Mental Healthcare Experiences and Preferences Among Lesbian, Gay, Bisexual, Transgender, and/or Queer/People of Color: A Scoping Review of Qualitative Research and Recommendations for Provider Training

Objective: Lesbian, gay, bisexual, transgender, and/or queer people of color (LGBTQ+/POC) experience systemic oppression and are vulnerable to negative mental health outcomes. Additionally, they often face discrimination and report dissatisfaction when accessing mental healthcare. Despite the need for culturally responsive and identity-affirming services for LGBTQ+/POC, there is a lack of research synthesizing how to best provide them. This scoping review summarizes the recent qualitative literature on mental healthcare treatment experiences and preferences among LGBTQ+/POC in the United States. Methods: A search was conducted using PubMed, Cochrane Library, Embase, PsycInfo, and ProQuest Dissertation and Theses. Inclusion criteria were: (1) qualitative data from LGBTQ+/POC adults; (2) relevant scope of content, including (a) mental healthcare experiences, (b) evaluation of interventions for improving mental healthcare, or (c) barriers or facilitators to accessing mental healthcare; and (3) publication date from 2010 to 2023. Results: Of the 1,071 texts identified, 23 met eligibility criteria. Thematic analysis of included texts yielded five themes: (a) key provider competencies; (b) provider identity factors; (c) structural barriers to mental health treatment; (d) factors facilitating treatment access; and (e) systemic needs. Discussion: The mental healthcare system underperforms in providing culturally responsive and identity-affirming care for LGBTQ+/POC. We mapped the current literature to examine perspectives and preferences of LGBTQ+/POC and identified a lack of intersectional research and an underrepresentation of specific social identities. We proposed data-driven training recommendations to improve the delivery of quality care for LGBTQ+/POC.