Functional, communicative, and hybrid barriers to accessing mental health care in LGBTQ+ communities

ABSTRACT

Understanding how LGBTQ+ populations experience common mental health care barriers reveals uncommon ways these barriers interact, layer, and compound to increase health disparities. This mixed methods study organised 250 open ended responses into 30 codes situated along a functional to communicative spectrum. The codes revealed sub-categories and relationships between barrier groupings which highlight ways mental health care obstacles for sexual and gender minorities span categories and are operationalised in unique ways that compound constraints. Organizing LGBTQ+ mental health care access obstacles along a continuum that spans functional barriers (i.e. time, money, transportation) to communicative ones (i.e. stigma, trust) revealed a hybrid category (i.e. providers, bureaucracy) where functional and communicative barriers overlap, mesh and operate simultaneously. Lack of access to trained mental health care providers who offer affirming, appropriate care sits at the centre of this web of constraints and as such is influential in a wide array of mental health care issues. Prioritising mental health care workforce training in LGBTQ+ specific competencies has the potential to create a ‘ripple effect’ that mitigates interconnected mental health care barriers throughout this spectrum.

KEYWORDS:

• Health disparities
• LGBTQ+
• mental health care
• health care barriers
• cultural competence

Acknowledgments

The authors wish to acknowledge Equitas Health for their feedback on the survey measure.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.

Notes

1. Because the health needs of sexual versus gender minorities are different, some researchers (see Spencer & Patterson, 2017) recommend referring to the various groups as LGB (lesbian, gay, bisexual) or Trans/GNC (Transgender or gender non-conforming). We initially adopted this separation in our study, but multiple participants expressed a desire to be referred to as a unified group. We use the LGBTQ+ term to represent all sexual and/or gender minority communities who participated in this study at their request.

Additional information

Funding

There are no funders to declare.