Prevalence of Mental Health and Substance Use Difficulties Among Sexual and Gender Diverse Youth During COVID-19: A Systematic Review and Meta-Analysis.

Purpose: Sexual and gender diverse (SGD) youth have been particularly vulnerable to mental health difficulties and substance use during the COVID-19 pandemic. However, estimates have varied across studies pointing to the potential for moderator variables. This meta-analytic and narrative synthesis provides estimates of the prevalence of mental health difficulties (anxiety, depression, suicidal ideation, suicide attempts) and substance use during COVID-19 among SGD youth. Methods: A comprehensive search strategy combining keywords and subject headings was designed and used across seven databases from inception to October 7, 2022. The search yielded 826 nonduplicate records of which 191 full-text articles were retrieved, evaluated, and extracted by two study authors. Data were analyzed from February 27 to March 1, 2023. Results: Using random-effects meta-analyses, 19 studies from 18 independent samples with 10,500 participants were included. Pooled prevalence rates for clinically elevated anxiety, depression, and suicidal ideation were 55.4% [95% confidence interval (CI):45.9%-64.5%], 61.8% (95% CI: 50.9%-71.7%), and 50.9% (95% CI: 42.8%-59.0%). There was no evidence of publication bias. Suicide attempts and substance use were summarized narratively with rates of suicide attempts being greater than 20% across included studies and variable reporting of substance use across substance types. No moderators explained variability across studies. Conclusion: More than 50% of SGD youth experienced clinically elevated symptoms of anxiety, depression, and suicidal ideation during the COVID-19 pandemic, compared to prepandemic estimates for both SGD and non-SGD youth. Targeted resource allocation is needed to specifically address the needs of SGD youth.

Healthcare Service Utilization and Perceived Gaps: The Experience of French-Speaking 2S/LGBTQI+ People in Manitoba.

Ethnolinguistically diverse 2S/LGBTQI+ (two-spirit, lesbian, gay, bisexual, transgender, queer and intersex) populations have unique healthcare needs and experience health inequities compared to their cisgender or heterosexual peers. This community-based participatory study sought to describe the profile and healthcare needs and experiences of official language minority French-speaking 2S/LGBTQI+ adults in Manitoba. Participants (N = 80) reported that gender and sexual identity were often concealed from service providers; many respondents faced discrimination based on their ethnolinguistic and sexual identities. Service gaps are identified pertaining to mental and sexual health; locating 2S/LGBTQI+-friendly, patient-centred care in French is difficult. Policy and practice should address systemic inequity and discrimination experienced by this equity-seeking population.

Recreational Cannabis Legislation: substance use and impaired driving among Canadian rural and urban postsecondary students.

BACKGROUND: Investigation of cannabis use trends among emerging adults (EA, aged between 18 and 24 years) following 2018 Canadian Recreational Cannabis Legislation (RCL) is critical. EAs report the heaviest cannabis use in Canada and are particularly vulnerable to the onset of problematic substance use. OBJECTIVES: To describe and compare post-RCL use of cannabis and other state-altering substances, as well as the prevalence of impaired driving, among EA postsecondary students in both rural and urban settings, studying on one of five campuses in either Manitoba, Ontario, or Quebec. METHODS: For this quantitative cross-sectional study, a self-report survey was administered to 1496 EA postsecondary students in the months following RCL (2018-2019). Multiple logistic regression analyses were conducted to explore the influence of provincial and urban/rural living contexts on recreational cannabis use, other state-altering substance use and impaired driving behaviours, adjusting for sociodemographic variables. RESULTS: Statistically significant differences were observed between cohorts in almost all measures. Quebec students were more likely to have consumed cannabis during their lifetime (AOR = 1.41, 95% CI [1.05, 1.90]) than all other cohorts. Rural cohorts all had greater odds of reporting consumption of cannabis during the previous year compared to urban cohorts (AOR = 1.32, 95% CI [1.04, 1.67]). However, the relation between cannabis use in the last month and operating a motor vehicle after using cannabis (lifetime and past month) and living context differed between subjects in Quebec and those in the two other provinces. Quebec's students having lived mostly in urban contexts had greater odds of using cannabis in the past month and operating a motor vehicle after using cannabis (lifetime and past month) than those in rural contexts; the opposite was observed in Manitoba and Ontario. Differing interprovincial prohibitive/permissive legislation and licit cannabis infrastructure appeared to have little impact on post-RCL substance use. CONCLUSIONS: In Manitoba and in Ontario, rural/urban living context seems to better predict substance use and related road-safety practices, suggesting these trends supersede permissive/prohibitive provincial legislation and licit cannabis-related infrastructures. Further investigation into sociodemographic factors influencing state-altering substance use and impaired driving, and maintaining tailored cannabis misuse prevention campaigns, is warranted on Canadian campuses.

Living in a liminal space: Experiences of 2SLGBTQ + official language minority Canadians during the COVID-19 pandemic.

The intersecting identities of those identifying with multiple minorities, such as 2SLGBTQ + and ethnolinguistic minorities, bring individuals to have unique experiences, especially concerning health and wellness. This topic is particularly poorly understood among French-speaking official language minority 2SLGBTQ + populations in Canada. Hence, this study was conducted to generate insights into their needs and experiences, through the lens of intersectionality. This quantitative community-based study, a first of its kind in Western Canada, describes the sociodemographic profile, experiences of discrimination and stigmatisation, and needs and challenges pertaining to mental health and social supports of this double minority group. Data were obtained by an online survey conducted in the Canadian province of Manitoba in June 2020. The participant sample was largely homogenous: most were under the age of 55 years, white, educated, and from urban areas. Many reported experiencing dual marginalisation, feeling unaccepted by both of their minority communities (Francophone and 2SLGBTQ+). A sense of isolation, as well as a lack of social connectedness and psychological support, were often reported. Social initiatives and mental health support within environments proactively affirming of the official language of the minority and inclusive of diverse 2SLGBTQ + identities are needed.