title: Positive strategies men regularly use to prevent and manage depression: a national survey of Australian men.
abstract: BACKGROUND
  Men are at greater risk than women of dying by suicide. One in eight will experience depression--a leading contributor to suicide--in their lifetime and men often delay seeking treatment. Previous research has focused on men's use of unhelpful coping strategies, with little emphasis on men's productive responses. The present study examines the positive strategies men use to prevent and manage depression.
  
  
  METHODS
  A national online survey investigated Australian men's use of positive strategies, including 26 strategies specifically nominated by men in a previous qualitative study. Data were collected regarding frequency of use or openness to using untried strategies, depression risk, depression symptoms, demographic factors, and other strategies suggested by men. Multivariate regression analyses explored relationships between regular use of strategies and other variables.
  
  
  RESULTS
  In total, 465 men aged between 18 and 74 years participated. The mean number of strategies used was 16.8 (SD 4.1) for preventing depression and 15.1 (SD 5.1) for management. The top five prevention strategies used regularly were eating healthily (54.2 %), keeping busy (50.1 %), exercising (44.9 %), humour (41.1 %) and helping others (35.7 %). The top five strategies used for management were taking time out (35.7 %), rewarding myself (35.1 %), keeping busy (35.1 %), exercising (33.3 %) and spending time with a pet (32.7 %). With untried strategies, a majority (58 %) were open to maintaining a relationship with a mentor, and nearly half were open to using meditation, mindfulness or gratitude exercises, seeing a health professional, or setting goals. In multivariate analyses, lower depression risk as measured by the Male Depression Risk Scale was associated with regular use of self-care, achievement-based and cognitive strategies, while lower scores on the Patient Health Questionnaire-9 was associated with regular use of cognitive strategies.
  
  
  CONCLUSIONS
  The results demonstrate that the men in the study currently use, and are open to using, a broad range of practical, social, emotional, cognitive and problem-solving strategies to maintain their mental health. This is significant for men in the community who may not be in contact with professional health services and would benefit from health messages promoting positive strategies as effective tools in the prevention and management of depression.
authors.affiliation: Black Dog Institute, UNSW, Sydney, Australia. j.proudfoot@unsw.edu.au.
authors.forename: Judy
authors.initials: J
authors.lastname: Proudfoot
authors.affiliation: Black Dog Institute, UNSW, Sydney, Australia. a.fogarty@unsw.edu.au.
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Fogarty
authors.affiliation: Black Dog Institute, UNSW, Sydney, Australia. isabelmctigue@gmail.com.
authors.forename: Isabel
authors.initials: I
authors.lastname: McTigue
authors.affiliation: School of Public Health and Community Medicine, UNSW, Sydney, Australia. s.nathan@unsw.edu.au.
authors.forename: Sally
authors.initials: S
authors.lastname: Nathan
authors.affiliation: Black Dog Institute, UNSW, Sydney, Australia. e.whittle@unsw.edu.au.
authors.forename: Erin L
authors.initials: EL
authors.lastname: Whittle
authors.affiliation: Black Dog Institute, UNSW, Sydney, Australia. h.christensen@blackdog.org.au.
authors.forename: Helen
authors.initials: H
authors.lastname: Christensen
authors.affiliation: Black Dog Institute, UNSW, Sydney, Australia. m.player@unsw.edu.au.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Player
authors.affiliation: Black Dog Institute, UNSW, Sydney, Australia. d.hadzi-pavlovic@unsw.edu.au.|School of Psychiatry, UNSW, Sydney, Australia. d.hadzi-pavlovic@unsw.edu.au.
authors.forename: Dusan
authors.initials: D
authors.lastname: Hadzi-Pavlovic
authors.affiliation: School of Psychiatry, UNSW, Sydney, Australia. kay.wilhelm@svha.org.au.|Faces in the Street, St Vincent's Urban Mental Health and Wellbeing Research Institute, Sydney, Australia. kay.wilhelm@svha.org.au.
authors.forename: Kay
authors.initials: K
authors.lastname: Wilhelm
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003866:Depressive Disorder / Q000517:prevention & control* / Q000523:psychology*; D004644:Emotions; D015438:Health Behavior; D006801:Humans; D008297:Male; D054526:Men's Health; D008603:Mental Health; D008875:Middle Aged; D036301:Qualitative Research; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult