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Explaining effective mental health support for LGBTQ+ youth: A meta-narrative review.

ABSTRACT: This meta-narrative review on mental health early intervention support for LGBTQ+ youth aimed to develop a theoretical framework to explain effective mental health support. Using the RAMESES standards for meta-narrative reviews, we identified studies from database searches and citation-tracking. Data extraction and synthesis was conducted through conceptual coding in Atlas.ti. in two stages: 1) conceptual mapping of the meta-narratives; 2) comparing the key concepts across the meta-narratives to produce a theoretical framework. In total, 2951 titles and abstracts were screened and 200 full papers reviewed. 88 studies were included in the final review. Stage 1 synthesis identified three meta-narratives - psychological, psycho-social, and social/youth work. Stage 2 synthesis resulted in a non-pathological theoretical framework for mental health support that acknowledged the intersectional aspects of LGBTQ+ youth lives, and placed youth at the centre of their own mental health care. The study of LGBTQ+ youth mental health has largely occurred independently across a range of disciplines such as psychology, sociology, public health, social work and youth studies. The interdisciplinary theoretical framework produced indicates that effective early intervention mental health support for LGBTQ+ youth must prioritise addressing normative environments that marginalises youth, LGBTQ+ identities and mental health problems.

SUBMITTER: McDermott E

PROVIDER: S-EPMC8654681 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Explaining effective mental health support for LGBTQ+ youth: A meta-narrative review.

McDermott Elizabeth E Eastham Rachael R Hughes Elizabeth E Pattinson Emily E Johnson Katherine K Davis Stephanie S Pryjmachuk Steven S Mateus Ceu C Jenzen Olu O

SSM. Mental health 20211201

This meta-narrative review on mental health early intervention support for LGBTQ+ youth aimed to develop a theoretical framework to explain effective mental health support. Using the RAMESES standards for meta-narrative reviews, we identified studies from database searches and citation-tracking. Data extraction and synthesis was conducted through conceptual coding in Atlas.ti. in two stages: 1) conceptual mapping of the meta-narratives; 2) comparing the key concepts across the meta-narratives t ...[more]

PMID: 34957424

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Project description:BackgroundMembers of the lesbian, gay, bisexual, transgender, queer, and other sexual and gender minorities (LGBTQ+) community have greater risk of mental health disorders compared to the general population, however most evidence is from young people. We sought to systematically review and summarise the evidence for the burden and risk of mental health disorders.MethodsA PRISMA-compliant literature search was conducted in MEDLINE, Embase, PsycInfo, Scopus, and CINAHL for articles published from 2000 to 2024. Quantitative or mixed-methods studies that reported mental health outcomes among LGBTQ+ workers were included. Effect measures included prevalence and odds ratios, with variations in mental health across occupations and specific sexual or gender minorities reported where possible. This systematic review was prospectively registered through PROSPERO (CRD42024587605).ResultsOut of 5736 unique articles screened, 33 articles (32 individual studies) fulfilled eligibility criteria, including 8369 LGBTQ+ workers. Other than studies of sex workers, only 12 studies had research questions specific to LGBTQ+ workers' mental health. Most studies (30/32) were cross-sectional and reported increased odds of depression, anxiety, or suicidality among LGBTQ+ compared to non-LGBTQ+ workers. Prevalence estimates and methodology varied widely. Factors associated with adverse mental health outcomes among select groups of LGBTQ+ workers included internalised stigma, heterosexism, job stress and low income. We found no studies comparing workers across industries and no studies involving workplace interventions.ConclusionsThere are limited objective data regarding LGBTQ+ workers' mental health. Given the heterogeneity of the LGBTQ+ population, dedicated longitudinal research into the mental health of specific sexual and gender minorities across all industries and occupations is needed to determine causal factors, the impact of intersectionality, and the effectiveness of workplace interventions.

Project description:Engagement is a key metric that researchers can use to assess whether participants received the intended dose of a digital health intervention. However, the prevailing approach has predominantly focused on individual paradata metrics, resulting in a fragmented understanding of overall engagement. To address this limitation, our study utilizes person-centered approaches that allow for the simultaneous capture of multiple engagement metrics within imi-a web application specifically designed to support the mental health of lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority youth (LGBTQ+ youth). This person-centered approach enabled us to explore the association between engagement patterns and stress appraisal outcomes within the imi intervention arm. Utilizing latent profile analysis, we classified users into two engagement forms: overall engagement (total number of sessions, pages visited, and external links clicked and their cumulative time spent using imi) and content engagement (number of pages viewed across imi's four core guides: gender, stress, queerness, and stigma). We identified two profiles for each form: a "high engagement" profile and an "average engagement" profile, with the majority of participants assigned to the "average engagement" profile. Our analyses revealed a significant association between overall engagement profiles and stress appraisals, with the "high engagement" profile demonstrating higher challenge appraisals and marginal improvements in threat appraisals compared to the "average engagement" profile. However, no such associations were observed for content engagement profiles and stress appraisal outcomes. The two person-centered approaches used were consistent with prior results utilizing a variable-centered approach, indicating a stronger intervention effect among individuals who exhibit higher engagement in digital health interventions. Although both methods yielded comparable findings, the person-centered approach mitigates concerns related to multi-collinearity and adds additional nuance and context to the study of digital engagement.

Project description:IntroductionVeterinary students face significant challenges impacting their mental health and wellbeing. The rigorous academic curriculum, high expectations, and demanding clinical training create an environment of intense pressure and constant stress. This review explores the demographic and psychosocial variables influencing mental health outcomes, highlighting common stressors and coping strategies.MethodsA systematic literature search was conducted using PubMed, CAB Abstracts, and Google Scholar. Studies published up to 2021 involving veterinary students were included. Twenty-one peer-reviewed studies met the inclusion criteria. Demographic data, stressors, mental health measures, and coping strategies were extracted and analyzed. Studies focused on various mental health aspects, including stress, anxiety, depression, and coping mechanisms. The final selection was based on relevance, quality, and comprehensiveness.ResultsThe reviewed studies indicated that rigorous academic demands, high expectations, and clinical training contribute to elevated stress levels among veterinary students. Women reported higher levels of stress, anxiety, and depression compared to men, necessitating gender-specific interventions. Social support and relationship quality were crucial for mental wellbeing, with students in supportive environments experiencing lower stress. Effective coping strategies included exercise and social activities; whereas, harmful behaviors like substance misuse exacerbated mental health issues. Despite using mental health services, barriers such as stigma and lack of awareness hindered access for some students.ConclusionThe findings underscore the need for targeted support systems to enhance the mental health and resilience of veterinary students. Interventions to promote healthy coping mechanisms, reduce stigma, and improve access to mental health resources are essential. Veterinary schools should prioritize creating a supportive environment to ensure students can manage the demands of their profession while maintaining their mental health and wellbeing.

Project description:BackgroundNon-binary identities are increasingly recognized within the spectrum of gender diversity, yet there is a dearth of research exploring the mental health challenges specific to this population. Therefore, this systematic review and meta-analysis aimed to comprehensively assess the mental health outcomes of non-binary youth in comparison to their transgender and cisgender peers.MethodsA systematic search was conducted to identify relevant studies across three electronic databases (PubMed, Scopus, Web of Science) covering the period from inception to October 2023. The meta-analysis was performed employing a random-effects model. Inclusion criteria encompassed studies comparing non-binary youth with transgender or cisgender youth, providing data on mental health outcomes such as general mental health, depressive and anxiety symptoms, self-harm and suicidality.ResultsTwenty-one studies, meeting the inclusion criteria and originating from six different countries, were included in the analysis. The sample encompassed 16,114 non-binary, 11,925 transgender, and 283,278 cisgender youth, with ages ranging from 11 to 25 years. Our meta-analysis revealed that non-binary youth exhibit significantly poorer general mental health compared to both transgender (d = 0.24, 95% CI, 0.05-0.43, p =.013) and cisgender youth (d = 0.48, 95% CI, 0.35-0.61, p <.001), indicating a more impaired general mental health in non-binary youth. Regarding depressive symptoms, when comparing non-binary and cisgender individuals, a moderate and significant effect was observed (d = 0.52, 95% CI, 0.41-0.63, p <.001). For anxiety symptoms, a small but significant effect was observed in the comparison with cisgender individuals (d = 0.44, 95% CI, 0.19-0.68, p =.001). Furthermore, non-binary individuals exhibited lower rates of past-year suicidal ideation than transgender peers (OR = 0.79, 95% CI, 0.65-0.97, p =.023) and higher rates of lifetime suicidal ideation than cisgender youth (OR = 2.14, 95% CI, 1.46-3.13, p <.001).ConclusionNon-binary youth face distinct mental health challenges, with poorer general mental health, elevated depressive and anxiety symptoms compared to cisgender, and similar rates of self-harm and suicidal behavior compared to transgender individuals. These findings underscore the urgent need for targeted interventions, including gender-affirming mental health support, to address the specific needs of non-binary youth.

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Explaining effective mental health support for LGBTQ+ youth: A meta-narrative review.

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Explaining effective mental health support for LGBTQ+ youth: A meta-narrative review.

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