"Shared and Collective Stress"

2SLGBTQI and Allied Mental Healthcare Providers' Experiences and Challenges During COVID-19 in Canada

Authors

Keywords:

2SLGBTQI, mental health, healthcare, COVID, service providers, Canada

Abstract

The confluence of increased demand for mental health services and decreased resources due to the COVID-19 pandemic has created multiple challenges for mental healthcare and social service providers. 2SLGBTQI service providers may be disproportionately impacted by pandemic-related challenges, such as psychological distress, vicarious traumatization, and burnout. However, there are significant knowledge gaps regarding the needs and experiences of 2SLGBTQI and allied service providers in the context of the COVID-19 pandemic in Canada. To address these gaps, we conducted a national survey (N = 304), eight semi-structured focus groups, and five semi-structured interviews (N = 61) with 2SLGBTQI care seekers and service providers across Canada. Based on data from the 106 2SLGBTQI service providers and 3 allied service providers who took part in these research activities, this paper explores the challenges service providers encounter when providing care to 2SLGBTQI individuals as well as their adaptive responses to these challenges. Understanding the experiences of service providers who share lived experiences of discrimination and marginalization with their clients is critical to addressing barriers to affirming mental healthcare, shifting services to meet the evolving needs of both care seekers and providers, and developing upstream, comprehensive solutions to address the causes of 2SLGBTQI mental health disparities.

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Author Biographies

Kimberly Seida, Egale Canada

Kimberly Seida is a qualitative researcher and PhD Candidate in Sociology at McGill University. Her dissertation explores the healthcare experiences, resilience strategies, and community-building efforts of sexual minority womxn in Canada. She has expertise in qualitative research methodologies (e.g., grounded theory, narrative research); critical media studies; and the sociology of health, illness, and medicine. Kim’s most recent work has focused on unpacking understandings of mental health recovery, social inclusion for folks living with disabilities, and Indigenous youth leadership. At Egale, Kim’s work is largely focused on addressing 2SLGBTQI mental health disparities and highlighting healthcare access issues.  

Félix Desmeules-Trudel, Egale Canada

Félix Desmeules-Trudel (he/him) is a Research Advisor at Collège Montmorency. In this role, he provides support to the research community for project conceptualization, methodology, knowledge mobilization and implementation, among other crucial aspects of college research. Formerly, Félix was a Senior Research Officer at Egale Canada. His work at Egale focused on quantitative research design and analysis. He completed his PhD in Linguistics at the University of Ottawa and postdoctoral fellowships in Psychology at several institutions in Canada.

Brittany A. E. Jakubiec , Egale Canada

Brittany A.E. Jakubiec is a qualitative and educational researcher based in Epetwitk (Prince Edward Island) whose research focuses on experiences of LGBTQ youth, and questions of gender and sexuality, identity, and educational experiences. Brittany completed a PhD in educational studies and an MEd in educational leadership from the University of Prince Edward Island. Brittany brings multi-sectoral experience to their director role, including experience in non-profit leadership, higher education teaching, and academic research. At Egale, Brittany’s current research and work focuses on 2SLGBTQI health and employment. 

References

Alegría, Margarita, Amanda NeMoyer, Irene Falgas, Ye Wang, and Kiara Alvarez. 2018. “Social Determinants of Mental Health: Where We Are and Where We Need to Go.” Current Psychiatry Reports 20(11): 95. doi.org/10.1007/s11920-018-0969-9

Anaraki, Nahid Rahimipour, Meghraj Mukhopadhyay, Yordan Karaivanov, Margo Wilson, and Shabnam Asghari. 2022. “Living and Working in Rural Healthcare During the COVID-19 Pandemic: A Qualitative Study of Rural Family Physicians’ Lived Experiences.” BMC Primary Care 23(1): 1–9. doi.org/10.1186/s12875-022-01942-1

Beagan, Brenda L., Kaitlin R. Sibbald, Stephanie R. Bizzeth, and Tara M. Pride. 2023. “Factors Influencing LGBTQ+ Disclosure Decision-Making by Canadian Health Professionals: A Qualitative Study.” PLOS One 18(2): e0280558. doi.org/10.1371/journal.pone.0280558.

Bishop, Joshua, Dimity Crisp, and Brett Scholz. 2022. “‘We are Better and Happier if We Are Inclusive.’ Therapist Perspectives on the Importance of LGB Cultural Competence in a Mental Health Setting.” Counselling and Psychotherapy Research 23: 995–1004. doi.org/10.1002/capr.12586.

Bizzeth, Stephanie R. and Brenda L. Beagan. 2023. “’Ah, it’s Best not to Mention That Here:’ Experiences of LGBTQ+ Health Professionals in (Heteronormative) Workplaces in Canada.” Frontiers in Sociology 8: 1138628. doi.org/10.3389/fsoc.2023.1138628.

Brennan, David J., Kiffer G. Card, David Collict, Jody Jollimore, and Nathan J. Lachowsky. 2020. “How Might Social Distancing Impact Gay, Bisexual, Queer, Trans and Two-Spirit Men in Canada?.” AIDS and Behavior 24: 2480–2482. doi.org/10.1007/s10461-020-02891-5.

Canvin, Lauren, Jos Twist, and Wendy Solomons. 2021. “How do Mental Health Professionals Describe Their Experiences of Providing Care for Gender Diverse Adults? A Systematic Literature Review.” Psychology & Sexuality 13(3): 717–741. doi.org/10.1080/19419899.2021.1916987.

Castro-Peraza, Maria Eliza, Jesús Manuel García-Acosta, Naira Delgado, Ana María Perdomo-Hernández, Maria Immaculada Sosa-Alvarez, Rosa Llabrés-Solé R, and Nieves Doria Lorenzo-Rocha. 2019. “Gender Identity: The Human Right of Depathologization.” International Journal of Environmental Research and Public Health 16(6): 978–989. https://doi.org/10.3390/ijerph16060978.

Daley, Andrea, Hannah Kia, David Kinitz, Stella A. Schneckenburger, Margaret Robinson, Jenna Reid, Nick J. Mulé, Faelix Kayn, Dejano Duncan, and Lori E. Ross. 2023. “‘This is the System We Live in’: The Role of Social Assistance in Producing and Sustaining 2SLGBTQ+ Poverty in Ontario, Canada.” Sexuality Research and Social Policy. doi.org/10.1007/s13178-023-00852-w.

De Kock, Johannes H., Helen Ann Latham, Stephen J. Leslie, Mark Grindle, Sarah-Anne Munoz, Liz Ellis, Rob Polson, and Christopher M. O’Malley. 2021. “A Rapid Review of the Impact of COVID-19 on the Mental Health of Healthcare Workers: Implications for Supporting Psychological Well-Being.” BMC Public Health 21(1): 104. doi.org/10.1186/s12889-020-10070-3.

Dickey, Iore M. and Annaliese A. Singh. 2017. “Finding a Trans-Affirmative Provider: Challenges Faced by Trans and Gender Diverse Psychologists and Psychology Trainees.” Journal of Clinical Psychology 73(8): 938–944. doi.org/10.1002/jclp.22508.

Eliason, Michele J., Carl Streed Jr., and Michael Henne. 2017. “Coping with Stress as an LGBTQ+ Health Care Professional.” Journal of Homosexuality 65(5): 561–578. doi.org/10.1080/00918369.2017.1328224.

Gavin, Sandra G. 2021. “Exploring Supervision, Efficacy Beliefs, and the Supervisory Working Alliance When Counselors-in-Training Work With LGBTGEQIAP+ Clients.” Doctoral dissertation, Northern Illinois University.

Giwa, Sulaimon, and Cameron Greensmith. 2012. “Race Relations and Racism in the LGBTQ Community of Toronto: Perceptions of Gay and Queer Social Service Providers of Color.” Journal of Homosexuality 59(2): 149–185. doi.org/10.1080/00918369.2012.648877.

Greenberg, Neil, Mary Docherty, Sam Gnanapragasam, and Simon Wessely. 2020. “Managing Mental Health Challenges Faced by Healthcare Workers During Covid-19 Pandemic.” The BMJ 368, m1211. doi.org/10.1136/bmj.m1211.

Holmberg, Mackenzie H., Suzanne G. Martin, and Mitchell R. Lunn. 2022. “Supporting Sexual and Gender Minority Health-Care Workers.” Nature Reviews Nephrology 18: 339–340. doi.org/10.1038/s41581-022-00573-0.

Joy, Eileen, Virginia Braun, and Victoria Clarke. 2023. “Doing Reflexive Thematic Analysis: A Reflexive Account.” In Research Methods in Education, Social Work, and Counselling, edited by Frauke Meyer and Kane Meissel, 155–171. Auckland: New Zealand Council for Educational Research Press.

Kennedy, Angel M., Stéphanie Black, Sarah Watt, Natasha Vitkin, James Young, Rowdy Reeves, and Travis Salway. 2022. “Health Provider and Sexual and Gender Minority Service User Perspectives on Provision of Mental Health Services During the Early Phase of the COVID-19 Pandemic in British Columbia, Canada.” medRxiv (pre-print). https://www.medrxiv.org/content/10.1101/2022.02.18.22271151v1.full.pdf.

Khan, Nadia, Anita Palepu, Peter Dodek, Amy Salmon, Heather Leitch, Shannon Ruzycki, Andrea Townson, and Diane Lacaille. 2021. “Cross-Sectional Survey on Physician Burnout During the COVID-19 Pandemic in Vancouver, Canada: The Role of Gender, Ethnicity and Sexual Orientation.” BMJ Open 11(5): e050380. doi.org/doi:10.1136/bmjopen-2021-050380.

Levenson, Jill S., Shelley L. Craig, and Ashley Austin. 2023. “Trauma-Informed and Affirmative Mental Health Practices with LGBTQ+ Clients.” Psychological Services 20(1): 134–144. doi.org/10.1037/ser0000540.

Loo, Stephanie, Matteo Peretti, Maksim Sigal, Bridget Noe, Chris Grasso, Alex S. Keuroghlian, and Kenneth H. Mayer. 2023. “Health Center Leadership Perspectives Regarding Barriers to and Facilitators of Providing Culturally Responsive Care for Sexual and Gender Minority Patients.” LGBT Health 10(5): 391–400. doi.org/doi:10.1089/lgbt.2022.0135.

Lykins, Corinne C. 2021. “Training While Queer: An Interpretative Phenomenological Analysis of the Experiences of Queer Therapists-in-Training.” Doctoral dissertation, The State University of New Jersey. doi.org/doi:10.7282/t3-nszf-m105.

MacKinnon, Kinnon R., Daniel Grace, Stella L. Ng, Suzanne R. Sicchia, and Lori E. Ross. 2020. “‘I don’t think they thought I was ready’: How Pre-transition Assessments Create Care Inequities for Trans People with Complex Mental Health in Canada.” International Journal of Mental Health 49(1): 56–80. doi.org/10.1080/00207411.2019.1711328

McInroy, Lauren, Shelley L. Craig, and Ashley Austin. 2014. “The Perceived Scarcity of Gender Identity Specific Content in Canadian Social Work Programs.” Canadian Social Work Review/Revue Canadienne De Service Social 31(1): 5–21.

McIntyre, John, Andrea Daley, Kimberly Rutherford, and Lori E. Ross. 2011. “Systems-Level Barriers in Accessing Supportive Mental Health Services for Sexual and Gender Minorities: Insights from the Provider’s Perspective.” Canadian Journal of Community Mental Health 30(2): 173–186. doi/10.7870/cjcmh-2011-0023.

Meyer, Ilan H. 2003. “Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence.” Psychological Bulletin 129(5): 674–697. doi.org/10.1037/0033-2909.129.5.674.

Miu, Adriana S. and Jessica R. Moore. 2021. “Behind the Masks: Experiences of Mental Health Practitioners of Color During the COVID-19 Pandemic.” Academic Psychiatry 45, 539-544. doi.org/10.1007/s40596-021-01427-w.

Munro, Lauren, Robb Travers, Alex St. John, Kate Klein, Heather Hunter, David Brennan, and Chavisa Brett. 2013. “A bed of roses?: Exploring the Experiences of LGBT Newcomer Youth who Migrate to Toronto.” Ethnicity and Inequalities in Health and Social Care 6(4): 137–150. doi:10.1108/EIHSC-09-2013-0018

Myers, Diane G. an David F. Wee. 2002. “Strategies for Managing Disaster Mental Health Worker Stress.” In Psychosocial Stress Series, no. 24. Treating Compassion Fatigue, edited by C. R. Figley, 181-211. Brunner-Routledge.

Pilling, Merrick. 2022. Queer and Trans Madness: Struggles for Social Justice. Cham: Palgrave MacMillan.

Pilling, Merrick, Meg Howison, Tyler Frederick, Lori Ross, Chyrell D. Bellamy, Larry Davidson, Kwame McKenzie, and Sean A. Kidd. 2017. “Fragmented Inclusion: Community Participation and Lesbian, Gay, Bisexual, Trans, and Queer People with Diagnoses of Schizophrenia and Bipolar Disorder.” American Journal of Orthopsychiatry 87(5): 606–613. doi.org/10.1037/ort0000215

Ranjibar, Noshene, Matt Erb, Othman Mohammad, and Francisco A. Moreno. 2020. “Trauma-Informed Care and Cultural Humility in the Mental Health Care of People From Minoritized Communities.” Focus 18(1): 8–15. doi.org/10.1176/appi.focus.20190027.

Rimby, Jarred. 2022. “Just Going Without”: A Health Needs Assessment for Queer Women, Non-binary, and Transgender People in Seattle, WA.” Masters’ thesis, The University of Washington.

Rowe, Denise, Yeow Chye Ng, Louise O’Keefe, and Desiree Crawford. 2017. “Providers’ Attitudes and Knowledge of Lesbian, Gay, Bisexual, and Transgender Health.” Federal Practitioner 34(11): 28–34.

Sebring, Jennifer C. 2021. “Towards a Sociological Understanding of Medical Gaslighting in Western Health Care.” Sociology of Health & Illness 43(9): 1951–1964. doi.org/10.1111/1467-9566.13367.

Seida, K. (2023). Queering mental health supports in Canada: A research report. Egale Canada. https://egale.ca/wp-content/uploads/2023/07/Queering-Mental-Health-in-Canada-4.0.pdf

Slemon, Allie, Chris Richardson, Trevor Goodyear, Travis Salway, Anne Gadermann, John L. Oliffe, Rod Knight, Shivinder Dhari, and Emily K. Jenkins. 2021. “Widening Mental Health and Substance Use Inequities Among Sexual and Gender Minority Populations: Findings from a Repeated Cross-sectional Monitoring Survey During the COVID-19 Pandemic.” Psychiatry Research 307 (August): 114327. doi.org/10.1016/j.psychres.2021.114327.

Stryker, Shanna D., Harini Pallerla, R. Andrew Yockey, Julia Bedard-Thomas, and Sarah Pickle. 2022. “Training Mental Health Professionals in Gender-Affirming Care: A Survey of Experienced Clinicians.” Transgender Health 7(1): 68–77. doi.org/10.1089/trgh.2020.0123.

van de Sande, Adje and Karen Schwartz. 2017. Research for Social Justice, 2nd Edition: A Community-Based Participatory Approach. https://discardstudies.com/2016/03/21/refusal-as-research-method-in-discard-studies/

Walubita, Tubanji, Ariel L. Beccia, Esther Boama-Nyarko, Eric Y. Ding, Katarina A. Ferrucci, and Bill M. Jesdale. 2022. “Complicating Narratives of Sexual Minority Mental Health: An Intersectional Analysis of Frequent Mental Distress at the Intersection of Sexual Orientation, Gender Identity, and Race/Ethnicity.” LGBT Health 9 (3): 1–8. doi.org/10.1089/lgbt.2021.0099.

Wojcik, Hailey, Aaron S. Breslow, Marla R. Fisher, Caryn R. Rodgers, Patryk Kubiszewski, and Vilma Gabbay. 2022. “Mental Health Disparities Among Sexual and Gender Minority Frontline Health Care Workers during the Height of the COVID-19 Pandemic.” LGBT Health 9(5): 359–367. doi.org/10.1089/lgbt.2021.0276.

Wolfe, Atticus. 2023. “Incongruous Identities: Mental Distress and Burnout Disparities in LGBTQ+ Health Care Professional Populations.” Heliyon 9: e14835. doi.org/10.1016/j.heliyon.2023.e14835.

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Published

2024-10-22