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Tam MW, Pilling MD, MacKay JM, Gos WG, Keating L, Ross LE. Development and implementation of a 2SLGBTQ+ competent trauma-informed care intervention. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2022. [DOI: 10.1080/19359705.2022.2141936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Michelle W. Tam
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - Jenna M. MacKay
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Wesley G. Gos
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Leah Keating
- Centre for Addiction and Mental Health, Toronto, Canada
| | - Lori E. Ross
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Turpin A, Charest M, Brennan DJ, Griffiths D. Exploring inter- and intra-organisational dynamics supporting task-shifting opportunities in AIDS service organisations: A qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4724-e4734. [PMID: 35698825 DOI: 10.1111/hsc.13879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/05/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
Task-shifting of combination sexual health services from clinicians to community workers has been well-studied in low-resource settings, but lacks empirical examination as a response to service inequities in North American community-based AIDS service organisations (ASOs). This study adopts a qualitative exploratory approach to understanding how ASOs may support task-shifting for gay, bisexual and other men who have sex with men (GBMSM), drawing from interviews (n = 33) with clinicians and community workers in southern Ontario. Results include intra-organisational (including resource supports, development of community worker roles, providing task-shifting training, provider representation and inclusive service environment) and inter-organisational (including structure of engagement, streamlining referrals, development of effective partnerships, development of a formal organisational network and increasing awareness) dynamics which, when applied at an organisation level within ASOs, encourage successful and effective task-shifting. Related activities may be used to increase service quality and access for GBMSM. Considerations for application and management practice is provided.
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Reynish T, Hoang H, Bridgman H, Nic Giolla Easpaig B. Barriers and enablers to mental health help seeking of sexual, gender, and erotic minorities: A systematic literature review. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2022. [DOI: 10.1080/19359705.2022.2036666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Tamara Reynish
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Ha Hoang
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Heather Bridgman
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Bróna Nic Giolla Easpaig
- Centre for Healthcare Resilience & Implement Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Gaspar M, Marshall Z, Rodrigues R, Adam BD, Brennan DJ, Hart TA, Grace D. Mental health and structural harm: a qualitative study of sexual minority men's experiences of mental healthcare in Toronto, Canada. CULTURE, HEALTH & SEXUALITY 2021; 23:98-114. [PMID: 31794349 DOI: 10.1080/13691058.2019.1692074] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 11/08/2019] [Indexed: 06/10/2023]
Abstract
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.
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Affiliation(s)
- Mark Gaspar
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Zack Marshall
- School of Social Work, McGill University, Montréal, QC, Canada
| | - Ricky Rodrigues
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Barry D Adam
- Department of Sociology, Anthropology, and Criminology, University of Windsor, Windsor, ON, Canada
- Ontario HIV Treatment Network, Toronto, ON, Canada
| | - David J Brennan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Trevor A Hart
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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