Gender Sensitivity, Mental Health Care Provision and Minority Communities in Ireland: A Realist Analysis

The Irish Government has adopted “Gender Mainstreaming” as a strategy to promote equal opportunities between women and men in its National Development Plan. While current mental health policy addresses the principle of partnership and social inclusiveness as a way forward for mental health service provision, it still does not explicitly deal with the notion of gender and gender sensitivity. For some minority groups a lack of trust is a key issue that affects their uptake and meaningful use of services resulting in inadequate and gender insensitive care provision. Aim: The aim of this paper is to describe and analyse service providers' views in relation to the gender sensitivity of mental health care provision particularly as it relates to minority (Traveller and gay) communities. Method: A qualitative social realist design was used guided by Layder's adaptive theory and ontological theory of the social world – ‘social domains theory'. In-depth interviews with twenty eight service providers were conducted within one mental health service in Ireland. Data was analysed using NVivo software. Results: The findings are presented in relation to tolerance and responsiveness of service providers towards the gay and Traveller communities. Service providers suggested that prejudices were held in relation to both indigenous and immigrant minority groups and this impacted upon care provision. Categorical intersectional understandings of gender were used by service providers to describe Travellers. Conclusion: Belonging to a minority group was a potential or actual threat to gender sensitive care and service providers managed such threats within a lay socialisation context. Arguably, a move towards developing gender-sensitive mental health care provision requires greater collaboration, education and understandings in relation to minority groups, their cultural differences and gendered identities.