Service-Level Barriers To Accessing Support Following Intimate Partner Violence For Men Who Have Sex With Men: Service Provider Perspectives

Background:
Research indicates that intimate partner violence occurs in male same-sex relationships at a similar or higher rate than in heterosexual relationships and is associated with significant distress and adverse physical and mental health outcomes. However, dominant understandings of intimate partner violence take a traditional feminist approach based on patriarchy and gender power imbalance; a framework which does not fit for male same-sex relationships. There is little understanding of the barriers which may impact men who have sex with men’s ability to seek help and the ways in which services contribute to these barriers, particularly in the UK.

Aims:
To explore mental health professionals’ views and experiences of the service-level barriers that face men who have sex with men who have experienced intimate partner violence as well as what services in the UK could be doing to better support them, in the hope that this will lead to improvements in support and services.

Methods: Semi-structured interviews were conducted with seven mental health professionals and covered participants’ experiences of working with men who have sex with men who have experienced intimate partner violence, their views on the barriers to accessing support and what services could be doing to better serve this community.

Results:
Thematic analysis from a critical realist perspective identified three overarching themes, each with their own subthemes: ‘Confined to within’ (‘Bound by abuse’, ‘Silenced by shame’), ‘The system says ‘no’’ (‘Toxic hetero-patriarchal lens’, ‘Intersecting layers of oppression’, ‘Not the ‘right’ client’) and ‘Minority becoming majority’ (‘Mainstream services exclude’, ‘Making the inaccessible accessible’, ‘Unlearning and re-learning’).

Conclusions:
Results from the analysis are discussed in the context of relevant theory, in particular the Barriers Model to Help-Seeking (St Pierre & Senn, 2010), and previous research. The study highlighted the importance of a nuanced understanding of intimate partner violence in male same-sex relationships as well as the importance of the socio-political context, including discourses of anti-LGBTQ+ prejudice, heteronormativity and hegemonic masculinity, in the setting up of structural barriers to accessing support.