The datasets analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request. The original data collection was supported by the National Institutes of Health, primarily by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R21HD to J.E.E. and M.S.F.). We use LGBTQ+ (lesbian, gay, bisexual, trans, queer+) to refer collectively to sexual minority and gender diverse identities because of the proliferation of terms used by young people.
Links to NCBI Databases
Research on the topic strongly supports the finding that policies for civil rights that are LGBTQ+ inclusive have a great and long-term positive effect on mental health outcomes in LGBTQ+ populations (26). Studies suggest that culturally competent treatment regimens in populations with different sociocultural backgrounds may help address racial bias in diagnosis formulation and lead to more appropriate treatment recommendations. Reports also suggest that these differences are mainly attributable to racial-ethnic bias or misattribution of psychotic symptoms (12, 13).
Minority Mental Health Resources That Provide Nationwide Support
At present, there are 23 CCAS, of which 12 are urban, 8 are suburban, and 3 are rural, with more communities likely to be added in subsequent years of the study. Collaborating community agency sites (CCASs) in a variety of urban, suburban, and rural communities across Ontario, Canada, are hosting a series of AFFIRM intervention groups, each consisting of 6 to 10 SGMY (aged years). Many community organizations do not focus on 1 particular SGM subpopulation but instead serve all SGMY. Importantly, similar to community programming, the groups are constructed to be developmentally appropriate.
- While we celebrate cultural diversity, it’s also important to acknowledge that mental health care doesn’t always reflect that diversity.
- Disparities in mental health treatment and outcomes for minority adults and youth are well-documented.
- Analyzing three nationally representative household surveys, Kataoka, Zhang and Wells9 found that both African American and Latino youth had lower rates of mental health service use compared to their non-Latino white counterparts.
- Addressing how cultural barriers to mental healthcare use can be overcome, Dr. Kim noted that “in practice, we need to have a two-pronged approach to address disparities in mental health for minority groups.”
- As a parent and as a physician, I am deeply concerned that some of the challenges and obstacles that this generation of young people face—the ubiquity of technology platforms, loneliness, economic inequality, and progress on issues such as racial injustice and climate change—are unprecedented and uniquely hard to navigate.
Modifiable neighborhood factors.
Unfortunately, achieving acceptance of one’s racial/ethnic identity can be challenging when messages of positivity being conveyed by close friends and family are directly opposed by surrounding messages in the external environment. Aspects of emotion regulation, such as effortful control, can protect Latinx youth exposed to stressors from poor mental health outcomes.69 Latinx immigrant youth, who may experience higher acculturation and assimilation related stressors, are more likely to have high levels of emotion regulation if they have positive social relationships, have a sense of purpose, and are adaptable to environmental demands.70 Black youth with good emotion regulation skills showed adaptive cortisol levels irrespective of degree of psychosocial stressors experienced.71 Flatter awakening slopes, or cortisol not appropriately peaking during awakening, is indicative of HPA dysregulation and has been previously linked to poor health outcomes and early death.65 Similar patterns of HPA dysregulation have been observed among American Indian young adults, perhaps indicative of heightened rates of chronic adversities during childhood.66 Experiencing discrimination has also been linked with HPA axis hyperactivity among racial diverse youth67 and young adults.68 Studies have found flatter awakening cortisol slopes among Latinx and African American youth, compared to their White peers 63,64. Researchers have more recently focused on ways stress “gets under the skin,”62 altering biology leading to mental health outcomes and disparities.
This may be particularly important for racial/ethnic minority youth because their behavior may vary across different environments (Kanawaza, White, & Hampson, 2007). Different cultures have been shown to have their own idioms of distress/specific illness categories (Nichter, 1981; Good & Delvecchio-Good, 1982) and it is conceivable that American psychologists’ conceptualization of youth’s problems may be incongruent with or may not fully accommodate ethnic minority children and parents’ perceptions of their problems under current nosological systems. Furthermore, misdiagnosis may imply that there is incongruence between how racial/ethnic minority children and their parents express and report their presenting problems and what is diagnosed by clinicians. Few studies have attempted to disentangle the racial/ethnic disparities in diagnoses and systematically investigate potential misdiagnosis.
It draws on models found in the literature that attempt to capture the multi-level (macro, meso, micro) interacting complex factors required to support the mental health of LGBTQ+ youth (Oransky et al., 2018). The framework we have produced is ‘theoretical’ (see Fig. 2) and it is not a blueprint for a mental health support service. Youth is rarely theorised and the dominant conceptual framework regarding LGBTQ+ youth mental health is usually implicitly minority stress theory. For clarity we grouped studies based on the underlying conceptualization of mental health rather than the discipline of the author or journal.
Most facilitators that we identified are related to therapist characteristics (e.g., client and therapist ethnic match), therapeutic interaction (e.g., client and therapist co-endorsement of etiological beliefs), and treatment process and delivery (e.g., referral sources and disposition after visit). Racial/ethnic minority parents, especially new immigrants, are often at high risk for behavioral and emotional problems due to various immigration-related financial, social, and cultural https://www.safeproject.us/resource/latinx/ stressors. In fact, research has suggested that between 40 and 55% of 15- to 17-year-old adolescents identify family as the major influence on their mental health help-seeking behavior (56).
