Severe Mental Illness in LGBT Populations: A Scoping Review

Abstract

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.

Eating disorders symptoms in sexual minority women: A systematic review

“…Moreover, no paper showed a protective role of SM orientation against ED diagnosis, with only two papers out of seven identifying no difference between the SM population and heterosexual peers. This is in accordance with the Stress Minority Theory and recent literature (Hatzenbuehler & Pachankis, ; Kidd, Howison, Pilling, Ross, & McKenzie, ), which has focused on the vulnerability of the fragile SM population in relation to mental and physical health issues and stigmatization, thus confirming the need for specific research and clinical target.…”

Sexual Intimacy, Mental Illness, and Homelessness

“…Although the studies reviewed had samples which largely identified as heterosexual, the dynamics of LGBTQ (lesbian, gay, bisexual, trans, queer) relationships involve unique considerations. The LGBTQ community is one that finds itself over‐represented among those experiencing an SMI (Kidd, Howison, Pilling, Ross & McKenzie, ). A scoping review found that compared to the general population, LGBTQ individuals have a greater risk of developing SMI, which appears to be associated with discrimination that they face (Kidd et al., ).…”

“…The community psychology value of diversity may be crucial to explore solutions that aim to reduce the discrimination faced by LGBTQ individuals. To promote diversity, it is important that mental health service providers are given explicit training and information about gender identity, sexual orientation, and stigmatizing beliefs (Kidd et al., ). Service providers should emphasize the creation of safer and more inclusive spaces and to create policies in shelters and care environments to better support inclusion and diversity.…”

“…Specific policies of respect (e.g., to treat transgender individuals according to their self‐identified gender) and consultations with local activists and educators when developing written policies about language, confidentiality, bathroom arrangements, and harassment are important in promoting diversity and safety for people who identify as sexual minorities (Mottet & Ohle, ). Due to their troubled history with and distrust of psychiatry (e.g., historical conflation of sexual identities with psychiatric symptomology, presence of gender dysphoria in the DSM‐5), clinicians may experience unique challenges including suspicion and distrust when discussing sexuality with clients who identify as sexual minorities (Kidd et al., ).…”

A qualitative description of community service, business, and organization perspectives on mental illness and inclusion

“…Stigmatization is highly prevalent internationally, with the majority of populations in many countries demonstrating moderate to high levels of stigmatizing views (Krajewski et al, 2013;Pescosolido, 2013). Stigmatizing beliefs lead to a desire for social distance and discrimination resulting in eroded mental health and a denial of access to a range of community resources (Corrigan & Watson, 2002;Corrigan, Larson, & Ruesch, 2009;Krajewski, Burazeri, & Brand, 2013) with further challenges arising as mental illness-related discrimination intersects with poverty and other stigmatized identities (Kidd et al, 2014;2016a).…”