Improving alcohol and mental health treatment for lesbian, bisexual and queer women: Identity matters

Abstract

Objective: Lesbian, bisexual and queer (LBQ) women experience substantial unmet alcohol and mental health treatment needs. This paper explores the way in which sexual identity shapes experience, and needs, in relation to alcohol and mental health treatment, and presents key messages for improving treatment.Methods: Twenty-five in-depth interviews were undertaken with same-sex attracted Australian women, aged 19-71. Interview transcripts were analysed thematically.Results: Key messages offered by participants focused on language, disclosure and practitioner training. Variation in sexual identity did not alter treatment expectations or needs; however, we noted an important difference with respect to identity salience, with high LBQ identity salience linked with preference for disclosure and acknowledgement of sexual identity in treatment interactions, and low identity salience linked with a preference not to disclose and for sexual identity not to require acknowledgement in treatment.Conclusions: Treatment providers may find it useful to gather information about the centrality of sexual identity to LBQ women as a means of overcoming treatment barriers related to heteronormative conventions and discrimination, language and disclosure.Implications for public health: Treatment providers should adopt more inclusive language, seek information about identity salience and the importance of sexual identity to the current treatment, and regularly pursue LBQ-related professional development upskilling.

Gender Differences in Use of Alcohol Treatment Services and Reasons for Nonuse in a National Sample

“…In addition, subgroups of women may have particularly lower likelihood of utilizing services because of the combination of gendered barriers and additional social disadvantages. For instance, women's alcohol problem characteristics and barriers to alcohol services could be exacerbated by demographic and contextual factors, such as minority race/ethnicity (Zemore et al., ), minority sexual orientation (Pennay et al., ), military service (Cucciare et al., ), or rural residence (Booth et al., ).…”

A systematic review to determine how service provider practises impact effective service provision to lesbian, gay and bisexual consumers in a mental health setting

“…Ten of the 24 studies in the systematic review examined why service provider acceptance of a consumer's sexual orientation was important (Burckell & Goldfried, 2006; Foy et al, 2019; Israel et al, 2008; Magee & Spangaro, 2017; Mair, 2003; McCann & Sharek, 2014a, 2014b; Moore et al, 2020; Pennay et al, 2018; Semp & Read, 2015). Three reasons were highlighted.…”

“…Eleven of the 24 articles in this review examined whether provider‐consumer sexual orientation matching leads to a more culturally competent provision of service (Anderson & Holliday, 2006; Bermea et al, 2019; Burckell & Goldfried, 2006; Croghan et al, 2015; Israel et al, 2008; Magee & Spangaro, 2017; Mair, 2003; McCann & Sharek, 2014b; Pennay et al, 2018; Rutherford et al, 2012; Semp, 2011). Anderson and Holliday (2006) and Rutherford et al (2012) conducted a survey design study and a semi‐structured interview design study, respectively, with providers who were LGB and had expertise providing service to LGB consumers.…”

“…Current research has examined the benefits to mental health services of providing culturally competent care to LGB consumers. Firstly, it has been suggested that mental health services that are culturally competent are more openly friendly towards LGB consumers, often demonstrating openness through LGB affirming positive posters, appropriate terminology on intake documents and using inclusive language when interacting with consumers (Pennay et al, 2018; Semp & Read, 2015). Secondly, service providers who are culturally competent demonstrate specific knowledge about being LGB, such as the importance of coming out to an LGB person or ways in which discrimination and prejudice cause stress in an LGB person's life (Burckell & Goldfried, 2006).…”

“…Secondly, service providers who are culturally competent demonstrate specific knowledge about being LGB, such as the importance of coming out to an LGB person or ways in which discrimination and prejudice cause stress in an LGB person's life (Burckell & Goldfried, 2006). Lastly, culturally competent service providers do not underemphasize or overemphasize the degree to which sexual orientation impacts mental health (Burckell & Goldfried, 2006; Pennay et al, 2018).…”