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"I feel freer here": engaging older men in mental health-promoting communities through a Shared Reading intervention
1National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark
2Danish Reading Society, 2400 Copenhagen, Denmark
3DaneAge Association, 2300 Copenhagen, Denmark
*Corresponding Author(s):memk@sdu.dk (Mette Marie Kristensen)
† These authors contributed equally.
| History | Submitted: 17 February 2025 | Accepted: 16 May 2025 | Published: 30 June 2025 |
| Copyright: | ©2025 The Author(s). Published by MRE Press. |
Background: Older men face higher rates of chronic illness, mental health challenges and social isolation, exacerbated by traditional masculinity norms that discourage emotional openness and help-seeking. Retirement and aging can further disrupt their social roles and identity, contributing to poorer well-being. Shared Reading, a reading group concept for guided collective engagement with literary texts, has shown potential to improve mental health outcomes and foster community among older men. This study aims to explore how Shared Reading may engage older men in health-promoting communities. Methods: The study was a qualitative exploration of a Shared Reading intervention targeting men aged 60 and above. It was based on six site visits to local Shared Reading group locations across Denmark, including interviews with local reading guides, participants in the Shared Reading groups across the sites, and the intervention project management. Results: We identified three central mechanisms for engagement across the Shared Reading groups: (1) the literature, serving as a common objective, a tool, and a window for the male participants; (2) the all-male setting, creating a safe space where the men felt more authentic, and (3) the combination of the all-male safe space and attributes of the literature created a confidential community, where participants felt at home and able to let their guards down. Based on these findings, we suggest that Shared Reading may be an effective way to engage men in mental health-promoting communities. Conclusions: The study highlights the broader implications of Shared Reading for mental health promotion among men. It demonstrates the importance of creating safe, activity-based and gender-sensitive interventions that resonate with male participants while subtly challenging traditional norms of masculinity. On this basis, we suggest that Shared Reading offers a framework for promoting mental well-being and provides valuable insights into the potential of literature for fostering connection and emotional exploration in male communities.
Cite this article
Mette Marie Kristensen, Anna Paldam Folker, Andreas Melson Gregersen, Lars Berg Schovsbo, Nana Cecilie Halmsted Kongsholm. "I feel freer here": engaging older men in mental health-promoting communities through a Shared Reading intervention.Journal of Men's Health,2025,21(6):53-61 DOI:10.22514/jomh.2025.080
1. Introduction
Older men are more likely than women to suffer from chronic diseases and fatal conditions, and they die younger on average than women, often due to higher rates of heart disease, cancer and other illnesses [1, 2]. Further, older men in the Western world have the highest rates of suicide across population groups, taking into account both age and gender [3, 4], and risks of mental health issues such as depression, anxiety and loneliness are increasing among this demographic. Many of the underlying factors influencing men’s health and health behaviors are based on sociocultural perceptions of masculinity, and the way masculinity is perceived and performed [5, 6]. As such, masculinity, particularly traditional norms of masculinity, has a profound influence on older men’s health behaviors and well-being.
Research has found that older men are often reluctant to acknowledge mental health challenges due to societal expectations of masculinity, which discourage emotional vulnerability [7]. Further, it is suggested that older men often underreport emotional distress, thus complicating early detection of mental health problems [4]. Many men avoid seeking therapy or mental health support, even when faced with severe mental health challenges such as suicidal ideation or depression—a pattern strongly influenced by traditional masculine norms [8]. This reluctance to seek medical care or emotional support contributes to poorer health outcomes and greater susceptibility to mental health disorders.
Norms of traditional masculinity that discourage emotional openness and dependence on others may also negatively affect the social lives of older men, who may struggle to form and maintain social networks in old age [8]. Studies indicate that older men are particularly prone to social withdrawal, partly due to the stigma they associate with expressing feelings or seeking help [9]. At the same time, research indicates that men who have strong social ties—whether through family, friendships or community groups—are less likely to experience mental health issues and loneliness [7]. As such, loneliness and social isolation play a significant role in mental health—not least for older men.
Aging also plays a vital role in masculinity, with the transition to retirement being a significant event in this regard. For some, the shift in social roles and structures that retirement brings about may prompt a shift away from traditional ideals of masculinity encouraging competitive and individualistic behavior, toward a more relational approach, where emotional connections and introspection are more accepted [9, 10], which may give way to new forms of meaning and connection [7, 11]. However, others may continue to internalize norms of hegemonic masculinity in old age, in light of which retirement may be associated with the loss of roles that have historically defined masculinity, such as the role of provider or worker, potentially disrupting men’s sense of purpose and identity, and leading to feelings of worthlessness and meaning-loss [8, 11, 12]. Further, many older men find it difficult to replace the social connections and structures that work provided and struggle to reconcile their former roles with the new expectations of later life [11, 13]. Traditional masculinity, thus, becomes more problematic to perform with age due to reduced societal roles, as well as declining physical health, and may become a barrier to help-seeking in a time when physical and mental health issues are increasing [8].
Promoting mental health for older men, thus, presents unique challenges, particularly due to the gendered expectations surrounding masculinity. A growing body of research emphasizes the need for gender-sensitive mental health promotion strategies, and suggests that mental health initiatives informed by ideals of masculinity may be an effective way to engage men in mental health promotion [12, 14, 15]. Further, the World Health Organization (WHO) has highlighted the importance of a specific focus on or responsiveness to gender in healthcare and health promotion efforts [16], and research highlights the critical need for mental health promotion strategies that effectively engage men [17, 18]. However, gender sensitivity has yet to be reflected in healthcare policies [6].
The current study aims to explore how Shared Reading (SR), a reading group concept for guided collective engagement with literary texts, may engage older men in health-promoting communities, and to identify central mechanisms for engagement. Research has found positive effects of SR on mental health outcomes for various social groups [19, 20, 21, 22], and a recent study suggests that SR holds the potential to strengthen affective well-being, meaning in life, and community for newly retired men [23]. Building on these findings, this study has investigated how SR engages older men. In doing this, the study explores (1) the men’s experiences of participation in SR as explicitly male communities, and (2) the role and relevance of SR in engaging men in mental health-promoting communities.
2. Methods and materials
The study was carried out as a qualitative exploration of an SR intervention targeting men aged 60+, based on the project Literary communities for men (LCM), which will be described further below. The study was based on six site visits to local SR group locations across Denmark, six interviews with reading guides (two group interviews and four individual interviews), nine interviews with participants in the SR groups across the sites (five group interviews and four individual interviews), participant observation in two reading groups, and one group interview with the project management.
2.1 The project
The overall objective of the LCM project is to enhance well-being and improve the quality of life for men aged 60+ through shared literary communities. The project builds on findings and experiences from a previous project investigating the mental health promotional potential of SR for newly retired men [23]. On this basis, LCM has sought to establish reading communities for men across Denmark, based on the concept of SR, facilitated by the Danish Reading Society (a nonprofit organization that works to promote literary communities for various groups). The project has spanned three years from 2022–2025, with gradual implementation of SR groups in local chapters of the DaneAge Association (a nonprofit membership organization working to promote senior citizens’ interests), driven by volunteer efforts.
In the SR groups carried out as part of LCM, older men met for an hour and a half each week and engaged in collective reading practices and discussions sparked by literary texts. The literary texts ranged from classics to contemporary and newer literature, with a broad variation in themes. Prose and poetry were combined to enhance the reading experience. The reading groups were led by a reading guide trained in the SR method. This method is based on read-aloud sessions, text excerpts and open questions, creating space for sharing participants’ immediate experiences and reactions to the texts. Participation did not require any preparation or prior knowledge of literature, as all texts were read “live” on-site. The purpose, ensured by the guide, was to create an environment where participants felt safe to engage in meaningful conversations based on literary texts, drawing on their own life experiences. In addition to the SR groups, the primary activities in LCM included recruiting and training volunteer reading guides—who facilitated the weekly reading groups—and recruiting participants for the SR groups. Reading guides were both male and female (based on research suggesting that the gender of the reading guides did not significantly affect the SR experience for this group [23], which was reaffirmed by participants in the current study). Within the project, 30 SR groups were established across different geographical locations all across Denmark, from cities to the rural countryside, with a total of approximately 200 participants and 45 reading guides.
2.2 Partnership
The project builds on an ongoing research collaboration, Read, Man! (2019–2023), between the National Institute of Public Health, University of Southern Denmark, the DaneAge Association, and the Danish Reading Society, supported by a research grant from TrygFonden. The Danish Reading Society served as the lead of the LCM project, responsible for the SR methodology. The DaneAge Association (DaneAge) was the primary partner, tasked with recruiting volunteers and participants, and implementing the project through local chapters. The National Institute of Public Health was responsible for the evaluation of the project.
2.3 Target group and recruitment
The target group for the project was men aged 60 and above—primarily men in the transition from working life to retirement. The reading guides were recruited through ads in Danish nationwide newspapers, the Danish Reading Society’s online newsletter, which was also distributed through various SoMe channels, and the DaneAge’s newsletter targeted at volunteers already within the organization (DaneAge has more than 20,000 volunteers working in the 215 local chapters spread across Denmark).
After the reading guides had attended a three-day training course, they were associated with their local DaneAge chapters, and together they started recruiting SR group participants through local newspapers, newsletters, Facebook groups, and most importantly by contacting the men in the local communities directly. DaneAge, being present in local communities across the country, has connections to men who are not socializing in the local community.
While the Danish Reading Society and DaneAge offered help and inspiration, the reading guides were also encouraged to communicate and frame the activity in the way they thought best appealed to the target group. For many reading guides, this entailed altering and challenging the way the Danish Reading Society and DaneAge originally proposed to communicate to the target group. In this regard, reading guides were generally concerned about describing the activity too academically. As a result, many reading guides, for instance, proposed to simply use the word “story” instead of “literature”, “prose” or “poetry”. In relation to this, reading guides also seemed to be guided by traditional notions of masculinity. This was, among other things, evidenced when the Danish Reading Society—as a way to indirectly challenge such notions—used a pink color for a flyer to recruit participants. The reading guides worried that the color would not appeal to the target group. Consequently, the pink flyer was never used.
2.4 Data analysis
Interviews were recorded and transcribed verbatim. A thematic analysis of the data material was conducted [24]. The last author read through the data material, and on this basis identified dominant themes and developed an initial coding template. The first author read through a selection of the data material, and subsequently, themes and an initial coding template were shared and discussed among the first, second, and last authors until agreement was reached on a final coding structure. The data material was coded in NVivo (version 14, Lumivero, Denver, CO, USA). After coding was completed, the first and last author read through selections of the coded material and discussed the material in light of theoretical perspectives on, e.g., masculinity. These discussions were expanded to include all authors.
3. Results
In the following, we present the study’s findings, reflecting central mechanisms for the engagement of older men in SR identified in the material. Findings are grouped around three central mechanisms: (1) the role of the literary texts, (2) the importance of an all-male setting, and (3) the establishment of a community of confidentiality and trust. For each mechanism, several sub-mechanisms were identified. Findings will be presented in the following subsections.
3.1 The role of the literary texts
A central mechanism in the material was the role of the literature as a basis for engagement in the groups. The literary texts played a central role in creating a safe space in the reading groups, serving as objects that participants could gather around, and in turn, as neutral tools to open up conversations about topics that were challenging, emotional or vulnerable. Furthermore, reading about other people’s experiences and feelings, and listening to other participants’ interpretations of them, served to open up the participants’ horizons.
3.1.1 Literary texts as a common object(ive)
It was repeated across the groups that for activities to be meaningfully engaging for men, they must center on an object or theme and/or include a certain notion of purpose or directionality. Several of the men expressed how they were puzzled by women’s ability to “just meet and talk”, and in contrast expressed how meaningful exchanges for their gender often took place in connection with a particular leisure activity, such as hunting or soccer.
I guess men are always together around something. There is always a theme, there is always something […] We’re not just together. We need something to do together. Otherwise, we don’t do anything. (Participant, site 1)
On this basis, the literature served as the object that the reading groups centered around and, in turn, gave the groups substance and meaning. The literature and the (to SR) particular way of engaging with it (pausing and allowing for reflections and discussion) also satisfied an expressed need for a purpose and directionality: the group participants joined forces in “figuring it out”. Several participants described the satisfaction of meeting around a certain object and having a community grow out of and center around this object:
Otherwise, we wouldn’t be together. We have agreed on that collectively and individually, and then we’re together around that and not necessarily anything more. It might be that we become best friends and all that shit, right. … But it’s not the goal. (Participant, site 1)
3.1.2 Literature as a tool
In addition to focusing and centering the groups, there was agreement across the groups that the literary texts served as indispensable tools in the intervention, as they facilitated a space to open up discussions and reflections on life matters. This was reflected in the different terms the groups and reading guides used to describe the role of the texts, namely: “crowbar”, “can opener”, “catalyst” and “enzyme”. However, there was disagreement as to whether this tool could be anything—hence not necessarily literature. Some reading group participants maintained that this was the case:
In principle, it doesn’t matter at all whether you’re hitting nails or whatever, senior workshop or whatsoever. There has to be a tangible thing, otherwise you won’t get men out of their armchair. … It plays the same role as a hammer to hit a nail, really. It’s just a tool. It could be anything. (Participant, site 1)
However, a majority of participants found that the literary texts, and the way of engaging with them as offered by SR, carried unique features that could create a safe space for conversations about personal and vulnerable topics:
I find that in a lot of the things we talk about, we dig deeper than you would with someone you just met on the street or a random friend. But it’s guided by the text. You start discussing things that you normally don’t just…” So by the way, how was your experience growing up?” and things like that. … the text invites you to do that. (Participant, site 5)
Another participant elaborated on this:
I feel like the literature is a mirror. A broad mirror of life, that you can then pick things out of to discuss. But if we were only discussing how much you can fish with either chip or fly, then that would be emptied out in no time. (Participant, site 4)
This made for a more indirect and less confrontational style of talking about personal topics. Several men expressed how they might otherwise be put off by feeling forced to open up about their inner lives, out of fear of losing status. However, they did not experience this in the reading groups:
I don’t feel forced to say anything at all about how I felt in my work life, or in my private life, or about my children and grandchildren. But it can enter the conversation naturally, you know? But it’s very much based on the text. And I really like it. (Participant, site 3)
One reading guide also reflected on how the literary texts may serve as proxies for the participants and what they are going through in life, suggesting that when one learns about a character going through a difficult situation that reminds one of one’s own experiences, it is easier and less vulnerable to talk about the literary character than oneself:
The literature asks a lot of questions and gives a lot of answers. But it can do it all. It’s something entirely different than, “now we have to sit here and talk about ourselves. How is it going in our marriages”. Or to talk about marriage and infidelity. Then it’s easier to present a short story about a man that brings a woman to his cabin”. (Reading guide, site 3)
3.1.3 Literature as a window
Another feature of the literary texts that participants emphasized as valuable was that it helped them broaden their horizons and served as a window into other milieus and worldviews—and how others have tackled challenges common to human existence. This effect was exacerbated in the group setting, where individual participants benefited from hearing how others perceived the text and contributed with their own experiences:
And we hear how others in the group have dealt with things or have met challenges that they have solved one way or another. And that can contribute to an attitude and understanding that when something looks like it’s absolute and over… there’s always a way around, you know? Others have done it. (Participant, site 2)
In the same vein, another participant reflected on the unique relationship between literature and human experience:
“[The literature] takes a go at some of life’s great questions, you know. The meaning of it all, and then there are stories that you can just immerse yourself in and disappear into. This whole identificatory reading… where you become one with the characters, and dissolve into it.” (Participant, site 4)
As such, the literary texts served as reminders to the participants that they were not alone with their challenges and that there are many different ways of being in the world and navigating challenges.
Based on our findings, we identify several important aspects of the literature and the role it plays in the intervention: it carries features of paramount importance in activities directed at men, namely object and directionality; it serves as a mirror against which participants can reflect their own experiences, providing an indirect and non-confrontational avenue for sharing personal stories; and it provides both mind-expanding, inspirational and comforting insights into other milieus and how others have tackled existential issues.
3.2 The importance of an all-male setting
For a majority of the male participants, it was of paramount importance that the SR groups only included male participants. They found that being with other participants of their gender and age narrowed the gulf of understanding that can be present when connecting with someone different from oneself. This created a safe space where participants felt they could let down their guards, speak freely, and not worry about how their statements came across because they felt that there was a common understanding:
I feel freer here, compared to other reading groups with more women, because women don’t always understand what we mean when we joke about something. And already I find there’s a comfort in that it’s men, because if you’ve been at a place of work where there have been men only, then you know that the tone is different among men. (Participant, site 1)
The sense of safety that the participants felt also stemmed from an experience that there was no sense of competition—a sense that was described as characteristic of all-male settings—as described by several participants. One participant expressed that what made the reading group a safe space for him was that: “there is no element of competition” (Participant, site 3). This, he elaborated, was owed to the fact that the discussions around the texts were based on participants’ reading experiences rather than textual analysis, where one interpretation of a text tends to be “truer” than others. As such, the sense of safety experienced in the SR space was facilitated both because of and in spite of the all-male setting.
The importance of the all-male setting was also manifested through participants’ expressions of the significance of the absence of women in the SR groups. In the participants’ accounts, this was in part owed to differences between how the genders communicate. Participants, to a large extent, found it easier to communicate and be understood by other men:
So, I think completely different things come forth, compared to if there had been women in here as well. There are some tacit agreements, we allow ourselves to be funny at the expense of women, but there is also a different understanding. … When we men say that we have experienced this or that in a certain way, women often sit and stare at you in complete disbelief, “what are you saying?”. And I’m not saying one is better than the other. But there is a difference. (Participant, site 5)
This difference was especially salient in participants’ expressions of how the two genders communicate about emotional, challenging or vulnerable matters. Many of the participants expressed that they had been raised to not speak openly about their inner lives, and that there were cultural expectations of them not to do so, as this was considered a sign of weakness that would result in loss of status. This was especially the case when they were in the company of women, but could also be present in all-male settings. However, many men expressed a need to be able to speak about these parts of their inner lives, and the reading group offered a space where this was safe to do:
The loneliness that men feel, and precisely that it is only men, make it so that you are not afraid of saying it out loud, as you would have if women had been present. You would never do that. Because you don’t want to show weakness or be like “I feel bad” or something like that. … and that is also in the difference between the genders and many other things. It’s a lot more than upbringing. (Participant, site 5)
On this basis, we find that the all-male setting helped create a safe space where the men felt more authentic: they felt more easily understood and felt that they had the freedom to be and speak as they desired without fear of being misunderstood or losing status. This facilitated the sharing of matters that the men might otherwise have withheld.
3.3 The establishment of a community of confidentiality and trust
The combination of the all-male safe space, the attributes of the literary texts, and the particular way of engaging with them created a particularly confidential community, where participants quickly felt “at home” and able to let their guards down. They explained this by the fact that there were no demands and that you were seen, respected, and valued “as you were” in the SR groups.
3.3.1 Sense of contributing
Many of the men expressed their appreciation of being part of a community where you contributed with what suited you—where you were valued not for your accomplishments, but simply for being present:
I guess it’s also that these guys want to contribute with something. And some perhaps don’t contribute that much, but that is just as fine. … It’s like a team where everyone counts. I think that people will think that way, that they’re part of this group. (Participant, site 3)
Another participant put it the following way: “Here I don’t come as the person I have been, but I come as the person I am in the moment we are together” (Participant, site 1). A reading guide described how they observed this effect on the participants:
And it’s not that we lift them, but that they lift each other. It’s like having the feeling of ‘we share something here’ and ‘we can talk about it’. … I think that’s it, that there is this immediate accept because everyone can say what they want and it will be heard and we ask about it if someone finds it challenging to speak up. So, I think they somehow feel that what they say has significance. And that is something they give to each other. (Reading guide, site 1)
3.3.2 Confidentiality and trust
Experiences of confidentiality and trust were at the core of the participants’ descriptions of being in the SR space. As accounted for above, this was partly born out of the combination of the all-male setting and the non-confrontational form of engagement with life matters, but also out of the implicit or explicit agreement that “what happens in the reading group stays in the reading group”:
Well, the talk we have here. It belongs here. I can’t imagine that I should sit here and share this with… I mean, if I met you downtown and it continued there. It belongs here. … I also find that that agreement makes it easier to share personal things, you know. … You could say that we’ve got each other, but we’ve got nothing on each other. (Participant, site 5)
Furthermore, many reading guides expressed that they deliberately abstained from inviting the mention of former job titles and experiences from reading group participants to allow for the freedom of expectations or roles that tend to follow certain vocations. Instead, this was allowed to come forth indirectly through group discussion, which some reading group participants experienced as a reprieve from status and expectations.
We really appreciated that we could come down here as… we didn’t have to start with “what have I accomplished” and all that. [Rather], it shines through in our conversations about the texts. (Participant, site 2)
Some participants also found that the anonymity allowed them to let down their guards, which in turn fostered a kind of openness necessary for a trusting relationship or even friendship to blossom:
I think it’s amazing after such a short period of time, the openness that is put forward. Even, about deeper, private, and perhaps unpleasant things you have experienced through a long life, which is something we all have in common. And in my view, that facilitates friendship. … Because, you know, if you’re hiding something, you’ll never become friends. (Participant, site 1)
A participant in another reading group tied this to the basic human need for having a confidant—which some of them, after perhaps losing close friends and/or partners, had found in the reading group:
At our age you don’t make friends. You make acquaintances. Because friendships take longer, and I can see that I don’t have any left of my old confidential friendships. Then you’re left sitting there, and the most confidential relation you have is your wife. … But she yells at you all day, so where the hell do you go? … it’s always nice if you have something that you’re mulling over in your noggin, that you can go over it with someone. And when you don’t have any more of those, it becomes difficult. (Participant, site 6).
3.3.3 No demands
Many of the men expressed appreciation of how the practical framework of the SR groups, prescribing that texts are read aloud and that there is no preparation required for participation in the SR sessions, which they found facilitated a welcoming, equal and safe space, where all that was demanded was to show up and contribute with what you felt like that day:
Also, there is no preparation here. We get a text, and we talk about it, but from there you take off in many other directions. And that’s what’s exciting about this, you know? That nothing is demanded other than opening up for whatever. And nothing is quoted from here and we don’t go around telling all kinds of things. It’s good. (Participant, site 2)
This was also found to diminish the element of competition that is otherwise often present in settings where men come together around an activity:
P1: Yes, and come in on the same level so no one is overprepared, or…
P2: Yes, yes, absolutely. That there isn’t a hierarchy. And who is the alpha male and so on and how do we all fit into the hierarchy. And I almost find that that is a cornerstone. That we’re on the same level, otherwise I don’t think it’s fun. (Participants, site 5)
In sum, we found that the specific sense of community among participants arose in the cross-section of the all-male setting on the one hand, and the SR framework on the other. Being with other participants, of their age and gender, facilitated a more instant understanding and acceptance among participants, which served as a safe space that allowed for the vulnerable and personal conversations that the literature, in turn, engendered.
4. Discussion
Based on our findings, we suggest that SR may be an effective way to engage men in mental health-promoting communities. We identified three main mechanisms that fostered this engagement. Firstly, literary texts provided a common object(ive) for the male participants to engage in and around, as they provided tools for opening up conversations about the personal, emotional and vulnerable experiences, and a window to milieus and worldviews different from participants’ own yet common to human existence. Secondly, the all-male setting provided a safe space where the male participants felt a sense of mutual understanding and a reprieve from status and societal expectations. Thirdly, the combination of the all-male setting and the literary engagement created a community characterized by a sense of contribution, confidentiality, and freedom of demand. These findings, we suggest, provide a relevant basis for situating SR within the broader context of mental health promotion for men.
A significant challenge in promoting mental health among men is overcoming traditional norms of masculinity, which often equate strength with emotional suppression. Men are frequently socialized to avoid vulnerability, creating tension with the openness required for many mental health interventions. Traditional masculinity often emphasizes stoicism, self-reliance, and physical toughness—traits that discourage men from acknowledging emotional struggles or seeking help [7]. Studies show that mental health interventions that fail to consider these deeply ingrained norms often face difficulties in engaging men. In contrast, men are more likely to participate in healthcare and mental health services when these align with their preferences and interests, highlighting the need for gender-sensitive approaches [14, 25, 26].
To address these challenges, research has suggested that mental health initiatives targeting men should be community- and activity-based and seek to create safe, male-positive environments while implicitly challenging stereotypical ideals of masculinity, such as emotional control, competitiveness and one-upmanship [12]. In the following discussion, we reflect on the findings of this study in light of these considerations, exploring how SR may engage men in mental health promotion.
4.1 Literature as a ”common third”
Much in line with the research literature on mental health promotion for men, the men in the SR groups expressed a preference for engagement in communities that revolved around an activity. In the research literature, men’s preference for side-by-side activities is emphasized, referring to activities that gather men around a common task, project or purpose [9, 14]. An example of a side-by-side initiative that has successfully engaged men is the Men’s Sheds movement. In Men’s Sheds, activities are defined and facilitated by male users themselves and are characterized by physical engagement, often revolving around practical or craft-based activities, allowing male participants to form social bonds and engage in questions around well-being without direct confrontation of issues concerning mental health or pressure of emotional introspection [27, 28]. This should be viewed in contrast to face-to-face activities, described as activities that encourage direct confrontation with or interaction around issues that a given intervention seeks to engage or address [14]—in the context of mental health promotion, exemplified by therapy or self-help groups.
With the engagement of literary texts as its core component, SR may be defined as a side-by-side activity. However, by fostering reflection on lived experiences and encouraging dialogue on this basis, SR also promotes face-to-face engagement. In this way, SR may offer a framework for mental health promotion that bridges side-by-side and face-to-face approaches—a kind of mediated face-to-face approach. This potential has been suggested in recent research on SR as health promotion for older men [29], but has not been empirically investigated or substantiated. Revisiting the findings of this study, a majority of the men, as well as reading guides, emphasized the particular role of the literary texts, using terms such as “tool”, “can-opener” and “crow-bar” in facilitating social engagement in the groups, indicating that the literary texts played a critical role in shaping the interactions and connections established in, or on the basis of, the SR groups. This is also reflected in participants’ descriptions of how the texts “invited” them to talk about things that they would not talk about with other men in other contexts, in a “natural” way. This resonates with what Pihl et al. [30] have termed literary connectivity, describing the particular potential of SR to provide a “type of sociality facilitated and enabled by texts in a way which stands out from other forms of human interaction, namely, a collective experience of literary art which fosters caring and sharing between people”. In a study on SR practices for newly retired men, Kristensen et al. [23] suggested that the particular form of social engagement fostered by SR allowed for “a sense of intimacy not found in other male-dominated contexts, and paved the way for a sense of togetherness, arising from, but also going beyond, the shared literary experience”.
SR does not have a therapeutic objective and, as such, is not specifically tailored for therapeutic purposes [31]. Further, the reading groups were not framed within a mental health promotion framework. As such, literary texts were not selected according to criteria for mental health and well-being, nor were these themes emphasized by the reading guide in the discussions following the readings. Instead, issues relating to the health and well-being of participants were implicitly engaged through the social and literary engagement taking place within the SR groups, and on the initiative of participants themselves. On this basis, we suggest that literary engagement may be useful in providing a space for the engagement of men’s mental health as it promotes an implicit and non-confrontational yet active engagement with issues relating to the mental health and well-being of participants. This may be particularly relevant for the engagement of men in mental health promotion. By balancing the communal focus of side-by-side activities with the reflective nature of face-to-face interactions, SR creates a uniquely supportive environment—avoiding direct confrontation of mental health issues in alignment with male preferences while providing a safe space for personal and social engagement for and among men.
4.2 Engaging masculinity
Research suggests that mental health interventions that directly confront or explicitly engage with mental health issues or issues involving emotional engagement may discourage participation for some men, as it conflicts with masculine ideals and may prompt feelings of shame, stigma and de-masculinization [14]. Further, it emphasizes the value of all-male spaces as environments where masculinity can be actively engaged in a safe, supportive setting. Establishing such spaces is therefore critical for engaging men in discussions related to mental health, given the stigmas often associated with vulnerability and emotional expression in traditional masculinity ideals. Historically, reading communities have been predominantly female domains, with women engaging in literary reading for pleasure, while men’s literary practices have mainly been solitary and normatively framed as intellectual [32]. This gendered divide makes reading-based interventions like SR appear, at first glance, less aligned with traditional male-friendly activities. However, research on men’s reading habits has shown that men, like women, read for emotional and personal gain [33]. Furthermore, findings from the SR intervention demonstrate that offering a space for literary engagement exclusively for men enabled a different kind of engagement than what other all-male environments, typically centered around more stereotypically male activities, offer.
Although one might have expected that the all-male context would have promoted masculine ideals such as competitiveness and control of one’s emotions, several participants highlighted the lack of a sense of competitiveness in the SR space, which, they emphasized, was in contrast to many other all-male settings, but nonetheless (and maybe for that very reason) greatly valued. This may be explained by what several participants expressed as the commitment- and demand-free space that SR offered, coupled with the approach to engagement with the literary texts central to the concept of SR, encouraging participants to draw on personal experiences rather than analytical observations in making sense of the literary texts. In a recent study, Kristensen et al. [34] have suggested that SR creates a basis for a sense of equality among participants, partly enabled by the social engagement between participants being centered around literary texts rather than social structures, thereby allowing participants to connect with one another as they are in the moment, disregarding societal roles or social status [34].
This dynamic, they argue, also allows for a positive engagement with vulnerability, which was also emphasized in the current study. Participants used their lived experiences as resources for interpreting texts, framing vulnerability not as a weakness but as a tool for making sense of the texts and, through that, fostering shared understanding and connection. This form of engagement stands in contrast to normative masculine views of vulnerability and aligns with broader recommendations for mental health initiatives targeting men, which suggest that interventions should balance affirming positive masculinity with challenging restrictive norms. This approach aligns with asset-based models of engagement, which prioritize leveraging participants’ strengths rather than focusing on deficits. Research has highlighted that such approaches are particularly effective for engaging men, emphasizing aspects such as productivity, belonging, reciprocity, connection, role renewal, and the creation of supportive environments [35].
As such, a masculinity-sensitive approach to mental health interventions targeting men should recognize the positive aspects of traditional masculine norms, such as resilience and strength, while simultaneously challenging ideals like emotional suppression and competitiveness that may conflict with positive health behaviors [8]. In summary, SR may provide a safe, non-competitive, and supportive space for men to engage emotionally and socially through literary texts. By doing so, it may provide an example of how mental health interventions targeting men may actively use masculinity as a resource while subtly challenging ideals of masculinity that conflict with the promotion of mental health.
4.3 Future directions
This study contributes new knowledge on how SR engages men and masculinity in the context of mental health promotion for older men. It sheds light on the intricate connections between masculinity and men’s health, the implications this has for mental health promotion efforts targeting men, and the opportunities and challenges of SR in engaging men in mental health-promoting communities.
SR offers a promising avenue for mental health promotion among men by addressing entrenched gender norms and providing a platform for meaningful engagement of men’s mental health. The sense of community fostered in SR groups highlights the value of activity-based interventions that integrate a focus on common objectives with opportunities for personal connection. Further, the SR intervention demonstrates the importance of safe, all-male environments that foster mutual understanding, confidentiality, and freedom from societal expectations. As such, SR may provide directions for future mental health promotion interventions targeting men.
Further, the dual nature of SR as both a side-by-side and face-to-face activity offers a unique perspective on male engagement. Future research should examine the underlying mechanisms that make this hybrid structure effective in fostering openness and emotional expression in male groups. Further, comparative studies between SR and other male-friendly interventions, such as Men’s Sheds or sports-based programs, could identify shared and unique mechanisms that contribute to their success, enhancing understanding of gender-sensitive approaches to mental health promotion.
The findings of this study emphasize the potential of gender-sensitive approaches to mental health promotion for men that reframe mental health within a masculine context and promote community engagement. Applying an assets-based approach aligned with men’s values—such as strength, independence and social contribution—may increase participation and improve mental health outcomes. In doing this, challenging ideals of masculinity that hinder health-promoting behavior while fostering forms of masculinity aligned with mental well-being is key.
Finally, men are often a challenging demographic to engage in health promotion, as confirmed by this intervention. The study’s findings highlight the positive role of providing a space for engagement in all-male contexts, explicitly framed as such. However, recognizing heterogeneity within male populations—including age, masculinities and social conditions—is essential for tailoring interventions to diverse needs.
4.4 Strengths and limitations
A key strength of this study was the close collaboration between researchers and practice partners in the partnership, ensuring sensitivity to local contexts, and enabling the adaptation of recruitment and implementation processes to meet community-specific needs. Another notable strength was the use and integration of multiple methods and data sources. By incorporating interviews with both participants and reading guides, alongside field notes from participant observations during selected SR sessions, the study was able to generate nuanced insights from various perspectives. A methodological limitation was that data was collected based on a single visit per site, which excludes potential changes or developments in participants’ and reading guides’ perspectives over time in the data. Further, it was a limitation that participants’ socio-demographic data were not collected. This might have provided useful insights into the representation and diversity of participants in relation to the general Danish population of older men. Given the study’s primary focus on factors influencing the engagement of the target group in literary communities, effect measurements were deemed beyond the scope of this research. The organizational and implementational aspects of the LCM project have been explored and reported elsewhere.
5. Conclusions
This study underscores the broader potential of SR as a meaningful approach to mental health promotion among men, demonstrating how its dual nature—as both a side-by-side and face-to-face activity—can foster inclusive spaces that resonate with male participants while at the same time subtly challenging restrictive norms of masculinity.
SR creates safe environments where men can explore emotional themes, share personal reflections, and experience a sense of community without the pressures often associated with the engagement of mental health, as experienced by many men. In doing so, SR offers an alternative to more traditional mental health promotion initiatives that often involve direct confrontation or explicit engagement with mental health issues, which may discourage participation for some men.
As such, we propose that SR and the use of literature as a catalyst for reflection and connection may contribute to the advancement of equitable and innovative public mental health initiatives for men. SR may serve as both a model and a methodological lens for future interventions aimed at promoting mental health, particularly in populations where stigma or gendered expectations may otherwise hinder engagement.
Availability of data and materials
Data are available on reasonable request.
Author contributions
MMK and APF—designed the research study; provided help and advice on the research process. NCHK—performed the research; analyzed the data. MMK, NCHK, AMG and LBS—contributed to writing of the manuscript. All authors contributed to editorial changes in the manuscript. All authors read and approved the final manuscript.
Ethics approval and consent to participate
Informed consent was obtained from all participants prior to the initial data collection, and all participants were informed of the purpose and procedures of the study as well as the implications of participation. All participants were pseudonymized, and personal characteristics or opinions that could disclose their identity have been excluded from this article. Data was handled and stored responsibly. Procedures performed in the study were in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments. The study was registered and approved by the University of Southern Denmark following the Data Protection Regulation (GDPR) (EU) 2016/679 with approval number 12.602.
Acknowledgment
We would like to thank all participants and reading guides for their participation in and contribution to the study. Further, we would like to thank TrygFonden for funding the study.
Funding
This research was funded by TrygFonden, grant number 156100.
Conflict of interest
The authors declare no conflict of interest.