How social networks influence young men to seek psychological help

Abstract There is a growing body of literature that recognizes young men’s reluctance to seek psychological help. However, how young men perceive the role of their social networks in their decision to seek help has received limited attention in research. Using thematic analysis, this study investigated 30 young men’s description of how members from three categories of their social networks: partner, family and friends have influenced them to seek psychological help and how they have experienced this influence. The results show that certain themes recur between various members of men's social networks while others were unique to roles in the social network. How this information can be used to make it easier for young men to seek psychological help is discussed.


Introduction
People who do not seek health care are assumed to be healthier than those who do. This simple logic, however, does not seem to be true regarding men (M€ oller-Leimk€ uhler, 2003).
The last two decades have seen a growing trend towards discussing the concept of masculinity from various perspectives and how this can be related to men's health. According to Messner (2000), men as a group enjoy institutional privileges at the expense of women as a group. However, there is also a cost for men attached to embracing the tenets of traditional masculinity. Men who follow the narrow paths of traditional masculinity tend to pay a substantial price in terms of shallower relationships, poorer health, and lower life expectancy, in exchange for the promise of greater status and privilege. Furthermore, Messner emphasizes that men share very unequally the privileges of masculinity. While masculinity is constructed in relation to femininities, men's statuses vary significantly, with the existence of various, racial, sexual and class subordinated masculinities (Messner, 2000).
In this article, the cost attached to men's adherence to narrow conceptions of masculinity and the consequences of this adherence for their psychological health is of specific interest. A review of the research literature has shown, that young men are underserved relative to their mental health needs compared to young women; furthermore, few young men who experience a mental health problem will access mental health services (Rice et al., 2018). Similar conclusions were reached in a meta-analytic study, where the relationships between conformity to masculine beliefs and negative mental health-related outcomes was positively associated (Wong et al., 2017).
Young men within Western countries tend to rely on masculine ideals, as most boys are socialized to embody masculine beliefs that actively discourage vulnerability, weakness, or emotional expression. Accordingly, help-seeking for men has traditionally been minimized and avoided, impacting boys from a young age (Rice et al., 2018). Research shows that men with higher endorsement of dominant masculine beliefs have less favorable attitudes toward seeking psychological help (Vogel et al., 2011).
To sum up, there is a growing body of literature that recognizes men's reluctance to seek psychological help and one important reason that has been proposed is that aspects associated with traditional masculinity do not seem to fit comfortably with seeking this type of help (Sagar-Ouriaghli et al., 2019;Seidler et al., 2016;Yousaf et al., 2015). While research about masculine ideologies helps to shed light on why men have negative attitudes towards help-seeking, it provides limited information about the men who actually do seek help and what circumstances facilitate this decision (Bennet & Thompson, 2017). One topic that is important to study in this context, which has received limited attention so far, is how young men perceive that their social networks are involved in their decision to seek psychological help.
Research about young men who seek psychological help and the influence from their social networks Previous studies have suggested that men under psychological stress rely on their social networks as an important source of support. One study, with the purpose of identifying young men's psychological health stressors and factors involved in their decisions to seek help, found that young men are inclined to rely upon informal resources as a primary source of support, such as members in their social networks, partners, family and friends (Timlin-Scalera et al., 2003). Similarly, a metanalysis of qualitative studies about men's experience with common mental health problems revealed that young men want to talk to family, partners or friends for emotional support before seeking psychological health care (McKenzie et al., 2016).
The importance of social networks for young men has also been found in other areas. For instance, it has been noted that young men's decision making in regard to stopping destructive patterns of behavior can be initiated by someone with whom they have an interpersonal relationship (Chuick et al., 2009). In line with this, a study on male victims of interpersonal violence found they got in contact with healthcare professionals through the help of others (Simmons et al., 2016), while young male survivors of sexual abuse were encouraged by a partner, family member, or friend to seek out services to find the necessary resources (Gagnier et al., 2017).
Young men who seek psychological help seem especially likely to be supported by their mothers (Seidler et al., 2016;Hassett & Isbister, 2017). Similarly, Wirback et al. (2018) noted that young men with depression talked particularly to their mothers about seeking psychological help.
Although some research has been carried out on what circumstances facilitate young people's decisions to seek psychological help, there have only been a few empirical investigations into the role played by social networks. Vogel et al. (2007) showed in their survey with college students that the majority of men and women who had sought psychological help had been prompted to do so by someone they knew. Furthermore, findings in a recent study, including both females and males, indicated that the approval from the social network was influential in encouraging the decision to seek help regardless of one's mental health severity (Muscari & Flemming, 2019).
To date, most studies have not specifically focused on young men's experiences. One exception is a survey investigating who influences men to go in therapy, where the majority of males reported they had been influenced to some degree by members in their social network (partner, family, friends), to seek help. Most men were influenced by more than one source and over one third suggested that without the influence of others, they would not have sought help at all (Cusack et al., 2004).
Taken together, these studies support the notion that members of young men's social network seem to influence their decision to seek psychological help. However, there remains unanswered questions on how and in what way the different members in the social network have influenced these young men to seek help as well as how these young men have experienced this influence. The answers to these questions are important not least when it comes to preventive work encouraging young men to seek help when needed. It is also important to understand more about the role of different parts of the social network when young men come to counselling in order to understand more about the process behind the decision to seek help. This paper reports on a study with a specific focus on the role of the social network when young men seek help for psychological problems and difficulties in close relationships.
Cultural setting for the study The study takes place in Sweden, where traditional definitions of masculinity have been challenged for several decades. Historically, Sweden in the 1930s laid the basis of the welfare state and the elaborated social democratic gender equality project (Hearn & Morrell, 2012). Swedish young men are actively challenging traditional notions of masculinity. This is evident in the emergence of organizations such as, "MEN" (https://mfj.se), "Under the Kevlar" (http://www.underkevlaret.se) and "Locker Room Talk" (https://lockerroomtalk.se), who are all engaged in problematizing and questioning destructive masculinity norms.
Since the 1970s there has been a growing awareness in Sweden that differences in men's and women's health is affected by sociocultural gender-related behaviors . Despite this, there is evidence that traditional norms about seeking psychological help are still operating in Sweden and young men's unwillingness to seek psychological help was pointed out as a major challenge in the society in the Swedish Government Official Report, titled Men and Equality (SOU, 2014, p. 6). Statistics on the use of psychological services in Sweden show a definite gender difference. For example, the Center for Epidemiology and Social Medicine reported that treatment by a psychologist in primary care in Stockholm was received by 2.1% of men and 5.0% of women, with a similar pattern reported from other regions (Center for Epidemiology and Social Medicine (CES), 2017, p. 2). In Sweden, there are 220 Youth Clinics offering free of charge health services to young people aged 12-25, including sexual health and therapeutic counselling for psychological problems (FSUM, 2015). A survey carried out at all the Youth Clinics found that young men are underrepresented as clients, being approximately only 10-15% of all visitors (SALAR, 2016).
Little research has been conducted on how young men in Sweden decide to seek help when they experience psychological problems. A study such as the present one has the potential to contribute new knowledge about how help-seeking among young men takes place in a culture where traditional norms of masculinity are somewhat challenged.

Purpose and research questions
This study aims to investigate how and in what ways young men have sought psychological help, focusing on the influence of three categories in the social network: partner, family, and friends has had on this helping-seeking behavior. The specific research questions are the following: Are young men's decisions to seek psychological help influenced by members of their social networks? How have the members of their social networks influenced the men in the decision to seek this help? How do the men experience the influence they receive to seek psychological help from the members of their social networks?

Method Participants and recruitment
According to primary inclusion criteria, a predefined number of 30 young men that sought help for psychological problems and difficulties in close relationships at a clinic for young men during a three-month period were included. In regard to the sampling frame it was required that the participants were either on the waiting list to receive counseling (n ¼ 4) had only had an initial contact with the clinic (n ¼ 23) or had received limited counseling, with a maximum of two sessions (n ¼ 3). Their ages ranged from 19 to 29 years, with an average age of 25. Of these men, 19 were in long-term relationships and 11 stated that they currently were single. Twenty-five referred to female partners and 5 referred to male partners. Prior to data collection, participants received information about the project and if they decided that they were interested in participating in the study, an appointment was booked. On arrival at the clinic, participants were asked to read through a written information sheet about the study. If they continued to express an interest in participating in the study the consent form was filled out. The names of the participants used in this paper were changed to maintain confidentiality.

Ethical considerations
This research study received ethical approval from the Central Ethical Review Board. Participants were informed about the participation being voluntary and their right to withdraw without adverse consequences. Anonymity was ensured though the removal of identifiers and change of names. The participants did not receive any monetary incentives or any other rewards for this interview.

Interviews
Data were collected using semi-structured interviews. All interviews were conducted faceto-face by the first author in a visiting room at a specific clinic targeting young men 18-30 years old. In the beginning of the interview an introduction was read aloud to the participants, informing them of the purpose of the study and the style of questioning. Participants were informed about the participation being voluntary and their right to withdraw without adverse consequences. The interview then contained five questions regarding each member of the following categories of social network: partner, family, and friends. If there were more than one person in the family, or more than one friend who had influenced the participant, questions were asked separately for each of these persons. The interviews lasted between 15 and 40 minutes. All interviews were recorded and transcribed verbatim before the analysis was conducted. The amount of text produced from answers in the interviews was 31 500 words.

Thematic analysis
The interviews were analyzed through inductive thematic analysis using Braun and Clarke (2006) six-step guidelines. This thematic analysis is a qualitative descriptive approach. Coding categories are derived directly from the data and provide a detailed and nuanced account of the data, involving the processes of naming, defining, and further analyzing to identify themes that can be considered important in relation to the purpose of the study (Braun & Clarke, 2006).
Thematic analyses were conducted separately for the three categories in the social network: partner, family, and friends. Two different aims were involved: To understand how this member of the social network had influenced the young man to seek psychological help, and how the young men experienced this influence. All transcripts from the interviews were examined and coded. Similar codes were then grouped together into clusters, which were analyzed in terms of similarities and differences. This process yielded the central themes of the analysis (Tables 1 and 2). In order to refine the themes, the authors had recurrent discussions and the themes were also cross-checked with the transcripts to ensure that the interpretations of the data were reflective of what the participants described.

Results
The aim of this study is to understand more about how young men's social networkspartner, family, friendshave influenced their decisions to seek psychological help, and how they have experienced this influence. The first research question focused on whether young men's decisions to seek psychological help is influenced by members of their social networks. Table 3 shows that of the 30 young men interviewed, almost all, 29 of the 30, say they have been influenced by someone in their social network. Over three-fourths (23) indicated that more than one type of network member influenced them, while over onethird (11) mentioned people from all three network categories. Their partners influenced the young men to seek psychological help in 19 cases (63%). The remaining 11 men said they were not in a relationship at the time of the study, so it is clear that partners were overwhelmingly important in young men seeking help for their psychological problems. A family member influenced 21 (70%) of the men to seek psychological help. This category includes mothers, fathers, sisters, and brothers. In this network group, men most commonly mentioned being influenced by their mothers: of the 18 men who mention their parents, 11 say that it is their mothers who influenced their decisions while seven say it was both their mother and father. For six of the young men it is brothers or sisters who have influenced their decision. One man also mentions two cousins with whom he had a close relationship that influenced his decision. Friends were also commonly described as influencing the decision to seek psychological help, for 23 (77%) of the young men. For 12 of these men, a single friend was mentioned as having an influence, while the remaining 11 men mention two or three friends. Of the total 36 friends mentioned, 26 are referred to as men and 10 as women.

How social networks influenced young men's decision to seek psychological help
The thematic analyses of how the young men perceive that their social network has influenced their decision to seek psychological help were conducted separately for the respective influence of the three members in the network: partner, parents, and friends. The different members of the social network share a number of similarities, with certain themes recurring for the various members while others are unique to one category in the social network (see Table 1).

Influence from partner
The men's decision to seek psychological help has been influenced by their partners primarily through encouragement and exhortation to seek help.  Table 3. Description of participants and main influences and experience of influence related to partner, family and friends.

Encouragement
Among the young men who report that their partner has influenced them, a prominent theme is that the partner has encouraged them to seek psychological help. Encouragement involves the partner having a positive attitude toward seeking psychological help and, for instance, offering suggestions or encouraging responses indicating that it is a good idea. For example, Anton refers to his partner saying, "That sounds great, it can't be that crazy to talk to somebody." It seems to involve an attitude that help-seeking is a given, as exemplified in Johan's description of what his partner said: "If you need help, simply seek help." Influence through encouragement takes place in a context characterized by agreement, as seen in Linus' description: Encouraging, that I should talk to somebody; she doesn't look down on me for a secondwe're here for each other and that feels really nice.

Exhortation
Another significant theme among the young men who have been influenced by their partner involves being exhorted to seek psychological help. In this context, there seems to be an underlying tone of a need for changes in the relationship. Exhortations from the partner take place through a clear statement addressed to the young man that he should do something about his problems and seek help. The partner can, for instance, bring up problems in the relationship, be a driving force, and stress the importance of seeking psychological help. In the men's descriptions it emerges that exhortations seem to occur when they resist seeking help. David says, for example, "At first I said no, but my partner pushed [the issue]." There seems to be an expectation on the partners' part that the men will take responsibility for what is problematic. As Andreas recounts: "There were certain things we discussed in the relationship that she thought I should discuss with someone else." Another form of exhortation involves the partner actively taking responsibility, as Felix describes: "To be accurate, she said 'Now I've booked an appointment, now I've found these people who you can talk to.'" At its extreme, exhortation seems to entail a demand. As Jesper says, "You kind of have to [ … ] and it's actually a little like a threat too." The exhortation involving the need for something to change can be illustrated by Oscar, who says it reached a point where his partner said: Now you have to straighten up somehow; for your own sake, maybe you should get to the bottom of this. It's affecting our relationship, so I really want you to do it.

Influence from family
People in the young men's family have influenced their decision to seek psychological help through encouragement, calling attention to their needs, and exhortation.

Encouragement
Among the men who say their family has influenced them, a prominent theme is that the family has encouraged them to seek psychological help. Encouragement from the family is similar to that from the partner, involving the fundamental idea that it is good to sort out one's problems as well as a positive attitude toward seeking psychological help. For example, Marcus expresses that " … then she (his mother) encouraged me to seek help from a psychologist." Influence through encouragement is described as wholly positive and help-seeking as a given. Anton says that his sister " … sort of did an advertisement for the whole thing" and was his inspiration for him getting a grip on his situation. Some aspects, however, differ in the type of encouragement received from one's partner compared to from one's family. For example, within the family the encouragement can include a practical element whereby the family can do more, for instance offer economic support, while encouragement from the partner is primarily verbal, addressing the young men's intention to seek psychological help. Another aspect that emerged was the existence over time within the family of an encouraging attitude toward seeking help: Mom's always encouraged and pushed when there's been something [ … ]. Because there can be something more underlying that you have a hard time figuring out in your own thoughts. I've always been encouraged to go talk [to someone] if something's going on. (Arjan)

Observation of needs
Another theme that further elucidates how the young men have been influenced by their family involves the family drawing attention to the men's needs. This theme can be exemplified by Amar, who says " … as Mom experienced it, I easily get angry in a matter of seconds [ … ]. So, she's been like this, sort of, 'maybe there's something going on'". When Jesper would talk with his father, his needs were observed more clearly when his father said " … he kind of recognized himself". The observation of needs entails someone drawing attention to the fact that there are problems or that the young men do not feel well, for instance in the case of Jakob, who says his mother " … has, like, observed that I've been sort of down for a while". When someone in the family draws attention to the young men's needs, this influences their decision to seek psychological help: What she (his mother) said actually confirmed what I'd been thinking and wondering a lot about, and that I'd also experienced was a problem. And I thought that was a factor that influenced that maybe it's time to do something when other people also start seeing this problem. (William)

Exhortation
Among the young men who report that their family has influenced them, another significant theme involves the family exhorting them to seek psychological help. A difference here, compared to the men being exhorted by a partner, is that with the family there is no undertone of a need for a change in the relationship. The similarities between partner and family influence involve a clear, amplified choice of words and that some form of demand is made. Formulations the men mention can entail, for instance, Anton's sister saying, "I definitely think you should do it", or Andreas' sister saying, "You should talk to somebody". For Adam, it involved an exhortative tone from both his parents; he refers to his mother saying he " … should see a psychologist, and really pushed", and his father being even "a little more pressing". Jesper, imitating his father's exhortative voice, quotes him: " … but talk to someone then!". The men say that in the situation at hand it was clear that they should seek psychological help. For example, Benito says his mother is "quite forceful". He describes how, in a way similar to how a partner could be exhortative through active efforts, his mother was actively involved: "That she sort of did like this, 'but then I'll help you now, so we can find somebody now', and then a half hour later she's got the number". Rasmus shares this experience, telling of how it came to a point where his mother used her contacts; as he puts it, "Absolutely, my Mom was very much in support of it". The family's exhortative influence can also be illustrated by Samuel: It's only Mom who's said I should see a psychologist. She's noticed that something isn't right. She's almost nagged me. 'Samuel, have you seen a psychologist now?
Influence from friends Friends influence the young men's decision to seek psychological help through encouraging them, serving as role models, and observing their needs.

Encouragement
A significant theme among the young men who report that friends have influenced them is that the friends have encouraged them to seek psychological help. In a way similar to the encouragement from partners and family, this involves the friends having a positive attitude toward seeking psychological help. An aspect that distinguishes encouragement from friends, however, is that the men highlight the friendly tone they use, their understanding, and the fact that having problems and seeking psychological help is accepted among them. Kevin mentions that his friends have said " … that it's a good thing there's help, and that everybody has their own problems, sort of".
Receiving encouragement in conversations with friends before taking the step, and knowing that their friends' display an understanding that psychological help is an alternative, seem to have a significant influence on young men's help seeking. Samuel exemplifies this, saying his friends " … don't become, like, totally excluding and weird". For William, who had been thinking about putting off seeking help, a friend's encouragement had " … actually strengthened this will, that it's good to face this and get a handle on it". The young men's highlighting of the positive tone from their friends is clearly illustrated by Linus: Only supportive, and thought it was good. I also have friends who I know should go talk to people, who, like, have their own stuff, their own problems, and I think I've gotten the absolute best feedback from them. Positive pats on the back from them.

Role models
A distinctive theme among the young men who have been influenced by friends is that these friends have served as role models of help seeking for them. This form of influence from friends was not noted among partners or family. As role models, friends legitimize the men's decision to seek help, but they can also inform them about how things can go, what one can talk about, and how it helps.
For Erik, it was not until a friend told him she had sought psychological help when she felt down after a relationship had ended that he understood that he could seek psychological help for this reason. As role models, friends serve as proof that there is help out there, that it works, and that seeking psychological help is nothing to be ashamed of.
Friends help to open young men's eyes and allow them to recognize their own needs for help and that it is possible to seek help themselves. As role models, friends can inform them about what talking to a professional can entail.
Andreas describes how a friend had talked about problems he had experienced in a previous relationship, and had talked to someone and that it had helped him " … handle relationships better and get to know himself more". When a friend shared their experiences of how talking to a professional had helped, this had a decisive influence on Jakob, who stresses the importance of the friend " … sufficiently well describing a tough situation that had been solved with the help of talking to a professional". Or, as Rasmus describes it: My friend said you that can't find the answers to all your questions but you can get help with it, and that he'd gone to a psychologist to talk about, like, completely different things, but that it's really good because you have sort of a sounding board and, like, he recommended it for me anyway.

Observation of needs
Something that further highlights how the young men have been influenced by friends to seek psychological help is that their friends point out their needs to them. This theme also emerged within the area of influence from family. Friends' observation of the men's needs entails a possibility for them to talk with these friends not only about their personal problems but also about seeking help. Through their friends' influence, the men realize that they need to seek psychological help.
Friends can also influence them by calling attention to specific problems; for instance, Daniel describes how a friend making the observation that his jealousy had taken up a great deal of space in a relationship. Additionally, Anton says a friend " … [pulled him] aside and said something like 'this mental health thing can be really dangerous'". When friends call attention to the men's need to seek outside help, this can have a decisive influence on their avoiding the postponement of seeking help. A clear example of this is expressed by Martin, who refers to a friend having said "It's better to talk about it now, instead of carrying it inside you for a long time". Arjan also mention a conversation with his friend: I guess he placed more focus on saying you can also go talk to somebody about this, relationship problems or however you want to put it. That there are also things you might need to talk about with somebody else who you don't know. We talked about it and he said if you think it's tough, maybe you should go talk to somebody. So maybe it was there that the idea was sort of born.
How the young men experience the influence from their social network In the thematic analysis of how the young men experienced the influence from their social network in their decision to seek psychological help, separate analyses were also conducted for each of the different members in the network: partner, parents, and friends. Similar to the thematic analysis of how their social networks influenced the men's decision to seek help, these separate analyses share a number of similarities, with certain themes recurring for the various members while others were unique to one network category ( Table 2).

Experience of influence from partner
The young men experienced the influence from their partner as supportive in an affirmatory way, as transformative, and also as an ambivalent experience.

Supportive
A clearly emergent theme among the young men who were influenced by their partner is that they experienced the partner's influence as supportive. They felt their partners affirmed and accepted that they had problems, and that these problems were something they could legitimately seek psychological help for. For Arjan, it felt supportive when his partner " … also thinks it's good to go talk to somebody". There seems to be an expectation among the men that their partner will not accept that they have problems, and when this occurs, they experience a feeling of support. For instance, Kevin reflects on the notion that " … that's nothing I've had to feelinstead, it's been positive". As Rasmus observes, it is " … positive when you get support in the home too, sort of". The experienced support from their partner, as in Robin's case, can result in the men coming to grips with problems they may have had for a longer time.
It felt good because I feel like I've, I mean, what I want to talk about, I feel like I've had inside me for a pretty long time. So, it feels really great that I've gotten her support.

Transformative
Another theme identified as significant among the young men who were influenced by their partner is that they experienced this influence as transformative. Initially, the men had refused to acknowledge the problems their partners called their attention to, but over time this developed into an insight that what their partner was expressing might be true. Oscar says, "In the beginning I guess I was more like, 'what, I don't need any help'. But then I understood [ … ] that there was something that was wrong, but I guess there was a bit of denial in the beginning". The men express that it is hard to take in what their partner is saying when they are in the middle of a discussion. It can happen, like with Mads, that they initially reject what their partner says as "nonsense", or as Linus says, "Then I might shut down instead". The initial denial however can give way to reflection, when they become aware that there is something wrong and realize that their partner is right. This is a transformative experience that allows them to take the first step and seek psychological help: First, I felt like I was being attacked when my partner asked if I would consider going to talk to a professional. I got defensiveno, I mean no waybut my partner pushed the issue a little and I think that was smart actually, so I would dare to take that step. (David)

Ambivalent
Yet another significant theme that emerged among the young men who were influenced by their partner was that this influence resulted in conflicting feelings and an ambivalent experience. While they understand the consideration when their partner brings up problems, it also becomes an uncomfortable experience when they perceive it as their partner being dissatisfied with the way they are. Even though the men are aware that it is in both their own and their partners' interest to do something about the problems, it can be like Jesper describes: "I guess you end up being pressed, sort of". It can also result in the partner being pushed away. As Linus describes it, the experience is " … mixed; it was mostly positive and felt nice, but it's also felt a little heavy because you realize you have something [ … ] that has to be dealt with". The influence from the partner can be experienced as an attack, but simultaneously feel like it's done with love.
The experience of ambivalence is also related to seeking psychological help, as in Benito's case: " … it might sound like a clich e, but as a man, it never feels good to go talk to somebody [ … ] nice to hear from someone else (one's partner) that maybe it's needed, so you don't feel so wimpy". A positive experience when your partner calls attention to problems and supports your decision to seek psychological help can also be mixed with a worry that you will not be able to find help; this can result in feelings of inadequacy. This type of ambivalent experience concerning the partner's influence is illustrated by Jakob: It's super complex and emotionally complicated, I think, because at the same time as I appreciate the concern maybe I don't want my partner to think that, oh, I don't know. But at the same time there are mixed feelings that you have to accept that it's coming from a place of concern and good intentions, and not this 'now there's something wrong with you that you have to fix', sort of.

Experience of influence from family
The young men experience the influence from their family as supportive in a reassuring way, as transformative, and as an ambivalent experience.

Supportive
For the young men who were influenced by their family, a prominent theme is that they experienced this influence as supportive. Compared to the experience of support from a partner, which was more affirmatory, the support from family was experienced as more reassuring. This could involve, for instance, members of one's family taking on an active role, as was the case for Benito, who says he is " … pretty helpless myself [ … ]. So it was rather nice that she [his mother] took over a bit in it just then"; or Simon, who says his father "wouldn't really give up", and that he experience support when his father showed that he truly wanted to understand how he felt.
This support from the family often was reinforced through continuous contact, for example with the family repeatedly asking how they feel and how it is going with their help-seeking. These conversations can result in a deepening of family relationships; for instance, Rasmus describes how he felt that his relationship with his father improved through these conversations, saying that he and his father "became a little closer to each other". He reflects on the idea that men of his father's age have a harder time talking about feelings, and said about their conversation that it "felt like this took us to some new level". Another example of the supportive experience is illustrated by Marcus, who says: Even though I felt like an adult, when it was actually time to be an adult, it felt nonetheless like you could get good support from your mother. That she could, that she had this control you get from a parent when you're younger.

Transformative
Another theme that was identified to be significant among the young men who were influenced by family is that they experienced this influence as transformative. This experience is similar to what the men describe in relation to their partner, with the difference that the men's initial resistance does not seem to be as strong in the case of their families.
The transformative experience involves the family calling attention to difficulties that exist, causing the men to reflect on how they handle various situations. They perceive the family's influence as reasonable, and as a signal that something has to change. For instance, William describes how he became more aware when he had his concerns confirmed regarding a behavior, he was unsure about: "When others saw this too, I could more easily put my finger on what my problem is".
Even if a change is initiated it can take time, as Andreas describes: " … I guess it was six or seven years ago. I guess there was something to it, but I dropped it pretty quick." The family's influence helped change the men's resistance to seeking help and lessened their tendency to play down the problems, as was the case for Anton, who says that his sister's influence resulted in his not needing to " … play tough [ … ]. Everybody should be able to see help when they need it". Amar's resistance was changed in a similar way: It felt kind of hard because in my head, you know, I'm normal. There's nothing wrong with me. But then I started thinking about it a little, and then it felt like she (his mother) was kind of right. But right now, it feels good.

Ambivalent
Yet another important theme that emerged among the young men who were influenced by their family was that this influence carried with it an ambivalent experience. There are similarities between this experience and what the men describe in relation to their partner, with the difference that in the family's case the men both did and did not want to involve their family in their problems. Even if they believed they would receive support, it seems to have been difficult for them to tell their parents about their problems. It could happen that the men avoided talking to their parents about how they felt, at the same time that it could happen, as Carl says, that " … (his mother) wished I would tell her a bit more".
The family's influence could also be experienced as contradictory; it could be positive, like planting a seed for making a decision, but could also feel strange since it meant that the men had to accept their problems and their need for psychological help. As Samuel says, it " … felt weird at first. Because isn't it people who are super broken who, like, go there?
[ … ] And you almost feel weak, 'okay, am I supposed to go to a psychologist?'" The men also perceive that there is an expectation from their family that they should take more responsibility, which can cause them to have an ambivalent experience. Adam says that the influence from his mother made him feel like he " … needed to find some kind of help, but [ … ] that it would've been easier to just, like, lie there at home and sleep". Something that also seems to create ambivalence is the feeling of wanting to turn to one's parents but not wanting to be a burden: So then I guess it's a bit of protecting her too, that I shouldn't take it all out on her because I know she's felt really bad too and then you feel like a jerk for handing over your own problems. Then again, she's the best person to talk to. (Jesper)

Experience of influence from friends
The young men experience the influence from their friends as supportive in a motivational way, as defusing, and as transformative. A small number of the men are ambivalent regarding their friends' influence.

Supportive
Among the young men who were influenced by friends, one of the themes identified was that they experienced this influence as supportive. This was also experienced in relation to the partner and the family, in which cases it involved a support that was respectively affirmatory and reassuring. In the case of their friends, the men's experience of support entailed more of a motivational element. Their friends' positive reactions to their decision to seek psychological help seem to have encouraged the men to continue the process. According to Jakob, friends' influence is " … motivational and gives hope". Strong motivation is important for the decision to seek help; for instance, Anton expressed that support from friends made him think: Maybe I have to talk to somebody for real, so it doesn't get worse for me myself.

Defusing
A prominent theme identified among the young men who were influenced by friends, which did not emerge in relation to either the partner or the family, is that this influence was experienced as defusing the negative feelings about the problem and seeking help. For example, having problems and deciding to seek psychological help came to feel more comfortable. This contributed to a feeling of safety and that one was not alone, as Simon describes in relation to seeking help: "It's absolutely nothing you have to be ashamed of; there are lots of people who do it". The men are aware of the effect social norms have. As Linus puts it, " … above all guys maybe haven't had the chance to talk about feelings growing up [ … ] then you're, I don't know, either gay or … ". Linus stresses that he rejects such stereotypes, but that the norm of a young man not being expected to seek psychological help seems to exist as an underlying notion for many people. Andreas says that seeking help is something " … you've gone around thinking about for a really long time". When the men hear that their friends have sought help, their own resistance is defused: It feels good, I guess, and that he's sought [help] and then of course I can also seek it. There's really not anything wrong with seeking help, like you think, actually. (Carl) Transformative Another significant theme that emerged among the young men who were influenced by their friends is that they experienced this influence as transformative. This experience was also present in relation to both the partner and the family, primarily concerning an initial resistance that changed. What distinguishes the men's transformative experience in relation to their friends, on the other hand, is the disappearance of a feeling of shame or heaviness they had carried inside them because of their problems and their need to seek psychological help. The transformation is experienced when they understand that their friends accept that they have problems and need to seek help. Carl says he " … actually keeps it pretty secret that I'm seeking [help]. You really don't want others to find out that there's, like, a bunch of things wrong with you". When a friend then influenced Carl, encouraging him to talk about his problems and to seek help, he says it was "really great". Or, as Jakob expresses it, how he experienced the influence from his friends, " … you go around and brood a lot and have anxiety, so it can be something that defuses that feeling". Alexander describes a similar experience: " … so much of a weight inside me that disappeared". Social norms come into play in this context as well; Samuel stresses that the influence is stronger " … especially if a guy thinks it's okay to talk about feelings". Benito confirms this: I guess he's made it so you're not ashamed over it, or ashamed to talk about it. It felt good when he said that. Because I've sought [help] at various places and I've felt so very wimpy for needing this help. But I guess he made it, so it felt pretty nice, or it wasn't so damned embarrassing anymore.

Ambivalent
Men influenced by their friends sometimes experienced ambivalence. It can feel contradictory to experience support from one's friends while at the same time feeling it is uncomfortable and unpleasant to talk about one's problems and seeking psychological help. Albin describes how he received support from a friend when he brought it up, but "Then we dropped the subject because it was pretty uncomfortable and there wasn't anything else to say about it, quite simply". Jesper explained the ambivalence he felt. Even when friends offer support and suggest that he " … .go talk to someone," he was concerned that he is annoying when he talks about himself: " It can also end up with them sort of not having the energy to listen". An ambivalent experience also seems to arise when the conversation enters more private areas, as Adam describes it: Because we talk to each other about how we feel and so on, but when it gets so serious and real it's, like, it gets a little more uncomfortable to talk about [ … ]. It's a little unpleasant; you don't exactly want to share it. And I think this thing with, like, talking to a psychologist is one of those things that are very private, sort of.

Discussion
The decisions of the young men in this study to seek psychological help for psychological problems appear to have been strongly influenced by their social network. All but one described in detail how at least one member of their social network had influenced their decision to seek help. Furthermore, the majority were influenced by members from more than one of the social network categories (partner, family and friends). This indicates that members of young men's social network are influential in their decision to seek help and the finding is in line with previous research that has found young men inclined to first receive support from informal resources such as members in the social network, partners, family and friends (McKenzie et al., 2016;Timlin-Scalera et al., 2003).
The young men described how they had been encouraged to seek professional help for their problems from all three of the social network categories by a positive attitude toward seeking psychological help as well as a fundamental idea that it is good to sort out one's problems. The encouragement from friends was different from the other social network categories in that friends had an understanding tone and that friends accepted that they had problems and that they needed to seek help. The friends also helped them overcome obstructive masculinity norms such that 'real men' should not seek psychological help for problems.
When it comes to experiencing network members' influence as supportive, this depended upon from whom they received the support. Young men experienced the support from partners to be more affirmatory, support from family as more reassuring and support from friends as more motivational. Social support has been found to be more relevant as an influential factor for help seeking than the severity of one's problem (Muscari & Flemming, 2019). Those who are close to the young man can be crucial as support in the help seeking process (Hiebert et al., 2018). The men described how the support made them come to grips with problems they may have had for a longer time and that it further deepened the relationship with members of their social networks.
One type of influence coming from partner and family was "exhortation". From partners the exhortation had an underlying demanding tone of a need for changes in the relationship. From families, the exhortation entailed a demand on the men to be actively involved in taking responsibility for their problems. A possible explanation for why this might be important is that young men often have initial difficulties accepting that they have problems (Wirback et al., 2018). Delays in help-seeking has, furthermore, been found to be caused by men waiting for other people to figure out that something is wrong (Lindsey & Marcell, 2012). Although the findings from the present study cannot explain why young men who need psychological help avoid seeking this help, it does show that the members of social networks influence young men to seek help in various ways. One way could be by acting as a counterforce towards traditional norms of masculinity and helping the young men to overcome the obstacles they are facing in regard of these norms.
In line with this, some young men found the influence of network members to be "transformative." This has to do with how the men initially refused to acknowledge what their partners were saying and how this attitude changed to a more affirmative position where they confirmed that there was something wrong. Similarly, the men described how they first felt resistant when their family members called attention to problems and how this influence causing them to reflect on how they handle various situations and inspired them to take steps towards the decision to seek help.
The transformative experience was also identified in relation to friends. In these situations, the young men described the transformative experience as helping make feelings of loneliness and shame, burdens they had carried inside them because of their problems, disappear. These burdens have to do with embodied masculine beliefs that actively discourage vulnerability or emotional expression (Rice et al., 2018). The tangibility in the way this was described by the young men was somewhat unexpected. Previous studies have indicated that social norms of masculinity affect men to be less willing to speak to friends about their emotional problems (Seidler et al., 2016). Accordingly, the young men and their male friends in this study overcome these social norms of masculinity when they have personal conversations about emotional distress and difficulties in close relationships.
Finally, it should be noted that the transformative experience was not unproblematic. Research has shown that young men's acknowledgement of problems can conflict with their ideals of self-reliance and such acknowledgement can threaten their self-image (Lynch et al., 2018). In this study, young men described conflicting feelings which are labelled in this paper as "ambivalent experiences". The young men mentioned it was uncomfortable when their partners expressed dissatisfaction with the way they were, even as the young men appreciated it when their partners brought up problems. They were also found to sometimes be ambivalent in relation to support from family members, since they both did and did not want to accept their families being involved in their problems. In regard to friends, there were also some indications of ambivalent experiences, involving a possible sense of feeling uncomfortable and noted it to be unpleasant talking about one's problems especially when the conversation entered more private areas.
Friends' importance was furthermore found in the theme identified as "defusing". This experience was exclusively identified in relation to friends. Friends seem to defuse the young men's attitude to be a normatively invulnerable young man who hide their problems or to conceal their needs in order to appear like nothing is wrong, in order to project an image of well-being (McKenzie et al., 2016). The young men described how they became more comfortable in having problems and seeking help when their friends confirmed that this was okay.
Another way the young men described friends as having a strong impact was when they described particularly male friends as "role models". These friends legitimized the decision to seek help and served as proof for the men that there is help out there, that it works, and that seeking psychological help is nothing to be ashamed of. These findings are especially noteworthy as research has shown that young men fear social consequences such as ridicule labelling and potential rejection from peers in these situations (Lynch et al., 2018). In our study, on the contrary, the young men explained how these friends helped them to open their eyes and allowed them to recognize their own needs for help. In this way, these young men not only appear to question the costs to men of embracing the tenets of traditional masculinity (Messner, 2000), but also appear to question the concept of masculinity as such. This evidence of the importance of friends' influence suggests new ways of supporting young men to seek psychological help when needed. Preventive efforts aimed at encouraging young men to support each other in resolving personal problems by seeking professional help might be a fruitful way forward.

Limitations and future research
Findings in this study need to be interpreted with caution. Below are presented five study limitations together with suggestions to future research.
First, consideration should be given to the sampling procedure selected for this study. The relatively small sample size was chosen to enable an in-depth investigation of participants' experiences of the topic of this study. This limits the possibility to generalize these findings to a wider population. Future research in this area would be beneficial to conduct larger scale investigations using quantitative methods including questions on psychological health, seeking help and the influence of the social network. In addition, it might be valuable to explore if there are other members of the young men's social networks that are important, such as workplace relations. Second, this study recruited participants who contacted a health clinic with a specific focus on young men; therefore, the experiences expressed in this study might not reflect experiences of help-seeking at other health services, which future studies could explore. In addition, it could be valuable for future studies to explore more about young men who do not seek psychological help when needed. Third, the study did not follow the young men over time to discover whether or not they continued to seek help with their problems; a longitudinal design would be needed for that purpose Future research may consider investigating the social networks influence on the continuances of the therapy as well as the so-called dropouts from treatment. Fourth, this study limited the recruitment of young men for study who have identified psychological problems and who had come to the decision to seek help. Future projects might consider recruiting a more general sample of young men to investigate factors that might be related to them avoiding seeking psychological help when they have problems. Future studies might also consider recruiting both young men and women in order to compare how their social networks influence their help-seeking. Finally, this study took place in Sweden, where young men perhaps are socialized and supported to be more concerned about relationships and health; future research would be beneficial to conduct in other cultural contexts.

Conclusions
This study shows that the social network is important in supporting young men in their decision to seek psychological help and that the different roles have somewhat different functions. The contribution of this study entails four important findings to further knowledge about the role of the social network in young men's help-seeking process. First, more than support, members of the social network are also influencing young men in other ways, such as exhortation, drawing attention to needs and being role models. Second, the young men experience the influence from the social network as transformative from denial and reluctance towards more constructive attitudes towards seeking help. Third, friends as role models seem to have a specific influence in giving the young men a transformative experience that reduces barriers and endorse that young men are entitled to seek psychological help when they have emotional problems and perceiving difficulties in close relationships. Finally, the findings also have practical implications. Knowledge about the involvement of the social network in the help-seeking process can be beneficial in clinical settings. For instance, when starting treatment an important issue can be to get an understanding of which, if any, members of the young man's social network have been supportive of his help-seeking. It might also be possible that if a young man did receive positive support to seek help in the first place, the social network might continue to give support during the treatment process. Furthermore, the findings implicate the importance of targeting social networks in prevention programs aimed at recognizing psychological and emotional problems among young men and encouraging them to seek psychological help when needed. This may reduce young men's stigma surrounding seeking help as well as promote healthier norms for masculinity.