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Bisexual People’s Experiences with Mental Health Services: A Qualitative Investigation

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Abstract

Bisexual people experience minority stress and social isolation as a result of their marginalized sexual identities, and likely due to this stigmatization, previous research has identified high rates of psychological distress, anxiety, depression, suicidality, alcohol misuse, and self-harming behaviour among bisexual populations. It is therefore important that mental health service providers are able to provide culturally competent care to bisexual people. This study used focus groups and interviews with 55 bisexual participants across the province of Ontario, Canada, to investigate their experiences with mental health care. Results suggest that bisexual people have both positive and negative experiences with mental health service providers. Specific provider practices which contribute to the perception of positive and negative experiences with mental heath services are described, and the implications for clinical practice discussed.

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Notes

  1. Cisgender: A word describing a person who is not transgender.

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Acknowledgments

This research was supported by a Community Research Capacity Enhancement grant from the Centre for Addiction and Mental Health. L.E. Ross is supported as a New Investigator by the Canadian Institutes of Health Research and Ontario Women’s Health Council, Award NOW-84656. In addition, support to CAMH for salary of scientists and infrastructure has been provided by the Ontario Ministry of Health and Long Term Care. The views expressed here do not necessarily reflect those of the Ministry of Health and Long Term Care. The authors would like to thank Anna Travers, Ayden Scheim, Loralee Gillis, and our participants for their essential contributions to this research.

Author information

Authors and Affiliations

  1. Social Equity and Health Research, Centre for Addiction and Mental Health, 455 Spadina Ave. Suite 300, Toronto, ON, M5S 2G8, Canada

    A. Eady, C. Dobinson & L. E. Ross

  2. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    L. E. Ross

Authors
  1. A. Eady
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  2. C. Dobinson
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  3. L. E. Ross
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Corresponding author

Correspondence to L. E. Ross.

Appendix: Interview Guide

Appendix: Interview Guide

What participants do to take care of their mental health, including any services or supports they access

  1. 1.

    What do you do in your own life to take care of your emotional and mental health? (related to being bi)

    Probes:

    1. a.

      Are you involved in bisexual groups, either in person or online? How does this affect your mental health and emotional well being, if at all?

    2. b.

      Do you know other bisexual people? How does this affect your mental health and emotional well being, if at all?

  2. 2.

    Do you use any mental health services now or have you used mental health services in the past?

    Probes for people who have used mental health services:

    1. a.

      Have you ever sought any mental health services related to your bisexuality?

      1. i.

        If yes, what was your experience using these services?

    2. b.

      What services or supports related to mental health and emotional well being have been or are most important to you as a bisexual? Why? Are there any other services or supports that you think will be important for you in the future?

    3. c.

      What is it like to be a bisexual looking for or using mental health services? Does it make a difference? Why or why not?

    4. d.

      Do you disclose your sexuality to your mental health service providers? If yes, how has the response been? If not, why not? If not, do you wish you had/could?

    5. e.

      Have the mental health services you have used been inclusive of bisexuality?

    6. f.

      Are there any gaps in the mental health services that you need as a bisexual? If yes, what are they?

  3. 3.

    Have you ever sought any other forms of support, such as formal or informal support groups?

    1. a.

      If yes, what was your experience with these forms of support?

  4. 4.

    In some areas, services have been developed specifically for lesbian and gay people, which may also include bisexuals, such as telephone support lines, counseling services, addictions services and support groups. Have you used any of these types of services? (If yes, what types?) Do you think that such services are adequate to meet the needs of bisexuals? Are some separate services for bisexuals needed?

  5. 5.

    Are there any specific barriers to mental health and emotional well being, or accessing services related to mental health and emotional well being, for bisexual people? If yes, what are they?

    Probes:

    1. a.

      What would make mental health services better for bisexuals?

    2. b.

      How could mental health services/programs/information be made more accessible to bisexuals?

    3. c.

      Are there any supports or services that you would like to see in place for bisexuals?

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Eady, A., Dobinson, C. & Ross, L.E. Bisexual People’s Experiences with Mental Health Services: A Qualitative Investigation. Community Ment Health J 47, 378–389 (2011). https://doi.org/10.1007/s10597-010-9329-x

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