The acronym LGBTIQ+ (lesbian, gay, bisexual, transgender, intersex, queer and other sexual minorities) is used in the title, but where other acronyms were used by the writers, these have been adopted in the bibliography.
Baskerville, N. B., Dash, D., Shuh, A., Wong, K., Abramowicz, A., Yessis, J., & Kennedy, R. D. (2017). Tobacco use cessation interventions for lesbian, gay, bisexual, transgender and queer youth and young adults: A scoping review. Preventive Medicine Reports.
Canadian statistics have indicated that LGBTQ+ youth and young adults have a significantly higher smoking rate than their non-LGBTQ+ counterparts. It has been suggested that this may be due to minority stress and discrimination. This has led to a need for culturally appropriate prevention and cessation programs tailored to the needs of this population. A scoping review aiming to map the literature on the programs available for LGBTQ+ young adults and youth was performed. It identified a large research gap in smoking prevention and cessation programs for this group, with little aimed specifically at the young LGBTQ+ age group. A need for community focused, effective and engaging community programs for this group was recognised.
Bond, K. S., Jorm, A. F., Kelly, C. M., Kitchener, B. A., Morris, S. L., & Mason, R. J. (2017). Considerations when providing mental health first aid to an LGBTIQ person: a Delphi study. Advances in Mental Health, 1-15.
The aim of this study was to develop guidelines for delivering appropriate and sensitive mental health first aid to LGBTIQ people, which can be used in conjunction with existing guidelines. The Delphi method was utilized, where a consensus is gained by a team, in this case a group of mental health professionals who either identified as LGBTIQ or had experience in working with this group. Numerous sources have identified a higher prevalence of mental health disorders, substance use disorders, suicidality and self-harm in LGBTIQ populations so the development of appropriate guidelines was deemed as important. A systematic review of journal articles, websites and books was performed to develop a questionnaire of the knowledge, skills and actions needed for assisting an LGBTIQ person experiencing a mental health problem. The experts rated these over three rounds as to whether they should appear in the guidelines. The results highlighted the complexity of supporting an LGBTIQ person experiencing mental health problems, along with the diversity of the population and their differing needs. The limitation was that the study focused on a Western, English speaking population. It recommended expanding it to examine the needs of Indigenous Australian and culturally and linguistically diverse LGBTIQ groups.
LGBTQ health research has traditionally focused on the deficit model and not on the ways that individuals in this group can improve their health. It is argued by the authors of this paper that a culturally competent health policy requires an evidence base that is focused on strengths rather than weaknesses. A scoping review was performed on strength-based approaches to LGBTQ health which indicated the concept of resilience as a key component. This resilience may have been built up due to discrimination and adversity. It identified a need for further research into LGBTQ- specific models of health policy and measures of resilience. They concluded that the resilience of LGBTQ population is embedded in advancing their health, although more research needs to be done before it is useful as a measurement of LGBTQ health.
Kelly, J., Davis, C., & Schlesinger, C. (2015). Substance use by same sex attracted young people: prevalence, perceptions and homophobia. Drug and Alcohol Review, 34(4), 358-365.
Research has indicated that LGBT people use alcohol and drugs (AOD) more than their heterosexual counterparts, but usage by LGBT youth is less understood. The aim of the study was to investigate the prevalence and perception of AOD use in LGBT youth in comparison with heterosexual youth. The impacts of homophobia and minority stress were also examined. It found that AOD use is higher in LGBT youth than heterosexual youth, with significantly higher rates in LGBT people under 18 years old. Those who believed homophobia impacted on AOD use were much more likely to use AOD themselves. It recommended that AOD agencies better support LGBT youth by screening for sexuality and gender identity and exploring issues specific to this group to improve the services that are offered.
The impact of stigma on the mental health of sexual and gender minority groups has widespread recognition. This is coupled with a movement towards increasing diversity in mental health services, but relatively little has been developed for severe mental illness. The authors define severe mental illness as that which is associated with psychosis and requires extensive periods of inpatient or outpatient treatment. A literature review was conducted which aimed to answer the question “What factors and strategies need to be considered when developing services for individuals from sexual or gender minority groups who are experiencing severe mental illness?” The 27 articles reviewed were in the main North American. A general dissatisfaction in mental health services was identified amongst the LGBT population and little evidence regarding culturally specific interventions. An increased risk of severe mental illness has been suggested which has been associated with discrimination. The report highlighted a need for research into specific interventions for LGBT people with severe mental illness, along with studies to inform efforts to reduce morbidity associated with discrimination.
Lea, T., Kolstee, J., Lambert, S., Ness, R., Hannan, S., & Holt, M. (2017). Methamphetamine treatment outcomes among gay men attending a LGBTI-specific treatment service in Sydney, Australia. PloS One, 12(2), e0172560
Gay and bisexual men (GBM) report higher rates of methamphetamine use compared to heterosexual men, and thus have a heightened risk of developing problems from their use. We examined treatment outcomes among GBM clients receiving outpatient counseling at a LGBTI-specific, harm reduction treatment service in Sydney, Australia. GBM receiving treatment for methamphetamine use from ACON’s Substance Support Service between 2012–15 (n = 101) were interviewed at treatment commencement, and after 4 sessions (n = 60; follow-up 1) and 8 sessions (n = 32; follow-up 2). At each interview, clients completed measures of methamphetamine use and dependence, other substance use, injecting risk practices, psychological distress and quality of life. The median age of participants was 41 years and 56.4% identified as HIV-positive. Participants attended a median of 5 sessions and attended treatment for a median of 112 days. There was a significant reduction in the median days of methamphetamine use in the previous 4 weeks between baseline (4 days), follow-up 1 (2 days) and follow-up 2 (2 days; p = .001). There was a significant reduction in the proportion of participants reporting methamphetamine dependence between baseline (92.1%), follow-up 1 (78.3%) and follow-up 2 (71.9%, p < .001). There were also significant reductions in psychological distress (p < .001), and significant improvements in quality of life (p < .001). Clients showed reductions in methamphetamine use and improved psychosocial functioning over time, demonstrating the potential effectiveness of a LGBTI-specific treatment service (copy of abstract used).
Skerrett, D. M., Kõlves, K., & De Leo, D. (2015). Are LGBT populations at a higher risk for suicidal behaviors in Australia? Research findings and implications. Journal of Homosexuality, 62(7), 883-901.
This is a review of Australian peer-reviewed literature published between 2008 and 2012 about suicidality in LGBT populations. It was performed to collect evidence on their reportedly higher incidence of suicidality and to identify predictive factors such as coming out, homophobia and non-acceptance by family and friends. The authors studied twelve articles, none of which was population-based. The evidence confirmed that LGBT people are at higher risk of suicidal behaviours Gaps in the literature included a lack of research on suicide deaths and a reliance on cross-sectional studies and convenience sampling usually with self-selected participants. Risk factors for suicidal behaviour in common with the non-LGBT population included mental illness and substance abuse, along with the unique factors discussed earlier. It was confirmed that gay men are a higher risk of suicidality than heterosexual men are, but at lower risk than bisexual men. The authors recommend that further research be undertaken to provide the evidence for future targeted intervention programs.
Stanley, N., Ellis, J., Farrelly, N., Hollinghurst, S., Bailey, S., & Downe, S. (2017). “What matters to someone who matters to me”: using media campaigns with young people to prevent interpersonal violence and abuse. Health Expectations, 20(4), 648-654.
This article examine ways that media campaigns could be used to prevent interpersonal violence and abuse (IPVA). Whilst not specifically about LGBT young adults it was identified that as although there is evidence of IPVA in LGBT communities on a par with heterosexual young adults, there is a lack of materials aimed at this group. This can be complicated by the threat of unwanted ‘outing’, particularly in young adults who may still be coming to terms with their sexuality. This lower disclosure rate results in a reluctance to access support and consequently support services are scarcer. Research and consultation with the target audience is important in producing effective campaigns.
Su, D., Irwin, J. A., Fisher, C., Ramos, A., Kelley, M., Mendoza, D. A. R., & Coleman, J. D. (2016). Mental health disparities within the LGBT population: A comparison between transgender and nontransgender individuals. Transgender Health, 1(1), 12-20.
A 2011 survey in the USA indicated that 41% of the transgender population had considered suicide compared to 1.6%of the general population. This could be associated with discrimination, which is a risk factor for depression. Transgender people commonly experience discrimination, including in healthcare settings. In addition, they often experience feelings of shame, rejection, isolation and anger, all of which may lead to depression. The study compared transgender participants with non-transgender participants for discrimination, depression and attempted suicide. It identified that transgender people had a higher incidence of all three, which was reduced with self-acceptance of their identity.
Talley, A. E., Gilbert, P. A., Mitchell, J., Goldbach, J., Marshall, B. D., & Kaysen, D. (2016). Addressing gaps on risk and resilience factors for alcohol use outcomes in sexual and gender minority populations. Drug and Alcohol Review, 35(4), 484-493.
This mini literature review aimed to examine the state of alcohol-related research in LGBT populations and in doing so identify any gaps in knowledge. Research was classified according to age groups and biological gender. The research contributed to a growing understanding of the differences in sub-groups within the LGBT population. Influences which account for these differences were identified but there are still large gaps in the knowledge, including the role of gender identity. The importance of how minority stress and society and relationships contribute to alcohol misuse over time were also identified. More studies are recommended to gain a clearer understanding.
With the exception of the articles from Drug and Alcohol Review all these articles are Open Access and can be retrieved using the links. The Drug and Alcohol Review articles are available on the library database to Healthy Options Australia staff and volunteers.