men, Hammond said, as farmer suicide statistics attest. “If I can help young men change their attitude about themselves, to look at themselves in more positive ways – that’s why I do this job.”

Hammond says he brings his toolbox of life experience and professional skills to his role. “I left school at 15 and my own journey was a little rocky. I bring trust and integrity to the relationship and my life skills have equipped me well for this role. Empathy is hugely important.”

He was a psychiatric assistant at the long-closed Cherry Farm Mental Hospital, near Dunedin, and worked as an enrolled nurse in paediatrics for 13 years before completing the inaugural nursing degree at Otago Polytechnic and getting his PHN job in 1995.

A father of four and grandfather of seven, he is very family-orientated and believes that is one of his strengths in his role.

Another aspect of his role is involvement in the HazDrink initiative. Any 16- and 17-year-olds admitted to Dunedin Hospi-tal’s emergency department (ED) with al-cohol-related injuries are asked to consent to PHN follow-up. Hammond sees about 50 per cent of those referred by the ED. He of-fers them strategies for keeping safe while drinking while stressing that ending up in ED because of drinking is serious.

Hammond said it helps to be an optimist and he gets great personal and professional satisfaction in playing a part, however small, in helping young men reach their potential.

“These young men also want to be happy, to have fun and need professional guidance and support while their maturity is kicking into play. I love being part of their journey.” •

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Kai Tiaki Nursing New Zealand * vol 21 no 6 * July 201516

system. He can offer brief interventions on drugs and alcohol and anxiety, in combina-tion with a strengths-based approach.

Hammond is often working under pres-sure – “If I see a young man more than once, I’m lucky. If I can work with a small group of young men over a six-week period on health issues, that’s a real bonus.”

Attitudes and resources are among the barriers to young men getting the holis-tic health care they need. Hammond says “men’s health” is as much about mental health and well-being as physical health and says not all professionals are prepared to work with young people.

As well as emotionally present fathers, he believes good mothers are vital to young men’s well-being. “It’s important they give their young men permission to talk about health and to explore with them what health means.”

Taking emotional risksHe urges young men to take more risks with their emotional health. “They take risks skateboarding, drinking, as boy racers, but they’re not so open to taking emotional risks – to opening up and talking, to asking a girl/boy/other out, to seeking help. As well as ‘mates’, I stress the importance of talking to an adult if they are worried about anything.”

Masculinity myths are tough on young men. “The perception is that to be a man is to be tough, to suck it up; to be a tough Kiwi bloke – the quintessential Southern Man.”

When young men can’t live up to the expectations placed on them – be they aca-demic, employment or sporting – they feel a sense of failure and really struggle. That sense of failure is not confined to young

Raising awareness of some of the mental health issues men face, in particular anxi-ety and depression, was the aim of three

positive mental health workshops for Canter-bury District Health Board staff last month.

The One for the Blokes workshops were organised by the staff wellness programme and facilitated by psychotherapist Jason Brennan and wellness consultant Pete Roe, from Wel-lington’s Think Well facility.

While stress was part of life and had many positive effects in relation to getting tasks achieved, efficiency could plummet when stress was cumulative and from multiple sources, Roe said. It was essential to recognise when stress turned into distress. Indicators included when it overwhelmed our coping abilities, when it demotivated and drained energy, and when it led to decreased perfor-mance. Ongoing distress, he said, predisposed us to anxiety and depression and was often when men could “hurt the people they love”.

Modern technology, Brennan said, was making it increasingly difficult to cut off from work because people could now contact us 24 hours a day. He explained human beings were born “naturally optimistic but learn to be pes-simistic” over our lives and became “very good at thinking negatively”.

Human beings were wired “to pick up threats – our chemicals warn us”. While adrenaline and cortisol “kicked our system into action” by activating survival responses, their ongoing presence and accumulation, in response to worry and perceived threat, could set up a destructive and distressing cycle for psychological health.

Warning signs, according to Roe, included feelings of helplessness and hopelessness, unusual anger, irritability, changes in appetite and sleep, increased social isolation, negative thoughts, reckless behaviour, loss of interest in daily activities and persistent unexplained pain. Coping strategies needed to be individu-al, as no one size fitted all. Keeping a regular

Talking about depression and anxiety

Some New Zealand men’s health facts• Every three hours a Kiwi bloke dies from a potentially preventable illness. If you are Mâori, that rate doubles.• One in eight men experience severe depression at some time in their lives.• Testicular cancer kills more 18-39-year-old men than any other disease. • Six out of 10 men are overweight.• Nearly a quarter of men smoke.• Twenty-seven per cent of men have potentially hazardous drinking patterns.

Reference1) Men’s Health Week Te Wiki Hauora Tane 2015 (2015) Health Info. Did you know . . . www.menshealthweek.co.nz. Retrieved 03/07/15.

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35Kai Tiaki Nursing New Zealand * vol 21 no 6 * July 2015 17

daily routine, talking to significant others, seeking professional help, structuring time by creating a work/home balance, exercising and temporarily avoiding life-altering decisions could all be worthwhile responses.

The DHB’s well-being coordinator, Andy Hearn, highlighted that mindfulness sessions, yoga, Pilates, site-based brief intervention counselling and a more expansive counsel-ling service via the employment assistance programme, were all available to staff.

The important message – that depression could happen to anybody – was reinforced by two men’s personal accounts of depression. The first, an ex-police officer, spoke of the role compassion fatigue and alcohol misuse played, and how family relationships became strained. “I bottled it all up at work and let go at home.”

When first diagnosed, he viewed it as “a weakness to be weak”. His recovery involved multiple life adjustments, including changing careers, forming balanced social connections, diet and exercise modifications, and cultivat-ing a deeper sense of self-awareness. Medica-tion, although initially trialed, didn’t work. Establishing “planks of wellness” was essen-tial. “These are the things that got me well and keep me well.”

The second personal story, told by a self-described “staunch, driven and arrogant” builder, highlighted how depression could permeate multiple aspects of daily life. His depression and anxiety, which followed the death of a spouse after a long illness, was something he initially hid from others before “recognising I couldn’t sort it out by myself”. A sign of strength, he learned, was “putting up your hand for help – being honest can be liberating”.

He described the roles medication and coun-selling played in his recovery and the realisa-tion that “you can’t look after your children without looking after yourself”. He spoke of learning the overlap between mental and phys-ical health – “my physical and mental health are definitely tied together” – and emphasised the importance of creating a family environ-ment that fostered emotional sharing.

A consistent message from the four present-ers was the importance of having a close circle of emotional support. Those attending the workshop were encouraged to think who these people might be. “Consider who is in your inner circle, who are the important people in your life, who are those that matter to you.” •

Report by Christchurch mental health nurse Bernadette Burns

The ups and downs of farming life can take their toll on men’s health – when times are tough, men tend to put

supporting their family financially and the welfare of their animals first, and neglect themselves. That’s the view of practice nurse Maree Rowley, who was born and raised in rural South Canterbury and has lived and worked in the region all her life.

“I understand how gut-wrenching it can be, through no fault or mismanagement of your own, that you can have a drought that puts you on your knees and you have to sell half your capital stock,” she said.

Dealing with floods, drought and snow – or for dairy farmers, with a vastly reduced milk payout from Fonterra – was extremely stressful for farmers, and could lead to elevated blood pressure, anger, excessive drinking, insomnia and depression, she said. However, the stress they were under could

By co-editor Kathy Stodart

make them even less likely to seek help for their health than usual. “But they’re no good to anybody if they keel over,” she said.

Rowley has nursed for 21 years, the first eight in surgery and orthopaedics at Timaru Hospital, followed by a long stint as a dis-trict nurse in the Timaru, Temuka and Geraldine areas. She worked for more than two years for the Temuka-based Mâori health pro-vider Arowhenua Whânau Services as a primary health nurse, and is now a practice nurse in Geraldine where she lives with her husband and four children.

She is very aware of male health, both in a professional capacity, and out of concern for the health of her close male relatives – hus-band, son, brother and late father. “Getting them [men] through the door is one of the first things. They have the attitude: if it ain’t broke, don’t fix it. Unless they have some-thing seriously wrong – acute pain or are very sick – or their sig-nificant other is nagging at them,

there’s no reason in their mind to come to the doctor,” Rowley said.

Men did not tend to be pro-active in fronting up for “warrant of fitness” health checks until they were older. Practice nurses had to be opportunistic and engage with men when they came into the practice for other reasons, such as if Dad brought in a child for immunisations or with an injury. Or if the nurse was seeing the wife or partner, they could make a general inquiry about their husband’s health.

Rowley said it was probably not a good thing there were so few men in practice nursing. “We’ve never walked in male shoes. We can gather experiences from the men in our lives, we can try to have empathy – that’s the best we can do.”

She said there were many services to support men’s health, but men needed to take that first step to engage with a health provider. It was then up to health workers to build good relationships with them, so they felt comfortable and would come back. •

Stresses on rural men

geraldine practice nurse maree Rowley.

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