Objective There is increasing attention to diversity in psychiatric services and a widespread recognition of the mental health implications of stigma for gender and sexual minority individuals. However, these areas remain markedly underdeveloped in the area of severe mental illness. This review is intended to map out the existing base of knowledge in this area to help inform future research, practice, and policy directions. Method A review of the literature was conducted to answer the question, ‘What factors and strategies need to be considered when developing services for sexual and gender minority individuals experiencing severe mental illness?’ A comprehensive search of MEDLINE, PsycINFO, and Google Scholar was completed using Arksey and O'Malley's methodological framework for scoping reviews. Results A total of 27 publications were identified in this review. Mental health services research revealed generally lower levels of service satisfaction among lesbian, gay, bisexual, transgender and transsexual (LGBT) individuals and minimal evidence for specific interventions. Descriptive research suggested an increased risk for severe mental illness among LGBT populations, an association between risk and discrimination, and the potential benefit of cultivating spaces where individuals can be ‘out’ in all aspects of themselves. Conclusions There is a pressing need for research into interventions for LGBT populations with severe mental illness as well as descriptive studies to inform efforts to reduce illness morbidity linked to discrimination.
Participatory research, or the practice of involving ‘peers’ with lived experience, has become popular in social work. Peer engagement is lauded for: ‘democratising’ the research process; providing ‘capacity building’ and facilitating opportunities to co-produce knowledge. Yet, these claims are rarely evaluated by empirical investigations into the socio-material work conditions of peer researchers. Here we present findings of a study that examined the experiences of peer researchers, focusing on payment inequities and social workers’ roles in advocating for economic justice. Together with peer research assistants, we conducted a participatory constructivist grounded theory study, interviewing peers (total n = 34) who were compensated to work on studies focused on the following: racialised communities, communities of people who use drugs, consumer/psychiatric survivor/ex-patient and mad communities and trans/non-binary communities. Our findings highlight divergent compensation practices in peer research work. Whilst some peers were satisfied with their treatment on research teams and payment received, others discussed challenges associated with precarious short-term casual work and managing formal income alongside state social assistance such as disability support. We conclude that in some cases, the peer role is characterised by precarious working conditions which compound rather than challenge injustice within the research enterprise, and we discuss implications for social work.
<p>In this article I draw on recent work regarding disabilities that are not readily apparent to analyze the experiences of lesbian, gay, bisexual, queer, and/or trans (LGBQT) mad people in the workplace. Based on interviews with LGBQT people about madness and everyday life, I use an intersectional approach to examine participants’ work lives. I argue that decisions about disclosure of mental health related information are particularly pressing and high risk at work, given the economic stakes and the effects on health and well-being. As is the case for others with invisible disabilities, notions of authenticity shape processes of disclosure and access to accommodations for LGBQT mad people in the workplace. An intersectional analysis shows how madness cannot be considered the only salient aspect of my participants’ subject positions and how multiple identities operate together to shape their experiences.</p><p> </p><p>Keywords: madness, invisible disability, LGBQT, intersectionality, workplace, race, sexuality, gender identity </p>
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