Mental health services use and depressive symptom scores among gay and bisexual men in Canada

Abstract

Purpose To evaluate the association between mental health services (MHS) use and depressive symptom scores among gay and bisexual men (GBM) and compare with heterosexual men in Canada. Methods We used data from the 2015–2016 cycles of the Canadian Community Health Survey. Depressive symptoms were assessed using the PHQ-9 questionnaire (prior two weeks). MHS consultations with any licensed mental health professional (prior year) were categorized as 0, 1, 2–11, ≥ 12. We fit linear regression models to quantify the associations between MHS use and PHQ-9 scores, with an interaction term for sexual identity (GBM and heterosexual men). Models were adjusted for socioeconomic and health-related indicators. Results Among 21,383 men, 97.3% self-identified as heterosexual and 2.7% as GBM. Compared to heterosexual men, GBM used any MHS (21% vs. 10%, p < 0.05) and consulted ≥ 2 health professionals for their mental health (6% vs. 2%, p < 0.05) in the preceding year more frequently. Overall, mean PHQ-9 scores were higher among GBM compared to heterosexual men (3.9 vs. 2.3, p < 0.05). Relative to no consultations, higher MHS use (2–11, ≥ 12 consultations) was associated with higher PHQ-9 scores (1.4–4.9 points higher). Associations between MHS use and PHQ-9 scores did not differ statistically between GBM and heterosexual men. Conclusion Our findings were inconclusive in demonstrating a difference between heterosexual men and GBM for the association between MHS use and PHQ-9 scores. However, GBM consistently had higher average PHQ-9 scores for every category of consultations. Considering the higher use of MHS and higher burden of depressive symptoms among GBM, more research is needed.

Self-Objectification, Disordered Eating and Sexual Orientation in Men

“…The difference between homosexual and heterosexual men for depressive symptoms, however, was not statistically significant. Many studies [51,54], but not all [55], have found homosexual men to have higher levels of depressive symptoms than heterosexual men. The small sample in this study and resulting lack of statistical power may provide the best explanation, since the between-group comparison on depressive symptoms in fact approached significance.…”

Using an intersectionality-based approach to evaluate mental health services use among gay, bisexual and other men who have sex with men in Montreal, Toronto and Vancouver

“…Compared with heterosexual men, heightened stress in GBM, secondary to societal homonegativity, triggers maladaptive psychological pathways that increase the risk of depression, anxiety, substance use and suicidality (Hatzenbuehler, 2009). This may contribute to GBM using mental health services (MHS) more frequently relative to heterosexual men (Hart et al , 2023; Marbaniang et al , 2022; Platt et al , 2018; Tjepkema, 2008), as a means to cope with negative psychological states that result from sexual minority stress (Giwa and Han, 2022).…”

‘It’s not as good as the face‐to‐face contact’: A sociomaterialist analysis of the use of virtual care among Canadian gay, bisexual and queer men during the COVID‐19 pandemic

“…The report also concluded that GBQM are at a greater risk for anal cancer, HIV transmission and other sexually transmitted infections (STIs) than heterosexual men (Casey, 2019; Hart et al., 2023). Although GBQM have higher utilisation rates for primary and mental health‐care services than heterosexual men, these services are often jeopardised by discrimination and stigma due to the lack of 2SLGBTQ+ competent providers (Marbaniang et al., 2022; McIntyre et al., 2011; Tjepkema, 2008). In addition, financial barriers continue to affect access to mental health services, not only for GBQM but for most Canadians, who must pay out of pocket or access services through private insurance (Steele et al., 2006).…”