One in three Australian men in mental distress don't seek help, so the University of Newcastle is running a clinical trial that aims to improve that.
Health researcher Myles Young said "we're looking at recruiting men with low mood or depressive symptoms".
"They'll be randomly allocated to 10 free fortnightly psychotherapy sessions indoors, or outdoors on a bushwalking route around the campus," Dr Young said.
Being physically active is known to be good for mental health, as is being in nature.
"Potentially, there may be some advantages to just getting outside, away from that indoor environment," he said.
He noted a recent research paper stating that the human species had "spent most of our days indoors for only six of the last 350,000 generations".
He said depression was "a really common mental illness in Australian men".
"There are social expectations that men should be strong, stoic, self-reliant and not feel sadness. It can be quite debilitating.
"We know that psychotherapy or counselling are really effective ways to treat depression for men and women.
"But typical forms of psychotherapy aren't engaging all types of men."
He said men were more likely than women to drop out early, often after the first session.
The National Health and Medical Research Council and Medical Research Future Fund are funding the $780,000 research project.
"We're looking to try to expand evidence-based options that appeal to men to treat depression," Dr Young said.
"Two-thirds suffer in silence and don't get the help they need.
"We're hoping to find out what works for men and different kinds of men."
Newcastle mental health advocate Elliot Waters, 33, is a "lived experience expert" for the trial.
"It's important to note that traditional sit-down therapy is not the enemy here," Mr Waters said.
"But at the same time, we need more options to get men help and be comfortable about doing it.
"There's that whole stigma associated with 'going to see the shrink'. This is turning that on its head a bit."
Mr Waters, who runs The Dysregulated Podcast, lives with complex mental health disorders.
"It took years to convince me to see a therapist. That was fraught with miscommunication and me not opening up," he said.
"It took a long time to break down those barriers with myself. Part of this research is to help break down the barriers for other people."
During COVID, therapists couldn't hold sessions indoors due to social distancing, so some started taking sessions outdoors.
A recent review showed positive results from this method.
"The missing piece is published evidence based on randomised trials demonstrating it is effective," Dr Young said.
He added that "we don't know if one approach will be better than the other".
"It could be that for some men, being indoors will be better.
"Some conversations may be more conducive to happening indoors. For other men, it may be preferable to get outdoors."
Mr Waters said walking with mates and having a chat was "a huge part of what helped me".
"It's that different environment. The fluorescent lights aren't pointing down and you're out there in nature having a good time," he said.
"Traditional therapy helped me as well."
For more information, visit tinyurl.com/menstherapystudy.
