Behavioural activation for low mood and anxiety in male frontline NHS workers
Context
Frontline NHS work can involve sustained pressure, difficult shift patterns and, in some roles, repeated exposure to distressing or potentially traumatic events. Yet conventional mental health support often fails to reach male frontline workers early, before difficulties become more severe. Organisational cultures that prize resilience and self-reliance can compound this mismatch.
BALM (Behavioural Activation for Low mood and anxiety in Male frontline NHS workers) was developed in response - a practical, structured early intervention for men experiencing low mood or anxiety, designed to strengthen everyday habits, support mental wellbeing, and prevent deterioration.
The research
The team co-produced a gender-responsive self-help programme with male NHS workers. Its practical, action-oriented approach, flexible remote delivery and emphasis on autonomy were designed to make early support more accessible and acceptable. Using behavioural activation, men complete a workbook supported by up to eight telephone or video sessions with a trained coach.
The first BALM evaluation involved 45 men across three NHS organisations and found high acceptability and large pre-post improvements in depression and anxiety. In a subsequent real-world evaluation, 50 men self-referred across two NHS trusts, with data showing similar levels of improvement and strong participant endorsement.
Featured publications
Funding
Featured researchers
- Professor Paul Galdas
- Professor Dean McMillan
- Dr Kate Bosanquet
- Dr Liz Littlewood