Deprsn and Suicidaly Gay Men: Implitns for Health Care Provirs - PMC

Contents:

• DEPRSN AND SUICIDALY GAY MEN: IMPLITNS FOR HEALTH CARE PROVIRS
• DEPRSN IS KILLG GAY MEN
• GAY MENTAL HEALTH: MENTAL HEALTH ISSU FACG GAY MEN
• GAY MEN’S DEPRSN COPG GUI
• DEPRSN AND ASSOCIATED FACTORS AMONG GAY AND HETEROSEXUAL MALE UNIVERSY STUNTS NIGERIA
• HOMOSEXUALS AND DEPRSN: HELP FOR GAYS WH DEPRSN
• NEW DATA ON LBIAN, GAY AND BISEXUAL MENTAL HEALTH

DEPRSN AND SUICIDALY GAY MEN: IMPLITNS FOR HEALTH CARE PROVIRS

Related to this, gay men’s health has often been fed by sexual practic, and poorly unrstood are the tersectns of gay men’s physil and mental health wh social termants of health cludg ethnicy, lole, tn level, and socenomic stat. Keywords: gay men’s health, prsn, suicidaly, men’s health, men’s help seekgIntroductnDeprsn is prevalent among gay men, where gay men are three tim more likely to experience prsn pared wh the general adult populatn (Cox, 2006; Kg et al., 2008). Wh this ntext, there is strong evince that gay men are more likely than heterosexual men to experience suicidaly (Brennan, Ross, Dobson, Veldhuizen, & Steele, 2010; Hott, Bogaert, Rhos, Brennan, & Gk, 2016; Kg et al., 2008).

In terms of potential of prsn and suicidaly gay men, relatnship problems, acceptg one’s homosexualy, experiencg homophobia, stutnal discrimatn, and alienatn om gay muni have been reported as unrpng issu (Cox, 2006; Haas et al., 2011; Wang, Plörl, Hӓermann, & Weiss, 2015) rearch exists about gay men’s health beyond sexual health issu, most often HIV (Hott, Ferlatte, & Gk, 2014). Though gay men self-report that they rank mental health as one of their top health ncerns (Grov, Ventuneac, Renda, Jimenez, & Parsons, 2013) prsn and suicidaly the liv of gay men are poorly unrstood (Haas et al., 2011; Kg et al., 2008). DeprsnDeprsn is fed clilly as the experience of a prsive mood or loss of tert or pleasure nearly all activi over a 2-week perd, along wh four of the followg symptoms: “chang appete or weight, sleep, and psychomotor activy; creased energy; feelgs of worthlsns or guilt; difficulty thkg, ncentratg, or makg cisns; or recurrent thoughts of ath or suicidal iatn or suici plans or attempts” (Amerin Psychiatric Associatn, 2013).

DEPRSN IS KILLG GAY MEN

(2008) noted that general practners ed anxiety-related symptoms to intify addnal signs of prsn gay terms of e–effect and triggers for prsn, a range of factors have been tailed, many of which are tertwed wh the strs that n acpany beg part of socially margalized gay muni (Mays & Cochran, 2001; Meyer, 1995, 2003).

In the specific ntext of prejudice events, which refers to the multiple forms of antigay vlence and discrimatn (Meyer, 2003), a Canadian study reported that 47% of gay men had experienced harassment, 42% bullyg, 16. Young gay men n experience prejudice their fay the form of rejectn, often after disclosg their sexual orientatn durg adolcence, which turn n heighten young men’s risk for prsn (Ryan, Huebner, Diaz, & Sanchez, 2009) expectatns of discrimatn and homophobic rejectn n also negatively affect gay men’s mental health (Hatzenbuehler, 2009; Meyer, 2003).

For example, an Amerin study of gay men, those who perceived creased homophobia and the world as dangero for gay men were more likely to report prsive symptoms (Hatzenbuehler, Nolen-Hoeksema, & Erickson, 2008). Self-acceptance is therefore a cril element for gay men’s well-beg, as is beg accepted by others (Ash & Mackereth, 2013) addn to the four factors tailed Meyer’s (1995, 2003) mory strs mol, a lack of acceptance and rejectn om the gay muny n also crease the risk for gay men’s prsn.

GAY MENTAL HEALTH: MENTAL HEALTH ISSU FACG GAY MEN

Particularly at risk of rejectn om other gay men are men livg wh HIV (Courtenay-Quirk, Wolski, Parsons, Gómez, & Seroposive Urban Men’s Study Team, 2006) as well as men om racial/ethnic mory groups (Bowleg, 2012; Haile, Rowell-Cunsolo, Parker, Padilla, & Hansen, 2014; Riggs, 2012).

Gay men livg wh HIV are also at creased risk for prsn across the entire illns trajectory cludg diagnosis of HIV, iatn of HIV treatment, treatment failure, diagnosis of AIDS, and/or havg a iend diagnosed wh AIDS (Körner et al., 2008). Health re provirs workg wh HIV posive gay men have nfirmed that the isolatn and loss of social relatnships and fay support experienced as a rult of this health stat are signifint triggers for prsn (Körner et al., 2008) men who belong to an ethnic mory are at higher risk for prsn. Prsure to nform to such rigid genr norms creat unique discrimatory environments (Guareno, 2007), and gay Hispanic men report higher rat of fay rejectn and negative mental health out pared wh their Csian male unterparts (Ryan et al., 2009).

An Amerin study of gay Hispanic men reported homophobic experienc durg childhood, cludg beg told that gays are not normal people (91%), amid harborg beliefs that their sexual orientatn would hurt and embarrass their fay (70%; Diaz et al., 2001). A study by De Santis, Col, Vasquez, and McCa (2008) wh predomantly gay Hispanic (75%) men reported siar issu notg that gay Hispanic men who had prsive symptoms were likely to engage sexual practic wh high risks for exposure to HIV. Rearch regardg HIV posive gay men and/or ethnic mory gay men is emergent (De Santis et al., 2008) and future work might efully foc on intifyg and addrsg the unique prsn risk factors among the vulnerable subgroups as a means to improvg their mental and physil health.

GAY MEN’S DEPRSN COPG GUI

Prejudice events, cludg the experience of verbal threats and sults, havg property damaged, and beg physilly or sexually asslted, has been intified as risk factors for suici among gay youth (Mtanski & Liu, 2012) and adults (Ferlatte et al., 2015). In a study wh 350 lbian, gay, and bisexual participants younger than age 21, gay men experienced signifintly more verbal attacks, threats of vlence, and objects thrown at them (D’Augelli, Pilkgton, & Hershberger, 2002).

In a study of 8, 382 Canadian adults intifyg as gay and bisexual, a majory of rponnts reported experiencg antigay margalizatn such as bullyg, harassment, physil vlence, and workplace discrimatn (Ferlatte et al., 2015). As prevly scribed, gay men may have difficulti acceptg their gay inty bee of the society’s negative views on homosexualy, and as such gay men n feel pelled to hi their inty and experience ner nflict amid spisg their sexual orientatn (Körner et al., 2008; McAndrew & Warne, 2010).

The thoughts of ternalized homophobia have been scribed as creasg the risk for self-harm among gay men (McLaren, 2016; Plörl et al., 2014) al relatnship between HIV and suicidaly is limed due to sufficient longudal studi and varyg illns fns and diverse study sample characteristics (Haas et al., 2011). As a rult, the prevalence of suici among gay men is approximated and likely men who suici embody diverse plex inti beyond their sexual orientatn, and tersectnaly rearch has argued the need to acunt for multiple social fluenc apprehendg sights to gay men’s suici.

DEPRSN AND ASSOCIATED FACTORS AMONG GAY AND HETEROSEXUAL MALE UNIVERSY STUNTS NIGERIA

This rearch illtrat the value of studyg and addrsg the multiple tersectg social factors on the health dispari experienced by gay men (Ferlatte et al., prs) SeekgRegardls of sexual orientatn, men n be reluctant to seek help for mental health problems (Addis & Mahalik, 2003). For example, gay men who attend clics for sexually transmted fectns or HIV screeng felt stigmatized for their sexual orientatn, suggtg they were treated based on generalizatns and stereotyp stead of their self-reported sexual practic and overall health (Knight, Shoveller, Oliffe, Gilbert, & Golnberg, 2012).

As a rult, gay men may feel “othered” and whhold rmatn om health re provirs about their sexual the ntext of receivg effective help, a range of potential issu have also been highlighted, cludg antiprsants’ si effects, illic substance and alhol ovese, and health re provir misterpretatn of prsive symptoms. Further plexi exist where prsn is wily perceived as a stereotypil feme disorr and gay men’s prsive symptoms may be ncealed by patients and/or advertently missed by health re provirs (Michniewicz, Bosson, Len, & Chen, 2016).

Implitns for Health Care ProvirsThe tn curriculums for health re provirs may not aquately equip them to addrs the needs of gay men (Blackwell, 2015; Gee, 2006; Rutherford et al., 2012; Substance Abe and Mental Health Servic Admistratn [SAMHSA], 2012).

HOMOSEXUALS AND DEPRSN: HELP FOR GAYS WH DEPRSN

As such, is important for provirs to discs nfintialy wh their patients, cludg how patient rmatn is rerd and potentially (2007) provis an onle gui for health re provirs to e when asssg lbian, gay, bisexual, and transgenr (LGBT) dividuals. Health re provirs n effectively tervene by providg rmatn and muny rourc to extend health rourc beyond their, bee gay men are at higher risk for substance ovese (Kg et al., 2008), they should be asssed for substance ovese, and s potential to be ed to self-medite prsn and/or suicidaly, and alleviate distrs.

Gay men may also ovese substanc to exprs or supprs same-sex sire (CAMH, 2007; SAMHSA, 2012) as well as to enhance sexual pleasure (Cox, 2006; Mattison, Ross, Wolfson, & Frankl, 2001; Semple, Patterson, & Grant, 2002). Health re provirs should be aware that nonverbal gtur such as rabow flags or gay affirmg posters (such as posters featurg gay upl) n be ed to signal safe environments (SAMHSA, 2012) and n help break down barriers (Ash & Mackereth, 2013).

This n be advanced by creatg nfintialy polici for staff and patients, and by tg patients about laws that protect their nfintialy (SAMHSA, 2012), prsive symptoms and suicidaly often tim begs adolcence, and gay youth n be a subgroup pecially vulnerable to suici. PFLAG Canada is a natnal anizatn that helps support, te, and provi rourc for dividuals wh issu round sexual orientatn, genr inty, and genr exprsn and provis an extensive rmatn document for parents whose child intifi as gay (PFLAG Canada, 2010).

NEW DATA ON LBIAN, GAY AND BISEXUAL MENTAL HEALTH

For example, a study of health re provirs who routely provid re for gay men, discrepanci between the classic textbook prsive symptoms and the psychosocial prentatn of prsn gay men’s liv were highlighted (Körner et al., 2008).

Rather than relyg on standardized prsn screeng tools, the health re provirs relied on their experience and relatnships wh patients quirg about the patient’s life and prsive symptoms orr to intify moods and/or social problems related to gay men’s prsn (Körner et al., 2008) help asss and terme the severy of gay men’s suicidaly, health re provirs n e the Suici Preventn Rource Center’s Suici Asssment Five-Step Evaluatn and Triage (SAFE-T; available at).