Local systems and services
Local systems and servicesThis chapter examines how well local systems and services in Cumberland align with the needs of boys and men across the life course. Drawing on professional survey responses, service mapping and interviews, it highlights a consistent pattern: while provision exists across statutory and voluntary sectors, many services are not designed in ways that reflect how boys and men access support or build trust.
Barriers to engagement are about not just awareness and motivation, but also service design, accessibility, cultural fit and continuity. Understanding this misalignment is essential to improving outcomes and preventing escalation to crisis.
What boys and men report needing from services
A central theme revealed was the importance of relationships. Respondents repeatedly emphasised that trust, familiarity and continuity are prerequisites for disclosure and meaningful engagement. Many men do not present with explicit emotional language or self-identify as needing mental health support; instead, distress is often expressed through physical symptoms, behaviour, substance use, anger, withdrawal or practical problems. Engagement tends to occur gradually, once a relationship feels safe and non-judgemental.
Activity-based and informal approaches were widely described as more effective entry points than clinic-based or verbally led services. Outdoor activity, sport, practical tasks, shared interests, group settings were seen as lowering the perceived threat of engagement and reducing stigma. This pattern was reflected in feedback for both boys and for adult men.
Relatable role models and lived experience were consistently valued. Men were more likely to engage when support was delivered by people they perceived as credible and able to understand their experiences, whether through shared background, gender, life experience or recovery journeys. Visible role models were also consistently reported as a vital component of creating aspiration for boys and young men. Seeing men in employed in a diverse range of roles is important in promoting the social acceptability of HEAL employment opportunities.
Neurodiversity, particularly patterns associated with ADHD and autism, emerged as a significant cross-cutting issue. Delays in assessment, limited understanding among professionals and underlying neurodivergence were reported to affect boys and men at multiple life stages. For some, unmet neurodiverse needs contribute to educational disengagement, employment difficulties, mental ill-health and contact with the justice system.
Rurality, transport limitations and limited evening or community-based provision were identified as major barriers to access. These constraints affect boys and men of all ages, particularly those without private transport, those in coastal or isolated communities, and those whose working patterns do not align with standard service hours.
How the current system is organised
The landscape of services in Cumberland is set-up of universal services (primary care, schools), council-commissioned (housing, sexual health services), NHS (mental health, addiction), and a large and vital network of voluntary/community sector offers. Some of these services, such as Andy’s Man Club, are male-specific initiatives, while some services, such as addiction services provide support for all but deliver interventions in an area of importance for male health outcomes. Some available services are listed in Appendix 1: Overview of current services, but this list is not exhaustive.
Statutory services are largely organised around referrals and episodes of care. Support is frequently time-limited, condition-specific or crisis-led, with multiple transitions between complementary services. While appropriate for some needs, this structure can be poorly suited to men whose engagement develops slowly or who require long-term relational support.
Outside of the voluntary and community sectors, services are predominantly clinic-based. Success of these services rely more heavily on the ability of individuals to articulate emotional distress, attend appointments and navigate complex pathways. For many men, particularly those experiencing stigma, mistrust of services, neurodivergence or chaotic life circumstances, these expectations act as barriers rather than gateways.
Workforce composition is also relevant. Services supporting emotional wellbeing are often female dominated, which may affect how safe or relatable some men perceive them to be, particularly in early engagement.
Gaps between the Cumberland system and population need
Rather than failures of individual service, the challenges identified indicate a system-level misalignment between need and design.
A timing gap was frequently described, with support often becoming available only once problems have escalated to crisis, safeguarding thresholds or acute mental health need. Earlier, informal or preventative engagement was reported to be limited or inconsistently available.
A mode of delivery gap was also described. Services that rely on formal appointments, verbal disclosure and clinical framing were perceived as less accessible to many men, particularly those who mask distress or present through behaviour or physical symptoms.
There is a distinct cultural gap, with stigma, fear of judgement and concerns about confidentiality, especially in small or close-knit communities, deterring engagement.
A physical access gap persists, particularly in rural areas, where transport, cost and service location limit participation. Even well-designed services may be effectively inaccessible to those who cannot physically reach them.
Finally, a continuity gap was highlighted. Short-term projects, time-limited interventions and frequent service changes were described as undermining trust and discouraging re-engagement, particularly for men who have previously disengaged or experienced rejection from services.
Services that help in practice
Services that help in practiceThe evidence assembled in this report suggests that boys and men in Cumberland are more likely to engage when services feel accessible, relational and non-judgemental, and when they meet men geographically, emotionally and practically. This aligns strongly with professional feedback that many boys and men will hold back from disclosing distress until trust is established, and that engagement is often more successful when it is informal, consistent and built around shared activity rather than clinical framing.
Local insights from The Big Question (Ashworth, E. et al, 2026) highlight several initiatives and organisations that participants felt are helpful in practice. These include the Baton of Hope tour (as a visible, community-level way to acknowledge suicidal distress and suicide bereavement), Every Life Matters (a training, campaigning and support offer for those impacted by suicide), and The Lighthouse (Mind) (for in-person, same-day crisis appointments). These services share features that are repeatedly valued by men and those supporting them: visibility, credibility, reduced stigma, and routes into support that do not rely solely on formal referral pathways.
A consistent theme was that services work best when they create multiple entry points. including community events, peer spaces, informal drop-ins and activity-based engagement. These entry points can act as bridges into more specialist care when required, while also providing ongoing social connection that reduces isolation.
Two local examples illustrate these design principles in practice. Firstly, Andy’s Man Club provides free, peer-led groups for men, offering a non-clinical and informal environment where men can attend regularly without referral (Box 3). Andy’s Man Club is an important complement to statutory services rather than a replacement, with value as an accessible route into support and onward signposting where needed. However, peer-led groups are not suited to everyone, and it is important to offer range of open access early support services. Secondly, The Hope Haven (Box 4) offers community-based support with an emphasis on referral-free, walk-in accessibility, with multi-agency partnerships.
Box 3: Andy's Man Club
Andys Man Club
“Andy’s man club (AMC) is a national volunteer led mental health and suicide prevention charity that opened in mid 2016 following the tragic suicide of Andrew Roberts in early 2016. Starting with just 9 men meeting in a small room there are now 334 physical venues across the UK and online sessions running every Monday (except bank holidays) from 7pm until 9pm where men over the age of 18 can meet in a non-judgement neutral and confidential setting to open up about their mental health struggles and get support from a group of peers in similar situations.”
Facts and figures
In Cumberland, there are eight groups. In 2025, there were 6,672 attendees, with 402 of these being new, first-time Andy’s Man Club attendees
Brampton: 106 attendees | 20 new (opened Oct 2025)
Carlisle: 1,988 attendees | 142 new
Cockermouth: 671 attendees | 37 new
Maryport: 798 attendees | 25 new
Millom: 362 attendees | 27 new
Whitehaven: 669 attendees | 52 new
Wigton: 261 attendees | 20 new
Workington: 1,818 attendees | 79 new
Box 4: Hope Haven
Hope Haven is a radical new collaborative mental health 24/7 neighbourhood centre and one of only 6 NHS England National Pilot sites, situated in Copeland in West Cumbria.
In this service the concepts of ‘referral’, ‘discharge’ and ‘criteria’ are all removed with access to support as easy as walking through the door, ringing our telephone number or connecting online.
Our partners all work together as a ‘Team of the day’ each day. This includes ‘welcomers’ who make sure anyone walking through the door receives a warm welcome and will listen to you to find out how we can help.
What’s unique about Hope Haven is that if you need more than one type of support, we’ll build that around you – you won’t get passed between different services. Our service is built on different organisations in the local community working together and collectively aiming to support a truly community led approach to mental health and wellbeing.
Hope Haven’s model is based on partnership working around the person’s needs. People will be able to access support for mental health experiences and help to identify what areas may trigger or drive their mental health distress. Support is then arranged across varied levels from providing advice and guidance to complex interventions.
This places the person and their family at the centre of a collective approach to listen and understand their needs and help to support, build strength, value and wellbeing as part of their daily life.
Hope Haven has a range of partners offering areas including:
Together in a crisis interventions.
Virtual safe haven (4pm to midnight 7 days a week with bookable appointments.
Support with housing needs.
Support with addictions.
Physical health support including GP access.
NHS mental health interventions for all ages.
Short stay beds for those in crisis.
Hope Haven supports a greater understanding of the person, their needs, and also their interests and aspirations, using a multi-disciplinary approach.
Implications for service design and system response
Evidence from The Big Question, local surveys and professional feedback converges on a clear message: improving outcomes for boys and men is about reshaping the system around accessibility, continuity and earlier engagement. Several specific implications emerge:
There is a need to strengthen crisis access and responsiveness, while avoiding an overall model where men only receive support once distress has escalated. Crisis support must therefore be visible, rapid and easy to navigate, with clear routes between crisis response and ongoing follow-up.
Cumberland requires a more geographically distributed offer, including outreach, evening provision and local “third spaces” that are welcoming and easy to access.
There is a strong case for embedding front-door early intervention and education across settings where boys and men already are: schools, colleges, workplaces, community venues and primary care, so that help-seeking is normalised long before crisis.
Services need to be more relational, recognising that engagement may be gradual and that many men present with practical, behavioural or physical concerns rather than explicit emotional distress. Models that allow men to engage through shared activity, peer spaces, trusted adults and informal drop-ins are routes to earlier contact and sustained engagement.
Peer-led spaces and public conversation reduce stigma create visible permission for men to speak about distress and suicide bereavement. These approaches work best when they are integrated with clear routes into support, so that awareness translates into access.
There is a need for stronger collaboration across statutory and third sector partners, including shared pathways, clearer signposting and smoother transitions. Many of the most acceptable entry points for men sit in community and voluntary settings, but they must be connected to clinical and safeguarding responses when risk is identified.
There must be deliberate attention to welcoming, psychologically safe spaces, including spaces that work for neurodivergent people. Across the evidence, neurodiversity, emerged as an important factor shaping behavioural presentation, disengagement from education and services, and later mental health risk.
Finally, the system should treat postvention, support after suicide bereavement, as a core component of prevention. Given the high proportion of residents reporting being affected by suicide, bereavement support is a population-level need that has the potential to reduce longer-term trauma, isolation and risk.
The recommendations in the next chapter translate these design implications into priorities for commissioning, workforce development and place-based delivery in Cumberland.