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Sexual, gender, and erotic minorities experience oppressions that psychologically harm and impact help seeking. The aim of this review was to integrate available evidence on the uptake, barriers, and facilitators of mental health help seeking in sexual, gender, and erotic minorities. Systematic searches were conducted in CINAHL, Medline, and Scopus for peer-reviewed articles and in Google for gray literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published in English in Organization for Economic Co-operation and Development countries between 2008 and 2018 regarding sexual, gender, and erotic minorities older than 18 years were eligible. Quality assessments were conducted and extracted data were analyzed thematically. Ninety documents were included in the review. Uptake is generally greater among sexual, gender, and erotic minorities, but worse in those who experience intersecting oppressions. Barriers to care manifest systemically, in services, and in individual mental health professionals (MHP) and contribute to psychological distress and impede help seeking. Protective factors (resilience, inclusion) and trained MHP counter these barriers. Despite the general prevalence and risk of mental illness among sexual, gender, and erotic minorities due to external, modifiable oppressions, opportunities for inclusive psychological care exist. [ABSTRACT FROM AUTHOR]

Sex workers experience risk and protective factors that affect their psychological well-being, yet little is known about sex workers' mental health and their experiences with related services in rural and remote Tasmania, Australia. Semi-structured interviews were conducted with six current or former sex workers with pre-existing mental health problems, and thematic analysis was used to identify their experiences with mental health and related care. Generally, sex work does not contribute to participants' mental health concerns; rather, social exclusion and systemic issues cause psychological harm. Ineffective mental health professionals and the lack of tailored or culturally competent support serve as barriers to care. Significantly, widespread stigma was both a risk factor to participants' mental health and a barrier to help seeking and resulted in isolation and identity concealment. Resilience, self-awareness and social inclusion reduce the psychological impact of exogenous oppression and encourage help seeking. The decriminalisation of sex work could improve sex worker mental health and reduce stigma by normalising sex work. [ABSTRACT FROM AUTHOR]

Introduction: Lesbian, gay, bisexual, transgender, intersex, queer, and people with a diversity of sexual and gender identities (LGBTIQ+) residing in rural contexts may face additional challenges to attaining wellbeing, yet a comprehensive understanding of these experiences is lacking. The purpose of the systematic review is to address this knowledge gap. The aims of the review are to progress understanding about rural LGBTIQ+ communities with regard to wellbeing, healthcare access and experience, and barriers and facilitators to health care. Methods: Peer-reviewed literature was searched in PubMed, Academic Search Premier, CINAHL, and PsychInfo databases, while grey literature was searched using Google Advanced Search. Documents produced between 2015 and 2020 in the USA, Canada, Australia, New Zealand, and UK were eligible and reference lists were screened. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adhered to. Relevant data were extracted and synthesized. The quality of the peerreviewed literature and grey literature was assessed using the Mixed Methods Appraisal Tool and the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist, respectively. At each stage of the study selection process, a second author reviewed a sample of 10% of the articles and documents to ensure consistent application of the inclusion criteria. Consultation within the team was used to resolve any discrepancies encountered. Results: The 297 unique peer-reviewed returned records were screened, with 69 full texts assessed for eligibility, resulting in the inclusion of 42 articles. The initial result of 2785 grey documents were similarly screened, resulting in the inclusion of 12 documents. Overall, the included literature was deemed to be of good quality. Synthesis of data resulted in the reporting of findings concerning mental, physical, and sexual wellbeing; healthcare access and experiences with care; and barriers and facilitators to health care for various communities in rural areas. The findings showed rural LGBTIQ+ communities shared many of the health concerns of nonrural LGBTIQ+ communities, as well as encountering similar issues and barriers to the receipt of high-quality appropriate care. However, the evidence also indicates an array of nuanced challenges for communities in rural areas such as a lack of available appropriate providers, and financial and practical barriers concerning the need to travel to obtain the services needed. The intersection of rurality and LGBTIQ+ identity was especially pronounced for rural LGBTIQ+ elders facing potential isolation in the context of declining mobility, service providers experiencing high demand and isolation from professional networks, and for LGBTIQ+ populations negotiating the complexities of disclosure in interactions with health professionals. The latter three findings in particular extend on the existing knowledge base. Conclusion: Investment is needed in the design, trialling, and evaluation of tailored models of care, which account for the specific challenges encountered in providing services to rural LGBTIQ+ communities. Such models, should also harness identified facilitators for rural LGBTIQ+ wellbeing, including the use of online technologies. Dedicated study is merited to inform policy and practice for aged care services in rural areas. Further, the development and implementation of strategies to support rural health service providers is warranted. [ABSTRACT FROM AUTHOR]

Objective: To examine the resettlement experiences of former refugees living in regional Australia, focusing on mental health and mental health and support services, including barriers to access. Design: A phenomenological approach utilising a combination of six qualitative, semi‐structured, face‐to‐face focus groups (n = 24) and seven individual interviews. Data were analysed thematically using NVivo 10 software. Setting: Launceston, Tasmania. Participants: Adult and youth former refugees from Afghanistan, Bhutan, Burma, Sierra Leone, Sudan and Iran, and essential service providers, residing in Launceston. Main outcome measures: Participants were asked about experiences of resettlement and mental health. Results: Participants reported that their mental health had improved since resettlement; however, major stressors impacted mental health and resettlement included employment and housing access and mastering the English language. Past experiences continued to impact current functioning, with trauma commonly experienced intergenerationally through parenting and attachment and ongoing trauma and feelings of guilt and responsibility experienced with families left behind. Participants noted barriers to accessing services: (a) Language difficulties including lack of interpreters; and (b) lack of culturally sensitive and trauma‐informed practices. Discrimination was experienced through the inconsistent provision of interpreters and lack of due consideration of cultural and religious differences. The use of children as interpreters enhanced a number of risk including miscommunication of medical information, exposure to age‐inappropriate information and the resulting increased risk of trauma for the child. Conclusion: Culturally sensitive, trauma‐informed and discrimination‐free practices should be employed across services, where Western‐views surrounding this medical model are not imposed, cultural differences are respected, and timely access to interpreters was provided. [ABSTRACT FROM AUTHOR]