Article Data

  • Views 950
  • Dowloads 162

Original Research

Open Access Special Issue

Exploring masculinity, experience of distress and help-seeking within a UK male prison

  • Taanvi Ramesh1,*,
  • Michael Mercieca2
  • Helen Valerie Curran1
  • Jarrod Cabourne1,2

1University College London, WC1E 6BT London, UK

2Barnet, Enfield and Haringey NHS Mental Health Trust, NW1 0PE London, UK

DOI: 10.22514/jomh.2023.134 Vol.19,Issue 12,December 2023 pp.87-98

Submitted: 30 July 2023 Accepted: 04 September 2023

Published: 30 December 2023

*Corresponding Author(s): Taanvi Ramesh E-mail:


Men’s prisons are theorised to perpetuate, if not heighten, masculine ideals. Research indicates that prisoners have high rates of mental health difficulties, but treatment uptake is low. This empirical study aimed to understand the prevalence of conformity to masculine norms amongst prisoners and how this shapes, and relates to, experiences of psychological distress and help-seeking. We hypothesised that conformity to masculine norms would be negatively correlated with help-seeking intentions and positively correlated with psychological distress. A mixed-methods approach was used with prisoners recruited from a Category C men’s prison in the UK. In Part 1, 109 prisoners completed three questionnaires assessing conformity to masculine norms, psychological distress and help-seeking intentions. Correlation analyses and group comparisons were conducted to determine associations between variables. In Part 2, semi-structured interviews were conducted with 6 prisoners who participated in Part 1. Reflexive thematic analysis was used to develop themes and sub-themes to understand how masculinity shapes experiences of distress and help-seeking in prison. As hypothesised, Part 1 found a negative correlation between conformity to masculine norms, particularly Emotional Control, and help-seeking intentions, as well as a positive correlation between conformity to masculine norms and psychological distress amongst prisoners. Thematic analysis in Part 2 highlighted themes of Holding it in, Image and perception and Control for prisoners. These findings support the understanding of prisons as environments where masculinity is performed, highlighting a distinction between public and private spaces where individuals’ conformity to masculinity is performed differently and highlighting some spaces where expression of vulnerability is permitted. Findings are discussed in relation to previous research, highlighting clinical implications and future directions for research.


Prison; Masculinity; Gender; Help-seeking; Psychological distress; Homosociality

Cite and Share

Taanvi Ramesh,Michael Mercieca,Helen Valerie Curran,Jarrod Cabourne. Exploring masculinity, experience of distress and help-seeking within a UK male prison. Journal of Men's Health. 2023. 19(12);87-98.


[1] Lubian K, Weich S, Stansfield S, Bebbington P, Brugha T, Spiers N, et al. Mental health treatment and services. In: McManus S and Bebbington P and Jenkins R and Brugha T (eds.) Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014 (pp. 69). NHS Digital: Leeds. 2016.

[2] Chatmon BN. Males and mental health stigma. American Journal of Men’s Health. 2020; 14: 155798832094932.

[3] Sagar-Ouriaghli I, Godfrey E, Bridge L, Meade L, Brown JSL. Improving mental health service utilization among men: a systematic review and synthesis of behavior change techniques within interventions targeting help-seeking. American Journal of Men’s Health. 2019; 13: 155798831985700.

[4] Henderson C, Evans-Lacko S, Thornicroft G. Mental illness stigma, help seeking, and public health programs. American Journal of Public Health. 2013; 103: 777–780.

[5] Schnyder N, Michel C, Panczak R, Ochsenbein S, Schimmelmann BG, Schultze-Lutter F. The interplay of etiological knowledge and mental illness stigma on healthcare utilisation in the community: a structural equation model. European Psychiatry. 2018; 51: 48–56.

[6] Mahalik JR, Locke BD, Ludlow LH, Diemer MA, Scott RP, Gottfried M, et al. Development of the conformity to masculine norms inventory. Psychology of Men & Masculinity. 2003; 4: 3–25.

[7] Wong YJ, Ho MR, Wang SY, Miller IS. Meta-analyses of the relationship between conformity to masculine norms and mental health-related outcomes. Journal of Counseling Psychology. 2017; 64: 80–93.

[8] Wasylkiw L, Clairo J. Help seeking in men: when masculinity and self-compassion collide. Psychology of Men & Masculinity. 2018; 19: 234–242.

[9] Shea M, Wong YJ, Nguyen KK, Gonzalez PD. College students’ barriers to seeking mental health counseling: scale development and psychometric evaluation. Journal of Counseling Psychology. 2019; 66: 626–639.

[10] Connell R. Masculinities. 2nd edn. Allen & Unwin: Sydney. 1995.

[11] Messerschmidt JW. The Salience of “Hegemonic Masculinity”. Men and Masculinities. 2019; 22: 85–91.

[12] Gough B, Novikova I. Mental health, men and culture: how do sociocultural constructions of masculinities relate to men’s mental health help-seeking behaviour in the WHO European Region? WHO: Copenhagen. 2020.

[13] Cohen S, Taylor L. Psychological survival: the experience of long-term imprisonment. 2nd edn. Penguin: Middlesex. 1972.

[14] de Viggiani N. Trying to be something you are not. Men and Masculinities. 2012; 15: 271–291.

[15] Symkovych A. The toll of totalising masculinities in prison. Prison Masculinities (pp. 67–83). 1st edn. Routledge. 2022.

[16] Maguire, D. Vulnerable prisoner masculinities in an English prison. Men and Masculinities. 2021; 24: 501–518.

[17] Scraton P, Sim J, Skidmore P. Prisons under protest. 2nd edn. Open University Press: Milton Keynes. 1991.

[18] McVittie C, Hepworth J, Goodall K. Masculinities and health. The Psychology of Gender and Health. 2017; 3: 119–141.

[19] Fazel S, Seewald K. Severe mental illness in 33 588 prisoners worldwide: systematic review and meta-regression analysis. British Journal of Psychiatry. 2012; 200: 364–373.

[20] Baranyi G, Cassidy M, Fazel S, Priebe S, Mundt AP. Prevalence of posttraumatic stress disorder in prisoners. Epidemiologic Reviews. 2018; 40: 134–145.

[21] Baranyi G, Fazel S, Langerfeldt SD, Mundt AP. The prevalence of comorbid serious mental illnesses and substance use disorders in prison populations: a systematic review and meta-analysis. The Lancet Public Health. 2022; 7: e557–e568.

[22] Fazel S, Hayes AJ, Bartellas K, Clerici M, Trestman R. Mental health of prisoners: prevalence, adverse outcomes, and interventions. The Lancet Psychiatry. 2016; 3: 871–881.

[23] Martin MS, Potter BK, Crocker AG, Wells GA, Grace RM, Colman I. Mental health treatment patterns following screening at intake to prison. Journal of Consulting and Clinical Psychology. 2018; 86: 15–23.

[24] O’Neil J, Helms B, Gable R, David L, Wrightsman L. Gender-role conflict scale: college men’s fear of femininity. Sex Roles. 1986; 14: 335–350.

[25] Levant RF, Hirsch LS, Celentano E, Cozza TM. The male role: an investigation of contemporary norms. Journal of Mental Health Counselling. 1992; 14: 325–337.

[26] Parent MC, Moradi B. Confirmatory factor analysis of the conformity to masculine norms inventory and development of the conformity to masculine norms inventory-46. Psychology of Men & Masculinity. 2009; 10: 175–189.

[27] Hamilton CJ, Mahalik JR. Minority stress, masculinity, and social norms predicting gay men’s health risk behaviors. Journal of Counseling Psychology. 2009; 56: 132.

[28] Liu WM, Iwamoto DK. Conformity to masculine norms, Asian values, coping strategies, peer group influences and substance use among Asian American men. Psychology of Men & Masculinity. 2007; 8: 25–39.

[29] Evans C, Mellor-Clark J, Margison F, Barkham M, Audin K, Connell J, et al. CORE: clinical outcomes in routine evaluation. Journal of Mental Health. 2000; 9: 247–255.

[30] Wilson CJ, Deane FP, Ciarrochi J, Rickwood D. Measuring help-seeking intentions: properties of the general help seeking questionnaire. Canadian Journal of Counselling. 2005; 39: 15–28.

[31] Wei Y, McGrath PJ, Hayden J, Kutcher S. Measurement properties of mental health literacy tools measuring help-seeking: a systematic review. Journal of Mental Health. 2017; 26: 543–555.

[32] Braun V, Clarke V. Successful qualitative research: a practical guide for beginners. 1st edn. Sage: London. 2013.

[33] Braun V, Clarke V. Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health. 2019; 11: 589–597.

[34] Willig C. Beyond appearances: a critical realist approach to social constructionist work. In D. J. N. Cromby & John (eds.) Social constructionist psychology: a critical analysis of theory and practice (pp. 37–52). 1st edn. Open University Press: Maidenhead. 1999.

[35] Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006; 3: 77–101.

[36] Cole BP. An exploration of men’s attitudes regarding depression and help-seeking. The University of Nebraska-Lincoln. 2013.

[37] Folberth WM. The relationship between conformity to masculine norms, help-seeking attitudes and health promotion behavior among males who use appearance and performance-enhancing drugs. [Doctor’s thesis]. Rutgers, The State University of New Jersey, Graduate School of Applied and Professional Psychology. 2014.

[38] Ramaeker J, Petrie TA. “Man up!”: exploring intersections of sport participation, masculinity, psychological distress, and help-seeking attitudes and intentions. Psychology of Men & Masculinities. 2019; 20: 515.

[39] O’Neil JM. Male sex role conflicts, sexism, and masculinity: psychological implications for men, women, and the counseling psychologist. The Counseling Psychologist. 1981; 9: 61–80.

[40] Edgemon TG, Clay-Warner J. Inmate mental health and the pains of imprisonment. Society and Mental Health. 2019; 9: 33–50.

[41] Galambos NL. Gender and gender role development in adolescence. Handbook of Adolescent Psychology (pp. 233–262). 2nd edn. John Wiley & Sons: Hoboken. 2004.

[42] Kågesten A, Gibbs S, Blum RW, Moreau C, Chandra-Mouli V, Herbert A, et al. Understanding factors that shape gender attitudes in early adolescence globally: a mixed-methods systematic review. PLOS ONE. 2016; 11: e0157805.

[43] Krumm S, Checchia C, Koesters M, Kilian R, Becker T. Men’s views on depression: a systematic review and metasynthesis of qualitative research. Psychopathology. 2017; 50: 107–124.

[44] Michalski JH. Status hierarchies and hegemonic masculinity: a general theory of prison violence. British Journal of Criminology. 2017; 57: 40–60.

[45] Newton C. Gender theory and prison sociology: using theories of masculinities to interpret the sociology of prisons for men. The Howard Journal of Criminal Justice. 1994; 33: 193–202.

[46] Johansson T, Odenbring Y. Rumbling and tumbling in school: jokes, masculinity and homosocial relations. Violence, Victimisation and Young People. 2021; 10: 59–73.

[47] Chang Z, Larsson H, Lichtenstein P, Fazel S. Psychiatric disorders and violent reoffending: a national cohort study of convicted prisoners in Sweden. The Lancet Psychiatry. 2015; 2: 891–900.

[48] Woods D, Breslin G, Hassan D. A systematic review of the impact of sport-based interventions on the psychological well-being of people in prison. Mental Health and Physical Activity. 2017; 12: 50–61.

[49] Woods D, Leavey G, Meek R, Breslin G. Developing mental health awareness and help seeking in prison: a feasibility study of the State of Mind Sport programme. International Journal of Prisoner Health. 2020; 16: 403–416.

[50] Maycock M, MacLean A, Gray CM, Hunt K. Transforming ways of ‘doing’ masculinity and health in prisons: performances of masculinity within the fit for LIFE programme delivered in two Scottish prisons. Issues and Innovations in Prison Health Research. 2021; 10: 279–306.

[51] Cannito M, Mercuri E. Caring masculinities in prison? Social workers and programs dealing with incarcerated fatherhood. Gender, Work & Organization. 2022.

[52] Howerton A, Byng R, Campbell J, Hess D, Owens C, Aitken P. Understanding help seeking behaviour among male offenders: qualitative interview study. BMJ. 2007; 334: 303.

[53] Mahalik JR, Di Bianca M. Help-seeking for depression as a stigmatized threat to masculinity. Professional Psychology: Research and Practice. 2021; 52: 146.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Directory of Open Access Journals (DOAJ) DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.

SCImago The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus® database (Elsevier B.V.)

Publication Forum - JUFO (Federation of Finnish Learned Societies) Publication Forum is a classification of publication channels created by the Finnish scientific community to support the quality assessment of academic research.

Scopus: CiteScore 0.9 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Norwegian Register for Scientific Journals, Series and Publishers Search for publication channels (journals, series and publishers) in the Norwegian Register for Scientific Journals, Series and Publishers to see if they are considered as scientific. (

Submission Turnaround Time