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Living in the modern world, every person encounters a situation that can cause mental health illnesses, of which one of the most common is depression. One of the social groups most vulnerable to depression is the LGBTQ community and, in particular, homosexual males. An approach in the management of mental illness that can help to overcome depression is Recovery Model. The literature used for the research on the paper aims to overview depression among homosexual males and describe the role of the nurse and practices based on the Recovery Model throughout the depression. The treatment of depression among homosexual males has its distinctive features due to social stigma and requires a unique nursing approach when using the Recovery Model, especially the one focused on social identity.
Depression among Homosexual Males: Overview
People want to be accepted by other people for who they are, and if society constantly rejects someone, they start developing insecurities and mental health issues. Research shows that being a member of a fewer social group can be a strong predictor of subsequent depression (Richardson & Barkham, 2017). Depression can be characterized as constant feelings of sadness and hopelessness, as well as a loss of pleasure in daily activities, typically continuing for more than two weeks (Richardson & Barkham, 2017). While more than 98 million people are affected by depression globally (Rees et al., 2020), statistics show that homosexual males are three times more likely to experience depression (Lee et al., 2017). Being rejected on the basis of sexuality from family, peers, and other social groups can cause the first symptoms of depression among sexual minorities.
While the initial cause of depression among homosexual males can be rejection from society, there are other factors. Relevant factors that can cause depression are prejudice events such as antigay violence and discrimination, concealment of identity, and internalized homophobia (Lee et al., 2017). For instance, some homosexual males tend to conceal their sexual orientation in fear of violence, thus increasing the risk of emotional distress (Lee et al., 2017). Research shows that homosexual males under the age of 21 experience more verbal attacks, threats of violence (Lee et al., 2017). Being victims because of something they cannot control, homosexual males have to be able to receive quality mental health care, so they do not develop further social insecurities.
Once starting to show symptoms of depression, people seek mental health care; however, homosexual people encounter various barriers as they try to get help. Research shows that instead of getting proper mental help, homosexual males experience stigma as they are expected to be vastly different from heterosexual people and have an abnormal appearance and behavior (Rees et al., 2020). People also point at the lack of knowledge of specific needs of sexual minorities by the staff. Some state that they were asked questions not related to their problems and felt as if they were providing education instead of getting help (Rees et al., 2020). Being distanced and not attended to by health care workers only enhances the level of depression among homosexual males.
The Recovery Model
When addressing depression among homosexual males, it is important to ensure that even if depression cannot be treated completely, the patients can find a way to overcome the symptoms. A way to achieve that is through the Recovery Model, which can be described as an experience of optimism, empowerment, and interpersonal support (Avdibegović & Hasanović, 2017). The process of recovery is unique to each person and should be focused on individual strength, health promotion, and resilience (Avdibegović & Hasanović, 2017). The Recovery Model aims at helping people to see life beyond just existence and encouraging them to move forward and give meaning to their lives.
The Recovery Model proposes that regardless of the severity of mental illness, each person should be able to live a meaningful life with hope for the future. Regarding depression among homosexual males, the Recovery Model focused on social identity may be most useful. The social identity approach suggests that a person’s self-concept depends both on personal identity and the social categories to which the person belongs (Cruwys et al., 2020). The social identity model of recovery focuses on recovery identity and collective efficacy. Recovery identity aims at choosing to establish a strong and positive social identity rather than relying on substance-user identity to overcome concealment of identity (Cruwys et al., 2020). Collective efficacy aims at recovering through a belief that the group as a whole can succeed by uniting groups of sexual minorities to find hope and a common purpose (Cruwys et al., 2020). The goal of the Recovery Model is to help homosexual males to overcome the symptoms of depression by learning how to accept themselves and becoming a part of a group of kindred people.
The Role of the Nurse
When using the Recovery Model for depression among homosexual males, the nurse plays an important role. Research shows that there is not enough training on the specific needs of sexual minorities for nurses, although about 78% of surveyed nursing educators point to its extreme importance (McEwing, 2020). In the Recovery Model, nurses can serve as consultants who, learning alongside the patients, encourage growth and belief in the potential of the patients to find meaning in their lives (Avdibegović & Hasanović, 2017). Nurses play significant roles in making sure that sexual minorities patients feel safe and welcomed.
There are specific needs of homosexual males with depression that nurses have to consider during the implementation of the Recovery Model. Despite the recent generation of nurses being more considered and comfortable with sexual minorities (Cruwys et al., 2020), conservative nurses show negative attitudes and stereotypes providing care to them (Hodges et al., 2020). Research shows that homosexual males want informed care during which people would not assume that their mental health issues are associated with their sexual identity issues (Cruwys et al., 2020). Homosexual males also seek care that would promote self-acceptance and address self-blame, loneliness, and the type of abuse that heterosexual people typically do not experience (Cruwys et al., 2020). Using the Recovery Model, whether as a student or a practitioner, it is important to be open-minded and promote equality, inclusion, and respect towards all patients.
Conclusion
The Recovery Model that is focused on social identity can be useful in overcoming depression among homosexual males. However, there are specific needs that have to be paid attention to when providing care for sexual minorities. Those specific needs are linked to social stereotypes and a lack of knowledge among health care workers regarding sexual orientation. For the Recovery Model to be efficient, all health care workers, including nurses, have to discard their biases and judgments so sexual minorities patients can become more confident in overcoming mental illnesses.
References
Avdibegović, E., & Hasanović, M. (2017). The stigma of mental illness and recovery. Psychiatria Danubina, 29(5), 900-905.
Cruwys, T., Stewart, B., Buckley, L., Gumley, J., & Scholz, B. (2020). The recovery model in chronic mental health: a community-based investigation of social identity processes. Psychiatry Research, 291(113241), Web.
Hodges, T., Seibenhener, S., & Young, D. (2020). Incorporating health care concepts addressing the needs of the lesbian, gay, bisexual, and transgender population in an associate of science in nursing curriculum: Are faculty prepared?. Teaching and Learning in Nursing, 16(2), 116-120.
Lee, C., Oliffe, J. L., Kelly, M. T., & Ferlatte, O. (2017). Depression and suicidality in gay men: Implications for health care providers. American Journal of Men’s health, 11(4), 910-919.
McEwing, E. (2020). Delivering culturally competent care to the lesbian, gay, bisexual, and transgender (LGBT) population: Education for nursing students. Nurse Education Today, 94(104573), Web.
Rees, S. N., Crowe, M., & Harris, S. (2020). The lesbian, gay, bisexual and transgender communities’ mental health care needs and experiences of mental health services: An integrative review of qualitative studies. Journal of Psychiatric and Mental Health Nursing, Web.
Richardson, K., & Barkham, M. (2017). Recovery from depression: a systematic review of perceptions and associated factors. Journal of Mental Health, 29(1), 103-115.
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