This 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.