A qualitative investigation of engagement in mental health services among black and Hispanic LGB young adults
Open accessAbstract
OBJECTIVE: Little attention has been paid to engagement in mental health services among racially and ethnically diverse youths who identify as a sexual minority, despite research indicating that they face significant mental health disparities. In this study, the authors assessed the service use experiences of black and Hispanic lesbian, gay, and bisexual (LGB) young adults to identify factors that promoted or hindered their engagement. METHODS: Semistructured interviews with 38 young adults regarding past and present experiences with mental health services were analyzed thematically for perceived challenges to and support for engagement. Participants' service use histories were reviewed for significant interruptions in services reported over the past year. RESULTS: Seventeen participants (45%) reported disengagement despite continuing to need services. Factors that influenced engagement were identified across four domains: personal, social environment, accessibility, and provider characteristics. Stigma related to sexual orientation and cultural attitudes presented engagement barriers, whereas providers who were knowledgeable about sexual-minority issues were important engagement promoters. Additional barriers to engagement were ambivalence about treatment efficacy, lack of family support, and difficulty finding suitable and affordable care. Peers who identified as a sexual minority helped participants locate LGB-affirming services. Rapport with providers and health care autonomy assisted participants to manage barriers to engagement. CONCLUSIONS: These findings offer insights about factors that can influence engagement with treatment among black and Hispanic LGB young adults. The findings reveal important provider competencies and can inform interventions to improve engagement and reduce mental health inequities among these youths.
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LGBTQ+ persons often report a lack of access to affirming care.
“Importantly, LGBTQ+ persons often report a lack of access to affirming care [15].”
From A randomized trial of acceptance-based behavioral therapy to improve mental health outcomes for LGBTQ+ persons: Study protocol (2023) · cites this paper as [15]
The Results (Provider Characteristics; page not provided) describe participants who valued LGBT-knowledgeable providers and one who felt uncomfortable with a provider's stereotypical views. The Abstract (Results; page not provided) also reports difficulty finding suitable care and help locating LGB-affirming services. The study concerns mental health care for Black and Hispanic LGB young adults, so it does not establish how often LGBTQ+ persons generally report this barrier across care settings. (LLM, conf=0.85)
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“Importantly, LGBTQ+ persons often report a lack of access to affirming care [15].”
- Authors
- Moore, K. L., Lopez, L., Camacho, D., & Munson, M. R.
- Affiliations
- City University of New York (US)
- Venue
- Psychiatric Services
- Published
- 2020-06-01
- Volume
- 71
- Issue
- 6
- Pages
- 555-561
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- PMC
- PMC7364786
- OpenAlex
- W3001621980
- Cited by
- 53
- References
- 46
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 11 · 2023: 8 · 2022: 10 · 2021: 6
- FWCI
- 6.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (T32AG049666, P30AG022845)
- National Institute of Mental Health (R34MH111861)
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Keywords
- mental health service engagement, Black young adults, Hispanic young adults, sexual minority mental health, mental health disparities, barriers to treatment, stigma, provider competence, family support, health care access, peer support, treatment discontinuation
- MeSH terms
- Sexual and Gender Minorities, Adolescent, Adult, Black or African American, Female, Health Services Accessibility, Hispanic or Latino, Humans, Male, Mental Health Services, New York, Social Environment, Qualitative Research, Healthcare Disparities, Young Adult, Social Stigma
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