Healthcare Engagement Among Gay and Bisexual Men With Recent Suicide Ideation or Attempts

Gay and bisexual men experience elevated rates of suicide ideation and attempts, as compared with heterosexual men, but face unique barriers in accessing health services. In this context, the present study sought to describe rates of health care engagement among gay and bisexual men with a recent history of suicide ideation or attempts. An anonymous online survey was conducted with 7,872 Canadian gay and bisexual men in 2014-2015. The sample was restricted to characterize patterns of mental health care engagement among respondents who reported suicide ideation or attempts in the previous 12 months. "Engagement" was defined as having discussed mental health concerns (depression, substance use, or suicide) with a provider in the previous 12 months. Rates and correlates of engagement were estimated. Nineteen percent of men reported suicide ideation or attempts in the previous 12 months, of whom 58% had discussed mental health concerns with a provider. Older age, larger social support networks, and being out to a health care provider about one's sexuality were all positively associated with mental health care engagement. Among those who had not engaged with the health care system, 88% had some contact with a provider in the previous 12 months. One-third of these men accessed care through a provider other than their family doctor. Drawing on lessons learned from the HIV crises, collaborations between gay and bisexual community organizations and decision-makers within the health system are needed to address elevated rates of suicide ideation and attempts affecting sexual minorities. Public Policy Relevance Statement Gay and bisexual men are at increased risk of suicide but have unique health care usage patterns that in turn require specific health care and community networks to reach those at risk. This study demonstrates that 88% of recently suicidal gay and bisexual men have had contact with a health care provider in the previous 12 months, but 1/3 of them sought care from an alternative site (other than a family doctor). Broad intersectoral networks can be mobilized to prevent suicide in gay and bisexual communities.