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Ion, Denisa-Alexandra (2025) Constructing the help-seeker role: Older LGBTQ+ adults on therapy waiting lists or attending early stages of therapy. Doctoral thesis, London Metropolitan University.
Background: Identities within the lesbian, gay, bisexual, transgender, or otherwise queer (LGBTQ+/queer) spectrum have been subject to various marginalising constructions over time, including as a criminal offence in the legislative field and a mental illness in the psy-complex. In recent decades, in the United Kingdom, socio-legislative narratives about queerness have become increasingly accepting.
Rationale: Older members of the LGBTQ+ community are in the unique position of navigating their current lives from within histories of criminalisation and pathologisation. This seems to contribute to mental health vulnerability in this population (Semlyen et al., 2016; Watkinson et al., 2024), potentially creating challenges in seeking psychological help such as therapy sessions. The Network Episode Model posits that the first step in seeking help is entering the role of the help-seeker, an interactive process between individuals and their social and treatment networks (Pescosolido et al., 2013). For older queer people, this process may be shaped by the marginalising contexts in which they lived their younger years. A literature review identified older queer people’s constructions of the help-seeker role as a previously unexplored research area.
Method: Semi-structured interviews were conducted with eight people identifying as LGBTQ+ and aged 50+ who were either waiting for therapy or in the early stages of therapy. These were analysed using Foucauldian Discourse Analysis, examining how participants constructed the help-seeker role as available or unavailable to them based on historical, political, and sociocultural pressures.
Findings: Participants mobilised three main discourses to talk about the help-seeker role: 1) a legitimacy discourse where they became eligible to attend services only in times of mental health crisis and, in queer services specifically, only if they performed their queerness in the ‘right’ ways; 2) a discourse about the importance of help-seekers being understood by their therapists and non-clinical staff as a function of empathy, mobilised especially in terms of trauma and ethnocultural diversity; and 3) a discourse about help-seekers beyond the act of seeking help, as social subjects who rely on their social networks to facilitate entry into the help-seeker role or who facilitate help-seeking for others in the queer community; and as self helpers who ‘work on’ themselves as an adjunct to therapy, feeling responsible for ‘fixing’ their own mental health difficulties.
Conclusion: These discourses are discussed in terms of their historical provenance and the institutions or social groups that they might harm or benefit. Suggestions are made for how counselling psychologists, allied mental health professionals, and mental health services could contribute to the deconstruction of discourses that make the help-seeker role unavailable to older queer people.
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