Abstract: [WITHDRAWN] Exploring Stigma Experiences Among Canadian Youth of Varying Genders Accessing Digital Mental Health Services (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)

Schedule:

Friday, January 12, 2024

Supreme Court, ML 4 (Marriott Marquis Washington DC)

* noted as presenting author

Shelly Ben-David, PhD, Assistant Professor, University of British Columbia Okanagan, Kelowna, BC, Canada

Melissa Campos, Clinical social worker, University of British Columbia, Kelowna, BC, Canada

Alicia Gonzalez, MSW student, University of British Columbia, BC, Canada

Kate Giebelhaus, MSW student, University of British Columbia, BC, Canada

Hannah Finkelstein, MSW student, University of British Columbia, BC, Canada

Gurvaan Mann, Youth research assistant, University of British Columbia, BC

Mikaela Basile, Youth research assistant, University of British Columbia, BC

T Schwab, Youth research assistant, University of British Columbia, BC

Julia Gray, Youth research assistant, University of British Columbia, BC

Skye Barbic, PhD, Assistant Professor, University of British Columbia, Vacouver, BC, Canada

Background and Purpose: One in four youth experience a mental health issue each year, but only 20% access services. One way to bridge the gap is by looking at digital mental health technology (DMHT) as an avenue for support, since youth are frequent users of technology, find it accessible, affordable, and beneficial to supporting their mental health. However, barriers to service access do exist, for example, youth across genders may experience stigma when deliberating on whether to access services. The followings qualitative study examined how Canadian youth of varying genders make decisions about accessing DMHT.

Methods: Youth aged 12-24 were recruited using purposeful sampling and invited to participate in 1-2 hour long virtual qualitative interviews. Interviews were conducted in 2020, by four youth research assistants who were supported by graduate student coaches. Questions were developed based on the ten constructs (e.g., beliefs, social norms, emotions, self-efficacy, social image, knowledge, environment, habits, cues, split-second decision-making) from the Unified Theory of Behavior (UTB), a decision-making framework. Youth were also asked questions related to how their gender influenced their services use experiences. For example, interviewers asked the question, “do you think there are gender differences in the way that a young person seeks out digital mental health technology?” Graduate social work students engaged in thematic analysis, identifying, analyzing, and reporting themes within the data

Results: Forty-five participants aged 12-24 were interviewed, with a mean age 19 (SD=3.3). Sample gender distribution included: 31% Female, 33% Male, and 38% Two-spirit and Non-Binary. Of those youth 38% were Transgender. Sample race distribution included: 42% White, 18% Chinese, 13% Mixed ethnicity, 11% Indigenous, 2% Filipino, and 2% South Asian. Youth discussed how their gender identities impacted (impeded and/facilitated) accessing DMHT. Three categories emerged regarding how stigma interacted with the gender identity of youth in our sample. The first was stigma’s impact on boys (n=24), with youth describing help-seeking as being weak if you are boy, and boys don’t show vulnerability. For example, one youth stated, “If you want to feel bad you can only feel angry”. The second category was stigma’s impact on girls (n=22), including service use viewed as socially acceptable for girls, and girls seen as oversensitive. One youth stated, “women are stereotyped as too emotional”. The third category was stigma’s impact on LGBTQIAS2+ youth (n=13), including experiencing stigma from services and practitioners. One youth said, “Trans people are seen as crazy or needing attention”. Findings also revealed that gender identity stigma barriers can influence whether or not a youth discloses their mental health and service use experiences to others. For example, girls disclose more, and boys disclose less.

Conclusion and Implications: Understanding the relationship between gender identity, stigma, and service use is critical when designing DMHT tailored to diverse youth. Findings from this study can be applied in the creation of DMHT engagement tools to help reduce the low rates of service use among youth across varying genders.