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Tse S, Chee K, Coleman TA, Coulombe S, Travers R. Exploring LGBT2Q+ Intracategorical Factors in Mental Health Service Utilization: Differences in Gender Modalities, Sexual Orientations, and Ethnoracial Groups in Canada. Community Ment Health J 2024:10.1007/s10597-024-01299-y. [PMID: 38850503 DOI: 10.1007/s10597-024-01299-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 05/19/2024] [Indexed: 06/10/2024]
Abstract
LGBT2Q+ (lesbian, gay, bisexual, transgender, Two-Spirit, queer, plus) Canadians face minority stressors that lead to higher mental health inequalities such as worse self-reported mental health and increased risk of mental health issues when compared to their heterosexual/straight and cisgender counterparts. However, there are within-group (intracategorical) differences within a community as large as LGBT2Q+ peoples. Guided by the Andersen Model of Healthcare Utilization, we sought to explore intracategorical differences in LGBT2Q+ Canadian predisposing, enabling, and need factors in mental health service utilization within the past year. Using data from the 2020 LGBT2Q+ Health Survey (N = 1542), modified Poisson logistic regression found that more polysexual respondents and trans/gender-diverse respondents were more likely to have utilized mental health services within the past year than their gay, lesbian, and cis male counterparts. As well, compared to White respondents, Indigenous respondents were more likely to have utilized mental health services, while other racialized respondents were associated with less utilization. Backwards elimination of Andersen model of healthcare utilization factors predicting mental health service utilization retained two predisposing factors (ethnoracial groups and gender modality) and two need factors (self-reporting living with a mood disorder and self-reporting living with an anxiety disorder). Results suggest that polysexual, trans and gender-diverse, and racialized LGBT2Q+ peoples have an increased need for mental health services due to increased specific minority stressors that cisgender, White, monosexual peoples do not face. Implications for healthcare providers are discussed on how to improve service provision to LGBT2Q+ peoples.
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Affiliation(s)
- Samson Tse
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada.
| | - Kenny Chee
- Faculty of Social Works, University of Toronto, Toronto, ON, Canada
| | - Todd A Coleman
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Simon Coulombe
- Department of Industrial Relations, Université Laval, Québec, QC, Canada
| | - Robb Travers
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
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2
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Szymanski DM, Dua V, Goates JD. Understanding Psychological Help-Seeking: The Role of Perceived LGBTQ+ Community Support. JOURNAL OF HOMOSEXUALITY 2024:1-25. [PMID: 38833637 DOI: 10.1080/00918369.2024.2362271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
In this cross-sectional study, we examined the relations between perceived LGBTQ+ community support for psychotherapy and both willingness to seek counseling and use of mental health services in the past year among 721 sexual minority persons. At the bivariate level, we found that LGBTQ+ community support for psychotherapy was positively correlated with both willingness to seek counseling and use of mental health services in the past year. Further, LGBTQ+ community support for psychotherapy was directly and indirectly related to willingness to seek counseling via less public stigma, less self-stigma, and more positive attitudes toward help-seeking in serial. LGBTQ+ community support for psychotherapy was indirectly related to use of mental health services in the past year via these same explanatory variables. Finally, we provide psychometric support for the LGBTQ+ Community Support for Psychotherapy Scale that we developed for this study. Our findings indicate the important role that contextual factors can have on psychological help-seeking attitudes, intentions, and behaviors for sexual minority persons.
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Affiliation(s)
- Dawn M Szymanski
- Department of Psychology, University of Tennessee, Knoxville, Tennessee, USA
| | - Vardaan Dua
- Department of Psychology, University of Tennessee, Knoxville, Tennessee, USA
| | - James D Goates
- Department of Psychology, University of Tennessee, Knoxville, Tennessee, USA
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3
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Ho SH, Shamsudin AH, Liow JW, Juhari JA, Ling SA, Tan K. Mental Healthcare Needs and Experiences of LGBT+ Individuals in Malaysia: Utility, Enablers, and Barriers. Healthcare (Basel) 2024; 12:998. [PMID: 38786409 PMCID: PMC11120647 DOI: 10.3390/healthcare12100998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/01/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
Access to mental healthcare is undoubtedly of major importance for LGBT+ people worldwide, given the high prevalence of mental health difficulties due to minority stress exposures. This study drew mixed-method survey data from the community-based KAMI Survey (n = 696) to examine the enablers, barriers, and unmet needs experiences of LGBT+ individuals in accessing mental healthcare services in Malaysia. First, we present findings from a series of descriptive analyses for sociodemographic differences in unmet needs for mental healthcare, barriers, and satisfaction levels with different types of mental healthcare. Next, we conducted an inductive thematic analysis of open-text comments (n = 273), with relevance drawn to Andersen's Behavioural Model of Healthcare. More than a quarter (29.5%) reported an unmet need for mental healthcare, and some groups (younger, asexual or queer, or participants living in non-major cities) reported higher unmet needs. More than three-fifths (60.5%) reported not knowing where to find culturally safe mental health professionals. The thematic analysis uncovered key contextual (e.g., mental health practitioners' stance, stigma, collaborative client-care) and individual (e.g., positive expectation of mental health services and anticipated stigma) attributes that influence healthcare experiences. Participants also identified resources that facilitate healthcare utilisation, such as affordability, availability of suitable professionals, and geographical considerations. The implications of our findings for the mental healthcare practices in Malaysia were outlined.
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Affiliation(s)
- Sheau Huey Ho
- Faculty of Arts and Social Science, Universiti Tunku Abdul Rahman, Bandar Barat, Kampar 31900, Malaysia;
| | - Amirul Hakim Shamsudin
- Department of English, Faculty of Languages and Linguistics, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Jun Wei Liow
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam 999077, Hong Kong;
| | | | - Sai Ang Ling
- Faculty of Social Science and Humanities, Tunku Abdul Rahman University of Management and Technology, Setapak, Kuala Lumpur 53300, Malaysia;
| | - Kyle Tan
- Faculty of Māori and Indigenous Studies, University of Waikato, Hamilton 3240, New Zealand;
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Shrader CH, Salerno JP, Lee JY, Johnson AL, Algarin AB. Mental health impact of multiple sexually minoritized and gender expansive stressors among LGBTQ+ young adults: a latent class analysis. Epidemiol Psychiatr Sci 2024; 33:e22. [PMID: 38602075 PMCID: PMC11022265 DOI: 10.1017/s2045796024000118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/18/2023] [Accepted: 02/03/2024] [Indexed: 04/12/2024] Open
Abstract
AIMS In the United States, lesbian, gay, bisexual, transgender, queer, intersex, asexual and other sexually minoritized and gender expansive (LGBTQ+) young adults are at increased risk for experiencing mental health inequities, including anxiety, depression and psychological distress-related challenges associated with their sexual and gender identities. LGBTQ+ young adults may have unique experiences of sexual and gender minority-related vulnerability because of LGBTQ+-related minority stress and stressors, such as heterosexism, family rejection, identity concealment and internalized homophobia. Identifying and understanding specific LGBTQ+-related minority stress experiences and their complex roles in contributing to mental health burden among LGBTQ+ young adults could inform public health efforts to eliminate mental health inequities experienced by LGBTQ+ young adults. Therefore, this study sought to form empirically based risk profiles (i.e., latent classes) of LGBTQ+ young adults based on their experiences with familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment, and then identify associations of derived classes with psychological distress. METHODS We recruited and enrolled participants using nonprobability, cross-sectional online survey data collected between May and August 2020 (N = 482). We used a three-step latent class analysis (LCA) approach to identify unique classes of response patterns to LGBTQ+-related minority stressor subscale items (i.e., familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment), and multinomial logistic regression to characterize the associations between the derived classes and psychological distress. RESULTS Five distinct latent classes emerged from the LCA: (1) low minority stress, (2) LGBTQ+ identity concealment, (3) family rejection, (4) moderate minority stress and (5) high minority stress. Participants who were classified in the high and moderate minority stress classes were more likely to suffer from moderate and severe psychological distress compared to those classified in the low minority stress class. Additionally, relative to those in the low minority stress class, participants who were classified in the LGBTQ+ identity concealment group were more likely to suffer from severe psychological distress. CONCLUSION Familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment are four constructs that have been extensively examined as predictors for mental health outcomes among LGBTQ+ persons, and our study is among the first to reveal nuanced gradients of these stressors. Additionally, we found that more severe endorsement of minority stress was associated with greater psychological distress. Given our study results and the previously established negative mental health impacts of minority stressors among LGBTQ+ young adults, findings from our study can inform research, practice, and policy reform and development that could prevent and reduce mental health inequities among LGBTQ+ young adults.
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Affiliation(s)
- C.-H. Shrader
- Department of Epidemiology, Columbia University, New York City, NY, USA
- ICAP at Columbia University, New York City, NY, USA
| | - J. P. Salerno
- School of Social Work, Columbia University, New York City, NY, USA
| | - J.-Y. Lee
- Department of Mental Health Law & Policy, University of South Florida, Tampa, FL, USA
| | - A. L. Johnson
- Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL, USA
| | - A. B. Algarin
- Department of Nursing and Health Innovations, Arizona State University, Phoenix, AZ, USA
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5
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Seager van Dyk I, Sena R, McCord C, Kodish T, DeAntonio M. Affirming LGBTQIA+ Youth in Inpatient Psychiatric Settings. J Am Acad Child Adolesc Psychiatry 2024; 63:296-300. [PMID: 37451313 DOI: 10.1016/j.jaac.2023.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/25/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023]
Abstract
Decades of research show that LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, and others) youth experience higher rates of psychiatric illness and present to mental health settings more often than their heterosexual, cisgender peers. General guidelines for working with LGBTQIA+ youth exist; however, little has been written about the unique challenges facing LGBTQIA+ youth and their families in inpatient psychiatric settings and strategies for ameliorating them. As LGBTQIA+ youth attempt suicide at much higher rates than their peers, inpatient settings see a disproportionate number of these youth. Providing LGBTQIA+ youth with affirming care during their inpatient admission therefore has the potential to shift mental illness trajectories of youth, increase family support, and reduce the number of lives lost to suicide. In this article, we outline specific barriers to affirming care in inpatient child and adolescent psychiatric settings and propose practical strategies that providers can implement to overcome these barriers.
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Affiliation(s)
- Ilana Seager van Dyk
- Yale School of Public Health, New Haven, Connecticut; Massey University, Wellington, New Zealand.
| | - Rhonda Sena
- UCLA Semel Institute, Los Angeles, California
| | - Colleen McCord
- UCLA Resnick Neuropsychiatric Hospital, Los Angeles, California
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Williams ND, Turpin RE, Boekeloo BO, King-Marshall EC, Fish JN. Black Sexual Minority Adults' Avoidance of Professional Mental Health Care. Psychiatr Serv 2024; 75:40-47. [PMID: 37386879 DOI: 10.1176/appi.ps.20220445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
OBJECTIVE The authors sought to determine whether Black sexual minority individuals were more likely than White sexual minority individuals to postpone or avoid professional mental health care (PMHC) and, if so, to identify the reasons for postponing or avoiding care. METHODS Analyses were conducted with a subsample of cisgender Black (N=78) and White (N=398) sexual minority individuals from a larger survey of U.S. adults administered via MTurk in 2020 (N=1,012). Logistic regression models were used to identify racial differences in overall postponement or avoidance of care as well as differences in the prevalence of each of nine reasons for postponing or avoiding care. RESULTS Black sexual minority individuals were more likely than their White counterparts to report ever postponing or avoiding PMHC (average marginal effect [AME]=13.7 percentage points, 95% CI=5.4-21.9). Black sexual minority people also were more likely than their White counterparts to cite beliefs that they should work out their problems on their own (AME=13.1 percentage points, 95% CI=1.2-24.9) or with family and friends (AME=17.5 percentage points, 95% CI=6.0-29.1) and to cite providers' refusal to treat them (AME=17.4 percentage points, 95% CI=7.6-27.1) as reasons for postponing or avoiding care. CONCLUSIONS Black sexual minority individuals were more likely than their White counterparts to report delaying or avoiding PMHC. Personal beliefs about managing mental health and providers' refusal to offer treatment influenced Black sexual minority individuals' willingness or ability to seek PMHC.
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Affiliation(s)
- Natasha D Williams
- University of Maryland Prevention Research Center, University of Maryland, College Park (all authors); Departments of Family Science (Williams, Fish) and Behavioral and Community Health (Boekeloo, King-Marshall), School of Public Health, University of Maryland, College Park; Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia (Turpin)
| | - Rodman E Turpin
- University of Maryland Prevention Research Center, University of Maryland, College Park (all authors); Departments of Family Science (Williams, Fish) and Behavioral and Community Health (Boekeloo, King-Marshall), School of Public Health, University of Maryland, College Park; Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia (Turpin)
| | - Bradley O Boekeloo
- University of Maryland Prevention Research Center, University of Maryland, College Park (all authors); Departments of Family Science (Williams, Fish) and Behavioral and Community Health (Boekeloo, King-Marshall), School of Public Health, University of Maryland, College Park; Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia (Turpin)
| | - Evelyn C King-Marshall
- University of Maryland Prevention Research Center, University of Maryland, College Park (all authors); Departments of Family Science (Williams, Fish) and Behavioral and Community Health (Boekeloo, King-Marshall), School of Public Health, University of Maryland, College Park; Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia (Turpin)
| | - Jessica N Fish
- University of Maryland Prevention Research Center, University of Maryland, College Park (all authors); Departments of Family Science (Williams, Fish) and Behavioral and Community Health (Boekeloo, King-Marshall), School of Public Health, University of Maryland, College Park; Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia (Turpin)
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7
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Tunks A, Berry C, Strauss C, Nyikavaranda P, Ford E. Patients' perspectives of barriers and facilitators to accessing support through primary care for common mental health problems in England: A systematic review. J Affect Disord 2023; 338:329-340. [PMID: 37348656 DOI: 10.1016/j.jad.2023.06.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Common mental disorders (CMDs) are prevalent throughout the population. Psychological therapy is often sought via primary care; however, equitable access is not commonplace. This review aims to investigate the barriers and facilitators adults experiencing CMDs perceive when accessing evidence-based psychological treatment in England. METHODS A qualitative systematic review with meta-synthesis was conducted (PROSPERO CRD42020227039). Seven electronic databases were searched for papers from 2008 to October 2022. RESULTS Searches identified 30 studies from which three themes were developed with seven subthemes. Stigma and patients' perceptions and understandings of CMDs impacted their help-seeking decision-making and engagement with services. This meant that services were not used as a first resort for help-seeking. Upon reaching services, patients appeared to perceive primary care as not prioritising mental health problems, nor as being the place where they would be supported, particularly as healthcare professionals did not appear to know about CMDs and therapy was seen as difficult to access. The interaction between healthcare professional and patients was seen as pivotal to whether patients accessed support or not. LIMITATIONS The review is limited to research conducted within England. Additionally, it only explores access barriers prior to treatment experiences. CONCLUSION Knowledge, attitudinal, systemic and relational barriers and facilitators were identified. Future research should focus on developing stigma reduction initiatives. Clinical implications include provision of standardised training across primary care HCP (healthcare professionals).
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Affiliation(s)
- Alice Tunks
- Primary Care and Public Health Department, Brighton and Sussex Medical School, United Kingdom.
| | - Clio Berry
- Primary Care and Public Health Department, Brighton and Sussex Medical School, United Kingdom.
| | - Clara Strauss
- School of Psychology, University of Sussex, United Kingdom; Sussex Partnership NHS Foundation Trust, United Kingdom.
| | - Patrick Nyikavaranda
- Primary Care and Public Health Department, Brighton and Sussex Medical School, United Kingdom.
| | - Elizabeth Ford
- Primary Care and Public Health Department, Brighton and Sussex Medical School, United Kingdom.
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8
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Baiden P, Onyeaka HK, Aneni K, Wood BM, LaBrenz CA, Hagedorn A, Muoghalu C, Gobodzo EC, Baiden JF, Adeku Y, Mets VE, Brown FA. Racial/ethnic differences in adolescents' non-response to suicide attempt: Findings from the Youth Risk Behavior Survey, 2015-2019. J Psychiatr Res 2023; 166:115-121. [PMID: 37757704 DOI: 10.1016/j.jpsychires.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/13/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
Racial/ethnic minority adolescents are at greater risk of attempting suicide compared to their White counterparts. Yet, racial/ethnic minority adolescents are more likely to not respond to questions on suicidal behaviors. The objective of this study was to investigate the association between race/ethnicity and missing response to suicide attempt among adolescents in the United States. Data for this study were obtained the 2015-2019 national Youth Risk Behavior Survey (n = 40,360). The outcome variable investigated in this study was missing response to suicide attempt and the main explanatory variable was race/ethnicity. Two hierarchical binary logistic regression models were fitted to examine the association between race/ethnicity and missing response to suicide attempt. Of the 40,036 adolescents, 13.4% had missing response to suicide attempt. Controlling for the effects of demographic factors and symptoms of depression, adolescents who self-identified as non-Hispanic Black had more than threefold higher odds of having missing response to suicide attempt when compared to their non-Hispanic White counterparts (AOR = 3.62, p < .001, 95% CI = 2.45-5.34). Adolescent males and adolescents questioning their sexual identity had higher odds of having missing response to suicide attempt. Adolescents with depressive symptoms had lower odds of having missing response to suicide attempt. Missing response to suicide attempt among adolescents continues to differ by race/ethnicity and other demographic factors. The use of a single item in assessing suicide attempt history may be inadequate in capturing national estimates of adolescent suicide metrics.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX, 76010, USA.
| | - Henry K Onyeaka
- Harvard Medical School, Department of Psychiatry, Boston, MA, 02115, USA; Massachusetts General Hospital, Department of Psychiatry, Boston, MA, 02115, USA; McLean Hospital, Department of Psychiatry, Boston, MA, 02478, USA
| | | | - Bethany M Wood
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX, 76010, USA
| | - Catherine A LaBrenz
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX, 76010, USA
| | - Aaron Hagedorn
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129, Arlington, TX, 76010, USA
| | | | | | - John F Baiden
- East Airport International School, P. O. Box KAPM 57, KIA, Accra, Ghana
| | - Yvonne Adeku
- Western University, Department of Sociology, Social Science Centre, Room 5306, London, Ontario, N6A 5C2, Canada
| | - Vera E Mets
- University of Ghana, Legon, Department of Social Work, P. O. Box LG 419, Legon, Accra, Ghana
| | - Fawn A Brown
- The University of Texas at Arlington, Department of Psychology, 501 Nedderman Dr., Box 19528, Arlington, TX, 76019, USA
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9
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Chum A, Kim C, Nielsen A, Dusing GJ, O'Campo P, Matheson FI, Barker L, Vigod S, Ling V, Fung K, Kennedy S. Disparities in Suicide-Related Behaviors Across Sexual Orientations by Gender: A Retrospective Cohort Study Using Linked Health Administrative Data. Am J Psychiatry 2023; 180:660-667. [PMID: 37282552 DOI: 10.1176/appi.ajp.20220763] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The authors used a population-representative sample and health administrative data to quantify suicide-related behavior leading to acute care or deaths across self-identified heterosexual, gay/lesbian, and bisexual individuals. METHODS Data from a population-based survey (N=123,995) were linked to health administrative data (2002-2019), and differences in time to suicide-related behavior events across sexual orientations were examined using Cox proportional hazards regression. RESULTS The crude incidence rates of suicide-related behavior events per 100,000 person-years were 224.7 for heterosexuals, 664.7 for gay/lesbian individuals, and 5,911.9 for bisexual individuals. In fully adjusted (gender-combined) models, bisexual individuals were 2.98 times (95% CI=2.08-4.27) more likely to have an event, and gay men and lesbians 2.10 times (95% CI=1.18-3.71) more likely, compared with heterosexual individuals. CONCLUSIONS In a large population-based sample of Ontario residents, using clinically relevant outcomes, the study found gay/lesbian and bisexual individuals to be at elevated risk of suicide-related behavior events. Increased education among psychiatric professionals is needed to improve awareness of and sensitivity to the elevated risk of suicide-related behavior among sexual minority individuals, and further research on interventions is needed to reduce such behaviors.
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Affiliation(s)
- Antony Chum
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Chungah Kim
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Andrew Nielsen
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Gabriel John Dusing
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Patricia O'Campo
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Flora I Matheson
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Lucy Barker
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Simone Vigod
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Vicki Ling
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Kinwah Fung
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
| | - Sidney Kennedy
- School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy)
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10
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Salerno JP, Doan L, Sayer LC, Drotning KJ, Rinderknecht RG, Fish JN. Changes in Mental Health and Well-Being Are Associated With Living Arrangements With Parents During COVID-19 Among Sexual Minority Young Persons in the U.S. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2023; 10:150-156. [PMID: 37283818 PMCID: PMC10241357 DOI: 10.1037/sgd0000520] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Sexual minority young persons may be at risk for compounding mental health effects of the COVID-19 pandemic due to their existing vulnerabilities for psychological inequities. Indeed, recent research has documented that sexual minority young persons are experiencing compounding psychiatric effects associated with the COVID-19 pandemic. Further, researchers and practitioners hypothesized that sexual minority youth and young adults may experience unique hardships related to their sexual and gender identities and familial conflict as a result of the COVID-19 pandemic and living arrangement changes with their parents and families. This study aims to investigate whether there are changes in sexual minority (and non-sexual minority) young adults' (SMYAs) mental health and wellbeing among those living with and living without their parents before and after the start of COVID-19. Among a cross-sectional sample of SMYAs (n=294; Mage=22 years; age range=18-26) and non-SMYAs (n=874; Mage=22 years; age range=18-26) defined by whether they were living with or living without their parents before and after the start of COVID-19, we retrospectively analyzed changes in psychological distress and wellbeing. SMYAs who returned to their parents' homes during post-onset of COVID-19 reported greater mental distress and lower wellbeing, followed by those who were living with their parents both before and after the start of COVID-19. Patterns were not consistent among non-SMYAs, and lower magnitudes of change were seen. There is a significant public health need for mental health services and family education resources for supporting SMYAs in the context of COVID-19 and beyond.
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Affiliation(s)
- John P. Salerno
- Department of Behavioral & Community Health, School of Public Health, University of Maryland, College Park, Maryland, United States, 4200 Valley Drive, Suite 1234, College Park, MD, USA 20742
| | - Long Doan
- Department of Sociology, College of Behavioral & Social Sciences, University of Maryland, College Park, Maryland, United States, 2112 Parren Mitchell Art-Sociology Building, 3834 Campus Dr, College Park, MD, USA 20742
| | - Liana C. Sayer
- Department of Sociology, College of Behavioral & Social Sciences, University of Maryland, College Park, Maryland, United States, 2112 Parren Mitchell Art-Sociology Building, 3834 Campus Dr, College Park, MD, USA 20742
| | - Kelsey J. Drotning
- Department of Sociology, College of Behavioral & Social Sciences, University of Maryland, College Park, Maryland, United States, 2112 Parren Mitchell Art-Sociology Building, 3834 Campus Dr, College Park, MD, USA 20742
| | - R. Gordon Rinderknecht
- Max Planck Institute for Demographic Research, Laboratory of Digital and Computational Demography, Rostock, Germany
| | - Jessica N. Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, United States, 4200 Valley Drive, Suite 1234, College Park, MD, USA 20742
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11
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Crockett MA, Martínez V, Caviedes P. Barriers and Facilitators to Mental Health Help-Seeking and Experiences with Service Use among LGBT+ University Students in Chile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16520. [PMID: 36554401 PMCID: PMC9779696 DOI: 10.3390/ijerph192416520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/02/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
Barriers limiting access to mental health care for lesbian, gay, bisexual, trans, and other sexual and gender minority (LGBT+) university students have not yet been explored in depth. The aim of this study was to explore the barriers and facilitators to mental health help seeking and experiences with service use among LGBT+ university students. Participants were 24 LGBT+ students between 18 and 23 years of age from a university in Chile. Individual semi-structured interviews were conducted and analysed using thematic content analysis. Multiple barriers and facilitators influence mental health help-seeking of LGBT+ students, with some of these barriers being explicitly related to LGBT+ issues (e.g., fear of discrimination or accessing specialised services). Perceived effectiveness of services was closely related to access safe/affirming care. Trans students reported more barriers to help-seeking and negative experiences with professionals than their cisgender peers. Perceptions of university mental health services as safe spaces for LGBT+ students were related to a positive perception of the university regarding LGBT+ issues. Knowing the factors that either hinder or facilitate help-seeking and characterising service use experiences in this population is useful for improving access to mental health services and for the development of policies that promote affirmative care for LGBT+ people.
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Affiliation(s)
- Marcelo A. Crockett
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago 8380455, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago 7820436, Chile
| | - Vania Martínez
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago 8380455, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago 7820436, Chile
- Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente (CEMERA), Facultad de Medicina, Universidad de Chile, Santiago 8380455, Chile
| | - Patricio Caviedes
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago 8380455, Chile
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12
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Marbaniang I, Rose E, Moodie EEM, Hart TA, Cox J. Mental health services use and depressive symptom scores among gay and bisexual men in Canada. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2333-2342. [PMID: 36121487 PMCID: PMC9636296 DOI: 10.1007/s00127-022-02362-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 09/02/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate the association between mental health services (MHS) use and depressive symptom scores among gay and bisexual men (GBM) and compare with heterosexual men in Canada. METHODS We used data from the 2015-2016 cycles of the Canadian Community Health Survey. Depressive symptoms were assessed using the PHQ-9 questionnaire (prior two weeks). MHS consultations with any licensed mental health professional (prior year) were categorized as 0, 1, 2-11, ≥ 12. We fit linear regression models to quantify the associations between MHS use and PHQ-9 scores, with an interaction term for sexual identity (GBM and heterosexual men). Models were adjusted for socioeconomic and health-related indicators. RESULTS Among 21,383 men, 97.3% self-identified as heterosexual and 2.7% as GBM. Compared to heterosexual men, GBM used any MHS (21% vs. 10%, p < 0.05) and consulted ≥ 2 health professionals for their mental health (6% vs. 2%, p < 0.05) in the preceding year more frequently. Overall, mean PHQ-9 scores were higher among GBM compared to heterosexual men (3.9 vs. 2.3, p < 0.05). Relative to no consultations, higher MHS use (2-11, ≥ 12 consultations) was associated with higher PHQ-9 scores (1.4-4.9 points higher). Associations between MHS use and PHQ-9 scores did not differ statistically between GBM and heterosexual men. CONCLUSION Our findings were inconclusive in demonstrating a difference between heterosexual men and GBM for the association between MHS use and PHQ-9 scores. However, GBM consistently had higher average PHQ-9 scores for every category of consultations. Considering the higher use of MHS and higher burden of depressive symptoms among GBM, more research is needed.
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Affiliation(s)
- Ivan Marbaniang
- Department of Epidemiology, 2001 McGill University, Suite 1200, Montreal, QC, H3A 1G1, Canada.
| | - Eric Rose
- Department of Biostatistics, McGill University, Montreal, QC, Canada
| | - Erica E M Moodie
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Trevor A Hart
- Department of Psychology, Ryerson University, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Joseph Cox
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- Direction Régionale de Santé Publique de Montréal, Montreal, QC, Canada
- Clinical Outcomes Research and Evaluation, Research Institute-McGill University Health Centre, Montreal, QC, Canada
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13
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Shin RQ, Keum BT, Smith LC, Lu Y, Yee S. The Development and Validation of the Heterosexism Erasure Scale. COUNSELING PSYCHOLOGIST 2022. [DOI: 10.1177/00110000221126997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The heterosexism erasure construct captures attitudes, which deny or minimize the systemic oppression of lesbian, gay, bisexual, and queer (LGBQ) persons in the United States. Heterosexism erasure expands the interrogation of denying or minimizing discrimination (Neville at al., 2006) beyond the realm of White supremacy and into the domain of heteronormativity. The purpose of this project was to develop a psychometrically sound measure of heterosexism erasure. Two independent samples were gathered to conduct exploratory ( n = 425) and confirmatory ( n = 367) factor analyses to assess for initial reliability and validity evidence of the Heterosexism Erasure Scale (HES). Results suggest that the final 13-item HES provides a general index of heterosexism erasure as well as assesses two related, but distinct factors named Heterosexism Denial and Heterosexism Minimization. Results support the internal consistency and factor structure of the measure. Expected relationships between the HES and existing measures provide validity evidence for the instrument.
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Affiliation(s)
| | | | | | - Yun Lu
- University of Maryland, College Park, MD, USA
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14
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Knowledge Management-Based Mental Health Service Model: Sustainable Application during College Students’ Education. SUSTAINABILITY 2022. [DOI: 10.3390/su14159008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In order to meet the dynamic mental health needs of college students, it is important to promote quality mental health services and to improve the development view of college students’ mental health. This paper uses a knowledge management method to construct college students’ developmental mental health service model. The model is informed by knowledge management, which comprehensively considers service-related components, namely, resources, content, approach, process, personnel, and objects. Furthermore, knowledge management constructs the system structure of the model and expands the research ideas and contents of the service resource pool. Moreover, knowledge management supports the platform, core technology system, and service process in the model. Finally, using Suzhou University as an example, this study examines the implementation and application of the service model to test the effectiveness of the knowledge management method. Thus, this study provides theoretical and methodological support for the construction, implementation, and application of a sustainable mental health service model for college students.
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15
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Panchal Z, Piper C, Whitmore C, Davies RD. Providing supportive transgender mental health care: A systemized narrative review of patient experiences, preferences, and outcomes. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2022. [DOI: 10.1080/19359705.2021.1899094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Zoë Panchal
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Christi Piper
- University of Colorado Anschutz Medical Campus Strauss Health Sciences Library, Aurora, CO, USA
| | | | - Robert D. Davies
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
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16
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Wang K, Yang J, Averett P. Mental Health Service Use Among Middle-aged and Older Lesbians: Application of Andersen's Health Service Use Model. JOURNAL OF HOMOSEXUALITY 2022; 69:1435-1448. [PMID: 33881384 DOI: 10.1080/00918369.2021.1912558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Guided by Andersen's Health Service Use Model, this study examined the predisposing, enabling, and need factors of MH service use among middle-aged and older lesbians. Data were collected from 455 lesbians ages 50 and over through a national online survey. Ordered logistic regression was conducted to examine the predictors of mental health counseling use. Results show that those who were widowed and single were more likely to participate in MH counseling than those who were partnered. Being out to healthcare providers, the number of mental health conditions, and being unsatisfied with sex were positively associated with participation in MH counseling. The study highlights the need to tailor MH service among those who are widowed and single and the importance of enhancing MH referral and integrating MH service in primary care for this population. Further, sexual health should be treated as an integral part of psychological wellbeing in MH treatment.
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Affiliation(s)
- Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Jie Yang
- School of Social Work, East Carolina University, Greenville, North Carolina, USA
| | - Paige Averett
- School of Social Work, North Carolina State University, Raleigh, North Carolina, USA
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17
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‘We Want to Help but We Don’t Know What to Do’: Service Providers Working with Indigenous LGBTIQ+ Youth in Australia. SEXES 2022. [DOI: 10.3390/sexes3020024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Access to adequate and appropriate service provision has a direct positive impact on health and wellbeing. Experiences of inaccessible, discriminatory, and culturally unsafe services and/or service providers are considered a root cause for the health inequalities that exist among Indigenous queer youth. Experiences of discrimination and cultural inappropriateness are commonplace, with Indigenous queer youth noting issues related to access to services and treatment, stereotyping, and a lack of quality in the care provided, which discourage Indigenous people from accessing care. This paper examines the perspectives of Indigenous LGBTIQ+ youth and health service providers to identify what challenges, obstacles and opportunities are currently being faced and what could be implemented to improve the health and wellbeing outcomes for Indigenous LGBTIQ+ youth in the future.
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18
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Fraser G, Brady A, Wilson MS. Mental health support experiences of rainbow rangatahi youth in Aotearoa New Zealand: results from a co-designed online survey. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2061019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Gloria Fraser
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Anita Brady
- School of English, Film, Theatre, Media Studies, and Art History, Victoria University of Wellington, Wellington, New Zealand
| | - Marc S. Wilson
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
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19
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Scheer JR, Batchelder AW, Bochicchio LA, Kidd JD, Hughes TL. Alcohol use, behavioral and mental health help-seeking, and treatment satisfaction among sexual minority women. Alcohol Clin Exp Res 2022; 46:641-656. [PMID: 35318685 PMCID: PMC9018513 DOI: 10.1111/acer.14789] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/23/2022] [Accepted: 01/31/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Sexual minority women (SMW) report higher rates of heavy episodic drinking (HED) and adverse alcohol-related outcomes, including poor mental health, than heterosexual women. These disparities indicate a greater need for behavioral and mental health treatment for SMW. This study examined associations among alcohol outcomes, behavioral and mental health help-seeking, and treatment satisfaction among SMW by age, sexual identity, race/ethnicity, and income. METHODS Participants included a community sample of 695 SMW (Mage = 40.0, SD = 14.1; 74.1% lesbian, 25.9% bisexual; 37.6% White, 35.8% Black, 23.2% Latinx; 26.3% annual income $14,999 or less). We used bivariate analyses to characterize the sample's demographic characteristics and multivariable logistic regression analyses to examine associations among variables. RESULTS SMW subgroups based on age, race/ethnicity, and annual income differed in alcohol outcomes (i.e., HED, DSM-IV alcohol dependence, alcohol-related problem consequences, alcohol problem recognition, and motivation to reduce drinking); help-seeking; and treatment satisfaction. SMW who engaged in help-seeking for alcohol-related concerns were more likely than those who did not to meet criteria for DSM-IV alcohol dependence (adjusted odds ratio [aOR] = 7.13; 95% CI = 2.77; 18.36), endorse alcohol-related problem consequences (aOR = 11.44; 95% CI = 3.88; 33.71), recognize problematic drinking (aOR = 14.56; 95% CI = 3.37; 62.97), and report motivation to reduce drinking (aOR = 5.26; 95% CI = 1.74; 15.88). SMW's alcohol outcomes did not differ based on their satisfaction with treatment or with providers. CONCLUSIONS This study's findings confirm SMW's elevated risk for HED and other alcohol-related outcomes and underscore the importance of identity-affirmative and accessible behavioral and mental health treatment for young, Black, and low-income SMW. Clinicians and intervention scientists should develop or enhance existing brief behavioral and mental health treatments for SMW engaging in HED who may not recognize that their drinking is problematic or who are not motivated to reduce drinking.
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Affiliation(s)
| | - Abigail W. Batchelder
- Harvard Medical School, Harvard University, Boston, MA
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- The Fenway Institute, Fenway Health, Boston, MA
| | - Lauren A. Bochicchio
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY
| | - Jeremy D. Kidd
- Columbia University Irving Medical Center, New York, NY
- New York State Psychiatric Institute, New York, NY
| | - Tonda L. Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY
- Columbia University Irving Medical Center, New York, NY
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20
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Vidales CA, Fernando GA, Vogel DL. Perceived Familial Stigma of Sexuality. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2022. [DOI: 10.1080/07481756.2022.2030238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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de Los Reyes GOR, Collict D. "It's Not Only about Clinical Tools but Also Our Role as Agents of Social Change": Implementing a LGBT Competency Training for Future Mental Health Practitioners in Mexico. JOURNAL OF HOMOSEXUALITY 2022; 69:230-253. [PMID: 32903169 DOI: 10.1080/00918369.2020.1815433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Recent studies recommend implementing a curriculum that is inclusive of lesbian, gay, bisexual, and transgender (LGBT) identities in health-related higher education programs. Inclusive health services are a means to address stigma-related adverse health outcomes in these populations. In Mexico, research has revealed that sexual and gender minority individuals experience discriminatory conditions that put them at risk for mental health problems. The present study tested the impact of a LGBT training protocol in Mexico; 17 psychology majors living in Mexico City received 12-plus hours of training on LGBT multicultural competencies. A quantitative retrospective assessment of participants' attitudes toward LGBT individuals, knowledge of LGBT issues, and willingness to work with LGBT clients, alongside qualitative data collected from a focus group, provided evidence on the impact of this training strategy. Implications for LGBT multicultural competency training in undergraduate and graduate programs in psychology are discussed herein.
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Affiliation(s)
- Gibran Omar Rodriguez de Los Reyes
- Department of Applied Psychology and Human Development (APHD), University of Toronto - Ontario Institute for Studies in Education (OISE), Toronto, Ontario, Canada
| | - David Collict
- Department of Applied Psychology and Human Development (APHD), University of Toronto - Ontario Institute for Studies in Education (OISE), Toronto, Ontario, Canada
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22
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Gattamorta K, Salerno JP, Laporte RR. Family Rejection During COVID-19: Effects on Sexual and Gender Minority Stress and Mental Health Among LGBTQ University Students. LGBTQ+ FAMILY : AN INTERDISCIPLINARY JOURNAL 2022; 18:305-318. [PMID: 37151804 PMCID: PMC10162589 DOI: 10.1080/27703371.2022.2083041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This study examines the relationship between family rejection and moderate to severe psychological distress during COVID-19 among LGBTQ university students. Data were obtained from a national cross-sectional electronic survey of LGBTQ university students (N = 565) collected in the summer of 2020. Hierarchical logistic regression models were used to examine the predictive association between increased family rejection and moderate to severe psychological distress. Respondents who reported increased rejection were more than twice as likely to report moderate to severe psychological distress, with social isolation and LGBTQ identity concealment being significant covariate predictors in the model. These results demonstrate the importance of public health, medical, mental health, and higher education stakeholders understanding the significance of LGBTQ-identity related family rejection when addressing the mental health and well-being of LGBTQ young people.
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Affiliation(s)
- Karina Gattamorta
- University of Miami, School of Nursing and Health Studies, Coral Gables, 33124 United States
| | - John P Salerno
- University of Maryland at College Park, School of Public Health, College Park, 20742-5031 United States
| | - Roberto Roman Laporte
- University of Miami, School of Nursing and Health Studies, Coral Gables, 33124 United States
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23
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Holland KJ, Cipriano AE, Huit TZ. LGBTQ and Straight Sexual Assault Survivors’ Interactions with Counseling in a Campus Counseling Center and Women’s Center. WOMEN & THERAPY 2021. [DOI: 10.1080/02703149.2021.1961439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Kathryn J. Holland
- Department of Psychology and Women’s & Gender Studies Program, University of Nebraska, Lincoln, Nebraska, USA
| | | | - T. Zachary Huit
- Department of Psychology, University of Nebraska, Lincoln, Nebraska, USA
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24
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LeBeau RT. The Rejection Sensitivity Framework's Promise as a Guiding Force for the Development of Sexual and Gender Minority Mental Health Interventions. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2275-2279. [PMID: 31872387 DOI: 10.1007/s10508-019-01613-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/12/2019] [Accepted: 12/14/2019] [Indexed: 05/08/2023]
Affiliation(s)
- Richard T LeBeau
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA.
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25
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Zhang L, Finan LJ, Bersamin M, Fisher DA, Paschall MJ. Sexual Orientation-Based Alcohol, Tobacco, and Other Drug Use Disparities: The Protective Role of School-Based Health Centers. YOUTH & SOCIETY 2020; 52:1153-1173. [PMID: 34321700 PMCID: PMC8315521 DOI: 10.1177/0044118x19851892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study investigated whether the presence of school-based health centers (SBHCs) was associated with six substance use behaviors among sexual minority youth (SMY) and their heterosexual peers. Data from the 2015 Oregon Healthy Teens Survey, including 13,608 11th graders in 137 schools (26 with SBHCs) were used in the current study. Multilevel logistic regression analyses were performed. Results revealed significant SBHC by SMY status interactions indicating a relatively lower likelihood of past 30-day alcohol use (23%), binge drinking (43%), use of e-cigarettes (22%), marijuana (44%), and unprescribed prescription drugs (28%) among SMY in SBHC schools compared with non-SMY at SBHC schools. Furthermore, SMY in SBHC schools reported lower likelihood of aforementioned substance use behaviors than SMY attending non-SBHC schools. Conversely, no differences in these outcomes were observed for non-SMY in SBHC and non-SBHC schools. Findings from this study suggest SBHCs may help to mitigate substance use disparities among marginalized populations, such as SMY.
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Affiliation(s)
- Lei Zhang
- Pacific Institute for Research and Evaluation, Chapel Hill, NC, USA
| | - Laura J. Finan
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | - Melina Bersamin
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | | | - Mallie J. Paschall
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
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26
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Moore KL, Lopez L, Camacho D, Munson MR. A Qualitative Investigation of Engagement in Mental Health Services Among Black and Hispanic LGB Young Adults. Psychiatr Serv 2020; 71:555-561. [PMID: 31960774 PMCID: PMC7364786 DOI: 10.1176/appi.ps.201900399] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Little attention has been paid to engagement in mental health services among racially and ethnically diverse youths who identify as a sexual minority, despite research indicating that they face significant mental health disparities. In this study, the authors assessed the service use experiences of black and Hispanic lesbian, gay, and bisexual (LGB) young adults to identify factors that promoted or hindered their engagement. METHODS Semistructured interviews with 38 young adults regarding past and present experiences with mental health services were analyzed thematically for perceived challenges to and support for engagement. Participants' service use histories were reviewed for significant interruptions in services reported over the past year. RESULTS Seventeen participants (45%) reported disengagement despite continuing to need services. Factors that influenced engagement were identified across four domains: personal, social environment, accessibility, and provider characteristics. Stigma related to sexual orientation and cultural attitudes presented engagement barriers, whereas providers who were knowledgeable about sexual-minority issues were important engagement promoters. Additional barriers to engagement were ambivalence about treatment efficacy, lack of family support, and difficulty finding suitable and affordable care. Peers who identified as a sexual minority helped participants locate LGB-affirming services. Rapport with providers and health care autonomy assisted participants to manage barriers to engagement. CONCLUSIONS These findings offer insights about factors that can influence engagement with treatment among black and Hispanic LGB young adults. The findings reveal important provider competencies and can inform interventions to improve engagement and reduce mental health inequities among these youths.
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Affiliation(s)
- Kiara L Moore
- Silver School of Social Work, New York University, New York (Moore, Munson); School of Medicine, City University of New York, New York (Lopez); Columbia University School of Social Work, New York (Camacho)
| | - Lucy Lopez
- Silver School of Social Work, New York University, New York (Moore, Munson); School of Medicine, City University of New York, New York (Lopez); Columbia University School of Social Work, New York (Camacho)
| | - David Camacho
- Silver School of Social Work, New York University, New York (Moore, Munson); School of Medicine, City University of New York, New York (Lopez); Columbia University School of Social Work, New York (Camacho)
| | - Michelle R Munson
- Silver School of Social Work, New York University, New York (Moore, Munson); School of Medicine, City University of New York, New York (Lopez); Columbia University School of Social Work, New York (Camacho)
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27
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Carter SP, Cowan T, Snow A, Cerel J, Tucker R. Health Insurance and Mental Health Care Utilization Among Adults Who Identify as Transgender and Gender Diverse. Psychiatr Serv 2020; 71:151-157. [PMID: 31658897 DOI: 10.1176/appi.ps.201900289] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Transgender people are less likely to have health insurance, which has been associated with reduced utilization of health care. In the current study, the authors sought to assess the role of health insurance in mental health care utilization among transgender individuals. METHODS A total of 4,334 adults who self-identified as transgender or gender diverse (neither male nor female) participated in the 2017 Trans Lifeline Mental Health Survey, which included self-report measures of current insurance type and lifetime history of having seen a therapist or psychiatric provider. Logistic regression analyses assessed the association of insurance status with lifetime utilization of a mental health therapist or psychiatric provider. RESULTS Although only 8% of the sample were uninsured, these individuals were significantly less likely to have seen a therapist or psychiatric provider in their lifetime compared with those with health insurance, even after the analyses were adjusted for sociodemographic factors. Conversely, those with insurance through the military or the Veterans Health Administration were more than twice as likely as those with employer-provided insurance to have seen a therapist or psychiatric provider. There were no significant differences in mental health care utilization between those with employer-provided insurance versus public or privately purchased insurance. CONCLUSIONS Rates of being uninsured were lower than in earlier assessments of transgender adults and adults who identify as gender diverse. However, type of health insurance also appeared to be a notable structural factor contributing to disparities in mental health care utilization among transgender individuals.
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Affiliation(s)
- Sarah P Carter
- Seattle-Denver Center of Innovation for Veteran-Centered Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Services, Seattle (Carter); Department of Health Services, University of Washington, Seattle (Carter); Department of Psychology, Louisiana State University, Baton Rouge (Cowan, Tucker); College of Social Work, University of Kentucky, Lexington (Snow, Cerel)
| | - Tovah Cowan
- Seattle-Denver Center of Innovation for Veteran-Centered Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Services, Seattle (Carter); Department of Health Services, University of Washington, Seattle (Carter); Department of Psychology, Louisiana State University, Baton Rouge (Cowan, Tucker); College of Social Work, University of Kentucky, Lexington (Snow, Cerel)
| | - Annie Snow
- Seattle-Denver Center of Innovation for Veteran-Centered Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Services, Seattle (Carter); Department of Health Services, University of Washington, Seattle (Carter); Department of Psychology, Louisiana State University, Baton Rouge (Cowan, Tucker); College of Social Work, University of Kentucky, Lexington (Snow, Cerel)
| | - Julie Cerel
- Seattle-Denver Center of Innovation for Veteran-Centered Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Services, Seattle (Carter); Department of Health Services, University of Washington, Seattle (Carter); Department of Psychology, Louisiana State University, Baton Rouge (Cowan, Tucker); College of Social Work, University of Kentucky, Lexington (Snow, Cerel)
| | - Raymond Tucker
- Seattle-Denver Center of Innovation for Veteran-Centered Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Services, Seattle (Carter); Department of Health Services, University of Washington, Seattle (Carter); Department of Psychology, Louisiana State University, Baton Rouge (Cowan, Tucker); College of Social Work, University of Kentucky, Lexington (Snow, Cerel)
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28
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Zhang L, Finan LJ, Bersamin M, Fisher DA. Sexual Orientation-Based Depression and Suicidality Health Disparities: The Protective Role of School-Based Health Centers. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2020; 30 Suppl 1:134-142. [PMID: 30230104 PMCID: PMC6430702 DOI: 10.1111/jora.12454] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study's purpose was to examine whether school-based health centers (SBHCs) support mental health indicators among sexual minority youth (SMY). Data came from the 2015 Oregon Healthy Teens Survey with 13,608 11th graders in 137 public high schools in Oregon. Regression results revealed significant SBHC by SMY status interactions indicating relative reductions in likelihood of depressive episodes (30%), suicidal ideation (34%), and suicide attempts (43%) among SMY in schools with SBHCs. SMY students in SBHC schools reported lower likelihood of a past-year depressive episode, suicidal ideation, and suicide attempt versus those attending non-SBHC schools. Conversely, no differences in these outcomes were observed for non-SMY by SBHC status. SBHCs may help reduce mental health disparities among SMY, a marginalized, underserved population.
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Affiliation(s)
- Lei Zhang
- Pacific Institute for Research and Evaluation
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29
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Moore KL, Camacho D, Munson MR. Identity negotiation processes among Black and Latinx sexual minority young adult mental health service users. JOURNAL OF GAY & LESBIAN SOCIAL SERVICES 2019; 32:21-48. [PMID: 33223785 PMCID: PMC7678912 DOI: 10.1080/10538720.2019.1677542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The transition to adulthood presents particular challenges for Black and Latinx sexual minorities in need of mental health services. Identity formation and marginalization during this developmental period can interfere with help-seeking and lead to health disparities. Identity-specific psychosocial supports are needed to assist young adults to successfully navigate these challenges, but research on identity processes, help-seeking, and service-utilization among sexual minority young people of color is very limited. To better understand how multiple minority young people navigate their identities in the context of using, or choosing not to use, mental health services, this study qualitatively explored the experiences of 31 emerging adults. Through in-depth interviews, analyses revealed that young adults negotiated social identity norms about mental health help-seeking by separating from unhelpful norms, managing stigmatized aspects of identity, integrating helpful identity alternatives, and forming individualized perspectives on help-seeking that allowed them to maintain important connections to their minority group identities. Findings are discussed in relation to previous research on ethnic and sexual minority identity development and service utilization. Practice and research recommendations for increasing knowledge, improving help-seeking, and promoting resilience around young adults' intersectional identities are offered.
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Affiliation(s)
- Kiara L. Moore
- Silver School of Social Work, New York University, New York, NY, USA
| | - David Camacho
- School of Social Work, Columbia University, New York, NY, USA
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30
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Sheinfil AZ, Foley JD, Ramos J, Antshel KM, Woolf-King SE. Psychotherapeutic depression interventions adapted for sexual and gender minority youth: A systematic review of an emerging literature. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2019. [DOI: 10.1080/19359705.2019.1622616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Alan Z. Sheinfil
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Jacklyn D. Foley
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Jeremy Ramos
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Kevin M. Antshel
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Sarah E. Woolf-King
- Department of Psychology, Syracuse University, Syracuse, New York, USA
- Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, California, USA
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31
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McIntosh CA. Denial of care is denial of evidence. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2019. [DOI: 10.1080/19359705.2019.1630793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Christopher A. McIntosh
- Michael Garron Hospital and Department of Psychiatry, University of Toronto, Toronto, Canada
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32
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Tabler J, Geist C, Schmitz RM, Nagata JM. Does it Get Better? Change in Depressive Symptoms from Late-Adolescence to Early-Adulthood, Disordered Eating Behaviors, and Sexual Identity. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2019; 23:221-243. [PMID: 33897935 DOI: 10.1080/19359705.2019.1568944] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Sexual minority youth are often described as at-risk for mental health comorbidities, including disordered eating behavior (DEB) and depression. This study assesses differences in late-adolescent DEB and depressive symptoms among gay/lesbian, bisexual, or mostly-heterosexual individuals, and how their symptoms change across early-adulthood. While sexual minority youth were more likely to report DEB and elevated depressive symptoms in late-adolescence relative to exclusively heterosexual peers, gay/lesbian individuals experienced improvement in early-adulthood depressive symptoms. Conversely, bisexual individuals maintained elevated depressive symptoms into early-adulthood, and additional depressive symptoms associated with DEB. DEB may be a unique risk-factor shaping the mental health of bisexual youth.
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Affiliation(s)
- Jennifer Tabler
- The University of Wyoming, Department of Criminal Justice and Sociology, University of Wyoming
| | - Claudia Geist
- The University of Utah, Department of Sociology, Salt Lake City, UT.,The University of Utah, Division of Gender Studies, Salt Lake City, UT
| | - Rachel M Schmitz
- The University of Wyoming, Department of Criminal Justice and Sociology, University of Wyoming
| | - Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA
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