2.1 Eligibility criteria

The eligibility criteria were related to the review’s objective and questions. The specific question of the scoping review should be explained in the protocol and clearly linked to the objective of the review. We used JBI’s population, concept and context (PCC) framework [25]. The selection criteria for analysis were as follows: (a) population: only male adult participants, aged 18 or older; (b) concept: an intervention or program for men’s mental health (e.g., randomized-controlled trial (RCT), pre-post, quasi-experimental and qualitative study to identify men’s mental health coping strategies); and (c) context: a recent men’s mental health intervention related to masculinity (research articles published in academic journals from January 2018 to June 2023). Using the PCC framework, our research question in this study was as follows: “How are the current status of men’s mental health and tailored interventions to help them related to masculinity?”.

2.2 Search strategy and information sources

A search strategy was drafted for one or more electronic databases, including planned limits, such that it could be repeated. All intended sources of information, such as electronic databases, contacts with study authors, or other gray literature sources were described [25].

We searched for studies dealing with men’s mental health and interventions tailored to masculinity among research articles published in academic journals from January 2018 to June 2023. PubMed, CINAHL, SCOPUS and Web of Science were searched for published articles using the following keywords: (Men OR Masculinity OR Male OR Gender) AND (Help-seeking OR Engagement OR Service use) AND (Mental health OR Depression) AND (Culture). The following search terms were used: English language, full-text available, published between January 2018 to June 2023, and male participants. An additional manual search was performed on PubMed.

In total, 1916 articles were retrieved from the across databases. PubMed yielded 939 articles, CINAHL yielded 37 articles, Scopus yielded 638 articles, and Web of Science yielded 302 articles; of these, 214 duplicate articles were excluded. The two authors reviewed the titles and abstracts of the remaining 1702 articles. After excluding 1671 articles that did not meet the selection criteria, 31 articles remained. The full-text versions of these 31 articles were obtained and individually reviewed by the two authors, and the references of each study were also individually reviewed to determine the final sample of selected studies. Finally, 12 studies were included in the analysis. The detailed search process for data collection, selection and extraction was conducted following the PRISMA 2020 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020) flow diagram (Fig. 1).

Fig. 1.Data collection, selection and extraction processes.

2.3 Data extraction

Extraction of evidence was conducted to present the findings of the scoping review clearly and comprehensibly [25]. Each author in this study extracted data using a data extraction sheet that presented conceptual categories such as authors, publication year, research country, study design, sample (population) and intervention or strategies [25]. For data extracting, the two authors engaged in discussions and cross-checking.

2.4 Data analysis and presentation

Scoping reviews typically do not involve data synthesis but rather focus on descriptive analysis, often employing basic frequency analysis and percentages as the most common approach [25]. In this study, data were analyzed both quantitatively and qualitatively. In the quantitative analysis, descriptive statistics used the characteristics of the 12 selected studies, including authors, publication year, research country, study design, sample (population), and intervention or strategies. For the qualitative analysis, the research findings were analyzed and categorized in accordance with the research questions (Table 1).

3.1 Characteristics of selected literature

Based on the scoping review, 12 studies were included. Their characteristics are presented in Table 1. First, in terms of the published year, there were five from 2023, three in 2022, one each from 2020 and 2019, and two from 2018. In terms of the origin countries of these studies, four were from the United States, two from Germany, and one each from Australia, the United Kingdom, Denmark, Kenya and South Africa. In terms of research design, RCTs and qualitative research were the most common, and there were two other mixed methods studies. Only adult male participants were considered, and their number ranged from at least 3 to 1193.

3.2 Tailored interventions related to masculinity and men’s mental health

The identified interventions were highly diverse. First, one study provided physical activity as an intervention so that soccer could be played three times a week. The study tested the effectiveness of behavioral interventions using soccer training to reduce the risks associated with HIV and drug use. The experimental group attended soccer three times a week and its effectiveness were evaluated six months later [26]. Two online interventions allowed visitors to navigate the website and alerted them to immediate risks. These studies evaluated the effectiveness of man therapy (MT), a randomly controlled online intervention experiment, in reducing suicidal thoughts and depression in working-age men [16, 29].

Another study provided 14 weeks of cognitive behavior group therapy and used a discourse analysis approach to investigate how traditional masculinity features affect men participating in cognitive-behavioral group therapy [15]. Two studies provided male-tailored psychoeducation for depression, which included information on the gender-specific etiology and role, comparing its outcomes with standard cognitive behavior therapy [27, 30].

Another intervention study featured family-centered behavioral correction and developed a program called intervention, learn, engage, act and dedicate (LEAD) by including motivational interviews based on behavioral activation [31]. A study on social media-based support interventions for young Black men examined 40 out of the 350 young Black men who had completed social media-based mental education programs for mental health promotion, gradual definition of masculinity, and sustainable social support [28]. In addition, one study was on Dynamic Interpersonal Therapy (DIT) [32]. DIT is a time-limited (16 sessions) psychodynamic model based on the editing of evidence-based short-term psychoanalysis or psychodynamic therapy for masculine depression. Here, the male depression scale was used, rather than a general depression instrument [32]. Another study was of mental distress counseling intervention through interviews [8].

One study used documentaries and digital campaigns, and developed a multimedia intervention called “ManUp”. Seventeen men of various ages and backgrounds were interviewed to determine if the multimedia materials aroused interest in the subject matter [21]. Finally, one study used the “multiple hub and spoke” approach and employed 13 key men working in the field of male mental health both inside and outside the UK, to collected data mainly through interviews in the broader geographic and professional community context where they had a network. The study examined “what is effective” in promoting mental health for men [5]. The summarized contents of the interventions featured in the analyzed studies are presented in Table 1.

4.1 Overview of the identified interventions and effectiveness of tailored interventions

The interventions identified in the scoping review varied widely, as presented in the results section. This is similar to previous scoping reviews that highlighted the diversity of approaches used to address men’s mental health [1, 33]. One intervention used physical activities such as soccer [26], four used online interventions [16, 21, 29, 31], six corresponded to therapeutic counseling interventions including interview and cognitive behavior group treatment [8, 15, 27, 30, 31, 32], and one intervention used expert networks [5]. Thus, the majority corresponded to online and therapeutic counseling interventions. These results are similar to those of a scoping review of studies published in English and Russian from 2009 to 2019 [1]. The potential benefits and limitations of each intervention should be discussed to address the unique challenges and difficulties men face in seeking help and exploring masculine norms [5, 8, 11, 15]. As compliance with traditional masculine norms has a problematic impact on men seeking assistance for multiple mental problems [11], customizing and targeting clinical interventions can improve men’s mental health [18, 19, 20]. Therefore, it is necessary to confirm the effectiveness of the interventions applied to improve the mental health outcomes of men. Results of the study that applied soccer to the experimental group thrice a week, reported after six months that it was not effective in addressing various risk behaviors in young people, suggesting that early adulthood may be too late to change established risk-behavior [26]. Therefore, it is evident that the age of the participants must be considered when employing interventions such as sports that involve physical activities, though this needs to be confirmed through further research. However, the results of studies applying various online interventions were helpful in improving men’s mental health [16, 21, 29, 31]. An online intervention designed for men, MT, reduced suicide risk, stigma and depression [16], while encouraging men to seek professional help [29]. Another online intervention called “The Young Black Men, Masculinities and Mental Health” (YBMen, Young Black Men) project provided a multimedia intervention with online social support to reduce depression [31]. To prevent men’s suicide, a multimedia intervention, “ManUp”, was incorporated into an online program to revise and improve website images and messages using feedback from male participants [21]. These online interventions used platforms such as Facebook or Twitter to deliver and advertise [16, 21, 29, 31]. However, careful design of online programs may be necessary, and some of the reviewed studies presented high deviations among men [34]; results on the effectiveness of online programs are also complex [33]. The results of the six studies corresponding to therapeutic counseling interventions, including interviews and cognitive behavior group therapy, are as follows. A study that applied group cognitive behavior therapy found that practicing expressing emotions in group therapy could help break the stigma of masculinity-related mental health, even though men did not expect such practice to help them [15]. Thus, it is necessary to provide men with opportunities to express and share their thoughts or feelings in small groups. The studies on male-tailored psychoeducation for depression provide information on the gender-specific etiology and role to the participants and compared outcomes with standard cognitive behavior therapy.

An intervention called learn, engage, act and dedicate (LEAD) applied motivational interventions to nine fathers who reported problem drinking, based on behavioral activation and was found to be highly accepted and helpful [31]. DIT is an effective counseling intervention for veterans form a military culture and hegemonic masculinity. Gender norms can be changed through training, and interpersonal therapy can relieve rigid gender norms [32]. Another study of men’s experience with mental health support groups identified the social benefits that support groups may have in men who have limited social networks or are experiencing isolation [8]. A support group is an organized group where people come together to share their health issues. The results of this study highlight how men in the group valued the shared understanding of experience and the mutual respect presented by the group environment. Thus, the effectiveness of peer support groups is presented, and corroborates previous findings that support from important people and online peer groups are effective [1].

Additionally, using an expert network, a multi-level project involving interviews, gray literature and survey, could be effective in identifying strategies to instill effective coping mechanisms in men for suicide prevention [5]. These findings show that men can reduce the negative aspects of masculinity by expanding their limited social network through support groups, sharing their experiences and understanding each other.

4.2 Addressing masculinity and gender norms

We then examined how the identified interventions affect masculinity and gender norms. Here, we would like to discuss the harmful aspects of traditional masculinity that these interventions challenge and their positive impact on male mental health within the framework of masculine norms. Theories have been proposed on traditional masculine norms to specify how they affect men’s depression and suicidal thoughts, and lead men to try to hide their emotions to prove their masculinity [13, 15, 16]. A multiple-expert network study to identify strategies for suicide prevention suggests preparing safe spaces in which men feel comfortable, providing male-centered language and activities that allow men to feel valued and engaged, establishing appropriate partnerships and understanding gender and masculinity. In addition, the intervention needs to be direct and purposeful [11].

Online interventions conducted in a gender-responsive manner to help reconstruct healthy definitions of masculinity suggest that online screening can play a role in reducing suicidal thoughts and depression among men, with potential benefits associated with mental health, social support and treatment motivation [16]. The interventions in these studies were as follows. All participants received standard treatment online, including immediate feedback on their personal screening outcomes on the website and recommendations of suicide and mental health resources. After receiving personalized results, participants were guided to browse related websites in a new web browser related to engaging men in psychotherapy, including the use of male-oriented language and metaphors. The main strategies to engage men involved hope, resilience and humor. MT provided male-oriented marketing, free online use, a more visual design, information tailored for men and anonymity [16, 29]. The YBMen project considered masculinity norms, culture and gender in their intervention for young Black men [32]. ManUp, a multimedia campaign website to prevent male suicide and correct masculine identity issues, revised the documentary synopsis with strong direct language and statistics, and used simplified humorous platform banners that considered multicultural diversity and varied sensitivity levels in men [21].

Although online interventions have been shown to be effective in this review, it should be considered that some men at risk of suicide may not prefer online support, at least as much as women do [35]. Men traditionally view asking for help as non-masculine; however, further intervention studies are required to identify the impact of web-based methods on men’s search for help [29]. The study that developed and applied LEAD [8] in relation to customized treatment for men suggested the following: It is about taking an open and evaluative approach toward men, using male counselors with common traits, dealing directly with masculinity norms in treatment, and building strong treatment alliances. It is noteworthy that dealing directly with masculinity in treatment was effective [31]. Relationship therapy can also help some men reframe their identities in relation to their rigid gender norms [32]. Another intervention that examined the effectiveness of support groups by forming a peer group comprising men who had experienced similar psychological distress such as depression, anxiety, loneliness and isolation, allowed participants to develop new roles and regain their masculine identity [8]. Although group therapy provides strategies to counter the stigma associated with mental health problems, therapists should consider that patients with strong masculine norms may have difficulty expressing their feelings in group therapy [15]. Masculine identities shared through support groups allow for expression of emotional vulnerabilities that may still be unacceptable. In addition, being with other men with shared experiences in the support group context facilitates the reconstruction of masculinity in a healthy way [8]. In other words, interventions using support groups can help rebuild masculinity in a healthy way through shared experiences. However, it is most important to give men an opportunity to express their emotions even in group interventions.

4.3 Policy implications and practical applications

Recognizing men’s mental health as a key public health issue is essential, and customized interventions are needed to support men’s welfare. Policymakers should actively implement and support effective interventions to this end, and promote mental health awareness among men.

As this is a scoping review, there may be limitations to the data comparison and the analysis results are not as comprehensively presented as a review that presents research conducted through different methods, samples and analyses. Therefore, it is necessary to discuss what the reviewed studies have in common, how these interventions can reduce the negative aspects of masculinity in seeking help and encourage men’s help-seeking behavior. Studies identified in this review commonly found that the influence of masculinity according to SRT limits health-seeking behavior [13], suppresses emotional exposure, and leads to maladaptive coping strategies such as avoidance.

Based on this review, strategies should be considered to engage men in mental health services, strengthen social support networks, and challenge harmful male norms within the medical discipline and the community at large. In addition, it may be useful to design an intervention that respects diversity by considering the differing characteristics of men and women [33]. However, men are not a homogeneous group and a single approach may not be effective for all men [34]. Future studies must employ innovative approaches such as technology-based or community-based programs.

The results of this scoping review are also linked to the role of masculinity in the psychological help-seeking process. However, future studies require experimental and intervention studies on participants of various cultures and ages to strengthen existing knowledge. Follow up studies on what form of intervention or program can help improve men’s mental health while minimizing the negative aspects of masculinity will be required.

This review has certain limitations. We chose to examine studies from the last five years, as several interventions related to male norms were developed in this period. However, we likely missed out on several older studies that may have provided invaluable information; thus, it is necessary to expand the publication period and include them as a subject of review. In addition, our inclusion of only literature in English and the small sample size of some of the reviewed studies may have skewed our findings.