Lesbian, gay and bisexual individuals experience of mental health services - a systematic review

Publication Date03 January 2020
Pages59-70
DOIhttps://doi.org/10.1108/JMHTEP-09-2019-0047
Date03 January 2020
AuthorGeraldine McNamara,Charlotte Wilson
SubjectHealth & social care,Mental health,Mental health education
Lesbian, gay and bisexual individuals
experience of mental health services
a systematic review
Geraldine McNamara and Charlotte Wilson
Abstract
Purpose Lesbian, gay and bisexual (LGB) individuals experience higher rates of mental health
difficulties in comparisonto their heterosexual counterparts (Meyer, 2003;Plo
¨derl and Tremblay, 2015).
This is in part due to theexperience of homophobia and stigmatisationwithin society. This discrimination
has also been perpetuated within the mental health field, where LGB individual’s sexuality has been
pathologised. In response to this historical stigmatisation a number of policies have been created to
develop ethical practice whileworking with this minority group (APA, 2012; BPS, 2019; HSE, 2009; PSI,
2015). The purpose of this paper is to capture the experience of LGB individuals within mental health
servicesand examine if these guidelines are being adhered to.
Design/methodology/approach This study is a meta-narrative synthesis of 13 empirical papers,
publishedbetween 1999 and 2019.
Findings This study has found both negative and positive experiences of service users. The paper
discussesmajor themes, implications for practiceand directions for future research.
Originality/value This is the first systematic review to look at the experiences of clients who have
attendedmental health services.
Keywords Bisexual, Mental health, Lesbian, Gay
Paper type Literature review
Introduction
Lesbian, gay and bisexual (LGB) individuals’individuals have a long history of experiencing
homophobia[1] in society. This has led to increased mental health difficulties within this
group. Studies have shown that LGB individuals experience higher rates of mental health
difficulties in comparison to their heterosexual counterparts (Meyer, 2003;Plo
¨derl and
Tremblay, 2015). A large body of research has demonstrated that these negative
psychological effects have been due, in part, to discrimination, harassment and
stigmatisation (D’Augelli et al., 2002;Kelleher, 2009;Mayock et al.,2008;Meyer, 1995). As
a result, LGB individuals are in greater need of mental health services.
When sexual minorities look for support from the mental health system, which focusses on
supporting the vulnerable, they may also experience homophobia from those who are
offering that support. Garnets et al. found that “as a result of societal indirect endorsement
of homophobia LGBT people can encounter stigmatisation and disapproval from
government bodies and also be exposed to social inequality in the counselling profession”.
The mental health system has a historyof pathologising homosexuality; only declassifying it
in 1974 from the DSM, in 1975 from the APA and in 1990 from the World Health
Organisation. In recent years policies have been developed in order to help create
awareness of specific difficulties experienced by this group with the hope of decreasing
Geraldine McNamara and
Charlotte Wilson are both
based at Clinical
Psychology, Trinity College
Dublin, Dublin, Ireland.
Received 23 September 2019
Revised 16 November 2019
Accepted 16 November 2019
DOI10.1108/JMHTEP-09-2019-0047 VOL. 15 NO. 2 2020, pp. 59-70, ©Emerald Publishing Limited, ISSN 1755-6228 jTHE JOURN AL OF MENTAL HEALTH TRAINING, EDUCATION AND P RACTICE jPAGE 59

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