{"id":15398,"date":"2023-05-10T00:00:00","date_gmt":"2023-05-10T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/publications\/journal-articles\/exploring-mediators-of-mental-health-service-use-among-transgender-individuals-in-ontario-canada\/"},"modified":"2023-07-24T15:21:10","modified_gmt":"2023-07-24T19:21:10","slug":"exploring-mediators-of-mental-health-service-use-among-transgender-individuals-in-ontario-canada","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/exploring-mediators-of-mental-health-service-use-among-transgender-individuals-in-ontario-canada\/","title":{"rendered":"Exploring mediators of mental health service use among transgender individuals in Ontario, Canada"},"content":{"rendered":"<p><strong>Objectives<\/strong> \u2014 To determine if and to what degree neighbourhood-level marginalization mediates mental health service use among transgender individuals.<\/p>\n<p><strong>Methods<\/strong> \u2014 This retrospective cohort study identified 2,085 transgender individuals through data obtained from 4 outpatient community and hospital clinics in 3 large cities in Ontario, which were linked with administrative health data between January 2015 and December 2019. An age-matched 1:5 comparison cohort was created from the general population of Ontario. Outcome measures were analysed from March 2020 to May 2022. The primary outcome was mental health service utilization, which included mental health-related visits to primary care providers, psychiatrists, mental health- and self-harm-related emergency department visits, and mental health hospitalizations. Mediation variables included ethnic concentration, residential instability, dependency, and material deprivation at the neighbourhood level and were derived from the Ontario Marginalization Index.<\/p>\n<p><strong>Results<\/strong> \u2014 This study identified 2,085 transgender individuals from participating outpatient community and hospital clinics, who were matched to the general population (<em>n<\/em> = 10,425). Overall, neighbourhood-level marginalization did not clinically mediate mental health service use. However, transgender individuals were more likely to be exposed to all forms of neighbourhood-level marginalization, as well as having higher rates of health service use across all outcome measures.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 In this study, mental health service use among transgender individuals was not clinically mediated by marginalization at the neighbourhood level. This study highlights the need to explore marginalization and mental health service use at the individual level to better understand the mental health disparities experienced by transgender individuals and to ensure that health-care services are inclusive and affirming.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objectives \u2014 To determine if and to what degree neighbourhood-level marginalization mediates mental health service use among transgender individuals. Methods \u2014 This retrospective cohort study identified 2,085 transgender individuals through data obtained from 4 outpatient community and hospital clinics in 3 large cities in Ontario, which were linked with administrative health data between January 2015 [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[19,34],"migration-helper-qa-sample-set":[],"class_list":["post-15398","journal_article","type-journal_article","status-publish","hentry","topic-marginalized-populations","topic-mental-health-and-addictions"],"acf":{"citation":"Abramovich A, Gould WA, Pang N, de Oliveira C, Iwajomo T, Vigny-Pau M, MacKinnon K, Lam JSH, Kurdyak P. <em>Can J Psychiatry<\/em>. 2023; May 10 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1177\/07067437231171541","ices_scientist":[1152,1210,22725],"site":[6735],"research_program":[6744],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"31ACD28D-13FD-4418-8039-513788BC5AFA","sitecore_item_name":"Exploring-mediators-of-mental-health-service-use-among-transgender-individuals-in-Ontario-Canada","sitecore_field_values":"{\r\n  \"Title\": \"Exploring mediators of mental health service use among transgender individuals in Ontario, Canada\",\r\n  \"Short title\": \"Exploring mediators of mental health\",\r\n  \"Summary\": \"The study aim was to determine if and to what degree neighbourhood-level marginalization mediates mental health service use among transgender individuals.\",\r\n  \"Citation\": \"<p>Abramovich A, Gould WA, Pang N, de Oliveira C, Iwajomo T, Vigny-Pau M, MacKinnon K, Lam JSH, Kurdyak P. <em>Can J Psychiatry<\/em>. 2023; May 10 [Epub ahead of print]. DOI: <a href=\"https:\/\/doi.org\/10.1177\/07067437231171541\" title=\"opens external link\">https:\/\/doi.org\/10.1177\/07067437231171541<\/a><\/p>\",\r\n  \"Abstract\": \"<p><strong>Objectives<\/strong> &mdash; To determine if and to what degree neighbourhood-level marginalization mediates mental health service use among transgender individuals.<\/p>n<p><strong>Methods<\/strong> &mdash; This retrospective cohort study identified 2,085 transgender individuals through data obtained from 4 outpatient community and hospital clinics in 3 large cities in Ontario, which were linked with administrative health data between January 2015 and December 2019. An age-matched 1:5 comparison cohort was created from the general population of Ontario. Outcome measures were analysed from March 2020 to May 2022. The primary outcome was mental health service utilization, which included mental health-related visits to primary care providers, psychiatrists, mental health- and self-harm-related emergency department visits, and mental health hospitalizations. Mediation variables included ethnic concentration, residential instability, dependency, and material deprivation at the neighbourhood level and were derived from the Ontario Marginalization Index.<\/p>n<p><strong>Results<\/strong> &mdash; This study identified 2,085 transgender individuals from participating outpatient community and hospital clinics, who were matched to the general population (<em>n<\/em> = 10,425). Overall, neighbourhood-level marginalization did not clinically mediate mental health service use. However, transgender individuals were more likely to be exposed to all forms of neighbourhood-level marginalization, as well as having higher rates of health service use across all outcome measures.<\/p>n<p><strong>Conclusions<\/strong> &mdash; In this study, mental health service use among transgender individuals was not clinically mediated by marginalization at the neighbourhood level. This study highlights the need to explore marginalization and mental health service use at the individual level to better understand the mental health disparities experienced by transgender individuals and to ensure that health-care services are inclusive and affirming.<\/p>\",\r\n  \"ICES Scientists\": \"{B5C574DB-2952-4976-9299-A6F54F1757FA}|{B0AEBBAD-2A5A-4165-BA3C-471B5BF30EA1}\",\r\n  \"Posted Date\": \"20230510T000000\",\r\n  \"Show on Publications Landing Page\": \"1\"\r\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2023\/May\/Exploring-mediators-of-mental-health-service-use-among-transgender-individuals-in-Ontario-Canada"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Exploring mediators of mental health service use among transgender individuals in Ontario, Canada<\/title>\n<meta name=\"description\" content=\"Objectives \u2014 To determine if and 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