Understanding key priority areas of mental health among queer asylum seekers and refugees in Australia through the lens of structural violence: A modified Delphi method study

Queer asylum seekers and refugees (QASaR) are more likely to have poor mental health compared to non-QASaR. This paper examines key priority areas for refugee services to improve mental health outcomes of QASaR in Australia. The key priority areas were identified through a modified Delphi method (DM), comprised of two stages: a scoping review of literature and three rounds of consensus building process. In the second stage, twenty-one participants were involved, including QASaR, health/social care professionals, and people in policy/funding-related roles. Drawing on Farmer’s understanding of structural violence, our consensus suggests QASaR’s poor mental health is primarily produced by the asylum system, further exacerbated by the lack of safe queer-inclusive refugee services, and can be improved by supporting QASaR-led organizations. Greater investments in QASaR-led organizations and initiatives are needed to improve cultural safety of refugee services and achieve systemic change.