3 - (SYM 28) Mental Healthcare Needs and Experiences of Lgbtq+/people of Color: A Scoping Review and Training Resource

Background: Individuals who identify as LGBTQ+ and a Person of Color (LGBTQ+/POC) experience multiple forms of oppression at the intersection of their identities, placing this community at higher risk for mental health difficulties. Further, LGBTQ+/POC report discrimination when accessing mental health services and lower quality of care overall. However, the literature on how to provide culturally-competent and affirming care for LGBTQ+/POC has yet to be synthesized.

Objective: The present study conducts a scoping review to assess the scope of literature and summarize the mental healthcare needs and experiences of LGBTQ+/POC in the United States. 

Methods: An electronic search was conducted from January 2010 to May 2022 using the following databases with forward and backward citation searching: PubMed, Cochrane Library, Embase, PsycInfo and ProQuest Dissertation and Theses. Inclusion criteria were: (1) perspectives from LGBTQ+/POC adults concerning the U.S. mental healthcare system and (2) relevant scope of content, including (a) mental healthcare experiences of LGBTQ+/POC, (b) evaluation of interventions for improving mental healthcare for LGBTQ+/POC, or (c) barriers to accessing mental healthcare for LGBTQ+/POC. Themes were identified using Braun & Clarke’s (2008) thematic analysis guidelines.

Results: Of the 786 texts identified, 19 were eligible for inclusion. The five emerging themes were (1) ideal provider competencies (e.g. avoiding over or under-emphasizing client identities), (2) provider identity factors (e.g. racial-ethnic identity, sexual orientation, gender), (3) structural barriers to mental health treatment (e.g. stigma, discrimination, cost), (4) factors facilitating treatment access (e.g. referrals from churches or LGBTQ+ organizations), and (5) stated system-level needs of the community (e.g. tailored services, support groups, paid community consultants to facilitate provider education).

Conclusions: The mental healthcare system severely underperforms in providing culturally competent and affirming care for LGBTQ+/POC. We identified and described current gaps in the literature (e.g., underrepresentation of specific LGBTQ+/POC subgroups) and provided recommendations to address these gaps in future research. Our hope is that this scoping review will inform an evidence-based provider training framework grounded in the perspectives, experiences, and stated needs of the LGBTQ+/POC community.