Preparedness of final year medical students in caring for lesbian, gay, bisexual, and transgender patients with mental illness

Background: Lesbian, gay, bisexual, and transgender (LGBT) individuals have a higher prevalence of mental illness compared to the general population. Discriminatory behaviour from mental health care providers impedes access to culturally competent mental health care. Undergraduate psychiatry education plays an important role in adequately preparing medical doctors to care for mental illness in LGBT patients. Aim: This study aims to assess the knowledge, attitudes and clinical preparedness of final -year medical students in caring for LGBT patients after completion of their psychiatry rotation. Setting: Faculty of health sciences at a large public university in Gauteng. Methods: This was a cross-sectional study using an anonymous self-administered questionnaire. The questionnaire comprised demographic data, the lesbian, gay, bisexual, and transgender development of clinical skills scale (LGBT-DOCSS) and questions relating to their subjective knowledge and preparedness in LGBT mental health care. The LGBT-DOCSS is a validated tool consisting of three subscales: basic knowledge, attitudinal awareness, and clinical preparedness. Results: Data from 170 final-year students were used in the analyses. Participants scored within the low range for clinical preparedness and basic knowledge subscales but high in the attitudinal subscale. Gender, sexual orientation and academic background were associated with higher overall scores and higher basic knowledge and attitudinal awareness scores. Conclusion: Final-year medical students were not adequately prepared in caring for LGBT patients with mental illness as indicated by the LGBT-DOCSS. Contribution: This study identifies a gap in undergraduate psychiatric training in providing culturally competent mental health care for a vulnerable population.