An Exploration of the Relationship Between Spirituality,Religion and Mental Health Among Youth Who Identify as LGBT+: A Systematic Literature Review

There is a growing interest in addressing spirituality in health care with evidence emerging that personal spiritual and religious practices, and support of these, can influence mental health in a positive way. However, there can be distinct challenges to spiritual expression and mental health issues for youth who identify as LGBT+. The goal of this paper was to undertake a systematic review of the available evidence to investigate the relationship between mental health, spirituality and religion as experienced by LGBT+ youth. A comprehensive literature search was conducted using medical and psychological databases that focused on spirituality, mental health and LGBT+ youth. The search yielded a total of ten articles published in English between May 2008 and June 2018. The key findings highlighted issues around discriminatory attitudes, shame related to disclosure, spirituality as a supportive resource, internalised conflict and external factors around sexual orientation concerns. The psychological, social and health implications are presented and discussed.

     

Intake Interviewing with Lesbian, Gay, Bisexual, and Transgender Clients: Starting from a Place of Affirmation

Initial interactions between lesbian, gay, bisexual, or transgender (LGBT) clients and psychotherapists can reveal existing biases from both parties. LGBT clients may have previous experiences with the mental health establishment and legitimate concerns about being pathologized. Psychotherapists may approach clients with openness and acceptance, but are likely to have little training in working with LGBT individuals. In this article, we discuss affirmative practices as a framework for clinicians beginning the intake process with LGBT clients. Through a brief history and overview of LGBT mental health, we provide mental health professionals with an appreciation of the multiple influences on LGBT individuals’ well-being. We then discuss the intake interview process in relation to each subgroup of the LGBT acronym, as each of these four populations face different (yet inter-related) challenges. While there is clearly no “formula” for working with LGBT individuals, in keeping with the principles of multicultural competency (Sue, The Counseling Psychologist, 29:790–821, 2001), our goal is to encourage therapists to reflect on their existing biases and to gain knowledge and skills for working with this diverse population. Overall, we hope this article demonstrates to therapists how to conduct an affirmative intake interview that minimizes heterosexual and dualistic gender assumptions that remain so pervasive in our society and in therapeutic practice.     

Koran reading and negotiation with jinn: strategies to deal with mental ill health among Swedish Somalis

In this paper, we discuss traditional Somali concepts of mental ill health. Qualitative interviews were conducted with some 20 Swedish Somali interviewees about factors causing mental ill health, traditional classification, strategies to deal with mental ill health, and attitudes to the mental health care services in Sweden. Social mobilisation and religious healing are cornerstones of traditional Somali measures to deal with mental suffering. Traditional Somali views of mental ill health stand in stark contrast to classification of mental ill health in the western biomedical model. These views deserve attention since they may have an impact on health-seeking behaviour among Somali immigrants in western countries. Yet a too strong focus on cultural aspects may over-shadow the fact that much mental suffering among Somali migrants must be understood within social, economic, and political contexts.     

Immigration Enforcement Policies and the Mental Health of US Citizens: Findings from a Comparative Analysis

We examined the differential impact of having a family member, friend, or co-worker/community member detained or deported on the mental health of US citizens. In 2019, a sample of 3446 adult participants of White, Black, and Latinx racial/ethnic descent were recruited to complete an online questionnaire. Participants completed the Patient Health Questionnaire-4 to screen for anxiety, depression, and psychological distress. Analyses were restricted to US citizens (n = 3282). Multivariable logistic and linear regressions were conducted to examine the mental health of US citizens who reported personally knowing a migrant who has been detained or deported and by their relationship to the migrant, overall and among Latinxs only. Among US citizens, 32% reported personally knowing someone who has been detained or deported. In multivariable analyses, US citizens who personally knew a detained or deported migrant were more likely to report anxiety, depression, and greater psychological distress. Associations were more pronounced among those who reported having a family member detained or deported. US-citizen Latinxs with social ties to migrants who have been detained or deported were especially more likely to report poor mental health than White and Latinx participants who did not personally know a migrant who has been detained or deported. It is critical that policy makers consider the potential mental health harms on migrants and its own citizens when designing policies targeting migrant communities.     

Addressing multiple relationships between clients and therapists in lesbian, gay, bisexual, transgender communities

Therapists working in lesbian, gay, bisexual, and transgender (LGBT) communities are likely to experience the potential to engage in multiple relationships with their clients. Currently, the American Psychological Association's (2002) ethics code and the related literature base offer minimal direct guidance to therapists practicing in LGBT communities. In this article, the authors review current literature regarding multiple relationships in psychotherapy, considering how this literature addresses issues specific to practitioners working within LGBT communities, present a case study highlighting the negotiation of a multiple relationship between a client and therapist who both identify as lesbian, and offer recommendations for practitioners working within LGBT communities.     

Rethinking Concepts in Participatory Action Research and Their Potential for Social Transformation: Post‐structuralist Informed Methodological Reflections from LGBT and Trans‐Collective Projects

Participatory Action Research (PAR) aims to articulate knowledge production and transformative action. In this paper, we outline the sociopolitical background to our interest in LGBT and trans‐collectives as an important territory where PAR might make some intervention in the social conditions of LGBT lives by transforming dominant forms of representation that have emerged from a history of psychological and medical pathology. We present two projects, from UK and Spain that utilize post‐structuralist informed methods (interviews, photo‐production, discourse analysis, narrative production) within a PAR framework. We examine their potential for problematising representations of sexuality and gender by reflecting on the knowledge produced and the transformative action they provoke. We rethink power relationships inherent in PAR concepts of ‘participation’ and ‘empowerment’ through a post‐structuralist lens and argue that the achievements of PAR projects can be better understood as ‘co‐produced artifacts’. These (e.g. photo‐exhibition) are co‐owned by community members and researchers and their deployment in different settings (e.g. community or university) impacts on the meanings they convey and the action they provoke. Finally, we argue that through the use of post‐structuralist methods PAR can enable effective transformative action, but caution against the practice of reinstating normative representations in the invitation to participate under specific identity categories (e.g. LGBT, Trans, mental health service user). PAR projects can do this by considering naturalized definitions of who is vulnerable or marginalized as the object and field of social transformation, and the starting point for collective and political action. Copyright © 2012 John Wiley & Sons, Ltd.     

幼儿心理健康评估现状和思考

婴幼儿期是人生的重要时期,这个时期的心理健康对一个人未来的心理发展起着非常大的影响作用。本文主要介绍国内外在幼儿心理健康评估方面的研究历史、现状,并做一个对比,比较国内外在幼儿心理健康评估方面研究的差异,指出国内在这方面研究的不足,并展望未来的研究趋势。     

Applying Person‐Centered Counseling to Sexual Minority Adolescents

Drawing attention to the very unique and complex needs of stigmatized sexual minority youth, the authors explore the therapeutic potential of person‐centered counseling in helping lesbian, gay, bisexual, transgender/sexual (LGBT) adolescents who are working toward the acceptance and disclosure of their sexual identity. They suggest that person‐centered counseling embodies 6 aspects that are particularly helpful to LGBT adolescent clients and propose 3 additional methods that compensate for the limitations of the person‐centered approach in this particular helping context.     

The Social and Economic Imperative of Lesbian, Gay, Bisexual, and Transgendered Supportive Organizational Policies

The central premise of this article is that organizations have social and economic interests in building policies and practices that support lesbian, gay, bisexual, and transgendered (LGBT) workers. This argument is based on empirical evidence that (a) LGBT workers continue to face discrimination at work from which they are not protected under federal law, and (b) discrimination has negative consequences for individual's mental and physical health, and on reasoning that (c) organizations share responsibility for the social good of the communities in which they operate. We offer practical suggestions for creating LGBT-supportive organizations and propose that industrial–organizational psychologists have an ethical obligation to support such efforts.     

Developing preventive mental health interventions for refugee families in resettlement

In refugee resettlement, positive psychosocial outcomes for youth and adults depend to a great extent on their families. Yet refugee families find few empirically based services geared toward them. Preventive mental health interventions that aim to stop, lessen, or delay possible negative individual mental health and behavioral sequelae through improving family and community protective resources in resettled refugee families are needed. This paper describes 8 characteristics that preventive mental health interventions should address to meet the needs of refugee families, including: Feasibility, Acceptability, Culturally Tailored, Multilevel, Time Focused, Prosaicness, Effectiveness, and Adaptability. To address these 8 characteristics in the complex environment of refugee resettlement requires modifying the process of developmental research through incorporating innovative mental health services research strategies, including: resilience framework, community collaboration, mixed methods with focused ethnography, and the comprehensive dynamic trial. A preventive intervention development cycle for refugee families is proposed based on a program of research on refugees and migrants using these services research strategies. Furthering preventive mental health for refugee families also requires new policy directives, multisystemic partnerships, and research training.     

The effect of acculturation and discrimination on mental health symptoms and risk behaviors among adolescent migrants in Israel

This study examines the role of acculturation, perceived discrimination, and self-esteem in predicting the mental health symptoms and risk behaviors among 1.5 and second generation non-Jewish adolescents born to migrant families compared with native-born Jewish Israeli adolescents in Israel. Participants included n = 65 1.5 migrant adolescents, n = 60 second generation migrant adolescents, and n = 146 age, gender, and socioeconomic matched sample of native-born Jewish Israelis. Participants completed measures of acculturation pattern, perceived discrimination, and self-esteem as well as measures of mental health symptoms and risk behaviors. Results show that migrant adolescents across generations reported worse mental health symptoms compared with native-born Jewish Israelis. However, only the 1.5 generation migrants reported higher engagement in risk behaviors compared with second generation migrants and native-born Jewish Israelis. Our findings further showed that acculturation plays an important role in predicting the mental health status of migrant youth, with those characterized with integrated acculturative pattern reporting lower mental health symptoms compared with assimilated acculturation pattern. Importantly, contextual factors, such as higher perception of discrimination in the receiving culture as well as individual factors such as lower self-esteem and female gender were strongly associated with worse mental health symptoms. The findings manifest the complex relationship between contextual factors and individual level variables in the acculturative process of migrants as well as the importance of examining the effect of migration generation on mental health outcomes.     

Migrant mental health: a model for indicators of mental health and health care consumption.

OBJECTIVE: This study explores the relationship between mental health and health care consumption among migrants in the Netherlands. DESIGN: Samples of the Turkish (n = 648), Moroccan (n = 102), and Surinamese (n = 311) populations in Amsterdam were examined. The study tested a hypothesized model of risk factors for psychiatric morbidity, indicators of well-being, and indicators of health care consumption. The model was specified on the basis of information from earlier research on the sample and literature on the topic. The model was tested and refined using structural equation modeling. MAIN OUTCOME MEASURES: Psychiatric morbidity and well-being measures were assessed with the CIDI 1.1 and MOS-sf-36 subscales, respectively. Health care consumption was assessed by the question "Have you ever consulted one or more of these professionals or health care facilities with respect to mental health problems or problems related to alcohol or drugs usage?" RESULTS: The primary result of this study was the confirmation that health care consumption among migrants is predicted by need and predisposition factors, such as health condition and sociodemographic characteristics. In addition, mental health care consumption of migrants is predicted by acculturation characteristics. This result suggests an effect of cultural and migrant-specific factors in help-seeking behavior and barriers to mental health care facilities. CONCLUSIONS: Findings confirm the existence of migrant-specific mechanisms in health care consumption. Mental health care professionals should be aware of these. However, ignoring common ground for interventions unnecessarily creates distance between migrant groups and between migrant and indigenous Dutch groups.     

Kultursensible Diagnostik in Forschung und Praxis

Nearly one fifth of the German population are migrants of the first and second generation. Evidence-based knowledge about mental health of migrants, their health care needs and the actual mental health care situation of this population is limited. Psychometric instruments are helpful for the assessment of mental disorders. Although a culture-sensitive approach in diagnostics is necessary it is often neglected in research as well as in clinical practice. This article describes culture-specific and linguistic challenges and specifies specific communication problems. In most cases psychometric instruments are not developed simultaneously in different languages but are translated later on. After translation psychometric instruments should be culturally validated and adapted with respect to linguistic, cultural and metric equivalence. The article gives an overview about the different aspects of equivalence and explains these aspects on the example of the PHQ-9.     

Addressing disparities: The impact of a lesbian,gay, bisexual,and transgender graduate counselling course

Background: Lesbian, gay, bisexual and transgender (LGBT) individuals experience serious mental health disparities and treatment inequities. Counsellor education has been identified as both a contributing factor to these problems as well as an ameliorating mechanism to address these inequalities. Aim: The purpose of the current study was to evaluate the impact of an LGBT‐affirmative counselling course. Method: A total of 23 students enrolled in a graduate LGBT counselling course were administered the Sexual Orientation Counselor Competency Scale (SOCCS, Bidell, 2005) and the Lesbian, Gay, and Bisexual Affirmative Counseling Self‐Efficacy Inventory (LGB‐CSI, Dillon & Worthington, 2003) pre‐ and post‐course. In addition, a comparison group of 23 matched counselling students was obtained from an existing data source in order to make further assessments of the course's effectiveness. Those in the comparison group were not enrolled in the LGBT course, but were administered the SOCCS at analogous time intervals. Results: After completing the LGBT course, enrolled students demonstrated significant improvements regarding their sexual orientation counsellor competency and self‐efficacy. In addition, these students showed significant gains in SOCCS scores versus those in the comparison group. Implications: Results from this study show the positive effect a full‐credit LGBT psychotherapy course can have on graduate counselling students' sexual orientation counsellor competency and self‐efficacy. The findings also indicate that such a course can significantly impact counselling skills, a facet of LGBT cultural competency found to be the most attenuated. Findings are discussed in conjunction with LGBT‐affirmative counsellor training and clinical practice.     

Ethical and Legal Considerations for Internet-Based Psychotherapy

The provision of mental health services over the Internet is becoming increasingly commonplace as new technologies continue to develop. Evidence in support of the efficacy of many such interventions is accumulating. Given the potential global reach of Internet-based psychological services, the authors examine ethical issues relating to this growing area of practice through the lens of the Universal Declaration of Ethical Principles for Psychologists (International Union of Psychological Science, 2008). They also raise issues relating to potential liability risks and offer recommendations intended to guide mental health practitioners who are considering involvement in the provision of Internet-based services.     

Individual and Community Resilience Factors Among Lesbian,Gay, Bisexual,Queer and Questioning Youth and Adults in Israel

Drawing on resilience theories, this study examined the individual and community factors of Israeli lesbians, gays, bisexuals, queers, and questioning (LGBQs) that contribute to positive mental health and the degree to which individual and community protective factors mitigate the adverse effect of risk factors for poor mental health. Differences in resilience factors between LGBQ youth and adults were explored. Data were collected on 890 LGBQ youth and adults. Findings emphasize the role of community‐level resilience factors in the lives of LGBQs, and that these support systems differ slightly between the two age groups. Among youth, family support was both a strong predictor for well‐being and a protective factor for mental distress. Although family support was found as a resilience factor among adults as well, other community‐level factors (friends’ support, LGBT connectedness and having steady partner) were found as protective factors for poorer mental health. These findings suggest for efforts on fostering familial support for LGBQ youth and a multi‐level system that offers support at the familial, peer, relationship and community levels for both LGBQ youth and adults.     

Towards Youth Happiness and Mental Health in the United Arab Emirates: The Path of Character Strengths in a Multicultural Population

Happiness, good mental health and the possession of character strengths have been proposed in the context of positive psychology as important conditions for achieving a life full of gratification. However, there is a scarcity of studies examining those conditions in Eastern cultural contexts, in order to replicate findings from the Western countries. In this vein, the present study aims to explore the influence of strengths on happiness and mental health in the multicultural context of United Arab Emirates and it is hypothesised that certain strengths are better predictors of happiness and mental health than others, also after controlling for potential sociodemographic confounders. A sample of young university students, in the majority coming from eastern countries was assessed through the Global Happiness Scale, the GHQ-12 and the VIA-IS-120. The results of the regression analyses revealed that the group of character strengths under the denomination of Transcendence together with being young was associated with higher levels of happiness and better mental health. In addition, the possession of strengths of Restraint was associated with less happiness, whilst being a man indicated a better mental health. Such results have important implications regarding the replication of previous results from Western contexts in the context of UAE, highlighting the need for implementation of culturally context-tailored strategies for achieving happiness and mental health through the use of character strengths.     

流动儿童歧视知觉与心理健康水平的关系及其心理机制

为了探讨流动儿童所感受到的歧视对他们心理健康水平的影响, 以及应对方式和自尊在其中所起的作用, 从北京市公立学校和打工子弟学校选取1164名流动儿童、从公立学校选取525名北京儿童、从流动儿童主要来源地的农村选取568名农村儿童作为被试, 采用问卷调查的形式, 测查了流动儿童感受到的歧视、他们的心理健康水平(社交焦虑、孤独感、抑郁)、应对方式和自尊。研究发现: (1) 流动儿童所感受到的社会歧视在学校类型、流动性上存在显著的差异, 打工子弟学校的流动儿童得分显著高于公立学校的, 流动性高的儿童得分显著高于流动性低的, 但在性别上不存在显著差异, 也不存在学校类型与性别和流动性的交互作用; (2) 流动儿童的心理健康水平在性别、学校类型和流动性上存在显著的差异, 女孩、来自公立学校的流动儿童、流动性高的儿童的心理健康水平显著差于与之相对应的被试, 除在社交焦虑和抑郁上存在学校类型和性别的交互作用外, 在孤独感上不存在学校类型和流动性的交互作用; (3) 不同类别儿童在心理健康水平上存在显著差异, 流动儿童在社交焦虑、孤独感上最差; (4) 除消极应对与自尊、积极应对与抑郁相关不显著外, 歧视、心理健康水平、应对方式、自尊两两之间都相关非常显著; (5) 歧视知觉对心理健康水平有显著的直接影响, 也通过应对方式和自尊对心理健康水平产生显著的影响。自尊不仅在歧视知觉与心理健康水平之间起到显著的部分中介作用, 在应对方式和心理健康水平之间也起到了显著的部分中介作用。     

Attachment, Acculturation and GHQ-30 of Chinese Students in Japan

This study examines how attachment and acculturation are associated with the general mental health of Chinese students in Japan. The participants were 194 Chinese students living in Japan, who were asked to complete a set of self-reported measures. The results showed that attachment anxiety predicted all subscales of general mental health, and attachment avoidance and acculturation predicted some aspects of general mental health. In addition, the number of years of residence in Japan was also found to be associated with the general mental health. The findings help improving intercultural communication between Asian countries as well as to facilitate clinical intervention and prevention.     

Preferences for Online Mental Health Services Among Australian and Indian Samples: A Cross-Cultural Comparison

Online mental health services provide a point-of-access to mental healthcare that may otherwise be unavailable or limited, particularly in developing countries. Nevertheless, there is a lack of research into individual differences between those who prefer online mental health services and those who prefer traditional in-person services, and whether these differences vary as a function of culture. This study investigated differences in preferences for online or in-person mental health services on e-health literacy, age, education level, and comfort using the internet in a general community sample recruited from Australia and India. A total of 487 participants (31.6% male; mean age?=?33.55, SD?=?12.20, range 18–78), 297 Australians and 190 Indians, completed an online or paper-and-pencil survey. A significant negative relationship between age and e-health literacy was found with younger ages associated with higher e-health literacy. Furthermore, e-health literacy scores were significantly higher for the Australian sample. Age, e-health literacy, country-of-residence, education level, and comfort in using the internet did not predict mental health service preference. The results suggest that preference for in-person or online mental healthcare is independent of demographic and cultural factors and indicate that online mental health services may be acceptable to Indian health service consumers.