Barriers and enablers to sex workers’ uptake of mental healthcare: a systematic literature review
Reynish, T and Hoang, Ha and Bridgman, H and Easpaig, BNG, Barriers and enablers to sex workers' uptake of mental healthcare: a systematic literature review, Sexuality Research and Social Policy, 18 pp. 184-201. ISSN 1868-9884 (2020) [Refereed Article]
Introduction: Sex workers face many barriers to accessing the inalienable human right of mental health. The aim of this review
was to synthesize the evidence on the barriers to mental healthcare for sex workers and the factors that facilitate uptake.
Methods: A search conducted in 2018 of peer-reviewed and gray literature produced between 2008 and 2018 in OECD countries
resulted in 32 documents eligible for inclusion.
Results: The literature revealed that the barriers of stigma, discrimination, violence, pathologization, and criminalization exacerbate the psychological distress of sex workers while impeding uptake of mental healthcare. Personal resilience, protective factors,
agency, and social inclusion offset these barriers.
Conclusions: Despite the risk of pervasive mental illness among sex workers due to, primarily, external factors, few studies
present comprehensive examinations of sex workers’ mental health and fewer still explore sex workers with gender identities
and sexual orientations that are not cisgender, heterosexual, or female.
Policy Implications: Although timely, equitable treatment of sex workers in mental healthcare is currently atypical, the findings of
this review suggest that inclusive, respectful psychological care is possible. Future research on holistic approaches to the mental
health of sex workers could support the creation of much-needed, inclusive services and policies that improve sex workers’
quality of life.
mental health services, sex work, enablers, barriers,