online education, research and treatment site from the University of NSW
focusing on anxiety and depression.
CRUFAD website (www.crufad.com)
Phoenix Australia: Centre for Posttraumatic Mental Health
Undertakes trauma-related research, policy advice, service development and
education.
Phoenix Australia website (www.phoenixaustralia.org)
Apps
There are many apps relating to mental health problems and mental wellness
available for tablets and smartphones. Some have little evidence of mental health
professional involvement and/or a sound testing and evidence base underpinning
their development. That is not to say they aren’t useful, but they are not a
replacement for professional treatment in most cases. MHPE suggests you
download any of interest and discuss their use with your doctor or mental health
professional to ascertain their appropriateness for your issues of concern.
Two apps that can be recommended are:
High Res (High Resilience)
Helps you manage stress, build resilience and optimise performance on the go.
PTSD Coach Australia
Can help you learn about and manage symptoms that commonly occur after
trauma.
Operation Life
Designed to help those at risk deal with suicidal thoughts and is recommended to
be used with the support of a clinician. The app complements the Operation Life
Online website (http://at-ease.dva.gov.au/suicideprevention/).
All are free at Apple store or Google play (for Android), or access via the DVA AtEase website.
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