The Role of Implementation Science in Reducing Sexual and Gender Minority Mental Health Disparities

Abstract

Owing to multiple and multilevel ecological factors, sexual and gender minority (SGM) populations exhibit persistent mental health disparities. SGM populations are also at increased risk for never being reached by evidencebased mental health care in real-world settings, which is essential for reducing these disparities. To be maximally effective in reducing these disparities, we must strive to bring our research findings into routine clinical care quickly. Implementation science can help SGM health researchers achieve this goal. This perspective outlines how researchers can use implementation science theories and methods to reduce SGM mental health disparities more efficiently and more durably.

What motivates community mental and behavioral health organizations to participate in LGBTQ+ cultural competency trainings?

“…Among the most prevalent findings were that therapists and organizational administrators recognized their current limitations in serving the LGBTQ+ community. These reflections on service constraints are not unique to our sample (Graham et al, 2012) and emphasize the importance of leveraging implementation science to address LGBTQ+ mental health service deficits (Perry & Elwy, 2021). The therapists in our study shared that they felt unsure of themselves when working therapeutically with LGBTQ+ clients, discussing a lack of knowledge of LGBTQ+-related language, and hesitance about their ability to speak with the population in a way that reflected basic knowledge and understanding.…”

“…Gaps in care for LGBTQ+ persons are well recognized, and a shortage and maldistribution of qualified mental health providers have contributed to these gaps (Mongelli et al, 2020; Williams & Fish, 2020). Implementation science is a vehicle to identify how to expand LGBTQ+ mental health care services to those most in need (Perry & Elwy, 2021). As our data suggest, mental health providers want to provide competent care for LGBTQ+ persons but cite a lack of coursework and training on LGBTQ+ competency.…”

“…For successful organization adoption and implementation, training and technical assistance programs must be designed and offered in ways that are sensitive to the constrained resources, including time, of community MBHOs. Given the scarcity of implementation research on LGBTQ+ mental health services (Perry & Elwy, 2021), this research provides a valuable window into what motivates MBHO administrators and therapists to participate in programs designed to accelerate the research to practice timeline and educate the mental health workforce in providing affirmative and effective services for the LGBTQ+ population. The scant existing research suggests that the primary barrier to mental health provider participation in such training is not a perceived lack of need but rather a lack of access (Smith et al, 2019; Holt et al, 2020).…”

Spreading pride in all who served: A health education program to improve access and mental health outcomes for sexual and gender minority veterans.

“…Healthcare disparities for sexual and gender minority people cannot effectively be addressed until interventions are adopted into clinical practice settings (Perry & Elwy, 2021). The VA Innovation Ecosystem offers a path for frontline innovative practices, developed in collaboration with “end users” (e.g., LGBTQ+ veterans) and providers (e.g., LGBTQ+ VCCs), to be piloted and spread to other VA facilities to meet urgent clinical needs (Kilbourne et al, 2019; Vega & Kizer, 2020).…”

Restriction of Access to Healthcare and Discrimination of Individuals of Sexual and Gender Minority: An Analysis of Judgments of the European Court of Human Rights from an Ethical Perspective

“…Thus, any form of discrimination can have a negative impact on the physical and mental health status of SGM individuals [ 16 , 17 , 18 ]. This might contribute to the persistent health disparities seen amongst the SGM population [ 40 , 41 ].…”