Disponibilidad no significa accesibilidad: revisión sistemática de las experiencias en los servicios de atención en salud mental en la población LGBTQ

Abstract

The experiences of users in mental healthcare system are important when considering eq¬uity of care. Current literature lacks exploration of mental health needs for LGBTQ popula¬tions, added marginalized identities nor country-level differences in their mental health care experiences. This systematic review aimed to synthesize for the first time the experience of lesbian, gay, bisexual, binary trans, and non-binary trans people in mental health care ser¬vices, identify country-level differences, and intersecting marginalized groups. A structured search was conducted through three databases for all empirical studies published until 2020. After following PRISMA guidelines for the selection process, N = 17 studies were included. The most common experiences of LGBTQ clients in mental health care concerned (1) training of the mental health care provider around LGBTQ issues, (2) negative attitudes from the provider towards their sexual identity, (3) use of an affirmative therapeutic ap¬proach. Invalidation of bisexuality and incorrect use of pronouns for transgender patients were the most salient subgroup differences. There is a lack of literature from Low-and Middle-Income Countries (LMICs). Intersecting marginalized identities had an impact on LGBTQ people’s experiences by adding unnecessary burdens to their mental health care experience. This study helped to understand how to improve mental health care access and treatment for LGBTQ subgroups specifically. LGBTQ training combined with affirmative therapy can significantly improve their mental health care experience and guarantee their mental health needs are met. Providers must recognize how multiple marginalized identities contribute to patients’ distress. More research is needed to understand global differences.