Mental Healthcare Experiences and Preferences Among Lesbian, Gay, Bisexual, Transgender, and/or Queer/People of Color: A Scoping Review of Qualitative Research and Recommendations for Provider Training

Abstract

Objective: Lesbian, gay, bisexual, transgender, and/or queer people of color (LGBTQ+/POC) experience systemic oppression and are vulnerable to negativemental health outcomes. Additionally, they often face discrimination and report dissatisfaction when accessing mental healthcare. Despite the need for culturally responsive and identity-affirming services for LGBTQ+/POC, there is a lack of research synthesizing how to best provide them. This scoping review summarizes the recent qualitative literature on mental healthcare treatment experiences and preferences among LGBTQ+/POC in the United States. Methods: A search was conducted using PubMed, Cochrane Library, Embase, PsycInfo, and ProQuest Dissertation and Theses. Inclusion criteria were: (1) qualitative data from LGBTQ+/POC adults; (2) relevant scope of content, including (a) mental healthcare experiences, (b) evaluation of interventions for improving mental healthcare, or (c) barriers or facilitators to accessingmental healthcare; and (3) publication date from2010 to 2023. Results:Of the 1,071 texts identified, 23 met eligibility criteria. Thematic analysis of included texts yielded five themes: (a) key provider competencies; (b) provider identity factors; (c) structural barriers to mental health treatment; (d) factors facilitating treatment access; and (e) systemic needs. Discussion: The mental healthcare system underperforms in providing culturally responsive and identity-affirming care for LGBTQ+/POC. We mapped the current literature to examine perspectives and preferences of LGBTQ+/POC and identified a lack of intersectional research and an underrepresentation of specific social identities. We proposed data-driven training recommendations to improve the delivery of quality care for LGBTQ+/POC.