Young gay and bisexual men under the age of 26 are six times more likely to attempt suicide or self-harm compared to men in that group aged over 45, and twice as likely to be depressed or anxious, according to a paper in the Journal of Public Health.

Using data from the Stonewall Gay and Bisexual Men's Health Survey, the researchers analyzed responses of 5,799 gay and bisexual men aged 16 and over living in the UK. Depression, anxiety, attempted suicide and self-harm were examined against a range of life factors. Age, ethnicity, income and education were all found to have a large impact on mental health. The authors from London School of Hygiene&Tropical Medicine say the results reinforce the importance of mental health interventions reaching those who need them most, as well as people who actively seek help.

Confounders are that survey participants were not a random sample of the population and were not representative of U.K. gay and bisexual men.

Black gay and bisexual men were twice as likely to be depressed and five times more likely to have attempted suicide than the white majority. Men in the lower wage bracket were more likely to be depressed, anxious, attempt suicide or self-harm. Those with lower levels of education were twice as likely to experience one of those issues compared to those with degree level education, only in part due to earning a lower wage.

The authors speculate that older men are able to cope better with homophobia and that homophobia is more prevalent in the lives of younger men. They further believe that gay and bisexual men may experience discrimination or marginalization unrelated to their sexuality.

Lead author Dr. Ford Hickson from the London School of Hygiene & Tropical Medicine said, "Our study showed that among gay and bisexual men, age and ethnicity had a significant impact on mental health, as did income and education. This is possibly because men are better able to cope with homophobia the older they are, or if they are relatively privileged in other areas of their lives."

The researchers also discovered cohabitation is key for positive mental health, with men who are living with a male partner 50% less likely to suffer from depression compared to gay and bisexual men living alone. Living in London was also shown to be advantageous, perhaps because London has the largest population of gay men in the world and isolation and discrimination are less common there.

Hickson said, "Minority groups are usually thought to be more homogenous than they actually are, when in fact there is great variation in health and life situations among this group. What's clear is that health inequalities among gay and bisexual men mirror those in the broader society.