Mr. Chair and members of the standing committee, it's a privilege to address you this afternoon. My name is Greg Oudman. I am the Executive Director of Health Initiative for Men, a community non-profit organization located in Vancouver that is both led by and run by gay men. Our mission is to strengthen the health and well-being of gay men toward a vision of gay men building healthy lives together.
You've heard from my esteemed colleagues about the results of research undertaken with sexual minorities and the continuing need for increased focus on this research. As a service provider, HIM is in a unique position in that we are able to put research into practice at the community level. Let me tell you a little bit about us. HIM was founded in 2008 by a group of community-minded thought leaders who were concerned about the lack of focus on the health of gay men in Vancouver's response to HIV and AIDS. HIM's inception happened at a time when there were elements of a perfect storm that were able to lead us to the development of a truly unique organization founded on the principles of for us, by us.
In the mid-2000s, the community was hearing increasing calls for effective programming for HIV/AIDS prevention and gay men's health at the same time that the region's primary health funder was looking to increase its focus on prevention. Community-based research was indicating that HIV infection and HIV and transmissible behaviours were on the rise. At the same time, testing for HIV was down in men having sex with men, especially in men under 30. The integration of the LGBTQ2 community into the mainstream as a result of expanded rights and increased societal acceptance meant that what were once traditional gay venues were disappearing. Gay men were increasingly living outside of traditionally gay urban areas, and instead connecting with each other through the realm of online networking. All of these factors led to an increasing awareness that innovative approaches had to be developed to significantly impact gay men's health.
It was into this environment that HIM was born as an organization with unique values that highlight the faith we have in our own community to be the authors of the most effective tools to ensure our own health. HIM's approach to gay men's health is an integrated one, understanding that sexual health is only one of several components of health and wellness. Physical, social and mental health needs are often drivers for more healthy, and sometimes less healthy, sexual behaviours. Very few of HIM's programs or interventions have a singular focus. All understand the role of syndemics in overall health outcomes.
HIM engages with gay men in the broadest range of ways to work with them to ensure the broadest of health outcomes. Interventions at HIM represent efforts designed to improve the sexual, physical, social and mental health of gay men, and are largely contained within health promotion and knowledge translation. They also relate to highly specific target populations, diseases and/or other important health factors or issues identified to be a priority.
Our health promotion efforts are based on scientific research and represent our largest mechanism for engaging with the health of gay men. Health promotion at HIM is delivered through a variety of methods, including social marketing campaigns, creation of unique and custom-tailored resources, health-centred communications and media, and educational and community engagement strategies. HIM recently partnered with a community-based research centre here in Vancouver to develop an official position statement on mental health and problematic substance use among gender and sexual minorities, including gay men. This statement outlines the impact of mental health on problematic substance use, highlights barriers to progress, and makes key recommendations to address issues related to mental health and problematic substance use. Much of the information I'm about to outline in this next section comes from the research done to inform that position.
We know that despite the experience of ongoing marginalization and oppression, gender and sexual minority individuals, including gay men, have made significant progress in human rights and recognition from broader society. Despite this progress, research demonstrates that gay men continue to be disproportionately impacted in terms of mental health and problematic substance use. As you have already heard, extensive research has shown that compared with the average population, gay men experience higher rates of mental illness, problematic substance use, and suicide. The overrepresentation of mental illness among gay men is also often accompanied by increased rates of problematic substance use, which are frequently part of a larger syndemic of interconnected health problems. For example, gay men are also shown to have higher rates of tobacco use, heavier episodic drinking, and nearly twice the level of substance use disorder as the general population.
This overrepresentation is also attributable to intersectionality, as key population segments of gay men also face additional barriers to accessing mental health and problematic substance use services, including racism, ableism, sexism, classism and other forms of oppression and discrimination. Some gay men identify with a combination of these social categories. Therefore, building services based on a singular aspect of their identity can represent a barrier to appropriate and effective care. The complexity of these intersecting identities requires a community-driven and evidence-based approach to ensure that the unique needs of diverse gay men are carefully considered in the delivery of services for mental health and problematic substance use.
Despite evidence of the disproportionate impact of mental health and problematic substance use in gay men, insufficient progress has been made to address this impact, and resources and support for addressing mental health and problematic substance use among gay men remain scarce.
Adequate treatment and prevention services in B.C. are not easily available to the general population and are often not funded by the public system. Most often these services are paid for out of pocket or through private insurance plans, while services that are publicly funded are often over-capacity and have extensive waitlists or challenging eligibility criteria.
The recent study noted by my esteemed colleague Travis Salway, which examined the effectiveness of integration of mental health services within a specialized STI clinic setting, found that 20% of respondents reported a recent unmet need for services related to mental health or problematic substance use, and 83% of those same respondents indicated they were comfortable talking with an STI clinic provider about mental health or problematic substance use. These statistics demonstrate both an unmet need and an untapped opportunity to address the specific mental health and problematic substance use needs of gay men.
As I've already noted, HIM is in a unique position in that it is a community-based organization that uses research to develop evidence-based practices. We actively engage in knowledge translation, which involves delivery of concise, clear and relevant translation of complex biomedical and/or health-related information and research to the community in a way that matches the community's needs.
Effective knowledge translation requires significant partnerships with researchers, universities and other research organizations such as the researchers you already heard from this afternoon. Knowledge translation initiatives work in conjunction with health promotion in that the goal for both is to create significant change in the health and well-being of gay men. HIM uses research such as that undertaken by Travis Salway and his colleagues to develop effective programming to address the challenge of mental health and problematic substance use. As I've already pointed out, HIM approaches all of its work from an integrated perspective, believing that social determinants of health are deeply interconnected and that the most effective programs and interventions are those that address more than one aspect of overall health.
Strong mental health supports good physical, sexual and social health. More than ever before in its 10-year history, HIM believes that specifically tailored mental health supports for gay men are desperately needed, including peer counselling, programming to address substance use and queer-focused suicide prevention programs, all of which are important in helping gay men to build healthy lives together.
Currently, Health Initiative for Men operates a professional volunteer counselling program, which at any given point engages 15 to 20 professionals—social workers, psychologists from the community, as well as students in the same fields—to volunteer their time to offer clinically supervised, solutions-focused sessions with an option for follow-up case management. This free program prioritizes gay men from economically disadvantaged or marginalized backgrounds.
HIM also offers a coaching program operated by volunteer peers, mentors and professional coaches who are supervised by an expert coach to offer multiple goal-focused sessions utilizing a HIM-designed motivational interview-based system.
HIM also offers specialized professionally facilitated closed mental health support groups that focus on specific needs, including issues such as anxiety and the problematic use of substances like crystal meth.
HIM also offers a subsidized counselling program, which provides reduced-rate counselling by registered and independent therapists, social workers and psychologists, all vetted by HIM's mental health advisory committee. These sessions have no session or cap limit and focus on clients with medium-to-high annual incomes.
As a community-based organization that has a unique ability to use research to inform its practice, HIM supports the recommendations made by Travis Salway in his presentation. Increasing the availability of access to mental health supports through the expansion of the Public Health Agency of Canada's HIV and hepatitis C community action fund, while increasing research on the health of sexual minorities, will help bolster the work that HIM already does to meet the need for more programming in mental health and substance use.
With the expansion of existing resources and increased capacity, we hope for expanded mental health programming to close the gap in unmet needs. We hope for increased counselling and therapy interventions within our community. We hope for new levels of excellence in mental health care. We hope to both develop and support groundbreaking programs to address forms of addiction that affect our community. We hope to develop higher standards for mental health and addictions care. We hope for a reduction of the stigma of mental illness, addiction and suicide among gay men. We hope to mobilize and engage the community to create a welcoming and healthy environment. Finally, we hope to become a beacon of change and hope for those facing loneliness, anxiety and thoughts of suicide.
In closing, I would like to thank the committee for undertaking this historic study, an important and necessary step toward national leadership in addressing the health needs of my LGBTQ2 health family.
Your leadership in this area will positively impact thousands of sexual and gender minority lives for years to come, and I thank you for that.