Mental Health Care Barriers and the Social Conditions Fostering Mental Health Disparities Among Sexual Minorities

• In Event: 3463 - Social Marginalization and Its Consequences on Mental Health

Abstract

Sexual minority men report poorer mental health outcomes and utilize mental health services at higher rates. Existing research has outlined significant barriers to access such as a lack of culturally-competent care. However, the role of power and structural forces – particularly outside of the context of individual-level prejudice – within this phenomenon has been undertheorized. Using Grounded Theory, we analyzed 24 in-depth qualitative interviews conducted with sexual minority men living in Toronto to understand their experiences accessing mental health services. We noted two types of barriers to services. The first were general barriers, obstacles to care not exclusive to sexual or gender minorities such as financial and logistical hurdles, the prominence of psychiatry and the biomedical model, and lackluster provider encounters. The second were sexual and gender minority related barriers, obstacles directly rooted in heterosexism and transphobia, including explicit instances of discrimination and distrust, and limited culturally-competent options. We argue that structural discrimination in mental health care systems reproduces powerlessness and stigma and exacerbates distress. Heath care inaccessibility, precarious employment, and the rising cost of living are the fundamental social conditions fostering adverse mental health outcomes among sexual minority men. Understanding these neoliberal trends helps to explain sustained mental health disparities among this group despite a narrative of increasing social acceptance. Thus we need to expand the scope of what we consider to be pertinent lines of inquiry within sexual minority health research and advocacy, thinking outside of the realms of individual-level interventions toward the structural forces and power relations amplifying mental distress.

Authors

• Mark Gaspar, University of Toronto

• Zack Marshall, McGill University

• Ricky Rodrigues, Ryerson University

• Barry D. Adam, University of Windsor

• Brennan J. David, University of Toronto

• Trevor A. Hart, Ryerson University

• Daniel Grace, University of Toronto