TY - JOUR
T1 - A qualitative investigation of engagement in mental health services among black and Hispanic LGB young adults
AU - Moore, Kiara L.
AU - Lopez, Lucy
AU - Camacho, David
AU - Munson, Michelle R.
N1 - Funding Information:
This study was supported by a grant from the Columbia University School of Social Work. Drs. Moore and Munson are supported by National Institute of Mental Health grant 3-R34-MH-111861-02S1. Dr. Camacho is supported by a T-32 training grant at Weill Cornell Medicine. The authors report no financial relationships with commercial interests. Received August 5, 2019; revision received November 4, 2019; accepted December 2, 2019; published online January 21, 2020.
Publisher Copyright:
© 2020 American Psychiatric Association. All rights reserved.
PY - 2020/6
Y1 - 2020/6
N2 - 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.
AB - 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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U2 - 10.1176/appi.ps.201900399
DO - 10.1176/appi.ps.201900399
M3 - Article
C2 - 31960774
AN - SCOPUS:85085712665
SN - 1075-2730
VL - 71
SP - 555
EP - 561
JO - Hospital and Community Psychiatry
JF - Hospital and Community Psychiatry
IS - 6
ER -