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MAKING CONNECTIONS 2017 ANNUAL CONVENING: Making Connections for mental health and wellbeing among men and boys

Transformation. Revolution. Compassion. Connection. These were among the ways participants at the annual Making Connections convening described wellbeing in the context of their work cultivating mental health and wellbeing with men and boys in their communities.

Watch this short video featuring some of the many words participants used to describe wellbeing.

At the three-day gathering at Prevention Institute in Oakland, California, representatives from Making Connections coalitions from across the US continued to build synergy and momentum, further exploring intersecting interests and opportunities to leverage talent and knowledge across the Community of Practice.

Pre-convening sessions included an orientation for those new to the national initiative, along with discussions on community actions to enhance wellbeing through the physical and built environment, and the emerging role of health care organizations in changing and sustaining community prevention approaches to mental wellbeing.

Discussions focused on the four shifts that are at the center of Making Connections’ transformative work:

  1. Reframing concepts of mental health to include wellbeing and resilience;
  2. Shifting the focus upstream to emphasize mental health strategies that promote prevention and resilience as a complement to treatment and services;
  3. Expanding our approaches to address community conditions that influence mental health and wellbeing in addition to those that focus on individuals; and
  4. Integrating gender- and culture-informed strategies that meet men and boys where they are and that embrace a broad range of positive masculine qualities.

Throughout the convening, communities grappled with the tensions inherent in making these shifts, recognizing that while strategies across the continuum are important, the aim of Making Connections is to disrupt the status quo and reach for upstream approaches that transform community conditions to promote wellbeing for men and boys. Stepping into these spaces that are relatively unexplored maximizes opportunities to accelerate progress and realize greater wellbeing across the population. The conversations began with an overview of the Making Connections National Theory of Change and how its strategies will contribute to making these shifts.

The connection you have in your community and this community are the fabric of resilience and thriving… What we’re doing here and what you’re doing in your community is forging the future for our society to heal ourselves and heal each other and to understand our potential as people and communities to be our most vibrant. -Howard Pinderhughes, Associate Professor & Chair, UCSF School of Nursing and Prevention Institute partner

Reframing Mental Health and Wellbeing

Conversations about changing the way we talk and think about mental health and wellbeing explored:

  • The need to normalize the idea of mental health; to strengthen the belief that as with physical health, it’s important to care for and sustain our mental health.
  • Finding opportunities to expand ideas around mental health to include positive aspects, such as resilience, joy, and self-confidence, and to embrace mental health and wellness as a goal for the population as a whole.
  • The importance of understanding and addressing cultural barriers and leveraging cultural assets. For example, in some immigrant cultures, the concept of mental health is either not discussed at all, or conflated with mental illness. At the same time, many indigenous traditions have strong intergenerational ties that can foster connection and wellbeing.

Example: In the Mental Health as Wellbeing discussion, Randell Dejesus from the Making Connections site in Kokua Kalihi Valley, Honolulu shared a story about a culture circle established for young men that illustrates the supportive nature of connection and the potential for surfacing and normalizing conversations around mental wellbeing. The young men began their meetings by naming their ancestors and inviting them into the space, a practice that brought forward their connections with their ancestry. As they continued to meet, the group decided to ban the word “good” in response to the question “How are you?” and found this generated more authentic reflections that allowed for connection and support. “It just makes them dig deep into their vocabulary to say how they’re really doing,” he said.

When you can open up and talk in a community that supports you, that’s a first step to wellbeing. -Teri Clark, Nebraska Association of Local Health Directors, talking about work with veterans and military service members in the Mental Health as Wellbeing breakout discussion.

Moving Upstream to Prevention

Discussions on resilience and prevention looked at moving strategies upstream to cultivate mental health and wellbeing.

  • A breakout session focused on the distinctions between primary, secondary, and tertiary approaches to public health problems.

Primary = Prevention

Secondary = Harm Reduction / Intervention

Tertiary = Treatment / Recovery

  • Communities considered where their different strategies fall on that continuum, and how to move towards primary prevention, or addressing problems before they occur. One example the group discussed was providing resilience training for military service members before or at the beginning of their service to help them cope with the stresses they will encounter in military service.
  • Another key point in discussions was the essential role youth and youth leaders play in changing narratives and systems to shift the focus to building resilience and wellbeing.

Example: Toby Joseph, a partner with Making Connections, Tacoma (253 MCI) offered the parable of the three sisters who come upon babies who have fallen into a river. One sister focuses on pulling the babies out of the river (a tertiary approach); the second goes upstream to teach the babies to swim (secondary); and the third ventures still farther upstream to prevent the babies from slipping into the river in the first place (primary).

Primary prevention is like turning off the faucet instead of mopping up the floor.

- The Movember Foundation

Improving Community Conditions

Discussions on changing community conditions to support mental health and wellbeing centered on strategies in the three areas illustrated below: People, Place, and Equitable Opportunity.

To learn more about how improving community conditions can reduce the incidence and intensity of mental health challenges, and help activate resilience, see PI’s new report, Back to Our Roots: Catalyzing Community Action for Mental Health and Wellbeing,

  • The seven community factors highlighted above particularly impact mental health and wellbeing. Often, it is the interplay of several of these factors that shape mental health status.
  • The areas of greatest impact depend on the needs and assets in particular communities and populations of focus. Veterans, for example, both benefit from connections with peers and have training and experiences that support those connections.

Example: Making Connections partners in Boston, who are working with men of color in three city neighborhoods, have developed strategies to address problems with housing and displacement, which are common contributors to stress for men in the communities where the coalition is working. The coalition’s strategies include a program providing housing for fathers and their children, opportunity centers fostering career and financial savvy, and initiatives focused on more systemic changes, such as revising the CORI (Criminal Offender Record Information) regulations so that men with a history of incarceration face less discrimination when they seek housing.

When we were doing focus groups, we were asking what the students see in their communities… One student mentioned that there were some really nice homes being built. His next sentence was, ‘They’re building these homes, but they’re not for us.’ - Aaron Cano, Houston Health Department, podcast discussion on Preventing and Addressing Community Trauma.

Click here to listen to a podcast discussion on Preventing and Addressing Community Trauma, or the impact of chronic adversity resulting from economic, social, and physical factors and structures, with Aaron Cano, My Brother’s Keeper, Houston Health Department; Jama Mohamed, United Women of East Africa Support Team; Toby Joseph, Consultants for Indian Progress, 253 MCI; and Andrew Phan, Hilltop Urban Gardens, 253 MCI. Participants talked about historic and emerging forms of community trauma, such as displacement, as well as solutions, including peer supports, healing circles, and culturally rooted activities such as canoe journeys.

"Healing comes when we realize we're not alone and people start to treat one another as equals." - Toby Joseph, right, with Andrew Phan.

Fostering Healthy Masculinity

An essential feature of Making Connections is the focus on men and boys—developing approaches that are not one-size-fits all, but instead intentionally consider both what works for men and boys and also how to elevate more robust and positive concepts of masculinity that better support wellbeing. The convening included a small-group discussion on developing gender-informed strategies as well as a larger conversation that touched on this topic, Telling the Story of Our Work, featuring Movember’s Craig Martin and Charles Corprew of WYRevolution, a partner in the New Orleans Making Connections coalition.

"We believe that if we create the right conditions, men will speak." Craig Martin, The Movember Foundation (right) with Charles Corprew, WY Revolution.

Key themes included:

  • The importance of - and sometimes lack of - meaningful social connections among men.
  • The opportunity to change misperceptions that men cannot or do not want to share their feelings, and the need to support people around men and boys to ask and listen in ways that work. (See example below for details.)
  • The possibilities that come from creating safe spaces where men (or boys or young men) naturally gather. Men and boys develop connections and authentic conversation while engaging in activities that matter to them, from carpentry workshops (called sheds in Australia), to a hub and meeting place for East African immigrants in San Diego, to a bike shop in Honolulu’s Kokua Kalihi Valley.

Example: In its suicide prevention research, The Movember Foundation has found that social connections are key. "We know that people who have strong social connections will have a reduced rate of suicide," said Craig Martin, Movember Global Director of Mental Health & Suicide Prevention in the convening session Telling the Story of Our Work. "We know that it also leads to improved mental health and wellbeing and it even leads to increased physical wellbeing, and also can lead to an increase in resilience." At the same time, Movember’s research showed that one in three men say they have zero social connections, or someone with whom they would be willing to open up as a friend. In the process of developing its annual suicide prevention campaign, Movember found that the common belief that men don’t want to talk about their feelings is misguided. In their research, Movember learned that men are willing to share their feelings if they are asked the right questions and if people listen to their responses in a way that feels genuine. As a result, Movember developed its Unmute: Ask Him video campaign that highlights the need to ask men how they’re doing, and to tune in when they respond.

Shame, societal pressure, norms, culture don’t allow men to really talk about their issues. – Jama Mohamed, Making Connections San Diego in discussion on Telling the Story of Our Work

In addition to developing gender-informed approaches, Making Connections communities are tailoring their strategies to reflect their particular populations of focus. In the fall of 2017, Making Connections sites that include veterans and military service members in their populations of focus came together in Nebraska to share ideas. They continued the conversation in a podcast discussion at the annual convening.

Click here to listen to the conversation on military cultural competence featuring Justine Ginsberg, Resilience Grows Here, Connecticut; Lance Newman, Brokenfocus, SC Thrive, Florence, South Carolina; and Teri Clark, VetSET, Nebraska Association of Local Health Directors. Participants explored opportunities for engaging veterans’ experience and skills to enable connection and healing, as well as ways to inform and activate whole communities to support veterans, from high schoolers to funeral directors.

Measuring Progress

Making Connections evaluation partners from University of South Florida provided an update on a Mental Well Being Index (MWBI) they are developing to help communities assess progress. The index, which is based on initial research emerging from Making Connections coalitions around what constitutes the foundations, or “pillars” of wellbeing, will gauge movement in relation to eight concepts:

  • Dignity and Respect
  • Safety
  • Institutional Relationships
  • Role of Community
  • Community Connections
  • Social Connection
  • Positive Self-Worth
  • Positive Masculinity

This index will be used across Making Connections communities to help tell the story of this work, and to create and measure shifts and inform communities’ work as they move forward.

The Year Ahead

In the coming year, Making Connections sites will become further immersed in implementing and enhancing their strategies and in sharing their results and lessons they learn. The closing circle at the convening included a gift exchange between communities that reflects the growing connection, collaboration, and unique contributions across the Making Connections Community of Practice.

This is hard work, we realize that, but at the end of the day, I go home knowing we’re making a difference. … I come away from this meeting every year with that positivity, that reminder that you all are doing some great things. Mark Hedstrom, The Movember Foundation

For more information on the Making Connections initiative and 2018 activities, visit:

www.preventioninstitute.org/projects/making-connections-mental-health-and-wellbeing-among-men-and-boys

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Prevention Institute
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