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Press N, Lewis C. 'Being Actively Confident in All Contexts': A Qualitative Exploration of Thriving as an Emerging Adult of Diverse Sexual Orientation. JOURNAL OF HOMOSEXUALITY 2024; 71:2664-2685. [PMID: 37643384 DOI: 10.1080/00918369.2023.2252966] [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: 08/31/2023]
Abstract
When one thrives, they grow, develop and succeed. For people of diverse sexual orientations (DSO) thriving within one's sexuality is often restricted by heteronormativity, minority stress and poor mental health outcomes. Particularly at risk, are DSO "emerging adults" aged between 18-29 years who seek stability before transitioning to adulthood. Therefore, this qualitative study interviewed 12 participants between the ages of 18-29 years to investigate perceptions of thriving within one's sexuality and factors that may foster or hinder its occurrence. The results indicated participants perceived thriving as a spectrum of states and processes involving a sense of personal safety with high levels of self-acceptance to believe one could exist freely as a person of DSO. The findings suggested thriving within one's sexuality during emerging adulthood is fostered through the factors of seeking personal growth, social representation/visibility, affirming social support and opportunities to support other DSO people. In contrast, identity denial, unsupportive social environments, erasure/tokenism, and experiences of discrimination eroded one's ability to thrive. Psychological interventions focusing on establishing a strong sense of identity, building a social support network and encouragement to seek thriving opportunities, may foster thriving experiences for Australian DSO emerging adults.
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Affiliation(s)
- Nicole Press
- School of Psychology, Charles Sturt University, Bathurst, Australia
| | - Clifford Lewis
- School of Business, Charles Sturt University, Bathurst, Australia
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2
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Bhugra D, Liebrenz M, Ventriglio A, Ng R, Javed A, Kar A, Chumakov E, Moura H, Tolentino E, Gupta S, Ruiz R, Okasha T, Chisolm MS, Castaldelli-Maia J, Torales J, Smith A. World Psychiatric Association-Asian Journal of Psychiatry Commission on Public Mental Health. Asian J Psychiatr 2024; 98:104105. [PMID: 38861790 DOI: 10.1016/j.ajp.2024.104105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/22/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
Although there is considerable evidence showing that the prevention of mental illnesses and adverse outcomes and mental health promotion can help people lead better and more functional lives, public mental health remains overlooked in the broader contexts of psychiatry and public health. Likewise, in undergraduate and postgraduate medical curricula, prevention and mental health promotion have often been ignored. However, there has been a recent increase in interest in public mental health, including an emphasis on the prevention of psychiatric disorders and improving individual and community wellbeing to support life trajectories, from childhood through to adulthood and into older age. These lifespan approaches have significant potential to reduce the onset of mental illnesses and the related burdens for the individual and communities, as well as mitigating social, economic, and political costs. Informed by principles of social justice and respect for human rights, this may be especially important for addressing salient problems in communities with distinct vulnerabilities, where prominent disadvantages and barriers for care delivery exist. Therefore, this Commission aims to address these topics, providing a narrative overview of relevant literature and suggesting ways forward. Additionally, proposals for improving mental health and preventing mental illnesses and adverse outcomes are presented, particularly amongst at-risk populations.
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Affiliation(s)
- Dinesh Bhugra
- Institute of Psychiatry, Psychology and Neurosciences, Kings College, London SE5 8AF, United Kingdom.
| | - Michael Liebrenz
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
| | | | - Roger Ng
- World Psychiatric Association, Geneva, Switzerland
| | | | - Anindya Kar
- Advanced Neuropsychiatry Institute, Kolkata, India
| | - Egor Chumakov
- Department of Psychiatry & Addiction, St Petersburg State University, St Petersburg, Russia
| | | | | | - Susham Gupta
- East London NHS Foundation Trust, London, United Kingdom
| | - Roxanna Ruiz
- University of Francisco Moaroquin, Guatemala City, Guatemala
| | | | | | | | | | - Alexander Smith
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
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3
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Esteban C, Hernández-López E, Francia-Martínez M, Ramos-Pibernus A. Development and Preliminary Validation of a Scale to Measure Perceived Therapist's Knowledge about Gender Identity Diversity among Trans and Non-Binary Individuals in Puerto Rico. Eur J Investig Health Psychol Educ 2024; 14:1890-1901. [PMID: 39056640 PMCID: PMC11276512 DOI: 10.3390/ejihpe14070125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/15/2024] [Accepted: 05/25/2024] [Indexed: 07/28/2024] Open
Abstract
This study aimed to describe the development of the Perceived Therapist's Knowledge about Gender Identity Diversity Scale and to preliminarily validate this scale by describing its psychometric properties. This research instrument was constructed based on the existing literature and recommendations for instrument development. Initially, a 36-item scale was devised to assess perceived openness and knowledge about gender identity diversity in therapy. The content validation process involved 12 expert judges, leading to a refined 25-item scale. Participants consisting of 57 trans and non-binary Puerto Rican individuals completed the scale. Exploratory factor analysis revealed a unidimensional structure, supporting a single factor named "perceived knowledge about gender identity diversity in therapy." The final scale demonstrated excellent reliability (α = 0.978; Sα = 0.980; ω = 0.979), indicating strong internal consistency. This validated scale contributes to assessing primarily Hispanic trans and non-binary individuals' perceptions of their therapists' knowledge about gender identity diversity.
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Affiliation(s)
- Caleb Esteban
- The Queer Biopsychosocial Health Laboratory (The Queer Lab), School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico;
- Ponce Research Institute, Ponce Health Sciences University, Ponce 00716, Puerto Rico
- Sex, Gender, and Sexual Orientation Diversity Committee, Puerto Rico Psychological Association, San Juan 00936, Puerto Rico; (M.F.-M.); (A.R.-P.)
| | - Eddiel Hernández-López
- The Queer Biopsychosocial Health Laboratory (The Queer Lab), School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico;
- Ponce Research Institute, Ponce Health Sciences University, Ponce 00716, Puerto Rico
| | - Margarita Francia-Martínez
- Sex, Gender, and Sexual Orientation Diversity Committee, Puerto Rico Psychological Association, San Juan 00936, Puerto Rico; (M.F.-M.); (A.R.-P.)
- Clinical Psychology Program, Universidad Carlos Albizu, San Juan 00901, Puerto Rico
| | - Alixida Ramos-Pibernus
- Sex, Gender, and Sexual Orientation Diversity Committee, Puerto Rico Psychological Association, San Juan 00936, Puerto Rico; (M.F.-M.); (A.R.-P.)
- Health Equity Research (HER) Lab, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico
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Esteban C, Francia-Martínez M, Vázquez-Rivera M, Crespo F, Bruno-Ortiz T, Santiago-Ortiz AM, Martínez-Taboas A. Sexual orientation knowledge and attitudes and its association with therapy satisfaction among lesbian, gay, and bisexual + Hispanic Puerto Ricans. BMC Public Health 2023; 23:857. [PMID: 37170078 PMCID: PMC10173566 DOI: 10.1186/s12889-023-15811-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/04/2023] [Indexed: 05/13/2023] Open
Abstract
This study aimed to examine the difference in therapy satisfaction between lesbian, gay, and bisexual + (LGB +) individuals and heterosexual individuals, and to identify the association between therapy satisfaction and the perception of knowledge and attitudes of their last therapist among the LGB + participants. Through an exploratory design with a comparative group, 125 LGB + and 75 heterosexual participants were recruited online by availability. Results indicate that the participants' sexual orientation has no significant relation on therapy satisfaction. However, there was a significant positive association between satisfaction with therapy and the LGB + participants' perception that their therapist demonstrated knowledge and positive attitudes. This research highlights the importance for continuous education and curriculum efforts on LGB + issues.
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Affiliation(s)
- Caleb Esteban
- Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, PO BOX 7004, 00732-7004, Ponce, Puerto Rico.
| | | | | | - Frances Crespo
- Instituto de Investigación y Desarrollo para Estudiantes Dotados, San Juan, Puerto Rico
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Why do queer men experience negative body image? A narrative review and testable stigma model. Body Image 2023; 45:94-104. [PMID: 36867966 DOI: 10.1016/j.bodyim.2023.02.005] [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: 08/30/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 03/05/2023]
Abstract
Queer men (i.e., men who are not heterosexual; sexual minority men) are disproportionately affected by negative body image - they experience greater body dissatisfaction are more likely to develop eating disorders than heterosexual men. While existing literature has examined individual-level predictors of negative body image for queer men, less is known about why queer men as a group are disproportionately affected by negative body image. By synthesising existing theoretical frameworks, research, policy, and media reporting, this narrative review moves towards an understanding of systemic-level negative body image for queer men. Through the lens of hegemonic masculinity, we explain how systemic experiences of stigma work to inform unattainable appearance standards for queer men, and how these standards then contribute to pervasive negative body image concerns among this community. Next, we describe how systemic stigma works to exacerbate negative health outcomes for queer men with body image concerns. Finally, we present a synthesized model of the processes outlined in this review, articulate testable predictions for future studies, and describe practical implications that could be widely employed to improve body image for queer men. Our review is the first to propose a comprehensive explanation of systemic negative body image for queer men.
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McNeill SG, McAteer J, Jepson R. Interactions Between Health Professionals and Lesbian, Gay and Bisexual Patients in Healthcare Settings: A Systematic Review. JOURNAL OF HOMOSEXUALITY 2023; 70:250-276. [PMID: 34292130 DOI: 10.1080/00918369.2021.1945338] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The ways in which health professionals (HPs) interact with individuals from sexual minorities can impact their perception of the health service and influence engagement. This systematic literature review aimed to identify and synthesize the qualitative literature exploring interactions between HPs and lesbian, gay and bisexual (LGB) patients in healthcare settings. A search strategy was developed and applied to CINAHL and Medline, inclusion criteria were then applied to results by two screeners with good agreement. Thematic analysis was carried out on papers meeting the inclusion criteria in three stages, beginning with coding the text line-by-line, developing descriptive themes and finally, analytical themes. Electronic searches identified 348 papers with 20 of these meeting the inclusion criteria. Thematic analysis found five themes; HPs' lack of knowledge regarding LGB specific issues, identification of sexual orientation, discomfort in interactions, LGB patients' experience of heteronormative attitudes and perceived judgment or other negative attitudes.
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Affiliation(s)
- Sarah G McNeill
- Centre for Public Health, Royal Victoria Hospital, Belfast, United Kingdom
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - John McAteer
- Grow Public Health Research and Consultancy, Edinburgh, Scotland, United Kingdom
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom
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Brown M, McCann E, Webster-Henderson B, Lim F, McCormick F. The Inclusion of LGBTQ+ Health across the Lifespan in Pre-Registration Nursing Programmes: Qualitative Findings from a Mixed-Methods Study. Healthcare (Basel) 2023; 11:healthcare11020198. [PMID: 36673566 PMCID: PMC9859530 DOI: 10.3390/healthcare11020198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/20/2022] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
Poor physical and mental ill-health is experienced by many LGBTQ+ people, compounded by a reluctance to access healthcare services. This reluctance is attributed to experiences of heteronormative assumptions and negative attitudes encountered. Despite increasing recognition of the need to include LGBTQ+ health in undergraduate healthcare programmes, inconsistencies and gaps in content, skills development, and assessment are still apparent. The aim of the study was to identify LGBTQ+ health content within nursing and midwifery pre-registration programmes and identify education best practice and innovation. A mixed-methods study involving a quantitative and qualitative design was undertaken. The qualitative findings from a nursing perspective were extracted from the dataset for further detailed analysis and are reported in this paper. Information about the study and an online survey were distributed to 135 Schools of Nursing and Midwifery in the UK and Ireland. Individual semi-structured online interviews took place with academics. Qualitative data from 29 survey responses and 12 follow-up interviews were thematically analysed. Eight of the 12 follow-up interviews were held with nursing academics and following data analysis three themes emerged: (i) LGBTQ+ health across the lifespan; (ii) taking the initiative for LGBTQ+ health inclusion; and (iii) identifying and overcoming challenges. The findings highlight the endeavours by nursing academics to integrate LGBTQ+ health within pre-registration programmes to meet the education needs of students and the opportunity to develop curriculum content to address the needs and concerns of LGBTQ+ people across the lifespan.
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Affiliation(s)
- Michael Brown
- School of Nursing and Midwifery, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
- Correspondence: ; Tel.: +44-(0)-28-9097-2387
| | - Edward McCann
- School of Nursing and Midwifery, Trinity College Dublin, D02 PN40 Dublin, Ireland
- School of Health and Psychological Sciences, Nursing Department, City, University of London, Myddelton Square, London EC1R 1UW, UK
| | | | - Fidelindo Lim
- Rory Meyers College of Nursing, New York University, 433 1st Avenue, New York, NY 10010, USA
| | - Freda McCormick
- School of Nursing and Midwifery, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
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Cámara-Liebana D, González-Carrasco M, Reig-Garcia G, Salleras-Duran L, Fuentes-Pumarola C, Ballester-Ferrando D. A Qualitative Approach to Exploring the Impact of the Gay Identity Formation Process. SAGE Open Nurs 2023; 9:23779608231185916. [PMID: 37425288 PMCID: PMC10328160 DOI: 10.1177/23779608231185916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 07/11/2023] Open
Abstract
Background Most gay men experience difficulty in coming to terms with their sexual orientation, with their health, wellbeing, and quality of life potentially affected by unpleasant experiences often associated with the formation of their gay identity. It is therefore important for nurses to understand the needs of gay men so that they can accompany them and provide quality care during and after the identity formation process. Objective The aim of the study was to explore and describe the identity formation and coming out experiences of gay men. Methods A qualitative design with a constructivist naturalist approach was used. Data were collected through in-depth semi-structured interviews with five gay men with experience of the gay identity formation process, and data were analyzed using a thematic analysis method. Results The results show that the men needed support, as they reported feeling different and alone during the identity formation and coming out process, and that their mental health was affected. Fear of rejection, negative reactions, and disappointing people were the reasons that led the men not to disclose their sexual orientation to family, while those who had come out defined a feeling of liberation. Conclusions The gay identity formation process has potential impacts on health, wellbeing, and quality of life. Nurses need cultural competence training to be able to understand the needs of gay men, accompany them in the identity formation process, and provide individualized and non-heteronormative care. Nurses also need to participate in dismantling a heterosexist social structure.
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Affiliation(s)
- David Cámara-Liebana
- Department of Nursing, University of Girona, Girona, Spain
- Quality of Life Research Institute,University of Girona, Girona, Spain
| | - Mònica González-Carrasco
- Quality of Life Research Institute,University of Girona, Girona, Spain
- Departament of Pyschology, University
of Girona, Girona, Spain
| | - Glòria Reig-Garcia
- Department of Nursing, University of Girona, Girona, Spain
- Health and Healthcare Research Group,
University of Girona, Girona, Spain
| | - Laia Salleras-Duran
- Department of Nursing, University of Girona, Girona, Spain
- Health, Gender and Aging Research
Group, University of Girona, Girona, Spain
| | - Concepció Fuentes-Pumarola
- Department of Nursing, University of Girona, Girona, Spain
- Health, Gender and Aging Research
Group, University of Girona, Girona, Spain
| | - David Ballester-Ferrando
- Department of Nursing, University of Girona, Girona, Spain
- Health, Gender and Aging Research
Group, University of Girona, Girona, Spain
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9
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Milanez LDS, Nabero APP, Silva ADN, Pedrosa JIDS, Ferreira BDO. Lesbian health: care experiences of primary care nurses. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-812320222710.06912022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Lesbians face many barriers in health services, and experience prejudice, stigmatization and the invisibility of their health demands. This article aimed at understanding the meanings attributed by primary care nurses to health care practices directed at lesbians. This is a qualitative research carried out with 15 nurses who worked in primary care in Teresina, Piauí. The analysis was based on Pierre Bourdieu’s theoretical framework of habitus, field and symbolic violence. It was observed that the practices of nurses in the field of primary care follow heteronormative protocols. Therefore, it is essential that these nurses develop other habitus, aiming to guarantee different types of identities within the health services.
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Milanez LDS, Nabero APP, Silva ADN, Pedrosa JIDS, Ferreira BDO. Lesbian health: care experiences of primary care nurses. CIENCIA & SAUDE COLETIVA 2022; 27:3891-3900. [PMID: 36134795 DOI: 10.1590/1413-812320222710.06912022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/27/2022] [Indexed: 11/22/2022] Open
Abstract
Lesbians face many barriers in health services, and experience prejudice, stigmatization and the invisibility of their health demands. This article aimed at understanding the meanings attributed by primary care nurses to health care practices directed at lesbians. This is a qualitative research carried out with 15 nurses who worked in primary care in Teresina, Piauí. The analysis was based on Pierre Bourdieu's theoretical framework of habitus, field and symbolic violence. It was observed that the practices of nurses in the field of primary care follow heteronormative protocols. Therefore, it is essential that these nurses develop other habitus, aiming to guarantee different types of identities within the health services.
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Affiliation(s)
- Letícia de Sousa Milanez
- Programa de Pós-Graduação em Ciências e Saúde, Centro de Ciências da Saúde, Universidade Federal do Piauí. Av. Frei Serafim 2280, Centro. 64001-020. Teresina PI Brasil.
| | | | - Adriane das Neves Silva
- Colégio Estadual Hilton Gama. Instituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro. Rio de Janeiro RJ Brasil
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de Vries JMA, Downes C, Sharek D, Doyle L, Murphy R, Begley T, McCann E, Sheerin F, Smyth S, Higgins A. An exploration of mental distress in transgender people in Ireland with reference to minority stress and dissonance theory. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2022; 24:469-486. [PMID: 37901058 PMCID: PMC10601524 DOI: 10.1080/26895269.2022.2105772] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Introduction: Internationally mental distress is more prominent in the LGBTI community than the general population. The LGBTIreland study was set up to take stock of this in the Republic of Ireland. This paper reports on the analysis of the transgender group with reference to minority stress theory and cognitive dissonance theory. Method: An online survey was conducted addressing several aspects of mental health and distress that received responses from all groupings (n = 2,264) among which 12.3% (n = 279) identified as transgender. The survey consisted of several validated tools to measure depression, anxiety, stress (DASS-21), coping (CSES), self-esteem (RSES), alcohol and drugs misuse (AUDIT) and a variety of questions addressing demographics, experiential aspects, coping and self-related factors. Data analysis focused on predicting mental distress using DASS-general (composite of depression, anxiety and stress). Results: Transgender participants reported higher levels of mental distress, self-harm, suicidal ideation and attempts, and lower levels of self-esteem in comparison with the LGB groups, as well as the general population. Hierarchical multiple regression showed that 53% of variance in mental distress could be predicted from reduced self-esteem, the experience of harassment and not belonging in school. Furthermore, mental distress was highest among younger participants, those who were 'not out', those who had self-harmed and used avoidant coping. There was no significant difference in distress levels among those who had sought mental health support and those who had not. Conclusions: To understand mental distress in transgender people, the minority stress model is useful when taking into account both adverse external (environmental) and internal (cognitive/emotional) factors. The cognitive dissonance mechanism is essential in outlining the mechanism whereby gender incongruence is associated with psychological discomfort, low self-esteem and high mental distress.
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Affiliation(s)
- Jan M. A. de Vries
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Carmel Downes
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Danika Sharek
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Louise Doyle
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Rebecca Murphy
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Thelma Begley
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Edward McCann
- Division of Nursing, City University of London, London, UK
| | - Fintan Sheerin
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Siobhán Smyth
- School of Nursing and Midwifery, National University Galway, Galway, Ireland
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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12
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She R, Mo PKH, Cai Y, Ma T, Liu Y, Lau JTF. Mental health service utilisation among transgender women sex workers who are at risk of mental health problems in Shenyang, China: An application of minority stress theory. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e981-e993. [PMID: 34240507 DOI: 10.1111/hsc.13501] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 05/26/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Transgender women sex workers (TGSW), as a highly stigmatised population, are at substantial risk for mental health problems but lack access to mental health care. This study investigated factors of mental health service utilisation (MHSU) behaviour and related behavioural intention among TGSW who were at risk of mental health problems in the past year [subsample 1: scored above the cut-off for probable depression or probable anxiety or had suicidal ideation (N = 126); subsample 2: perceived needs for mental health services (N = 109)]. A cross-sectional survey was conducted among TGSW in Shenyang, China during 2017-2018. Data on minority stress, coping, mental health and MHSU were collected. 10.3% of participants in subsample 1 and 14.7% in subsample 2 had sought help from mental health professionals in the last year. Unwillingness to disclose minority identity and gender non-affirmation were negatively associated with MHSU. Factors for behavioural intention of MHSU included unwillingness to disclose minority identity and social support for both subsamples and adaptive coping for subsample 2. Confidentiality concern, discrimination and cost were the most frequently endorsed barriers to mental health services. Interventions should promote gender affirmation, social support and adaptive coping as well as remove stigma to increase health service access and utilisation among minority populations.
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Affiliation(s)
- Rui She
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yong Cai
- Department of Community Health and Family Medicine, School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Tiecheng Ma
- Shenyang Consultation Centre of AIDS Aid and Health Service, Shenyang, China
| | - Yan Liu
- Shenyang Consultation Centre of AIDS Aid and Health Service, Shenyang, China
| | - Joseph T F Lau
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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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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Reynish T, Hoang H, Bridgman H, Nic Giolla Easpaig B. Barriers and enablers to mental health help seeking of sexual, gender, and erotic minorities: A systematic literature review. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2022. [DOI: 10.1080/19359705.2022.2036666] [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)
- Tamara Reynish
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Ha Hoang
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Heather Bridgman
- Centre for Rural Health, College of Health and Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Bróna Nic Giolla Easpaig
- Centre for Healthcare Resilience & Implement Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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15
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O'Connell S, Ruane-McAteer E, Daly C, O’Connor C, Tuomey F, McDonnell L, Arensman E, Andriessen K, Griffin E. Exploring experiences of supports for suicide bereavement in Ireland: protocol for a national survey. HRB Open Res 2022; 4:114. [PMID: 34870092 PMCID: PMC8602958 DOI: 10.12688/hrbopenres.13437.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 12/03/2022] Open
Abstract
Background A suicide death impacts upon the wellbeing of close family members and friends but has also been shown to affect many people outside of this immediate circle. This will be the first large-scale national study of adults bereaved or affected by suicide in Ireland, using a cross-sectional online survey. The overarching aim will be to gain insight into the experiences of supports received by people bereaved or affected by suicide and to identify the barriers to engagement following their loss. Methods A cross-sectional survey will be conducted among adults in Ireland who have been bereaved or affected by suicide. This project will seek to represent people with different demographics and backgrounds in the Irish population using a multifaceted approach to survey recruitment. A range of validated measures will be used to examine participants’ current wellbeing and grief experience. A combination of closed and open-ended questions will provide participants the opportunity to share their individual experiences, the services and supports available to them, and barriers and enablers to accessing supports. Results Quantitative data will be analysed using descriptive statistics. Chi-squared tests will be used to compare subgroups within categorical data items, and multivariable regression models will be used to examine differences in psychosocial and physical wellbeing across key groups. Qualitative content analysis will be used for qualitative responses to open-ended questions. Conclusions The survey will provide an in-depth understanding of the psychosocial and mental health impacts of suicide bereavement in Ireland; insight into the range of informal and formal supports accessed; and will identify unmet needs and challenges of accessing appropriate and timely supports. The findings will inform current national actions aimed at ensuring the standardisation and quality of the services and supports for those bereaved or affected by suicide.
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Affiliation(s)
- Selena O'Connell
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Eimear Ruane-McAteer
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Caroline Daly
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
| | - Clíodhna O’Connor
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
| | - Fiona Tuomey
- Healing Untold Grief Groups (HUGG), Dublin, Ireland
| | | | - Ella Arensman
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3010, Australia
| | - Eve Griffin
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
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16
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O'Connell S, Ruane-McAteer E, Daly C, O'Connor C, Tuomey F, McDonnell L, Arensman E, Andriessen K, Griffin E. Exploring experiences of supports for suicide bereavement in Ireland: protocol for a national survey. HRB Open Res 2021; 4:114. [PMID: 34870092 DOI: 10.12688/hrbopenres.13437.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 11/20/2022] Open
Abstract
Background A suicide death impacts upon the wellbeing of close family members and friends but has also been shown to affect many people outside of this immediate circle. This will be the first large-scale national study of adults bereaved or affected by suicide in Ireland, using a cross-sectional online survey. The overarching aim will be to gain insight into the experiences of supports received by people bereaved or affected by suicide and to identify the barriers to engagement following their loss. Methods A cross-sectional survey will be conducted among adults in Ireland who have been bereaved or affected by suicide. This project will seek to represent people with different demographics and backgrounds in the Irish population using a multifaceted approach to survey recruitment. A range of validated measures will be used to examine participants' current wellbeing and grief experience. A combination of closed and open-ended questions will provide participants the opportunity to share their individual experiences, the services and supports available to them, and barriers and enablers to accessing supports. Results Quantitative data will be analysed using descriptive statistics. Chi-squared tests will be used to compare subgroups within categorical data items, and multivariable regression models will be used to examine differences in psychosocial and physical wellbeing across key groups. Qualitative content analysis will be used for qualitative responses to open-ended questions. Conclusions The survey will provide an in-depth understanding of the psychosocial and mental health impacts of suicide bereavement in Ireland; insight into the range of informal and formal supports accessed; and will identify unmet needs and challenges of accessing appropriate and timely supports. The findings will inform current national actions aimed at ensuring the standardisation and quality of the services and supports for those bereaved or affected by suicide.
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Affiliation(s)
- Selena O'Connell
- National Suicide Research Foundation, University College Cork, Cork,, Ireland.,School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Eimear Ruane-McAteer
- National Suicide Research Foundation, University College Cork, Cork,, Ireland.,School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Caroline Daly
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
| | - Clíodhna O'Connor
- National Suicide Research Foundation, University College Cork, Cork,, Ireland
| | - Fiona Tuomey
- Healing Untold Grief Groups (HUGG), Dublin, Ireland
| | | | - Ella Arensman
- National Suicide Research Foundation, University College Cork, Cork,, Ireland.,School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3010, Australia
| | - Eve Griffin
- National Suicide Research Foundation, University College Cork, Cork,, Ireland.,School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
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17
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Bishop J, Crisp DA, Scholz B. A systematic review to determine how service provider practises impact effective service provision to lesbian, gay and bisexual consumers in a mental health setting. Clin Psychol Psychother 2021; 29:874-894. [PMID: 34873771 DOI: 10.1002/cpp.2699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 10/31/2021] [Accepted: 11/29/2021] [Indexed: 11/09/2022]
Abstract
Lesbian, gay and bisexual (LGB) consumers utilize mental health services at a similar rate to their heterosexual counterparts yet report greater dissatisfaction with service quality. This dissatisfaction may be explained by service provider's microaggressions, stemming from a lack of cultural competence in working with LGB consumers. This systematic review examines how the practises of mental health service providers impacted effective service provision to LGB people in a clinical practice. Five health databases (Scopus, MEDLINE, PsycINFO, Web of Science and CINAHL) were examined to determine relevant studies for this review. Twenty four qualitative and quantitative studies between 2000 and 2020 examining data related to how service provider practises impacted effective service provision to LGB people were included in the final review. A narrative synthesis, thematic summary approach was employed to account for the multi-method nature of the data. Themes developed in our analysis are organized under the three components of cultural competence, service provider attitudes, knowledge and skills. Provider attitudes ranged from positive to negative towards LGB people and heterosexism were present in several services. Poor service provider knowledge about the issues impacting LGB consumers leads to a weakened therapeutic alliance and service providers often lacked a comprehensive understanding of the issues impacting LGB people. Service providers were seen as more skilful if they were LGB, created a safe space and had completed cultural competence training. Trends within the characteristics (explorative nature, mixed service provider samples, potential for bias) of the 24 studies included in the review are discussed. Based on the results, recommendations are included to ensure services demonstrate cultural competence in working with LGB consumers.
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Affiliation(s)
- Joshua Bishop
- Centre of Applied Psychology, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Dimity A Crisp
- Centre of Applied Psychology, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Brett Scholz
- College of Health and Medicine, Australian National University, Canberra, ACT, Australia
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18
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Rees SN, Crowe M, Harris S. The lesbian, gay, bisexual and transgender communities' mental health care needs and experiences of mental health services: An integrative review of qualitative studies. J Psychiatr Ment Health Nurs 2021; 28:578-589. [PMID: 33295065 DOI: 10.1111/jpm.12720] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/19/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: There is evidence that the LGBT communities experience greater health disparities, particularly in relation to their mental health needs. The LGBT communities are often faced with stigma and discrimination within mental health services. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: People within the LGBT communities have identified that their experiences of mental health services reinforce stigma and lack an understanding of their specific needs. Their needs can be addressed by mental health services that challenge heteronormative assumptions and promote self-acceptance and equity. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The existing heteronormative culture in mental health nursing practice needs to be challenged. Practice needs to demonstrate self-awareness of personal and societal LGBT biases, prejudices, and stigma. Practice needs to demonstrate knowledge of important LGBT health care and psychosocial issues. Practice needs to reflect LGBT clinical skills grounded in professional ethics, guidelines, and standards of care. ABSTRACT INTRODUCTION: The lesbian, gay, bisexual and transgender (LGBT) communities are a minority population that experience a range of health disparities, including mental health. Because these groups have higher rates of mental disorder than the general population it is, therefore, pertinent to identify their specific mental health needs and their experiences when accessing mental health care. AIM To identify the mental health needs of the LGBT communities and their experiences of accessing mental health care. METHODS An integrative review of qualitative studies was conducted. RESULTS A total of fourteen studies were selected for this review. The studies identified that participants' experiences of accessing mental health care were related to (a) experiencing stigma and (b) staff's lack of knowledge and understanding of LGBT people's needs. They identified a need for mental health care that promotes the principles of equity, inclusion and respect for diversity. DISCUSSION The LGBT communities while not a homogenous group, face unique challenges when dealing with their mental health needs. Services that promote health equity and self-acceptance are important for this group. IMPLICATIONS FOR PRACTICE It is vital that mental health nursing education incorporate models that promote equity, inclusion and respect for diversity regarding this group of people.
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Affiliation(s)
- Samuel N Rees
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
| | - Marie Crowe
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
| | - Shirley Harris
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
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19
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McCann E, Brown MJ, Taylor J. The views and experiences of bisexual people regarding their psychosocial support needs: a qualitative evidence synthesis. J Psychiatr Ment Health Nurs 2021; 28:430-443. [PMID: 32780489 DOI: 10.1111/jpm.12680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/12/2020] [Accepted: 07/21/2020] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Bisexual people experience significantly poorer mental health and higher rates of self-harm and suicidality than their gay, lesbian or heterosexual counterparts. Although little is understood about why these disparities exist, bisexual people have been found to have unique life experiences that separate them from other sexual minority groups. Despite these health disparities and unique experiences, in research and in clinical settings, bisexual people are often incorporated under the LGBTQI+ umbrella and their needs are not seen as being different to those of other sub-groups. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper brings together the findings of the small but growing body of literature reporting on the psychosocial support needs of bisexual people. The findings reported on herein provide novel insights, collated and synthesized that will prove valuable to policy makers, service providers and researchers. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This paper clearly illustrates that bisexual people experience significant barriers to accessing the support services they need and that current competent service provision for this population is severely limited. The findings presented in this paper shed light on the unique psychosocial needs of bisexual people and highlight the need for practice change to reduce barriers to service access and ensure inclusive and culturally competent care for this community. ABSTRACT: Introduction Despite consistent evidence of poor mental health among what is a relatively large population group, research examining bisexual mental health remains sparse. Aim To identify the psychosocial needs of people who are bisexual and establish factors that may support or inhibit access to appropriate psychosocial interventions and supports. Method A qualitative evidence syntheses of the empirical evidence. Results A total of 15 papers were included in the review. The PRISMA process was used. Following data analysis, four main themes emerged that were (a) experiences of being bisexual, (b) mental health experiences and concerns, (c) service access and responses and (iv) communities and supports. Discussion Bisexual people have unique and specific psychosocial support needs that relate to, but are also different from, the needs of the broader LGBTIQ+ community. This study provides valuable insights into how future policy, practice, education and training and research can better address the needs of this highly vulnerable group. Implications for Practice This study highlights the psychosocial complexities associated with bisexuality and provides evidence for the need for improvement in current support services to ensure inclusivity and culturally competent care.
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Affiliation(s)
- Edward McCann
- School of Nursing and Midwifery, Trinity College, University of Dublin, Dublin, Ireland
| | - Michael J Brown
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Julia Taylor
- School of Nursing, University of Tasmania, Hobart, TAS, Australia
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20
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Moagi MM, van Der Wath AE, Jiyane PM, Rikhotso RS. Mental health challenges of lesbian, gay, bisexual and transgender people: An integrated literature review. Health SA 2021; 26:1487. [PMID: 33604059 PMCID: PMC7876969 DOI: 10.4102/hsag.v26i0.1487] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 11/03/2020] [Indexed: 11/01/2022] Open
Abstract
Lesbian, gay, bisexual and transgender (LGBT) individuals are often stigmatised and discriminated against. This population is expected to experience poorer mental health outcomes compared with heterosexual and cis-gendered people, a phenomenon healthcare providers need to take note of and act upon. This study aimed to explore and describe the mental health challenges of LGBT people. An integrative literature search was conducted. The following electronic databases were searched: Academic Search Premier, Africa-Wide Information, Business Source Premier, eBook Collection (EBSCOhost), E-Journals, ERIC, Family & Society Studies Worldwide, Health Source: Nursing/Academic Edition, Humanities Source, MasterFILE Premier, MEDLINE, PsycARTICLES, Social Work Abstracts, TOC Premier, WorldCat.org, Taylor and Francis Journals, Biomed Central and Wiley Online Library. An internet search was also carried out using Google and Google Scholar databases. The following search terms were identified: 'LGBT' OR 'LGBT community' AND 'mental health challenges/problems' OR 'mental/psychiatric illness'. The reviewed literature comprised research conducted globally between 2010 and 2019. From the 2545 titles, 345 abstracts were examined, resulting in 57 articles. The 57 full-text articles were examined to verify whether they addressed the scope of the literature review, of them, 21 addressed the mental health challenges of LGBT people. Lesbian, gay, bisexual and transgender people experience the following mental health challenges: emotional distress, stigmatisation, victimisation, discrimination and barriers to accessing healthcare services. The results showed that although LGBT has been legalised in many countries, LGBT communities still experience significant mental health challenges. Healthcare providers are in a position to address challenges related to social and healthcare structures and act as advocates in order to promote the mental health of LGBT individuals.
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Affiliation(s)
- Miriam M Moagi
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Tshwane, South Africa
| | - Anna E van Der Wath
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Tshwane, South Africa
| | - Priscilla M Jiyane
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Tshwane, South Africa
| | - Richard S Rikhotso
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Tshwane, South Africa
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21
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Carlström R, Ek S, Gabrielsson S. 'Treat me with respect': transgender persons' experiences of encounters with healthcare staff. Scand J Caring Sci 2020; 35:600-607. [PMID: 33128475 DOI: 10.1111/scs.12876] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/30/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Transgender persons face barriers to health care including discrimination and lack of awareness by professionals. This study aimed to describe transgender persons' experiences of encounters with healthcare staff. METHODS Participants were recruited through postings in social media and on websites targeting people identifying as transgender. Through an online form, 21 people identifying as transgender provided written self-reports. These were analysed using a method for inductive qualitative content analysis. The study was conducted in Sweden in 2018. RESULTS The results describe transgender persons' experiences and perceptions of encounters with healthcare staff in one theme: treat me with respect, and three main categories: accept me for who I am; treat me according to my needs; and meet me with competence. CONCLUSIONS Healthcare professionals can contribute in restoring and upholding transgender people's trust in health care by accepting their identity and focusing on their healthcare needs while also being informed about transgender people's needs and realities. A key point in this is recognising transgender person's vulnerability to violations of dignity in relation to health care.
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Affiliation(s)
- Rebeccah Carlström
- Psychiatric Outpatient Clinic, Örnsköldsvik Hospital, Örnsköldsvik, Sweden
| | - Susanna Ek
- Psychiatric Emergency Department, Vrinnevi Hospital, Region Östergötland, Norrköping, Sweden
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22
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The Disparities in Mental Health between Gay and Bisexual Men Following Positive HIV Diagnosis in China: A One-Year Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103414. [PMID: 32422918 PMCID: PMC7277388 DOI: 10.3390/ijerph17103414] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 12/22/2022]
Abstract
This study aimed to determine the change in mental health (depression and anxiety) among HIV-positive gay and bisexual men (GBM) one year after diagnosis and the disparities in trajectories of mental health between them. The potential factors contributing to the disparities were also investigated. This was a one-year follow-up study focusing on the mental health of newly diagnosed HIV-positive individuals. Participants rated their depression, anxiety, stress, and social support levels at baseline and one year later. Information on the utilization of mental healthcare and the initiation of antiretroviral therapy (ART) after diagnosis was collected at one-year follow-up. A total of 171 and 87 HIV-positive gay and bisexual men, respectively, completed two-time points surveys in this study. The depressive and anxiety symptoms experienced by HIV-positive GBM improvement one year after diagnosis. These improvements tended to be smaller in gay participants. Other factors including mental health care utilization and ART status during the one-year follow-up period, changes in social stress scores and objective social support scores were also associated with the changes in depression and anxiety, and all these factors, except for change in objective support, were found to be statistically different between HIV-positive GBM. Special attention should be given to the mental health of HIV-positive gay men. Promoting HIV-positive gay men to assess to mental health services and ART may be important for these populations to improve mental health. Enhancing social support and reducing stress levels may also be necessary for the vulnerable HIV-positive sexual minority groups.
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23
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Jackman KB, Bosse JD, Eliason MJ, Hughes TL. Sexual and gender minority health research in nursing. Nurs Outlook 2019; 67:21-38. [DOI: 10.1016/j.outlook.2018.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 10/24/2018] [Accepted: 10/27/2018] [Indexed: 01/15/2023]
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24
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Liu X, Jiang D, Chen X, Tan A, Hou Y, He M, Lu Y, Mao Z. Mental Health Status and Associated Contributing Factors among Gay Men in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:1065. [PMID: 29795013 PMCID: PMC6025140 DOI: 10.3390/ijerph15061065] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/12/2018] [Accepted: 05/17/2018] [Indexed: 11/17/2022]
Abstract
Chinese gay men are preferentially vulnerable to mental health problems because of deep-rooted, traditional social influence that overemphasizes heterosexual marriage, fertility, and filial piety. A cross-sectional survey was conducted from November to December 2017 using the Chinese version of the Symptom Checklist-90-R (SCL-90-R) to assess the status of, and factors associated with the mental health of Chinese gay men. Unadjusted associations between demographic factors and the total score of SCL-90-R were examined using t/F tests or person correlation analysis. The main factors that were most predictive of the aggregate score of SCL-90-R were identified by multiple linear regressions. A total of 367 gay men participated in this survey with an average score of SCL-90-R of 180.78 ± 79.58. The scores of seven dimensions (OCS, INTS, DEPR, ANX, HOS, PHOA, PARI) for Chinese gay men were found to be significantly higher than the national norm (all p < 0.001). Age (B = -1.088, SE = 0.478, p = 0.023), educational level (B = -14.053, SE = 5.270, p = 0.008), and degree of coming out publicly (B = -23.750, SE = 4.690, p < 0.001) were protective factors for participants' mental health status. A gay man who is the only child in his family was more likely to obtain a higher total score of SCL-90-R in China (B = 59.321, SE = 7.798, p < 0.001). Our study reveals the worrying mental health status of Chinese gay men. Shifts in familial, governmental, and societal normas are suggested to improve the current social acceptance towards sexual minority men, as well as to reduce detrimental health effects.
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Affiliation(s)
- Xiaojun Liu
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
| | - Dongdong Jiang
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
| | - Xiangfan Chen
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
| | - Anran Tan
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
- Global Health Research Center, Duke Kunshan University, 8# Duke Road, Kunshan 215316, China.
| | - Yitan Hou
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
| | - Meikun He
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
| | - Yuanan Lu
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
- Department of Public Health Sciences, University of Hawaii at Mānoa, 1960 East-West Road, Honolulu, HI 96822, USA.
| | - Zongfu Mao
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
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25
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Filice E, Meyer SB. Patterns, predictors, and outcomes of mental health service utilization among lesbians, gay men, and bisexuals: A scoping review. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2018. [DOI: 10.1080/19359705.2017.1418468] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Eric Filice
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Samantha B. Meyer
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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26
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Sharek D, Huntley-Moore S, McCann E. Education Needs of Families of Transgender Young People: A Narrative Review of International Literature. Issues Ment Health Nurs 2018; 39:59-72. [PMID: 29333892 DOI: 10.1080/01612840.2017.1395500] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Education plays a crucial role in the lives of families of transgender young people and mental healthcare practitioners are well-placed to support families in this regard. This paper reports findings from a narrative review of 31 papers that explored the education needs of families of transgender young people. The emergent themes were synthesised to develop a five-stage model that depicts the role of education in the lives of these families. Key themes included: (i) learning that a family member is trans; (ii) family responses; (iii) accessing education and information; (iv) impact on the individual; and (iv) moving beyond the individual. The key implications for mental health practitioners, families, and future research are discussed.
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Affiliation(s)
- Danika Sharek
- a University of Dublin, Trinity College , School of Nursing and Midwifery , Dublin , Ireland
| | - Sylvia Huntley-Moore
- a University of Dublin, Trinity College , School of Nursing and Midwifery , Dublin , Ireland
| | - Edward McCann
- a University of Dublin, Trinity College , School of Nursing and Midwifery , Dublin , Ireland
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27
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Watts C, Watts P, Collier E, Ashmore R. The impact on relationships following disclosure of transgenderism: a wife's tale. J Psychiatr Ment Health Nurs 2017; 24:302-310. [PMID: 28543869 DOI: 10.1111/jpm.12371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2017] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The experiences of transgender people are becoming increasingly more visible in popular culture, biographical literature and the media. The topic has received little attention within the psychiatric and mental health nursing literature. There is a paucity of literature exploring the impact on relationships following a disclosure of transgenderism. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: A narrative account of the consequences for the wife of one transwoman and their relationships with friends and family following the disclosure of transgenderism. The article identifies a range of issues that require further attention in relation to healthcare provision. These include the mental health needs of partners and spouses; attitudes of healthcare professionals towards transgender issues; and the adequacy of the formal support offered to partners and spouses of transgender people. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: There is a need for healthcare practitioners to explore their understanding of transgender issues and how these may impact on the mental health of partners and spouses. It is important that healthcare professionals provide a hopeful and supportive environment to enable couples to explore their relationships following disclosure of transgenderism.
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Affiliation(s)
- C Watts
- School of Nursing, Midwifery, Midwifery, Social Work & Social Sciences, University of Salford, Salford, UK
| | - P Watts
- School of Nursing, Midwifery, Midwifery, Social Work & Social Sciences, University of Salford, Salford, UK
| | - E Collier
- School of Nursing, Midwifery, Midwifery, Social Work & Social Sciences, University of Salford, Salford, UK
| | - R Ashmore
- Department of Nursing & Midwifery, Sheffield Hallam University, Sheffield, UK
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28
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Carrotte ER, Vella AM, Bowring AL, Douglass C, Hellard ME, Lim MSC. "I am yet to encounter any survey that actually reflects my life": a qualitative study of inclusivity in sexual health research. BMC Med Res Methodol 2016; 16:86. [PMID: 27465507 PMCID: PMC4964098 DOI: 10.1186/s12874-016-0193-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 07/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Heteronormativity describes a set of norms and assumptions pertaining to heterosexual identities and binary gender. In 2015, we conducted our annual Sex, Drugs and Rock'n'Roll study, an online health survey of over 1000 Victorians aged 15-29 years. Feedback from participants suggested that our survey contained heteronormative language. In response to this, we aimed to make inclusive changes to our survey via consultation with young gender and sexually diverse (GSD) people. METHODS We conducted two semi-structured focus groups in Melbourne with a total of 16 participants (age range: 21-28 years). Participants were mostly cisgender women, and there were two transgender participants and one non-binary participant. Participants also had a range of sexual identities including lesbian, queer, bisexual, pansexual, and asexual. Focus group discussions were transcribed verbatim and analysed thematically. RESULTS Most participants indicated heteronormativity affects their lives in multiple ways, noting its impacts on access to sexual healthcare, invalidating sexual experiences and miscommunication in forms and surveys. Overall, participants emphasised the need for sexual health research to avoid assumptions about behaviour, to be clear and eliminate question ambiguity and avoiding treating gender as binary. Participants also discussed how the Sex, Drugs and Rock'n'Roll survey could address a range of sexual behaviours and experiences, rather than focusing on penetrative sex, which many participants found invalidating. CONCLUSIONS Our findings have important implications for future health surveys aimed at general populations. We present recommendations that encourage research to be more inclusive to ensure data collection from GSD participants is respectful and rigorous.
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Affiliation(s)
- Elise R Carrotte
- Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Alyce M Vella
- Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Anna L Bowring
- Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.,School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne, VIC, 3004, Australia
| | - Caitlin Douglass
- Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.,School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne, VIC, 3004, Australia
| | - Margaret E Hellard
- Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.,School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne, VIC, 3004, Australia
| | - Megan S C Lim
- Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.,School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne, VIC, 3004, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Melbourne, VIC, 3010, Australia
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Gascoyne S, Hughes E, McCann E, Quinn C. The sexual health and relationship needs of people with severe mental illness. J Psychiatr Ment Health Nurs 2016; 23:338-43. [PMID: 27307265 DOI: 10.1111/jpm.12317] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2016] [Indexed: 11/29/2022]
Affiliation(s)
- S Gascoyne
- Department of Health Sciences, University of York, Heslington, York, UK
| | - E Hughes
- School of Health and Human Sciences, University of Huddersfield, Huddersfield, UK
| | - E McCann
- Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - C Quinn
- University of Canberra, Canberra, Australia
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30
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Review: Australian mental health nurses and transgender clients: Attitudes and knowledge. J Res Nurs 2016. [DOI: 10.1177/1744987115625008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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