By Ben Jefferson, Counsellor & Men's Counselling Service Co-Founder 

We’re constantly looking for ways that we can expand access to counselling for men. To build an effective platform, it’s vital that we’re not only speaking to our counsellors and men directly, but also looking at the bigger picture and analysing what’s happening at a national level.

Over the summer we carried out a research project into general trends in men’s therapy over the past 20 years, which was drawn from publicly available data published by organisations like the NHS, the ONS and BMJ.

We concluded that despite male access to therapy growing, more needs to be done to ensure that therapy remains an actionable, practical and reliable option for men.

Statistically, it’s clear that many men do struggle, yet men are still less likely to access counselling – they make up only around a third of referrals to NHS Talking Therapies (you can find more in our guide to men’s mental health statistics). The barriers preventing men from accessing therapy at the same level as women are also well documented, from stigma and traditional notions of masculinity to a lack of targeted campaigns. Today, we’re taking the conversation in a different direction, to look at what is gaining traction outside of those statistics and barriers.

When looking at male help-seeking behaviours, two trends emerged. Firstly, despite the number of men receiving no treatment whatsoever for a common mental health condition falling from 77.5% to 53.4% over the past 20 years, pharmaceutical intervention has grown by far more than therapy has. Secondly, too many men who are referred to therapy don’t start it or complete it.

In order to boost male engagement with therapy, we have put together a list of five practical steps policymakers and industry could take to position counselling as something men find more appealing.

Pharmaceutical intervention grows faster than therapy

Our analysis reveals pharmaceutical intervention for men’s common mental health conditions (CMHCs) has grown by three times as many percentage points as therapeutic intervention has since 2000.

According to NHS data, between 2000 and 2023/4 (published in 2025), the proportion of men with a CMHC increased from 14.6% to 17.3% of the population.

Over the same timeframe, the same data show the proportion of men with a CMHC receiving psychological therapy increased 7.1 percentage points from 10.4% to 17.5%, while the rate of men receiving medication for their condition increased by 21.6 percentage points, from 18.3% to 39.9%.

This suggests that problems persist on both the supply and demand side for therapy relative to pharmaceutical intervention. Despite the positive steps the country has taken in the provision of therapy for men and growing awareness of its benefits, there is clearly some way to go to ensure it is perceived as a visible and desirable option.

Pharmaceutical interventions are vitally important in many instances, and they shouldn’t be framed as competing with therapy, as they often work together. That said, the disparity in the growth between the two does underline the importance of making sure therapy is available to all men who could benefit from it. Men need to feel comfortable using these services; too many men still view therapy as a last resort, and not something fundamentally ‘for them’.

Too few men complete therapy

The analysis also revealed that many men referred to public therapy services drop out before completion, or never even start at all.

NHS Talking Therapies’ data for 2024/5 shows that among the 597,796 men referred to the service with anxiety and depression – the two most prevalent CMHCs – a third (202,660 / 33.9%) ended their engagement with it prior to receiving treatment. A further 172,451 (28.8%) ended after just one treatment. Of the total referrals received, just 205,418 (34.4%) finished their treatment with NHS Talking Therapies.

To us, this indicates that too many men who clinicians identify as potentially benefitting from counselling decide not to proceed with it, or don’t make it past the first session. This could indicate that the well-documented barriers to counselling (stigma, traditional notions of masculinity, a lack of targeted services and campaigns), or more practical barriers (a lack of available time, a lack of choice, a lack of privacy), may impact retention rates of male clients.

That matters, because the men who do stay often get a lot from it. In our 2026 counsellors survey, 70% of counsellors said men often or almost always wish they had come sooner, and 79% said more than three-quarters of men experience some degree of constructive change after 10 or more sessions.

How can we better design counselling services around male engagement?

Based on our research, and extensive conversations with our counsellors, we have identified five key ways that counselling services can be designed to boost engagement with men:

1. Is counselling too difficult to access? Make the first step the easiest one: Counsellors report that men rarely arrive on impulse. Most have been turning the decision over privately for months or years before making contact. By the time a man reaches out, the hard part is often already behind him. A process that adds friction at that moment, through sign-ups, accounts or admin, risks losing him at the point he has decided to act. In our survey, a third (34%) of counsellors said men usually take between a month and a year to go from recognising a problem to booking a first session, and a further 15% said it usually takes more than a year.

2. What is therapy? State plainly what therapy is: One barrier is uncertainty about what therapy involves. Counsellors describe men arriving braced for intense emotional exposure, awkward silence, or being pushed further than they are ready to go. Much of the early work is simply demystifying the process and explaining, in plain terms, what a first session is actually like. In our survey, 77% of counsellors agreed that men don’t understand what happens in counselling, and 44% said worries about being pushed to confront things before they’re ready slow men down from booking.

3. Is therapy for men? Meet men where they are, in a practical way: Many men come to therapy looking for tools, solutions or a way to deal with a specific problem, rather than to talk about feelings in the abstract. Counsellors consistently note that this practical, outcome-focused framing is often what lets men engage at all, and that removing clinical distance and language, and communicating plainly what therapy offers, helps too. In our survey, 60% of counsellors said men most commonly arrive wanting a specific problem solved or tools and strategies they can apply, while 53% said men assume counselling will be too passive, too slow or not practical enough.

4. Is counselling private? Treat privacy as a feature: Confidentiality is one of the first things men raise. Counsellors describe male clients asking directly whether what they say will stay in the room before they are willing to continue. For many men, a discreet, private route to support is a precondition rather than a preference. In our survey, 81% of counsellors agreed that men worry about being judged negatively for seeking support.

5. Is choice of counsellor important? Give men a genuine choice of therapists: Counsellors emphasise that the relationship between a man and his therapist matters more than any single method or modality. Men engage more readily when they can choose someone who feels right for them, rather than being assigned or matched by a process they cannot see. In our survey, 81% of counsellors said men are more engaged when they have chosen their own counsellor, with 66% saying they are significantly more engaged.

What are we doing at Men’s Counselling Service?

Medication and therapy both have an important place, but we believe more can be done to make counselling feel like a real option for men, and one worth sticking with. This thinking is central to what we’ve built at Men’s Counselling Service. Our directory lets men browse counsellors without signing up, choose someone who feels right for them and make contact privately, on their own terms. It’s designed to make private, professional counselling for men easy to reach in a few small steps, and we’ll keep refining it with these findings in mind.

To find a men’s therapist near you via our directory, click the Find Counselling For Men button below.

References

Men’s Counselling Service (2026) How Can We Design Counselling Services Around Men? Our 2026 Counsellors Survey

NHS England Digital (2025) Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2023/4

NHS England Digital (2025) NHS Talking Therapies, for anxiety and depression, Annual reports, 2024-25

Seidler, Z. E., Dawes, A. J., Rice, S. M., Oliffe, J. L. and Dhillon, H. M. (2016) The role of masculinity in men’s help-seeking for depression: A systematic review. Clinical Psychology Review, 49, 106–118.

Related Articles:

How Can We Design Counselling Services Around Men? Our 2026 Counsellors Survey (4 minute read)
Why Do Men Wait So Long To Get Help? (4 minute read)
Key Men’s Mental Health Statistics: A Guide To The Data (7 minute read)

Disclaimer: 

This article is for information only and reflects the thoughts of the writer. It's not medical or mental health advice. Seek professional help for your needs. Men's Counselling Service LTD is not a crisis service. For emergencies, call your local services or the Samaritans at 116 123.

Next Steps: 

To find a men's therapist near you via our directory, click the Find Counselling For Men button below.