August 14, 2009
Lesbians, gays and bisexuals are twice as likely as heterosexual men and women to seek help from mental health professionals, according to a new study by the UCLA School of Public Health.
The study, published today in the journal BMC Psychiatry, examines the relationship of gender and sexual orientation to the use of services to treat psychiatric problems such as mental health and alcohol and drug disorders.
Researchers collected data on 2,074 people, who were first interviewed in the California Health Interview Survey, in a new survey known as the California Quality of Life Survey. They found that 48.5 percent of lesbian, gay and bisexual individuals reported receiving treatment in the past year, compared with 22.5 percent of heterosexuals. Overall, lesbians and bisexual women were most likely to receive treatment, and heterosexual men were least likely.
While men and women, regardless of sexual orientation, who had an alcohol and/or drug disorder showed no significant differences in treatment rates, the study found that lesbian and bisexual women who had not been diagnosed with mental and drug disorders were more likely to seek mental health counseling than heterosexual women. This is consistent with emerging findings from national surveys showing that many individuals who receive mental health treatment do not have a diagnosable disorder but may have other symptoms, such as psychological distress or impairments in functioning, that lead them to seek care.
The researchers considered several factors that may explain these findings. Discrimination, violence and other stressful life events may be greater among sexual and gender minorities, they said, and homosexuality and issues associated with it may be construed as mental health problems -- particularly among racial and ethnic minorities -- which may encourage people to seek treatment. Further, in gay and lesbian communities, therapeutic services are considered appropriate places for coping with the stresses associated with being a sexual minority.
"It is well known that health services utilization is greater among women generally," said Susan Cochran, professor of epidemiology at the UCLA School of Public Health and one of the study's authors. "Here we have shown that minority sexual orientation is also an important consideration. Lesbians and bisexual women appear to be approximately twice as likely as heterosexual women to report having received recent treatment for mental health or substance use disorders."
However, the study found that ethnic and racial minorities overall were less likely to utilize mental health or substance use-related services. African Americans and Hispanics may underutilize services for mental health and substance use problems for a variety of reasons, including a lack of familiarity with the types of services available, prior negative experiences with service providers, or because of greater stigma attached to use of these services by their families and communities.
According to the study authors, the findings show that minority sexual orientation predisposes individuals to seek out mental health services. The findings also have implications for the allocation of public funding for the provision of public mental health and substance abuse treatment. The authors suggest that service planning and public policy experts interested in cost of care should take into consideration the effects of environmental and life stressors, including experiences of discrimination, violence, and hate crimes, in incurring mental health costs not only to the individual but to society.
Further, the study points to the need to examine how the treatment of individuals who do not have diagnosable disorders may reduce the likelihood that they will develop greater severity of distress, disorders or impairments in functioning in the future. Lastly, a better understanding of the factors that lead sexual minorities, and especially lesbians and gay women, to seek treatment may generate knowledge that can be used to improve delivery of treatment to those who would benefit from it or who currently do not take advantage of mental health resources.
Cochran was joined on this study by her colleagues Vickie M. Mays, also of the School of Public Health, and Christine Grella and Lisa Greenwell of the Integrated Substance Abuse Program at the Semel Institute for Neuroscience and Human Behavior at UCLA.