The Experience of Sexual Minority Men & Mental Healthcare in Toronto, Canada

Research Paper Title

Mental health and structural harm: a qualitative study of sexual minority men’s experiences of mental healthcare in Toronto, Canada.

Background

Compared to the general population, sexual minority men report poorer mental health outcomes and higher mental healthcare utilisation.

However, they also report more unmet mental health needs.

Methods

To better understand this phenomenon, the researchers conducted qualitative interviews with 24 sexual minority men to explore the structural factors shaping their encounters with mental healthcare in Toronto, Canada.

Interviews were analysed using grounded theory.

Results

Many participants struggled to access mental healthcare and felt more marginalised and distressed because of two interrelated sets of barriers.

  • The first were general barriers, hurdles to mental healthcare not exclusive to sexual minorities. These included:
    • Financial and logistical obstacles;
    • The prominence of psychiatry and the biomedical model; and
    • Unsatisfactory provider encounters.
  • The second were sexual minority barriers, obstacles explicitly rooted in heterosexism and homophobia sometimes intersecting with other forms of marginality. These included:
    • Experiencing discrimination and distrust; and
    • Limited sexual minority affirming options.

Discussions of general barriers outweighed those of sexual minority barriers, demonstrating the health consequences of structural harms in the absence of overt structural stigma.

Conclusions

Healthcare inaccessibility, income insecurity and the high cost of living are fostering poor mental health among sexual minority men.

Research must consider the upstream policy changes necessary to counteract these harms.

Reference

Gaspar, M., Marshall, Z., Rodrigues, R., Adam, B.D., Brennan, D.J., Hart, T.A. & Grace, D. (2019) Mental health and structural harm: a qualitative study of sexual minority men’s experiences of mental healthcare in Toronto, Canada. Culture, Health, & Sexuality. 1-17. doi: 10.1080/13691058.2019.1692074. [Epub ahead of print].

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