Queering mental health supports in Canada: Developing a training program for service providers


Kimberly Seida, Egale Canada

A robust evidence base has confirmed the presence of socioeconomic and health inequities among 2SLGBTQI people in Canada due to exclusion, discrimination, and a lack of affirming healthcare (Bettergarcia et al., 2021). The COVID-19 pandemic has exacerbated these inequities, disproportionately impacting numerous social determinants of mental health for 2SLGBTQI individuals, including access to primary and mental healthcare, housing, food, and employment (Seida, 2023). Alongside these deepened disparities wrought by the pandemic, the last few years have been characterized by troublesome rises in gender-based and anti-2SLGBTQI violence (Women and Gender Equality Canada, 2022). In the current context of national anti-2SLGBTQI movements and rhetoric, 2SLGBTQI people are being systematically marginalized and excluded from Canadian mental health care and social services. To address these challenges, Egale Canada’s researchers and instructional designers co-developed a cost-free and self-led virtual training program for mental health and social service providers across Canada. The bilingual training program is based on research conducted between 2021 - 2022, which included a national survey ( N = 304) and virtual focus groups ( N = 61) with 2SLGBTQI service seekers as well as queer and allied service providers, giving participants a space to share their experiences regarding the pandemic’s wide-ranging impacts on mental health and well-being. Queer and allied service providers similarly shared the challenges they faced in delivering inclusive care for 2SLGBTQI people during the pandemic. The training is entirely rooted in the experiences, challenges, and priorities for change shared by research participants. The Queering Mental Health Supports in Canada training is a four-module interactive program incorporating both service recipients’ and providers’ experiences. Specifically, it builds on the needs identified by service providers in earlier phrases of the research, including: strategies on how to provide safer, more affirming care and services; incorporating rural and remote experiences; using socio-ecological and intersectional modalities; adapting to more virtual care provision; and responding to the needs of 2SLGBTQI service providers (e.g., burnout prevention). The first module reviews content from the “Inclusion 101” trainings Egale already provides. The second module puts forward the theoretical foundations of the training program: social determinants of mental health, intersectionality, minority stress, and trauma-informed care. The intent is to move beyond biomedical, individualistic, and westernized understandings of mental health to wholistically address 2SLGBTQI mental health disparities. The third module aims to create safer mental health care with a focus on cultural safety, anti-oppression, and neurodiversity-affirming care. In the final module, learners will explore how the field responded to pandemic-related challenges by adopting alternate strategies and modes of delivery, and how to dismantle financial, proximity, and physical barriers to care. Egale’s training challenges existing frameworks of “cultural sensitivity” or “cultural competency”, which risk reducing safe and appropriate care to a finite set of practices or knowledge canons which, if applied, will result in better healthcare experiences and decreased disparities. Instead, it invites learners to focus on approaching care through the lens of cultural humility, an approach which places the service seeker at the centre and which understands provider and organizational improvement and growth as ongoing processes. Going beyond the typical risk discourses which only serve to pathologize and further marginalize 2SLGBTQI care and service seekers, our training highlights the strengths and resilience of 2SLGBTQI people in their efforts to navigate and optimize their healthcare, health, and well-being. Our training also builds on the adaptive approaches already being employed by 2SLGBTQI and allied service providers to provide a roadmap for new learners. Incorporating both provider and seeker perspectives in the same training is key to mapping out collaborative approaches to improve health care delivery and to maximize learners’ application and integration of the training. Egale Canada’s training serves as a critical intervention to support the health and well-being of 2SLGBTQI communities. Addressing key training and knowledge gaps among frontline service providers, managers, and decision-makers 2SLGBTQI communities’ health and healthcare needs is urgent within a shifting sociopolitical landscape increasingly marred by anti-2SLGBTQI behaviours, discourse, and legislation.

Non-presenting author: Krista Ceccolini, Egale Canada

This paper will be presented at the following session: