What is the Role of Informant Discrepancies in Mental Health in Relation to Sexuality?

Research Paper Title

Mental-health disparities between heterosexual and sexual-minority adolescents: Examining the role of informant discrepancies.

Background

An emerging literature documents substantial mental-health disparities by sexual orientation amongst adolescents, with sexual-minority youth exhibiting poorer mental health than heterosexual youth.

This brief report provides the first empirical account of how the association between sexual-minority status and adolescent mental health differs depending on who assesses adolescents’ mental health (child/mother/father/teacher), and how informant discrepancies in assessments of adolescent mental health differ by adolescents’ sexual orientation.

Methods

Data come from an Australian national sample of 14-/15-year-old adolescents (Longitudinal Study of Australian Children; n = 3,000).

Adolescent mental health is measured using multiple measures from the Strengths and Difficulties Questionnaire, and modelled using multivariable linear regression models.

Results

Mental-health disparities between sexual-minority and heterosexual adolescents emerged irrespective of who assessed the child’s mental health.

However, their magnitude varied substantially by informant, being largest when mental-health was reported by adolescents (~0.7 standard deviations) and smallest when reported by teachers (~0.2 standard deviations).

Discrepancies between mental-health scores collected from the child and other informants were largest for internalising than externalising behaviours, and in child-father than child-mother comparisons.

Conclusions

Understanding informant discrepancies and their meaning is pivotal to designing surveys that generate robust insights into the health of sexual-minority adolescents, as well as appropriate policy interventions.

Reference

Perales, F., Campbell, A. & Johnson, S. (2020) Mental-health disparities between heterosexual and sexual-minority adolescents: Examining the role of informant discrepancies. Journal of Adolescence. 79, pp.122-127. doi: 10.1016/j.adolescence.2020.01.006. Epub 2020 Jan 15.

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].