Mental health treatment lacking for gay men

Depression and suicidality in gay men require significantly increased efforts from health care providers, educators and researchers, according to recent findings.

“Depression is prevalent among gay men, wherein gay men are three times more likely to experience depression compared with the general adult population. Depression is a risk factor for suicide, and suicide is a leading cause of male death,” Carrie Lee, NP(F), MScN, of the University of British Columbia, Vancouver, and colleagues wrote. “Within this context, there is strong evidence that gay men are more likely than heterosexual men to experience suicidality. Depression and suicidality may also increase gay men’s risk of alcohol and drug overuse, unprotected anal intercourse, and HIV.”

Numerous studies have identified cause-effect triggers for depression in gay men. A minority stress model indicated four interconnected factors, including prejudice events, expectations of rejection and discrimination, concealment of identity, and internalized homophobia.

A 2015 Canadian study found that 47% of gay men experienced harassment, 42% experienced bullying, 16.1% experienced workplace discrimination and 13% experienced physical violence due to their sexuality.

Additional studies have shown that such experiences are associated with depression and emotional distress, according to researchers.

Prejudice events have also been indicated as risk factors for suicide among gay youth and adults.

Another predictor of suicidality is lack of familial support. A 2009 study of 224 gay, lesbian and bisexual youth indicated that those who experienced familial rejection were 8.4 times more likely to report attempted suicide.

In addition, a 2012 study indicated family support was protective and lowered suicide risk.

Health care providers play an important role in addressing depression and suicidality among gay men. However, studies have shown that education curriculums for health care providers may not adequately train them to address this population’s needs.

A study conducted in 2015 indicated health care providers working with gay men reported a lack of professional education and training opportunities that address issues and needs of gay men.

“In providing care for gay men, it is essential that health care providers create a safe environment in which men can confide and discuss their sexual orientation and mental health issues openly. Creating such an environment will help health care providers identify those who are at risk for depression and suicidality,” the researchers wrote.

To reduce risk for suicide among gay men, health care providers should:

establish trust;

determine the degree to which a patient is “out” to his family and friends and the strength of his support system;

assess for substance abuse;

educate parents on the negative mental health effects of rejecting behaviors; and

schedule frequent follow-ups to monitor and manage depression and suicidality.

“Health care providers can champion gay men’s health services by extending the focus on sexually transmitted infections and HIV screening and treatment to address gay men’s mental health. By being cognizant of the risk factors, stigma, and vulnerabilities gay men face, health care providers can ably lead gay men’s depression and suicide prevention efforts,” the researchers concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.