Lesbian, Gay, Bisexual, Transgender and Queer People's Experiences of Stigma Across the Spectrum of Inpatient Psychiatric Care: A Systematic Review.

Kristen D Clark, Jaylyn Jewell, Athena D F Sherman, Monique S Balthazar, Shawn B Murray, Jordon D Bosse
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Abstract

Lesbian, gay, bisexual, transgender, queer and other diverse sexual orientations and gender identity groups (LGBTQ+) face high rates of poor mental health. In the most severe and emergent of instances, inpatient psychiatric care may be required. LGBTQ+ people report experiences of mistreatment in healthcare settings broadly, such as denial of healthcare services and harassment from healthcare providers and other patients. However, little is known about the experiences of LGBTQ+ people in inpatient psychiatric care settings, specifically. The purpose of this review was to assess the existing literature for descriptions of LGBTQ+ people's experiences within inpatient psychiatric care. We searched multiple databases (i.e., PubMed, PsychINFO, CINAHL, Web of Science and Google Scholar) for peer-reviewed articles that described the experiences of LGBTQ+ people within inpatient psychiatric care that were published in English. The included articles (N = 14) were analysed using a conceptual model of stigma and organised within those strata (structural, interpersonal and individual stigma) across the inpatient experience, (admission, inpatient unit, and discharge). Themes identified included: noninclusive intake tools and pervasive misgendering during the admission process; lack of healthcare infrastructure, inadequate training and lack of cultural humility, pervasive discrimination and victimization, silencing of LGBTQ+ patients, and feelings of fear and shame while on inpatient units, and lack of community resources during the discharge process. Clinicians should consider the perspectives and experiences of LGBTQ+ people to enact identity-affirming care practices that may increase mental healthcare engagement and improve long-term mental health outcomes.

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女同性恋者、男同性恋者、双性恋者、变性者和同性恋者在整个精神病住院治疗过程中的污名化经历:系统回顾。
女同性恋、男同性恋、双性恋、变性人、同性恋者和其他不同性取向和性别认同群体(LGBTQ+)的心理健康状况不佳的比例很高。在最严重和最紧急的情况下,可能需要住院精神病治疗。LGBTQ+ 广泛地报告了他们在医疗环境中遭受虐待的经历,例如被拒绝提供医疗服务以及受到医疗服务提供者和其他患者的骚扰。然而,人们对 LGBTQ+ 在精神科住院治疗环境中的具体经历知之甚少。本综述旨在对现有文献进行评估,以了解 LGBTQ+ 在住院精神病护理中的经历。我们在多个数据库(即 PubMed、PsychINFO、CINAHL、Web of Science 和 Google Scholar)中搜索了描述 LGBTQ+ 在住院精神病护理中的经历的同行评审文章,这些文章均以英文发表。我们使用成见概念模型对所收录的文章(N = 14)进行了分析,并在这些分层(结构、人际和个人成见)中对整个住院经历(入院、住院部和出院)进行了组织。确定的主题包括:非包容性的入院工具和入院过程中普遍存在的性别误解;缺乏医疗保健基础设施、培训不足和缺乏文化谦逊、普遍存在的歧视和伤害、对 LGBTQ+ 患者的沉默、住院期间的恐惧和羞耻感,以及出院过程中缺乏社区资源。临床医生应该考虑到 LGBTQ+ 患者的观点和经历,制定出能提高心理保健参与度并改善长期心理健康结果的身份确认护理措施。
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