Lesbian, gay and bisexual individuals experience of mental health services - a systematic review

Abstract

<jats:sec> <jats:title content-type="abstract-subheading">Purpose</jats:title> <jats:p>Lesbian, gay and bisexual (LGB) individuals experience higher rates of mental health difficulties in comparison to their heterosexual counterparts (Meyer, 2003; Plöderl and Tremblay, 2015). This is in part due to the experience of homophobia and stigmatisation within society. This discrimination has also been perpetuated within the mental health field, where LGB individual’s sexuality has been pathologised. In response to this historical stigmatisation a number of policies have been created to develop ethical practice while working with this minority group (APA, 2012; BPS, 2019; HSE, 2009; PSI, 2015). The purpose of this paper is to capture the experience of LGB individuals within mental health services and examine if these guidelines are being adhered to.</jats:p> </jats:sec> <jats:sec> <jats:title content-type="abstract-subheading">Design/methodology/approach</jats:title> <jats:p>This study is a meta-narrative synthesis of 13 empirical papers, published between 1999 and 2019.</jats:p> </jats:sec> <jats:sec> <jats:title content-type="abstract-subheading">Findings</jats:title> <jats:p>This study has found both negative and positive experiences of service users. The paper discusses major themes, implications for practice and directions for future research.</jats:p> </jats:sec> <jats:sec> <jats:title content-type="abstract-subheading">Originality/value</jats:title> <jats:p>This is the first systematic review to look at the experiences of clients who have attended mental health services.</jats:p> </jats:sec>

The real and ideal experiences of what culturally competent counselling or psychotherapy service provision means to lesbian, gay and bisexual people

“…Fewer studies have attempted to understand, from the perspective of LGB consumers, what their ideal or actual experiences are when accessing a mental health service, and no consumer‐focused studies, to our knowledge, have evaluated the implementation of culturally competent practices of counsellors and psychologists (long‐term mental health recovery providers) specifically (McNamara & Wilson, 2020; O'Shaughnessy & Speir, 2018; Tribe & Morrissey, 2015). McNamara and Wilson (2020) sought to determine the actual experience of LGB consumers accessing a mental health service; they found themes related to negative experiences (heteronormativity, dismissal of the consumer's sexual orientation and lack of knowledge regarding minority stress) and positive experiences (good knowledge of LGB people and good therapeutic skills). These researchers acknowledge these were the actual experiences of LGB consumers, though they also acknowledge this systematic review did not determine whether these actual experiences differed from their ideal experiences.…”

Barriers to LGBQ- and TGNB-affirmative clinical training in psychology doctoral programs.

“…Affirmative care in the therapeutic setting is associated with greater psychological well-being for SGM clients, as well as a stronger therapeutic relationship (Alessi et al, 2019) (Boroughs et al, 2015;Cochran & Robohm, 2015;Hope & Chappell, 2015;McNamara & Wilson, 2020). Results most notably reflect concerns regarding limitations in faculty competence, the presence of faculty negativity, and inadequate course work, as well as insufficient clinical and general training.…”

“…Researchers have emphasized a need to provide affirmative therapy for SGM clients (Johnson, 2012; Perez, 2007), which has been found to be correlated with a stronger therapeutic relationship and has been associated with higher levels of psychological well-being for lesbian, gay, bisexual, or queer (LGBQ) clients (Alessi et al, 2019). When affirmed within the therapeutic setting, clients tend to remain engaged in therapy; thus, providing them with the opportunity to address their mental health concerns (McNamara & Wilson, 2020). Specifically, the practice of transgender and gender nonbinary (TGNB) affirmative therapy, such as embracing affirmed names and pronouns and demonstrating knowledge of TGNB identities and related concerns, has been recognized as effective for TGNB clients (Goldberg et al, 2019; Knutson et al, 2022).…”

“…In some cases, LGBQ clients report negative experiences in mental health treatment including mental health therapists’ lack of understanding and discomfort discussing sexual orientation. Moreover, clients are also subject to therapists’ tendency to pathologize sexual orientation, as well as therapists’ use of microaggressive language (McNamara & Wilson, 2020; Spengler et al, 2016). Similarly, difficulties with mental health care have been reported by transgender clients, including clinicians’ lack of knowledge and awareness of TGNB issues and experiences (Hanssmann et al, 2008; Mizock & Lundquist, 2016; Roberts & Fantz, 2014).…”

The needs of LGBTI+ people within student nurse education programmes: A new conceptualisation

“…In contrast, lesbian women access preventative health services less frequently then non-lesbians and are at greater risk of physical health conditions such as heart disease, obesity and cancer (Simoni et al 2017). Mental health conditions across all LGBTI+ populations are more common including anxiety disorders, depression, suicidality, substance use and eating disorders (King et al 2008;Kuyper & Fokkema 2011;Kidd et al 2016;Reiger et al 2019;McNamara & Wilson 2020). Some LGBTI+ youth can experience a lack of family support and may become homeless which can result in other service utilisation concerns (McCann & Brown 2019).…”