Building men’s mental fitness behind bars: Evaluating Talk Club in prisons
Funding
NHS Bristol, North Somerset and South Gloucestershire ICB Research Capability Funding.
What is the problem?
In the UK, 3 in 4 suicides are men, with rates at their highest since 1999 (ONS, 2023). Men in prison are almost four times more likely to die by suicide than men in the general population (House of Commons Library, 2024). In 2023-2024, self-harm rates in men’s prisons increased by 25% compared with 2022-2023 (HMPPS, 2024).
Men are less likely than women to seek mental health support (Galdas et al, 2005). When men do engage, they prefer informal, male-friendly spaces that normalise talking about feelings (Oliffe et al, 2020). The importance of providing mental health support that reflects men’s needs is recognised internationally (WHO, 2018) and in England’s first Men’s Health Strategy (DHSC, 2025), which identifies mental health and suicide prevention as key priorities.
Talk Club is an award-winning, community-based charity delivering structured peer-led ‘mental fitness’ groups for men: “We prefer to call it mental fitness because our talking groups actively help men to understand how they’re feeling by asking ‘How are you? Out of 10?’ then explaining why” (https://talkclub.org/). Talk Club currently operates in 21 UK prisons, with prisoners trained to lead sessions (‘Captains’). While both prisoners and staff report positive experiences, the impact of Talk Club in prisons has not been formally evaluated.
This project aligns with ICB priorities on early identification and support for anxiety and depression. It tackles health inequalities and strengthens the building blocks of good health and wellbeing through an established VCSE-based intervention to reach a prison population with high unmet mental health needs.
What is the aim of the research?
Future NIHR-funded work will look at how Talk Club works in prisons, and what difference it makes for men who take part and the people around them (family, prison staff). Five to six prisons across England will be included, covering different types of prisons and prisoner backgrounds.
The research will look at who takes part in Talk Club, how often men attend, and how satisfied they are with it. Men who attend Talk Club will be invited to complete short questionnaires about mental wellbeing, coping, social support, loneliness, and interpersonal skills development at different points during the study. In addition, the “How are you? Out of 10?” score that is already used before and after each Talk Club will be analysed to look at changes in how men feel as they continue to attend.
Interviews will be carried out with prisoners to understand their experiences of Talk Club, what helps or gets in the way of attending, and how they feel it affects their daily lives and relationships. Prison staff and family members will also be interviewed to gather wider views.
Finally, where possible, existing prison records relating to self-harm, suicide, and serious incidents will be reviewed to explore patterns before and after the introduction of Talk Club. Together, this work will build a clear picture of how Talk Club operates alongside existing prison health services, and how it can be improved.
How will this be achieved?
- Ongoing PPI: Continued involvement of people with direct experience of Talk Club, including community members and prisoner members, to shape the study design, refine study materials, and identify practical or ethical challenges.
- Steering group meetings:
- Prison, probation, and commissioning staff to shape the study design, highlight challenges, ensure any evidence collected is relevant for decision making about wider delivery of Talk club in prisons, and identify any information that could be collected to support future decisions about using Talk Club in probation services.
- Clinical and commissioning staff to identify any information that could be collected to support future decisions about using Talk Club in broader NHS services (e.g., long-term conditions).
- Rapid literature review: A focused review of existing research on mental health and well-being support for men in prison to understand what is already known, how similar interventions have been evaluated, and where important gaps remain.
- Pilot the research process at HMP Bristol:
- Test recruitment processes.
- Explore ways of assessing whether Talk Club sessions are delivered as intended, including identifying practical and acceptable ways of checking delivery consistency.
- Interview a small number of prisoners to refine questions and identify any practical and ethical challenges in the research process.
- Trial the proposed questionnaires for length and clarity.
- Test practical ways for routinely collected “How are you? Out of 10?” scores to be securely shared with the research team.
- Test whether it is practical to access prison records relating to self-harm, suicide, and serious incidents.
- NIHR application development: Research team meetings and writing time to refine and submit a high-quality NIHR grant application
Who is leading the research?
This research is led by Dr Caroline Flurey, Associate Professor of Men’s Health and Long-Term Conditions at the University of the West of England, Bristol, College of Health, Science and Society School of Social Sciences
Further information
For more information or to get involved with this project, please email bnssg.research@nhs.net