The National Male Survivor Helpline and Online Service
Background
Safeline has worked with male survivors for 28 years and we are expert in supporting male survivors. We have a wealth of experience in this area and our team of professional helpline and online support staff are highly skilled at providing remote for male survivors. Safeline’s commitment to male survivors is evidenced by being the first multi-gender organisation to achieve the independently accredited Male Survivor Partnership Quality standard for male survivors in 2019 and the Helplines Partnership Quality Standard in 2020.
Prevalence of male sexual abuse
It is estimated that 1 in 6 males in the UK have experienced unwanted sexual abuse or attempted sexual abuse in their lives. Research by Mankind in 2021 found even higher prevalence rates:
- 50% of men had unwanted sexual experiences
- 1 in 7 men had been coerced into sex
- 1 in 10 men had experienced rape or non-consensual penetration
The Crime Survey for England and Wales 2020 estimated 155,000 men aged 16 to 74 years experienced sexual assault including attempts
The Impact of Sexual Abuse upon Males
The impact can be profound, extensive, and long-lasting and common reactions include self-harm, mental health issues, eating disorders, homelessness, emotional dysregulation, relationship difficulties and guilt/shame/blame. Foster, Boyd, and O’Leary (2012) report that male survivors are:
- 10 times more likely to be diagnosed with PTSD
- 10 times more likely to report suicidal ideation (46% of male survivors of childhood sexual abuse had attempted suicide)
- More likely to cope with the aftermath of childhood sexual abuse with drug and alcohol misuse
- Less likely than girls to disclose at the time of the sexual abuse and men and boys are less likely to disclose at all compared with females.
- On average, disclosing their abuse 22 years after the assault which is c.10 years later than females and only 5% report to the Police.
I didn’t think anyone would believe what my father did to me. I didn’t want to believe it myself. I kept trying to puse the memories down but they were always there, and it took me almost 60 years to tell somebody. It was a relief to call the helpline and finally talk about what happened to me.
Barriers to Male Help Seeking
Societal expectations around masculinity and gender norms are considerable barriers to male help seeking and thus gender is a major barrier to disclosure of male sexual abuse. The impacts of societal expectations around the male gender role include:
- Males blame themselves both for not stopping the abuse from happening and for struggling with the aftermath, because ‘as men they should be able to cope’.
- The sense of not living up to the masculine ideal of being strong, tough, and able to protect themselves from adversity makes men who have been sexually abused unlikely to seek help due to their fear of ridicule and blame
- Many male survivors are left questioning their gender identity after sexual abuse believing ‘I’m not a real man’
The rise of feminism and services for female survivors, whilst much needed and of huge benefit for females, has further impacted on male help seeking by enforcing male rape myths and stereotypes and creating a lack of provision for male survivors.
These myths and stereotypes include:
- ‘Men can’t be sexually abused’ (hence no need for services)
- ‘Only gay men and boys are sexually abused’
- ‘Sexual abuse makes you gay’
- ‘A male who discloses sexual abuse is probably a perpetrator’
Seeking help for sexual abuse or rape (for which society has traditionally considered a feminine issue), for struggling to cope with the aftermath and for thinking they were to blame for not stopping the assault carries, a high level of self-stigma, guilt, and shame for male survivors. This extremely difficult and challenging situation leaves males believing they must be weak, unable to cope and emasculated and thus has a huge impact on help seeking behaviours that needs to be understood by commissionaires and service providers.
It is important to have a service especially for males because other services are very directed at females
The National Male Survivor Helpline and Online Service (NMSHOS), managed by Safeline, is aware of and understands the barriers to male help seeking and hence the service provision is designed specifically to encourage males to seek support through:
- Extensive staff training in working with male survivors
- Service promotion that makes it clear this service is specifically for males that ‘talks’ to males with male associated language, images and dispels myths and stereotypes
- Provides a choice of gender for males to talk with – vitally important and essential to meet accreditation standards
- Provides a choice of ways to communicate with the service (telephone, text, webchat, and email)
Having someone who understands how trauma effects males is a real help, as there are differences which need to be signalled and addressed
The importance of a Male Specific Sexual Abuse Helpline and Online Service
Attention needs to shift from solely addressing traditional views that men do not, and will not, seek help, to include a focus on increasing awareness of suitable support for men (Seidler et al., 2017).
Males endorsing high conformity to masculine norms (e.g., power over others, dominance, and pursuit of status) are far less likely to talk to a mental health professional and more likely to engage in self-medicating behaviours (Cole and Ingram, 2019).
This is crucial to understand to promote and manage a service specifically for male survivors. Services must recognise:
- Perceptions that informal help seeking is more confidential and less vulnerable than professional help seeking (Johnson et al., 2012), a reason why the NMSHOS is seen and promoted as friendly, compassionate support that is confidential, and men can ‘drop in’ and call on a day and time that works for them. In this regard it is purposefully not promoted as formal structured support as that would be applicable to professional counselling only.
- Professional titles can also affect the decisions that men make about when and where to seek help (Brown & Chambers, 1986) and in some cases may act as a barrier to seeking help. Men may perceive that formal help seeking approaches such as counselling are inherently “feminine” due to their emphasis on emotional expression and self-disclosure (Boespflug, 2005). As a result, men may be drawn to “masculinised” professional titles such as “executive coach” because coaching is associated with a more directive relationship than media portrayals of counselling (Boespflug, 2005).
- Similarly, the names of organisations that offer psychological support appear to influence the decision to seek help. Hence the term we use at Safeline for our NMSHOS staff is ‘Helpline and Online Advisor’ emphasising that men can ask for advice and information and there is no assumption in the title that they will have to talk about their emotions. This provides a sense of emotional safety and aids a sense of being in control of what is shared, crucial components to build trust in a service.
- Perceptions that other men are engaging in health seeking behaviours also increases the likelihood that males will engage in healthy behaviours (Mahalik et al., 2007); Seeing other men violate gender norms related to help seeking improves utilisation of mental health services (Vogel et al., 2008). Using the words ‘National’, ‘Male’ and ‘Survivor’ in the title of the NMSHOS clearly spells out who this service is for and being the support helpline for BBC TV and radio and ITV it is now a prominent and recognised service for male survivors across England and Wales. Consistent spikes in calls following high profile cases such as the footballers’ disclosures in 2017 and the male rape storylines on Coronation Street and Hollyoaks in 2018 have been observed.
- Men weigh up potential benefits and drawbacks to seeking support and must decide which is more important, getting relief or avoiding increased gender role conflict (GRC) and potential loss of status (Perlick & Manning, 2007). Hence, acceptance of treatment is associated with short-term struggles with GRC (e.g., discomfort with disclosure, shame, fear of dependence on the therapist, and fear of being perceived as weak by peers).
Avoiding treatment will lead to continued psychological distress and ultimately a mental health crisis. In relation to this, many male survivors who contact the NMSHOS are at this point – the need to finally take control gives them permission to call and seek the support they need. Hence, as an organisation, it is important that we psychoeducate males to help normalise their reactions to coping with their abuse (such as mental health issues and self-harming behaviours) and the utilisation of emotional support when they experience these issues.
Repeat callers to the NMSHOS – what do they tell us?
The average number of repeat and new male callers to the service was 58.1% and 41.9% respectively during the reporting year April 2021 to March 2022.
The impact on relationships is now well known for survivors of sexual abuse and leads to high levels of isolation and loneliness but the perception that frequent callers are lonely and contacting helplines for general support underestimates their needs.
There is evidence that regular callers may have fewer social supports than other callers, if never having been married is regarded as a proxy for this, but, as a group, they do not call without good reason.
Regular callers to crisis services are more likely to be male and unmarried. Compared with non-frequent callers, regular callers are more likely to present with significant mental health problems and high levels of risk, including suicide (Spittal et al., 2015). Hence, the benefits of talking to a trained NMSHOS professional in that moment of crisis, cannot be underestimated not only to aid a sense of connection which is crucial for wellbeing but also to help alleviate the experience of crisis and to be heard and supported.
I’ve been able to talk about things I’ve never talked about before and the support from Safeline has been the only ever consistent support I’ve ever had in my life
Which type of communication do male survivors prefer?
Providing different forms of communication for male survivors and those supporting them is important to enable them to get in touch with the NMSHOS via a medium that suits everyone. Since inception in 2015 this service provided support via the telephone, text, instant messaging, and email. The male telephone helpline has consistently been the preferred medium to use to contact the service and as awareness of the male helpline grows the preference for talking over the phone has become highly significant.
Independent research of Safeline’s service data by Weare et al., (2019) on behalf of Male Survivors Partnership, identified that 95% of contact with the NMSHOS was via the telephone service. This data overwhelmingly shows that male survivors prefer seeking advice, information, and support via talking to a trained professional over the phone.
The preference for talking over the phone is also reported for the UK Stop it Now helpline that reports that 56.9% of contacts were through the helpline with only 1.7% via web chat (Grant et al., 2019).
The Samaritans report that those who had phoned or visited a branch tended to report higher levels of satisfaction with the length of response time than those who had used e-mail or text message (Coveney et al., 2012). A survey by Agilent Technologies (2005) identified that men preferred to talk more on their mobile phone than females who preferred text-based methods.
The role of the third sector in supporting male survivors
Javaid (2017) in a review of the third sector working with male rape victims outlined four areas to address to meet the needs of male survivors, these are outlined below.
It is important to point out a key difference at Safeline is that due to the need for highly trained staff the NMSHOS does not use volunteers – all NMSHOS staff are salaried employees that have undertaken extensive and ongoing training and supervision to ensure they are providing the best support for the callers and adhering to our multiple accreditation standards:
- The need for a choice of a voluntary agency practitioner (regarding gender) offered to victims. Callers to the NMSHOS have a choice of gender of staff
- The need for gender-specific training in the third sector. At Safeline all staff have gender specific training before working with males and ongoing continual professional development
- The impact of limited resources and funding in the voluntary sector. Whilst this has improved in recent years the economic impact of not supporting male survivors would create a much larger burden on government finances (e.g., on the NHS, Police, social care, benefits) as the impact of abuse on male survivors is so wide ranging. In terms of statutory funding, the long-term funding of the NMSHOS, already recognised nationally as the place a male survivor can access to gain the right advice and support, would enable the service to continue to support males as soon as they feel ready to talk, helping to limit the long-term damage that keeping silent can do and enabling males to cope and recover.
- To be inclusive of all ages of male survivors and not to prioritise male rape victims in the voluntary sector in terms of their age. The NMSHOS does not prioritise – we support all individuals who identify as male of all ages and are fully inclusive
Comprehensive health economic data is urgently needed to estimate the public health costs of men’s lack of service engagement, its impact on the community, and the changes required for future programs.
Clinicians, researchers, and policy makers need to appreciate that men’s mental health outcomes involve both getting more men to call the NMSHOS and providing effective tailored gender-specific support. Failing to deliver a service tailored and responsive to men’s diverse needs has, and will continue to, increase many men’s feelings of alienation and shame regarding their sexual violence. This creates more barriers to males seeking help and heightens the potential for long term psychological, sociological, relational, financial, physical, and emotional consequences.
A person-centred framework, and treatment approaches adapting and embracing the diversity of men and masculinities to provide gender-sensitive and specific care, is critical. Even marginal reductions in men’s rates of substance overuse and violence would result in lower public health and social costs.
The NMSHOS meets all the requirements outlined above by academic research but more importantly, based on usage and feedback, it meets the needs of the males who choose to access and engage with the service. This is a result of constantly reviewing the service such as which communication methods males prefer when they need the service to be open and having a choice of staff of different genders to talk with. The NMSHOS is therefore an essential and necessary part of the male survivors’ cope and recovery journey.
Service Feedback
Feedback from service users demonstrates that the service delivers exceptional quality and meets male survivor needs:
- SurveyMonkey Question: After your call with us today how are you now feeling? 83% responded ‘much better’
- SurveyMonkey Question: How would you rate the service you received today? 93% responded ’very good’
- SurveyMonkey Question: Would you recommend the service? 99% responded ‘yes’, they would recommend the service
References
AGILENT TECHNOLOGIES (2005). Women prefer text; 72% text more regularly than call, says mobile phone survey; Men talk more on phone than women, Coventry.
Boespflug, S. A. (2005). Attitudes of future male business managers towards seeking psychotherapy. Dissertation Abstracts International: Section B: The Sciences and Engineering, 65, 6642.
Coveney, CM, Pollock, K, Armstrong, S and Moore, J. (2012). Callers’ experiences of contacting a national suicide prevention helpline: report of an online survey. Crisis 33, 313– 24. doi.org/10.1027/0227-5910/a000151
Foster,G., Boyd, C. & O’Leary, P. (2012). Improving policy and practice responses for men sexually abused in childhood. Australian Institute of Family Studies 12, 1-20.
Grant, B.-J., Shields, R. T., Tabachnick, J., & Coleman, J. (2019). “I Didn’t Know Where To Go”: An Examination of Stop It Now!’s Sexual Abuse Prevention Helpline. Journal of Interpersonal Violence, 34(20), 4225–4253. https://doi.org/10.1177/0886260519869237
Javaid, A. (2017) “Making the invisible visible: (un)meeting male rape victims’ needs in the third sector”. Journal of Aggression, Conflict and Peace Research, 9(2): 106-115.
Johnson, J. L., Oliffe, J. L., Kelly, M. T., Galdas, P., & Ogrodniczuk, J. S. (2012). Men’s discourses of help-seeking in the context of depression. Sociology of Health & Illness, 34, 345–361. http://dx.doi.org/10.1111/j .1467-9566.2011.01372.x
Mahalik, J.R., Burns, S.M. and Syzdek, M. (2007). Masculinity and perceived normative health behaviors as predictors of men’s health behaviors. Soc Sci Med, 64(11), 2201-9. DOI: 10.1016/j.socscimed.2007.02.035
Perlick, D. A., & Manning, L. N. (2007). Overcoming stigma and barriers to mental health treatment. In J. E. Grant & M. N. Potenza (Eds.), Textbook of men’s mental health (pp. 389 – 417). Washington, DC: American Psychiatric Publishing, Inc.
Seidler, Z., Rice, S., River, J., Oliffe, J. and Dhillon, H. (2017). Men’s mental health: The case for a masculinities model. The Journal of Men s Studies. 26. 1-13. 10.1177/1060826517729406.
