Mental health and structural harm

A qualitative study of sexual minority men’s experiences of mental healthcare in Toronto, Canada

Bibliographic Data

ID15098462
AuthorsMartín Gaspar (0000-0002-9015-2838, University of Toronto, corresponding author), Zack Marshall (0000-0003-2315-3512, McGill University), Ricky Rodrigues (Toronto Metropolitan University), B D Adam (0000-0002-8836-4153, Ontario HIV Treatment Network), David J Brennan (0000-0002-7663-9869, University of Toronto), Trevor Hart (0000-0001-5107-7452, University of Toronto), Daphne Grace (0000-0002-9032-3959, University of Toronto, corresponding author)
Year2021
Volume23
Issue1
Pages98-114
Publication date2021-01-02
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueCulture Health & Sexuality (JOURNAL)
Journal identifiersISSN: 1369-1058 • E-ISSN: 1464-5351
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/13691058.2019.1692074
PMID31794349
OpenAlexW2993130633
LanguageEN
Citations received11
References cited45

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. To better understand this phenomenon, we 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. 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. 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

Distrust · Environmental health · Grounded theory · Harm · Health care · Heterosexism · Homosexuality · Mental health · Mental healthcare · Political science · Population · Psychiatry · Psychotherapist · Qualitative research · Sexual minority · Sexual orientation · Sociology · Stigma (botany · African Sexualities and LGBTQ+ Issues · LGBTQ Health, Identity, and Policy · Medicine · Psychology · Reproductive Health and Technologies · Social Psychology

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