Concluding discussion

Young men’s health and masculinity norms are closely intertwined. And masculinity norms are embedded in society’s norms. These norms, although they are constantly changing, shape and contribute to young men’s health and health behaviours; thus, individual and structural factors interact in complex ways (Robertson, 2007; Thorpe & Halkitis, 2016). Masculinity norms are limiting for boys’ and young men’s health even though masculinities are constantly changing and allowing for new, more health-promoting masculinities to be created.

Traditional masculinity norms emphasise traits that have been shown to be obstacles to seeking help. These norms are also an obstacle to valuing connection and relationships that increase well-being and can provide resilience against many forms of mental ill-health. Young men’s lower propensity to seek help compared to young women is well-known (Granrud, Bisholt, Anderzèn-Carlsson & Steffenak, 2020; Wirback, Forsell, Larsson, Engström & Edhborg, 2018). Having to bear the burden of your own difficulties without having anyone to turn to can result in increased stress, anxiety and depression, which ultimately risks leading to suicide. The term ‘homosociality’ refers to how men identify with and understand their social position in relation to other men. Homosociality can explain why it may be experienced as shameful to seek help and show weakness, since this is linked to ‘being feminised’. In comparison with many others, the Nordic countries are streets ahead in certain areas of equality, but the reiteration of hegemonic masculinity norms in the Nordic countries still excludes and still identifies non-white, non-heterosexual and disabled men as ‘other’ (Egeberg Holmgren, 2011). Important contexts for well-being such as education or training and the workplace also tend to be places where hierarchies based on hegemonic masculinity are repeated and cemented, while these are also places where young men can come into contact with health promotion efforts and support.

The overall aim of this research overview was to highlight knowledge about young men’s mental health in relation to current conditions and challenges in schools and the workplace in the Nordic countries in particular. In addition, the overview highlights knowledge about the consequences that the COVID-19 pandemic has had on young men’s mental ill-health. The pandemic has had severe consequences for young people in schools and those in work. Studies in the overview show that an insecure labour market and increased unemployment, especially among young adults, distance teaching, social isolation and reduced opportunities for leisure activities, have had a negative impact on mental well-being.

Schools and workplaces are important places for offering support to young men and for changing masculinity norms that tend to be antagonistic to practices that are health-promoting. But the relationship between mental ill-health on the one hand and education and training and the workplace on the other is complex. Mental health and well-being alone are the strongest predictors for a positive experience of school, and getting to participate in sports, having a positive body image and satisfactory sleep nearly double pupils’ opportunities for a positive experience of school according to Forsberg et al. (2019). The context that a workplace provides can also provide support for young men. But this overview also shows that much of this mental ill-health can be seen as a product of poor experiences of education and training systems and a poor work environment. Education and training institutions and workplaces can also reproduce norms and notions of masculinity and thus hinder practices such as seeking help or establishing meaningful relationships.

In most of the studies included in this research overview, no analyses were made from a theory of masculinity perspective; instead, the division into sex categories is taken for granted and implies a stable way of looking at gender. This way of looking at the groups men and women can provide important knowledge about how current categorisations can have different effects in the two groups but can also stand in the way of a perspective on masculinity as something historically and socially dynamic. It is important to highlight the concept of social health – which emphasises how health and ill-health are directly related to social relationships and hierarchies, as well as to experiences of being capable of change and influence – in order to understand many of the results of this overview. It is important to demonstrate alternative masculinities to young men to promote their mental health and well-being, and to challenge and redefine the kinds of traditional masculinity norms that can be harmful to young men’s health. Thus, viewing masculinity as dynamic can both increase the quality of research on young men’s mental ill-health and help in work to prevent ill-health among young men.

In summary, young men face many challenges when it comes to contemporary masculinity in the Nordic countries, although the impact of masculinity norms on mental health can vary between groups and countries. The potentially negative effects of certain masculinity norms need to be addressed in order to demonstrate alternative masculinities. School is perhaps the most important arena where you can reach everyone. Therefore, all schoolchildren should be offered a talk with a school counsellor, similar to health talks with the school pupil health service, in order to avoid the stigma of seeking help for mental health issues. When an intervention targets all, no one feels stigmatised and therefore access to support can be on equal terms, and thus support can be provided on equal terms, regardless of socio-economic status or gender. Being able to talk about health from a holistic point of view comprising mental, physical and social aspects, where body, mind and relationships are all included, can improve understanding of how a person’s experience of their health is related to multiple aspects. Relational health, that is, how well the person feels in their social relationships, has proven to be crucial for young men’s development, and social health can also affect mental health. Good health is a prerequisite for coping with the challenges of school and the workplace and for resilience in the face of negative and limiting masculinity norms.

Practical implications

The studies have the following practical implications for young men’s health:

Young men find it more difficult to seek help and counselling and admit mental ill-health. A more inclusive and supportive attitude to young people’s mental health and enabling early and accessible support for young people is therefore desirable.
It is important that schools detect young men with mental health issues early and address questions of mental ill-health among pupils in order to reduce the stigma and shame associated with mental ill-health.
Access to psychosocial support in the form of a school counsellor should be readily accessible, and young people should be offered a visit to the school counsellor to reduce stigma around seeking psychosocial support.
Early intervention can prevent mental ill-health later in life and general interventions, information and discussion among school pupils can constitute preventive intervention.
For some young men, the transition from education or training to the workplace can be a challenging period and increased support is needed for a smooth transition.
Young men who are NEETs need immediate, individually adapted measures.
In future action plans, intensified measures are needed to mitigate inequalities, particularly when it comes to the health of young people. 
Some groups are especially exposed and vulnerable in times of crisis and they need specific, targeted interventions. More knowledge is needed about which interventions, for whom and when, do the most good. Social and health policies should direct support to these least privileged groups.
Should society face a similar crisis in the future, with such a pervasive impact as the pandemic had on young people, preparedness in the health care system, municipalities, social services, school pupil health services and occupational health services must do better at meeting the needs for psychosocial support of young people who exhibit signs of impaired psychosocial functioning, increased stress and vulnerability.
Risks for mental ill-health do not exist at the individual level alone, but also involve the family, social network and structural levels. It is important to consider the wider context and include entire families in the formulation of interventions in the event of a future situation similar to the pandemic.

Identified knowledge gaps

All the Nordic countries have addressed the consequences of the pandemic, and for all the Nordic countries there are research studies and reports on education and training, the workplace, health and masculinity. However, some knowledge gaps have been identified. The knowledge gaps identified in this research overview are listed below.

This overview consistently took an interest in studies related to ill-health. However, it is of great importance in future studies to investigate factors that contribute to health from a salutogenic perspective.
Longitudinal studies are needed to investigate the possible long-term effects of crises on mental health and well-being.
More qualitative studies are needed to investigate the profound consequences of such crises and increase understanding of young people’s perspectives.
While there are plenty of studies of young men who are NEETs, it has been difficult to identify studies of the mental health of young men in the workplace. This indicates that more knowledge is needed regarding the specific challenges they face in the workplace.
More knowledge is needed about the specific challenges that young men face in understanding and managing their mental health, in education and training as well as in the workplace.
More knowledge is needed about how we can promote mental health in young men. An understanding-oriented, holistic approach to health and a supportive, solution-focused approach can contribute to this.
Another area of knowledge that needs to be strengthened is how young men can overcome the stigma attached to seeking help for mental ill-health in time.
In order to strengthen the state of the knowledge in this area, it is important to report gender at the variable level in quantitative studies.
This overview indicates that young people with a non-binary gender identity can be subject to negative consequences for their health and also stigmatisation, discrimination and lack of access to support. Future studies should therefore include non-binary as a variable to a greater extent.
The gender dimension needs to be highlighted in future studies, and include questions that relate specifically to gender identity in order to highlight and strengthen knowledge about possible differences.
The category of age also needs to be clarified in more studies to enable further analyses.