Sexual orientation differences in functional limitations, disability, and mental health services use: Results from the 2013–2014 National Health Interview Survey.

Abstract

Objectives We investigated sexual orientation differences in risk for mental health morbidity, functional limitations/disability, and mental health services use among adults interviewed in the nationally representative 2013–2014 National Health Interview Survey (NHIS). Method Respondents were 68,816 adults (n=67,152 heterosexual and n=1,664 lesbian, gay, and bisexual (LGB) individuals), age 18 and older. Fully structured interviews assessed sexual orientation identity, health status, and services use. Using sex-stratified analyses while adjusting for demographic confounding, we compared LGB and heterosexual individuals for evidence of mental health-related impairments and use of mental health services. Results LGB adults, as compared to heterosexual adults, demonstrated higher prevalences of mental health morbidity and functional limitations. However, this varied by gender with LGB women evidencing elevated risk for both mental health and substance abuse (MHSA) and non-MHSA limitations. Among men, sexual orientation differences clustered among MHSA-related limitations. Overall, LGB adults were more likely than heterosexual adults to use services, with the source of functional limitations moderating these effects among men. Conclusion MHSA-related morbidity is a significant concern among LGB individuals and is associated with higher levels of functional limitations/disability. Our findings highlight that LGB persons use MHSA-related treatment at higher rates than heterosexuals do, and, among men, are more likely to do so absent MHSA or non-MHSA-related functional limitations. This presents a unique set of concerns within the integrated care setting, including the need to deliver culturally competent care sensitive to the context of probablep sex differences among LGB individuals.

Who attempts suicide among medical students?

“…Although we believe that this positive relation may be related to the fact that this population suffers more discrimination and difficulty of acceptance, often isolating themselves and presenting a higher prevalence of depressive symptoms, we were unable to identify a significant interaction between history of bullying and sexuality. As described in the literature, homosexual‐lesbian/gay, bisexual, and questioning students had more stressful life events, perceived stress, bullying victimization, functional limitations, and depressive symptoms than heterosexual peers . Future work should assess suicide attempts in other groups of students and compare their findings with our findings.…”

“…symptoms, we were unable to identify a significant interaction between history of bullying and sexuality. As described in the literature, homosexual-lesbian/gay, bisexual, and questioning students had more stressful life events, perceived stress, bullying victimization, functional limitations, and depressive symptoms than heterosexual peers (37,38). Future work should assess suicide attempts in other groups of students and compare their findings with our findings.…”

LGBTQ* Responsive Sand Tray: Creative Arts and Counseling

“…Therefore, Luke andGoodrich (2015a, 2015b) purported that supervision offered a direct mechanism to increase counselors' multicultural competence, social justice competence, and clinical competence when working with LGBTQ* individuals. Increasing counselors' ability to serve LGBTQ* persons is of the utmost importance, given that persons who identify as LGBTQ* seek counseling services at disproportionately higher rates than their heterosexual and gender normative peers (Cochran et al, 2017;Dilley, Simmons, Boysun, Pizacani, & Stark, 2010;Fredriksen-Goldsen et al, 2014;Luke & Goodrich, 2015a;Thorne et al, 2018). One such study conducted by Grella, Green-well, Mays, and Cochran (2009) reported that LGBTQ* persons experiencing mental health-related issues sought mental health or substance-use services within the last year at a rate of 48.5%, while their counterparts sought the same services at a rate of 22.5%.…”

“…One such study conducted by Grella, Green-well, Mays, and Cochran (2009) reported that LGBTQ* persons experiencing mental health-related issues sought mental health or substance-use services within the last year at a rate of 48.5%, while their counterparts sought the same services at a rate of 22.5%. Further, several authors have argued that the multiple forms of discrimination experienced by LGBTQ* persons are linked to increased mental health issues, which can begin to explain LGBTQ* personsâȂŹ disproportionate need for mental health services (Cochran et al, 2017;Thorne et al, 2018).…”

“…Developing the use of ST to serve the LGBTQ* com-munity is crucial, as the LGBTQ* community faces many issues, such as discrimination, bullying, and homelessness ; internalized homophobia and genderism (Farmer & Byrd, 2015); dating and sexuality (Cavanaugh & Peters, 2019;Zeglin, Van Dam, & Hergenrather, 2018); emotional, physical, and sexual abuse (Dank, Lachman, Zweig, & Yahner, 2013); and a variety of mental health and substance-use-related issues (Cochran, Björkenstam, & Mays, 2017;Thorne et al, 2018). More importantly, scholars have suggested that counselors and related mental health professionals are not adequately prepared to work with those within marginalized affectional orientations and gender identities or the many issues LGBTQ* persons face (Luke & Goodrich, 2012, 2013, such as dating and sexuality (Cavanaugh & Peters, 2019;Zeglin et al, 2018).…”