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Increasing research examines social determinants of health, including structural oppression and discrimination. Microaggression – subtle/ambiguous slights against one's marginalized identity – is distinct from discrimination, which typically presents as overt and hostile. The current study investigated the comparative effects of each exposure on young adult anxiety, depression, and sleep. Race-stratified analyses investigated patterns across groups. Young adults (N = 48,606) completed the Spring 2022 American College Health Association-National College Health Assessment III. Logistic regressions tested odds of anxiety symptoms, depressive symptoms, and sleep disturbance in association with microaggression and discrimination exposure. Microaggression and discrimination equally predicted increased likelihood of anxiety symptoms (OR Micro = 1.42, OR Discrim = 1.46). Discrimination more strongly predicted depressive symptoms (OR = 1.59) and sleep disturbance (OR = 1.54) than did microaggression (OR Depress = 1.24, OR Sleep = 1.27). Race-stratified analyses indicated stronger associations between the each exposure and poor mental health in Whites than Asian American, Black/African American, and Hispanic or Latino/a/x respondents. Microaggression and discrimination exposure were each assessed using a single item. The outcome measures were not assessed using validated measures of anxiety, depression, and sleep (e.g., GAD-7, MOS-SS); thus results should be interpreted with caution. Analyses were cross-sectional hindering our ability to make causal inferences. The findings provide preliminary evidence that microaggression and discrimination exposure operate on health in distinct ways. Racially marginalized individuals may demonstrate a blunted stress response relative to Whites. Treatment approaches must be tailored to the particular exposures facing affected individuals to maximize benefits. • One in five college students experienced microaggression/discrimination the past year. • Exposure rates were higher in racially marginalized students than in Whites. • Microaggression and discrimination each predicted increased odds of all symptoms. • Pathways from the exposures to anxiety, depression, and sleep varied for microaggression versus discrimination. • Clinicians must proactively address identity-based exposures to advance mental health equity. [ABSTRACT FROM AUTHOR]

Background: The use of machine learning (ML) in mental health (MH) research is increasing, especially as new, more complex data types become available to analyze. By examining the published literature, this review aims to explore the current applications of ML in MH research, with a particular focus on its use in studying diverse and vulnerable populations, including immigrants, refugees, migrants, and racial and ethnic minorities. Methods: From October 2022 to March 2024, Google Scholar, EMBASE, and PubMed were queried. ML-related, MH-related, and population-of-focus search terms were strung together with Boolean operators. Backward reference searching was also conducted. Included peer-reviewed studies reported using a method or application of ML in an MH context and focused on the populations of interest. We did not have date cutoffs. Publications were excluded if they were narrative or did not exclusively focus on a minority population from the respective country. Data including study context, the focus of mental healthcare, sample, data type, type of ML algorithm used, and algorithm performance were extracted from each. Results: Ultimately, 13 peer-reviewed publications were included. All the articles were published within the last 6 years, and over half of them studied populations within the US. Most reviewed studies used supervised learning to explain or predict MH outcomes. Some publications used up to 16 models to determine the best predictive power. Almost half of the included publications did not discuss their cross-validation method. Conclusions: The included studies provide proof-of-concept for the potential use of ML algorithms to address MH concerns in these special populations, few as they may be. Our review finds that the clinical application of these models for classifying and predicting MH disorders is still under development. [ABSTRACT FROM AUTHOR]

Introduction: This review synthesizes the literature on the associations between concealment and mental health problems among Black, Indigenous, and People of Color (BIPOC) men who have sex with men (MSM). Methods: Following PRISMA guidelines, a systematic search was conducted using five databases to identify peer-reviewed articles and published dissertations. Results: Eleven studies were included. Mental health outcomes were (a) poor psychological well-being (k = 7), (b) depressive symptoms (k = 6), (c) anxiety symptoms (k = 4), and (d) substance use (k = 2). Conclusions: Results suggest potential differential associations by race/ethnicity. Methodological limitations and future directions are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Increased rates of mental health issues among LGBTQ+ people have been reported during the COVID-19 pandemic, particularly among young people. Method: Semi-structured interviews were conducted in 2021 with 61 young adult LGBTQ+ people residing in France, Italy, Portugal, Sweden, and the UK. Each interview was summarized on a template covering the participants' experiences of pandemic restrictions, mental health, and minority stress during this period. A thematic analysis was conducted on the templates. Results: The pandemic restrictions had a large impact on the participants' lives, leaving them stuck at home. Not having access to the LGBTQ+ community was an additional stress, as this is a venue for support. Half of the participants had suffered from mental health issues during the pandemic. Those who were living in non-affirmative households had a particularly difficult time and experienced overwhelming stress. Increased feelings of gender dysphoria were seen among trans participants due to the lack of access to gender-affirming healthcare. Most participants experienced less distal minority stress than usual due to social isolation restrictions. Conclusion: The COVID-19 pandemic and the associated social restrictions had a large impact on the lives of LGBTQ+ young adults. Many experience worse mental health, although relief from distal minority stress was common. Policy Implications: Policy makers must consider the needs of LGBTQ+ young adults as they seek to explore and establish their gender and/or sexual identity. During a pandemic, it is particularly important to help young LGBTQ+ people to engage with the LGBTQ+ community. [ABSTRACT FROM AUTHOR]

This study examined the indirect effect of relationship and parental status on mental health through internalized homonegativity among lesbian, gay, and bisexual (LGB) individuals. Prior research suggested that being in a relationship and becoming a parent may improve the mental health of LGB individuals, acting as protective factors against stigma and discrimination. However, the role of internalized homonegativity in mental health disparities between LGB individuals in relationships/parents and those who are not remains unclear. Therefore, we surveyed 491 LGB cisgender Israelis aged 18–64 years (M = 33.51, SD = 9.09) assessing relationship status, parental status, internalized homonegativity, depressive symptomatology, and life satisfaction. Indirect effects were explored using the PROCESS macro. Results showed that LGB individuals in romantic relationships reported lower depressive symptomatology and higher life satisfaction compared to those not in relationships. Similarly, LGB individuals who were parents reported lower depressive symptomatology and higher life satisfaction compared to non-parents. Significant indirect effect was found for couplehood/parenthood on depressive symptomatology/life satisfaction through internalized homonegativity. This study deepens the understanding of the interplay between couplehood, parenthood, and internalized homonegativity and their contribution to mental health of LGB individuals. It provides valuable insights for researchers and practitioners, highlighting the potential role of couplehood and parenthood in the mental health of sexual minority groups facing legal restrictions on marriage and parenting. [ABSTRACT FROM AUTHOR]

Lesbian and gay (LG) people experience minority stressors, resulting in adverse mental health outcomes. To cope, many LG people engage in individualistic or collectivistic strategies, that is, self-distancing or connecting with their in-group, the LGBTQ+ community. Even though research suggests what may help LG people cope with minority stress, it is less clear how and under which conditions they do so. In this study, we examine how LG people employ individualistic and collectivistic strategies and what that entails for the negative relationship between minority stress and mental health. A total of 199 responses from British LG people were collected via the online crowdsourcing platform Clickworker. A custom mediation model indicated that, for collectivistic strategies, higher levels of minority stress were associated with increased LGBTQ+ community identification, and LGBTQ+ identification was positively related to high LGBTQ+ social support; in turn, LGBTQ+ social support was associated with positive mental health outcomes. For individualistic strategies, results show higher minority stress was related to an increased likelihood of individual mobility, but individual mobility was not associated with mental health outcomes. These findings highlight how collectivistic responses to minority stress might prove more reliable than individualistic ones in enhancing the mental health of LG people. [ABSTRACT FROM AUTHOR]

Background Perceived discrimination in health care settings can have adverse consequences on mental health in minority groups. However, the association between perceived discrimination and mental health is prone to unmeasured confounding. The study aims to quantitatively evaluate the influence of unmeasured confounding in this association, using g-estimation. Methods In a predominantly African American cohort, we applied g-estimation to estimate the association between perceived discrimination and mental health, adjusted and unadjusted for measured confounders. Mental health was measured using clinical diagnoses of anxiety, depression and bipolar disorder. Perceived discrimination was measured as the number of patient-reported discrimination events in health care settings. Measured confounders included demographic, socioeconomic, residential and health characteristics. The influence of confounding was denoted as α 1 from g-estimation. We compared α 1 for measured and unmeasured confounding. Results Strong associations between perceived discrimination in health care settings and mental health outcomes were observed. For anxiety, the odds ratio (95% confidence interval) unadjusted and adjusted for measured confounders were 1.30 (1.21, 1.39) and 1.26 (1.17, 1.36), respectively. The α 1 for measured confounding was –0.066. Unmeasured confounding with α 1 = 0.200 ⁠ , which was over three times that of measured confounding, corresponds to an odds ratio of 1.12 (1.01, 1.24). Similar results were observed for other mental health outcomes. Conclusion Compared with measured confounding, unmeasured that was three times measured confounding was not enough to explain away the association between perceived discrimination and mental health, suggesting that this association is robust to unmeasured confounding. This study provides a novel framework to quantitatively evaluate unmeasured confounding. [ABSTRACT FROM AUTHOR]

Objective: Sexual minority disparities in behavioral health (e.g., mental health and substance use) are well-established. However, sexual identity is dynamic, and changes are common across the life course (e.g., identifying with a monosexual [lesbian or gay] label and later with a plurisexual [queer, pansexual, etc.] label). This study assessed whether behavioral health risks coincide with sexual identity change among sexual minority people. Methods: Associations in a 3-year U.S. national probability sample of sexual minority adults were assessed between sexual minority identity change (consistently monosexual [N=400; 44.3% weighted], consistently plurisexual [N=239; 46.7% weighted], monosexual to plurisexual [N=19; 4.2% weighted], and plurisexual to monosexual [N=25; 4.8% weighted]) and five behavioral health indicators (psychological distress, social well-being, number of poor mental health days in the past month, problematic alcohol use, and problematic use of other drugs), controlling for demographic characteristics and baseline behavioral health. Results: Among female participants, monosexual-to-plurisexual identity change (vs. consistently monosexual identity) was associated with greater psychological distress (B=3.41, SE=1.13), lower social well-being (B=−0.61, SE=0.25), and more days of poor mental health in the past month (B=0.69 [Bexp=1.99], SE=0.23). Among male participants, plurisexual-to-monosexual identity change (vs. consistently plurisexual identity) was associated with lower social well-being (B=−0.56, SE=0.25), and identity change (regardless of type) was generally associated with increased problematic use of alcohol and other drugs. Conclusions: Sexual identity change is an important consideration for sexual minority behavioral health research, with changes (vs. consistency) in identity being an important risk factor for compromised behavioral health. Prevention and treatment interventions may need to tailor messaging to sexual minority men and women differently. [ABSTRACT FROM AUTHOR]

The current study examines the impact of COVID-19 for a sample of lesbian, gay, bisexual, transgender, queer and questioning, and other emerging sexual (and gender) identities (LGBTQ+) adults. We hypothesized that financial strain, mental health, job loss, and physical COVID-19 symptoms would be positively related to intimate partner violence (IPV). Data were collected through recruitment using Amazon Mechanical Turk (MTurk) from May to September 2020. Respondents were 18+ years old, identified as a member of the LGBTQ + community, and resided in the United States. Participant ages ranged from 18-90 years old, and most of the sample identified as White (53.9%), bisexual (47.6%), and transgender (32.6%). The final sample consisted of 1,249 participants. All types of perpetration violence were significantly associated with COVID-19 symptoms. Both physical perpetration and psychological victimization were significantly associated with financial strain. All types of perpetration violence were significantly associated with COVID-19 symptoms. Both physical perpetration and psychological victimization were significantly associated with financial strain. Results highlight the increased need for access to IPV prevention resources for LGBTQ + adults, especially during national public health crises such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Sexual minority (SM) youth experience a greater mental health burden compared with their heterosexual peers. This study aimed to characterize mental health disparities among SM compared with non-SM youth, test main and interactive associations of SM identity and stressors targeting SM youth at the individual level (interpersonal SM discrimination) and structural level (state-level structural SM stigma) with youth mental health, and explore the contribution of interpersonal SM discrimination to the mental health burden of SM youth. Participants included 11,622 youth (ages 9-13; 47.6% assigned female at birth) from the Adolescent Brain Cognitive Development (ABCD) Study. Linear mixed-effects models tested main and interactive associations of SM identity, interpersonal SM discrimination, and structural SM stigma with mental health measures (self-reported overall psychopathology, suicidal ideation, and suicide attempts), adjusting for demographics and other interpersonal stressors not specific to SM (other discrimination types, peer victimization, and cyberbullying). Longitudinal mediation models tested whether interpersonal SM discrimination mediated the associations between SM identity and mental health measures. SM youth (n = 1,051) experienced more interpersonal SM discrimination and overall psychopathology compared with their non-SM peers (n = 10,571). Adjusting for demographics, there were significant associations (main effects) of interpersonal SM discrimination and structural SM stigma with overall psychopathology. When further adjusting for other non-SM–related stressors, the main effect of structural SM stigma was no longer significant. Interpersonal SM discrimination was also significantly associated with suicidal ideation and attempt, accounting for demographics, while structural SM stigma was not. Accounting for both demographics and other non-SM stressors, there was a significant interaction between SM identity and structural SM stigma in association with psychopathology (p =.02), such that, compared with their peers, SM youth showed a greater association between structural SM stigma and psychopathology. Longitudinal mediation revealed that interpersonal SM discrimination was a significant mediator explaining approximately 10% to 15% of the variance of the pathways between SM identity and all mental health outcomes. Results delineate contributions of interpersonal discrimination and structural stigma targeting SM youth to their heightened mental health burden in early adolescence. These findings underscore the need to address microlevel and macrolevel SM discrimination and structural stigma when caring for this population. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. [ABSTRACT FROM AUTHOR]

Aims: Sexual minority youth experience health disparities across mental, physical and sexual domains. However, little is known about the extent to which mental health overlaps with sexual and physical health to compound health problems among sexual minority youth. This study examined risky health behaviours, adverse health outcomes, and their overlap across mental, physical and sexual domains, in lesbian, gay, bisexual, questioning (LGBQ) and heterosexual third‐level students in Ireland. Method: Cross‐sectional data from the My World Survey 2‐Post Second Level (MWS2‐PSL) were used. Analyses were conducted on data from N = 7950 18–25‐year‐old students, of which 6204 (78%) identified as heterosexual, 910 (11.4%) bisexual, 412 (5.2%) lesbian/gay and 424 (5.3%) questioning. Risky health behaviours (e.g., self‐harm), adverse outcomes (e.g., mental health difficulties, physical health conditions) and their overlap across mental, physical and sexual domains were compared across heterosexual and LGBQ students using Chi‐square tests. Clustering of health behaviours/outcomes within and between domains were examined. Results: LGBQ students were more likely to exhibit a greater number of risky mental and sexual health behaviours and outcomes. Sexual, physical and mental health behaviours and outcomes overlapped to a greater extent in LGBQ versus heterosexual students. Distinct health outcomes were observed across sexual minority subgroups (e.g., bisexual women reported greater mental health difficulties). Conclusion: Findings demonstrate health inequalities experienced by LGBQ students, particularly across mental and sexual domains. Holistic integrated approaches that consider multiple health domains simultaneously and the distinct health needs of sexual minority subgroups are needed to promote greater health equity. [ABSTRACT FROM AUTHOR]

Copyright of Sexuality, Gender & Policy Journal is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Sexual minorities experience higher rates of psychological distress than heterosexual people, likely due to minority stress. While rates of help‐seeking by sexual minorities are high, sexual minorities report greater dissatisfaction with mental health service providers. This dissatisfaction may result from poor cultural competence practices. Our study sought to determine the importance of service provider cultural competence practices to a community sample of sexual minority people. Methods: Participants (n = 274) were sexual minority Australians recruited from affirming Facebook groups, organizations, and research‐based organizations. To measure the importance of cultural competence practices, participants completed a modified online version of the Gay Affirming Practices Scale (GAP) and responded to open‐ended questions. Results: Between 80% and 99% of participants endorsed each item on the GAP, indicating the importance of service providers demonstrating an array of culturally affirming practices. No significant associations were found between overall GAP score and age or sexual orientation, though further analyses revealed individual items on the GAP showed associations with age. A structured tabular thematic analysis, of open‐ended participant responses, found positive attitudes, knowledge, and affirming practices were the three most important characteristics for service providers seeking to demonstrate culturally competent practices, mirroring the tripartite model (attitudes, knowledge, and skills) of cultural competence. Conclusion: Recommendations for service providers to demonstrate cultural competence include: utilizing affirming practices such as inclusive language, increasing knowledge about sexual minorities, and utilizing education resources such as cultural competence workshops, lived experience stories, and seeking mentorship from service providers with expertise in working with sexual minorities. [ABSTRACT FROM AUTHOR]

Copyright of Psychiatria Hungarica is the property of Hungarian Psychiatric Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The study examines associations between social rejection, family acceptance, economic recession, and physical and mental health outcomes for sexual minorities in Greece. This is the first Greek study to evaluate the concept of minority stress theory for sexual minorities. In addition, this is among the first international studies to examine whether, during a period of economic recession, sexual minorities experience deteriorated physical and mental health. Methods: Utilizing two panel datasets (n = 866) covering the periods 2013–2014 and 2018–2019, the study examines whether social rejection, family acceptance, and economic conditions bear an association with self-rated physical and mental health. Results: Social rejection bears a negative association with physical and mental health. Family acceptance shares a positive association with physical and mental health. Periods characterized by worse economic conditions (2013–2014 versus 2018–2019) correlate with a decline in sexual minorities' physical and mental health. It is found that women, trans people, people without higher education degrees, unemployed people, and relatively poor people experience worse physical and mental health than the corresponding reference categories. Conclusions: Sexual minorities who experienced societal rejections, such as unfair treatment in educational, workplace environments, and/or public and health services prompted deteriorated physical and mental health. Sexual minorities who experienced acceptance from their families over their sexual orientation status, experienced better physical and mental health. Moreover, during periods of increased aggregate unemployment, the physical and mental health status of sexual minorities was deteriorated. Policy Implications: Antidiscrimination policies help reduce homophobic incidents and positively impact sexual/gender identity minorities' progression, self-esteem, income, and well-being. Public health services should ensure that policies are inclusive of the physical and mental health needs of sexual/gender identity minority groups. Reducing stigma and addressing financial hardships for minority population groups should form part of the policymakers' agenda and this study provides new evidence on the subject matter. [ABSTRACT FROM AUTHOR]

Objective: This study sought to evaluate the association between discrimination and having mental health problems in the past 12 months in the sexual minority population in Peru. Methods: We conducted a cross-sectional analysis of a secondary database corresponding to the first LGBTI survey in Peru in 2017. We included adults who self-identified their sexual orientation as gay, lesbian, bisexual, pansexual, or asexual/others. Both the exposure and dependent variables were self-reported by the participants. Multivariable Poisson regression was used to determine the association by calculating adjusted prevalence ratios (APR) with 95% confidence intervals (95% CI). Results: Out of 9760 respondents, more than two-thirds of the participants reported having been discriminated against or having experienced violence at some time in their lives (70.3%) and one-fourth reported having mental health problems (23.8%). In the multivariable regression model, the prevalence of mental health problems in the last 12 months was 72% higher for the group of individuals who experienced discrimination when compared with the group that did not experience discrimination (APR = 1.72, 95% CI 1.57–1.88). The association was stronger among who self-identified lesbians (APR = 2.08, 95% CI 1.65–2.64). Conclusion: The prevalence of mental health problems and discrimination was high in this population. In addition, we found a statistically significant association between discrimination and the occurrence of mental health problems in the last 12 months. [ABSTRACT FROM AUTHOR]

Sexual minority men have consistently shown to be at-risk for adverse mental health outcomes due to minority stress, yet studies show some men successfully navigate these barriers. What is less known are the environmental and social/emotional factors to which minority stress is amplified (or attenuated). We comparatively investigate rural versus urban sexual minority men and how levels of 'outness' (the degree to which an individual discloses their sexual identity to others around them) interacts with gay-related rejection anxieties (a specific type of minority stress). Results broadly show that 1. higher levels of gay-related rejection are statistically associated with higher levels of loneliness, and 2. outness moderated this link in rural, but not urban men. In other words, higher levels of outness amplified the deleterious effects of gay-related rejection in the rural sample only. Although previous research shows mixed results in regards to how coming out affects the mental health of sexual minority men, our stratified results show that rural men may be at a higher risk for deleterious mental health with higher levels of outness. Implications from this study bolster the mental health field, particular mental health practitioners working with rural sexual minority men and the aftermath of coming out. [ABSTRACT FROM AUTHOR]

Backgrounds: In the context of increasing hate crimes, legislative challenges, and anti-LGBTQ + sentiment, we conducted the first study that comprehensively examined long-term mental health disparities across sexual orientations in the UK from 2010 to 2021. Prior studies predominantly relied on cross-sectional or limited longitudinal designs, thus failing to capture evolving trends over a decade and providing crucial insights into the dynamics of mental health challenges faced by sexual minorities, essential for devising targeted public health interventions and policies.Waves 2–12 of the UK Longitudinal Household Survey for adults (n = 52,591) were used. MCS-12 (Mental Health Component Scale of the Short-Form Health Survey) for mental functioning and GHQ (General Health Questionnaire) for psychological distress were included as the main outcomes, along with other measures of well-being. Mixed-effect longitudinal models were used to examine the trends of mental health disparities across sexual orientations.Relative to their heterosexual counterparts, psychological distress (GHQ) increased for gay men, lesbians, and women with “other” orientations. Bisexual women saw the steepest increase from 1.69 higher GHQ vs. their heterosexual counterparts in 2010 (95%CI: 0.81 to 2.57), up to 3.37 in 2021 (95%CI: 2.28 to 4.45). Similar trends were also shown in the other measures.The study highlights increases in mental health disparities between sexual minorities and heterosexuals. The escalating psychological distress among sexual minorities, particularly bisexual women, calls for an urgent, multi-faceted, and intersectoral response. This approach must address both symptoms and the social structures perpetuating these disparities across sexual orientations.Methods: In the context of increasing hate crimes, legislative challenges, and anti-LGBTQ + sentiment, we conducted the first study that comprehensively examined long-term mental health disparities across sexual orientations in the UK from 2010 to 2021. Prior studies predominantly relied on cross-sectional or limited longitudinal designs, thus failing to capture evolving trends over a decade and providing crucial insights into the dynamics of mental health challenges faced by sexual minorities, essential for devising targeted public health interventions and policies.Waves 2–12 of the UK Longitudinal Household Survey for adults (n = 52,591) were used. MCS-12 (Mental Health Component Scale of the Short-Form Health Survey) for mental functioning and GHQ (General Health Questionnaire) for psychological distress were included as the main outcomes, along with other measures of well-being. Mixed-effect longitudinal models were used to examine the trends of mental health disparities across sexual orientations.Relative to their heterosexual counterparts, psychological distress (GHQ) increased for gay men, lesbians, and women with “other” orientations. Bisexual women saw the steepest increase from 1.69 higher GHQ vs. their heterosexual counterparts in 2010 (95%CI: 0.81 to 2.57), up to 3.37 in 2021 (95%CI: 2.28 to 4.45). Similar trends were also shown in the other measures.The study highlights increases in mental health disparities between sexual minorities and heterosexuals. The escalating psychological distress among sexual minorities, particularly bisexual women, calls for an urgent, multi-faceted, and intersectoral response. This approach must address both symptoms and the social structures perpetuating these disparities across sexual orientations.Results: In the context of increasing hate crimes, legislative challenges, and anti-LGBTQ + sentiment, we conducted the first study that comprehensively examined long-term mental health disparities across sexual orientations in the UK from 2010 to 2021. Prior studies predominantly relied on cross-sectional or limited longitudinal designs, thus failing to capture evolving trends over a decade and providing crucial insights into the dynamics of mental health challenges faced by sexual minorities, essential for devising targeted public health interventions and policies.Waves 2–12 of the UK Longitudinal Household Survey for adults (n = 52,591) were used. MCS-12 (Mental Health Component Scale of the Short-Form Health Survey) for mental functioning and GHQ (General Health Questionnaire) for psychological distress were included as the main outcomes, along with other measures of well-being. Mixed-effect longitudinal models were used to examine the trends of mental health disparities across sexual orientations.Relative to their heterosexual counterparts, psychological distress (GHQ) increased for gay men, lesbians, and women with “other” orientations. Bisexual women saw the steepest increase from 1.69 higher GHQ vs. their heterosexual counterparts in 2010 (95%CI: 0.81 to 2.57), up to 3.37 in 2021 (95%CI: 2.28 to 4.45). Similar trends were also shown in the other measures.The study highlights increases in mental health disparities between sexual minorities and heterosexuals. The escalating psychological distress among sexual minorities, particularly bisexual women, calls for an urgent, multi-faceted, and intersectoral response. This approach must address both symptoms and the social structures perpetuating these disparities across sexual orientations.Conclusions: In the context of increasing hate crimes, legislative challenges, and anti-LGBTQ + sentiment, we conducted the first study that comprehensively examined long-term mental health disparities across sexual orientations in the UK from 2010 to 2021. Prior studies predominantly relied on cross-sectional or limited longitudinal designs, thus failing to capture evolving trends over a decade and providing crucial insights into the dynamics of mental health challenges faced by sexual minorities, essential for devising targeted public health interventions and policies.Waves 2–12 of the UK Longitudinal Household Survey for adults (n = 52,591) were used. MCS-12 (Mental Health Component Scale of the Short-Form Health Survey) for mental functioning and GHQ (General Health Questionnaire) for psychological distress were included as the main outcomes, along with other measures of well-being. Mixed-effect longitudinal models were used to examine the trends of mental health disparities across sexual orientations.Relative to their heterosexual counterparts, psychological distress (GHQ) increased for gay men, lesbians, and women with “other” orientations. Bisexual women saw the steepest increase from 1.69 higher GHQ vs. their heterosexual counterparts in 2010 (95%CI: 0.81 to 2.57), up to 3.37 in 2021 (95%CI: 2.28 to 4.45). Similar trends were also shown in the other measures.The study highlights increases in mental health disparities between sexual minorities and heterosexuals. The escalating psychological distress among sexual minorities, particularly bisexual women, calls for an urgent, multi-faceted, and intersectoral response. This approach must address both symptoms and the social structures perpetuating these disparities across sexual orientations. [ABSTRACT FROM AUTHOR]

To explore minority, adolescent birth and perinatal experiences to inform and improve quality of care for this unique group. Mixed quantitative and qualitative study guided by Bourdieu's Social Fields framework. Clinic dedicated to parenting adolescents, and a local charter school founded to serve pregnant and parenting young adults. Sample size for quantitative data: n = 27; qualitative data: n = 14. Average age was 16.39 years (SD = 1.29); most self-identified as Latina/Hispanic or African American/Black/Afro-Caribbean/African. We used 2 validated surveys: Birth Satisfaction Scale-Revised (BSS-R), and the Postpartum Worry Scale-Revised (PWS-R). The BSS-R has 10 items, and quantifies labor and delivery experiences. The PWS-R has 20 items, and quantifies maternal, infant, and social-emotional worries. The qualitative, semistructured 30-minute interviews with a subset of survey respondents further explored perinatal mental health, labor experiences, and support networks. BSS-R data resulted in an average score of 25.14 (SD = 5.35), which correlated to moderate satisfaction with birth experience (range, 0-40 with 0 = most negative). The PWS-R average score of 55.79 (SD = 21.06) indicated elevated postpartum worry (range, 20-100 with 20 = most worry). Qualitative interviewees worried about relationships and newborn well-being; support networks fluctuated; distinct events, pain, and fear during labor dominated birth stories. Advice for peers included: tending to social support, stress, and self-care. Nonjudgmental communication, empathy, and emotional connection were desired attributes of their health care team. Participants had anxiety related to social networks and newborn care. Although birth experiences were moderately positive, they were also described as stressful. However, participants were resourceful, insightful, and took advantage of social supports. Birth experiences, patterns of stress, and support networks are uniquely identified and utilized by adolescent mothers. Being heard and feeling connected to providers empowered this group of young, minority adolescents. Participant advice could inform future educational courses, programs, and hospital innovations for perinatal adolescents. [ABSTRACT FROM AUTHOR]

Forty-nine people were killed in the Orlando shooting at Pulse nightclub on June 12, 2016. The objective of this study was to examine the association between the Orlando shooting and sexual minority mental health. We used data from the 2013–2018 National Health Interview Survey and a difference-in-differences approach to compare changes in severe psychological distress (SPD) between sexual minorities and their heterosexual peers. Compared to heterosexual men, the Orlando shooting was associated with a 25.6 percentage point (p < 0.05) increase in SPD for sexual minority men in June 2016. We did not observe a similar pattern of heightened SPD for sexual minority women following the Orlando shooting. This study suggests that the Orlando shooting was detrimental to the mental health of sexual minority men. [ABSTRACT FROM AUTHOR]

Schools can be a setting to address mental health needs of sexual and gender minority (SGM) youth. Gender-Sexuality Alliances (GSAs), as extracurricular support groups, provide an existing structure that could be leveraged to reach SGM youth and deliver services. Nevertheless, limited data indicate the prevalence of depression and anxiety among GSA members, how often GSAs discuss mental health, or their receptivity to resources. Participants in the current study were 580 youth (Mage = 15.59; 79% sexual minority, 57% cisgender female; 68% White) and 58 advisors in 38 GSAs purposively sampled across Massachusetts. Youth completed established measures of depression and anxiety; advisors reported how frequently their GSAs discussed mental health; and both reported their interest in mental health materials. Among youth, 70.1% scored above the threshold indicating probable mild depression, and 34.4% scored above the threshold suggesting concerning anxiety. Adjusted odds ratios indicated that the odds of depression and anxiety were higher for SGM members relative to heterosexual and cisgender members, particularly among youth reporting SGM identities that have been underrepresented. GSAs discussed mental health with some frequency over the school year. Youth and advisors expressed strong interest in resources. Findings support the case for developing selective and indicated school-based prevention programming for youth in GSAs to address their mental health needs. [ABSTRACT FROM AUTHOR]

Identity concealment affects all sexual minority individuals, with potentially complex mental health implications. Concealing a sexual minority identity can simultaneously generate the stress of hiding, protect against the stress of discrimination, and keep one apart from sexual minority communities and their norms and supports. Not surprisingly, existing studies of the association between sexual orientation concealment and mental health problems show contradictory associations—from positive to negative to null. This meta-analysis attempts to resolve these contradictions. Across 193 studies (n = 92,236) we find a small positive association between sexual orientation concealment and internalizing mental health problems (i.e., depression, anxiety, distress, problematic eating; ESr = 0.126; 95% CI [0.102, 0.151]) and a small negative association between concealment and substance use problems (ESr = −0.061; 95% CI [−0.096, −0.026]). The association between concealment and internalizing mental health problems was larger for those studies that assessed concealment as lack of open behavior, those conducted recently, and those with younger samples; it was smaller in exclusively bisexual samples. Year of data collection, study location, and sample gender, education, and racial/ethnic composition did not explain between-study heterogeneity. Results extend existing theories of stigma and sexual minority mental health, suggesting potentially distinct stress processes for internalizing problems versus substance use problems, life course fluctuations in the experience of concealment, distinct experiences of concealment for bisexual individuals, and measurement recommendations for future studies. Small overall effects, heavy reliance on cross-sectional designs, relatively few effects for substance use problems, and the necessarily coarse classification of effect moderators in this meta-analysis suggest future needed methodological advances to further understand the mental health of this still-increasingly visible population. Public Significance Statement: Across 193 studies, sexual orientation concealment demonstrates small positive associations with internalizing mental health problems (i.e., depression, anxiety, distress, problematic eating) and a small negative association with substance use problems, suggesting potentially distinct pathways to these outcomes among sexual minorities. The association between sexual orientation concealment and mental health likely depends on the time period in which the study was conducted, the specific measurement of concealment used, and the age and sexual identity of sexual minority participants. [ABSTRACT FROM AUTHOR]

Rural residents in the USA experience significant disparities in mental health outcomes even though the prevalence of mental illness in rural and metropolitan areas is similar. This is a persistent problem that requires innovative approaches to resolve. Adopting and appropriately modifying the National Institute on Minority Health and Health Disparities research framework are the potential approaches to understanding how these disparities might be addressed through research. Using this research framework can facilitate interrogation of multiple levels of influence, encompassing complex domains of influence and consideration of the entire life course trajectory, which is consistent with several National Institute of Mental Health priorities. [ABSTRACT FROM AUTHOR]

Sexual and gender minority (SGM) people experience significant disparities in mental health and substances use disorders. This study reached out to mental health professionals (MHPs) who treat SGM people to determine mental health priorities for research that would better inform their clinical practice. MHPs were surveyed and asked to rate items based on a likert-type scale. Open-ended questions were also queried and analyzed qualitatively. Five items had the highest mean scores: "stressors related to SGM status," "lifestyle factors that support emotional resilience and wellbeing," "depression," "intimate relationships," and "suicide." Intersecting identities and sexual relationships emerged as qualitative themes. [ABSTRACT FROM AUTHOR]

We explored how perceived discrimination and mental illness change as a function of mono vs non-monosexual minority identity. Archival data gathered through the Healthy Minds Network was used to examine these relationships between 249 mono and 554 non-monosexual minority individuals. Results indicated no differences in perceived discrimination between mono and non-monosexual minority individuals. Non-monosexual individuals evidenced significantly higher rates of mental health problems. Moderation analyses suggested perceived discrimination was a significant predictor of mental illness symptoms only for non-monosexual minority individuals. Clinical implication, limitations, and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

To estimate the prevalence of adverse childhood experiences (ACEs) and their association with mental health outcomes in adulthood by gender identity. Data come from 2019 to 2021 US Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, among 17 states collecting gender identity and ACEs. We estimated the prevalence of ACEs and used Poisson family regression to estimate the association between ACEs and mental health stratified by gender identity. Mental health was assessed as current frequent mental distress and lifetime depression diagnosis. The sample included n = 141,615 adults, 556 of whom identified as gender minority (including transgender or gender non-binary). Gender minority respondents were 18% more likely [95% CI 8% to 29%, p < 0.01] to be exposed to 3 or more ACEs relative to cisgender respondents. Among respondents exposed to 3 or more ACEs, gender minority adults were 25% [95% CI 10% to 43%, p < 0.01] more likely to report current frequent mental distress and 26% [95% CI 14% to 40%, p < 0.01] more likely to report a lifetime depression diagnosis than their cisgender peers. Using population-level data, we identified higher prevalence of ACEs among gender minority adults than cisgender adults, and greater associations of ACEs and adverse mental health in adulthood. The prevalence of current and lifetime adverse mental health outcomes increased with higher levels of ACE exposure among cisgender and gender minority respondents. Action by stakeholders at the community, health system, and legislative levels are needed to improve gender minority population health. [ABSTRACT FROM AUTHOR]

Purpose: There is substantial evidence to suggest that Black and minority ethnic (BME) patients are disproportionately detained under the Mental Health Act (MHA). We examined ethnic differences in patients assessed for detention and explored the effect of ethnicity after controlling for confounders.Methods: A prospective study of all MHA assessments conducted in 1 year (April 2009-March 2010) within Birmingham and Solihull Mental Health Foundation Trust, UK. Proportion of assessments and detentions within denominator population of service users and regional populations were calculated. Multiple regression analysis was conducted to determine which variables were associated with the outcome of MHA assessment and the role of ethnicity.Results: Of the 1115 assessments, 709 led to detentions (63.58 %). BME ethnic groups were statistically more likely to be assessed and detained under the MHA as compared to Whites, both in the service user and the ethnic population estimates in Birmingham, UK. MHA detention was predicted by having a serious mental illness, the presence of risk, older age and living alone. Ethnicity was not associated with detention under the MHA with age, diagnosis, risk and level of social support accounted for.Conclusion: The BME 'disproportionality' in detention rates seems to be due to higher rates of mental illness, greater risk and poorer levels of social support rather than ethnicity per se. [ABSTRACT FROM AUTHOR]