Barber shops and male mental health

Barber shops may provide a vital opportunity to start engaging men in discussing their mental health, according to a recent initiative led by Cardiff and Vale University Health Board and the Lions Barber Collective, in collaboration with Cardiff and Vale College and Truth N Hair.

Currently, many healthcare professionals do not recognise mental health issues in men and may not recommend mental health services when they do. This is one of the findings of an important new report on men’s mental health recently published by the WHO European Region.1 

The report highlights that men are also reluctant to seek help for mental health issues in the first place. This can be because of stigma, a lack of mental health literacy or a fear of being judged for exposing vulnerability. Men who closely adhere to traditional masculinity norms (such as self-reliance, difficulty in expressing emotions, independence, dominance and self-control) are significantly less likely to seek help. For some, depression may precipitate greater risk-taking behaviour, including alcohol and drug abuse, overworking and violence.1

Community-based interventions may be part of the solution as they can offer informal, easily accessible and collegial spaces where men feel safe to talk about personal issues. One such community space that is generating increasing interest among public health policymakers is the barber shop. A longstanding presence on the high street, the trend for male facial hair has seen barbering become one of the fastest-growing retail sectors.2 One analysis suggests that UK men visit a barber shop as frequently as every 2.5 weeks on average.3 It is well-known that many men enjoy and value talking to their barber and, with some seeing the same barber each time, a level of intimacy can develop. The barber-client relationship, which has been described as ‘quasi-therapeutic’, therefore presents a very useful opportunity for a male-targeted health intervention.4

The Lions Barber Collective has taken the lead in developing the role of barbers in improving men’s mental health in the UK.5 A charity established by Torquay-based barber Tom Chapman in 2015, the Collective is an international group of barbers who have undergone ‘BarberTalk’ training to recognise symptoms of common mental health problems in their clients and to signpost them to appropriate support services.

Barbers have previously been recruited as community health champions for other issues. In Birmingham, Alabama, for example, barbershops have had a role in the education of African American men about prostate and colorectal cancer.6 In Bradford, the Health of Men programme successfully worked with a local barber shop to deliver blood pressure monitoring, BMI measurement, cholesterol and blood sugar analysis and smoking cessation advice mainly to men in the South Asian community.7 It has been suggested that the barber shop may be particularly well-suited to the engagement of black men.4

In early 2020, before the COVID-19 lockdown, Cardiff and Vale UHB commissioned the Lions Barber Collective to provide ‘BarberTalk’ training for barbers in the Cardiff area, funded by the Welsh government. An evaluation of 20 participating barbers showed a marked increase in self-reported confidence following training in supporting clients with mental health problems, including suicide ideation.8 In terms of the Likert scale used in the evaluation, the mean knowledge and confidence levels increased from ‘Fair’/’Good’ to ‘Good’/’Very good’. A small survey of clients undertaken before the barber shops were closed in the COVID-19 lockdown found that the respondents were overwhelmingly pleased to have had the opportunity to talk to their barber about mental health issues and all said they would talk to their GP as a result.

Men’s mental health is moving up the policy agenda in the UK and elsewhere, in part driven by the disproportionately high male suicide rate. In June 2020, BBC TV aired a documentary about the Duke of Cambridge’s work to use football as a way to get men talking and to break the taboo surrounding mental health.9 In August, the Samaritans published the findings of a survey that showed that 42% of 18–59 year old men felt that the restrictions imposed by the COVID-19 pandemic have had a negative impact on their mental health, with loneliness and/or isolation, anxiety, financial worries and separation from loved ones among their concerns.10 The Samaritans’ Real People, Real Stories campaign during August and September aims to reach men who are feeling low and struggling to cope.

There is increasing concern that the economic recession caused by COVID-19 could, like past recessions, lead to a significant spike in male suicides. This highlights the need for greater investment in a range of support services for men, including community interventions in barber shops and elsewhere.

References

1. Gough B, Novikova I. Mental health, men and culture: How do sociocultural constructions of masculinities relate to men’s mental health help-seeking behaviour in the WHO European Region? Copenhagen: WHO Regional Office for Europe; 2020 (https://apps.who.int/iris/bitstream/handle/10665/332974/9789289055130-eng.pdf; accessed 29 July 2020).
2. Ward V. Barbers have become the fastest growing shops on the British high street. The Telegraph, 10 May 2019 (https://www.telegraph.co.uk/news/2019/05/10/barbers-have-become-fastest-growing-shops-british-high-street/; accessed 29 July 2020).
3. Sabanoglu T. Average frequency of barber visits in the United Kingdom (UK) 2017. Statista 3 September 2019 (https://www.statista.com/statistics/719264/average-barber-visit-frequency-in-the-uk/; accessed 29 July 2020).
4. Roper T, Barry JA. Is having a haircut good for your mental health? New Male Studies 2016;5(2):58-75.
5. The Lions Barber Collective (https://www.thelionsbarbercollective.com/; accessed 10 August 2020).
6. Holt CL, Wynn TA, Debnam K, et al. Cancer Awareness in Alternative Settings: Lessons Learned and Evaluation of the Barbershop Men’s Health Project. Journal of Health Disparities Research and Practice 2010;4(2):100-110.
7. White A, Cash K, Conrad D, et al. The Bradford & Airedale Health of Men Initiative: A study of its effectiveness in engaging with men. Leeds: Leeds Metropolitan University, 2008 (https://tinyurl.com/y2xqxb45; accessed 10 August 2020).
8. Baker P (2020). Barbers and Mental Health Project: Evaluation. Unpublished.
9. BBC One. Football, Prince William and Our Mental Health. BBC, 27 June 2020 (https://www.bbc.co.uk/programmes/m000jkbr; accessed 11 August 2020).
10. Samaritans. Real People, Real Stories launches with new research on men’s mental health during lockdown. Samaritans, 11 August 2020 (https://www.samaritans.org/news/real-people-real-stories-launches-new-research-mens-mental-health-during-lockdown/; accessed 11 August 2020).

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